A brief report from Mark Farrah Associates indicates that Blue Cross/Blue Shield plans currently enroll about 98.7 million Americans, 31% of the total population and 40% of the commercially insured group. There are 36 BCBS companies, several are large multi-state organizations such as WellPoint, with plans in 14 states and HCSC, with plans in 5 states, including Texas and Illinois. Blues plans received over $186 billion in premiums in 2012 and are the largest plans in 45 states.
According to Mark Farrah Associates as of December 1, 2013, there were 15,146,000 people in Medicare Advantage plans, about a 9% increase over the same time last year. UnitedHealth Group has about 21% of the market, followed by Humana with 16% and Kaiser with 8%. Around 17% of MA enrollment comes from employer retiree group plans. 2014 open enrollment ended on December 7, so the early indications are that there was strong growth.
Millenium Laboratories, which helps personalize drug therapies, has acquired RxAnte, which provides analytics and decision support for medication adherence.
HHS has announced that it will begin releasing physician level utilization data on a case-by-case basis. This is a huge development that will allow the identification of physician practice patterns and an understanding of which doctors may be engaging in inappropriate overuse.
The Employee Benefits Research Institute issued a short brief detailing reasons for wellness program participation. A survey found that the desire to improve health was the main reason for participating and that a belief that the person could make changes on their own or lack of time were the main reasons for not participating. Cash incentives and premium discounts would motivate more participation.
United Recovery Systems, which provides receivables management across several industries, has acquired Financial Health Strategies, which provides revenue cycle management services to hospitals and health systems. United Recovery is backed by Audax Private Equity.
CareCore National, which began as an imaging benefits manager and has expanded to managing utilization and cost of other specialty care, has received a "significant" investment from Great Atlantic, a private equity firm, which probably means a majority recap transaction.
RestorixHealth, a wound care clinic company, received an investment from Sverica International to fund its merger with Candescent Healing, which is in the same business.
HealthSparq, a health care price transparency company which is owned by health plan company Cambia, has acquired ClarusHealth, which offers provider search capabilities.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.