Market Access Insights

The HealthLeaders-InterStudy Market Analyst team analyzes major developments at the nation’s publicly held health plans each quarter through their financial releases and conference call transcripts. T…

Wisconsin state officials are dictating to state HMOs that changes be made in how care is delivered in the state's Medicaid/BadgerCare Plus program. Faced with unacceptable HMO quality scores as w…

The recession severely damaged Florida insurers in 2008 as the ranks of commercially insured members dropped by 1.2 million last year amid layoffs and benefit cuts at Florida businesses. Every signifi…

Texas has taken its largest step yet toward addressing the nation's worst uninsured rate by green-lighting the first step toward Healthy Texas, a reinsurance program that could allow small busines…

The winds of change are about to reshape the TriState health insurance market, starting with the announcement that UnitedHealth Group is planning to buy Health Net of the Northeast within 12 months. I…

The effects of the recession continue to be seen among carriers in the South, particularly the Blues in both Alabama and Georgia where big drops in enrollment and earnings in 2008 were reported. Howev…

Michigan has awarded its bids to health plans administering Medicaid throughout the state, granting additional territory and clout to two regional players and rebuffing another major plan's attemp…

With the economy hitting California hard, the pressure is on more than ever for health insurers to respond to the small employer group market, in particular, with plan designs that get the premiums do…

Oregon's Drug Effectiveness Review Project is just the kind of independent comparative study of prescription drugs that health policy makers are looking to as they try to trim healthcare costs tow…

Health plans have begun to put generic dispensing goals into their pay-for-performance packages with some health plans. Advocate Physicians, which works closely with its payors, instituted a focused g…

Biologics used to treat immune diseases cost much more than their small-molecule counterparts, and so their use involves costs disproportionate to the number of patients treated. As a result of thi…