Pennsylvania | Winter | 2010 | Health Plan Analysis
One by one, the Blue Cross and Blue Shield plans in Pennsylvania are changing their underwriting practices to better compete with for-profit insurers they say are cherry picking the best health risks in their markets. The latest move comes from Pittsburgh-based Highmark Inc., which is moving non-HMO products to a for-profit subsidiary so it can start medically underwriting small-groups. Blue Cross of Northeastern Pennsylvania took the same step about a year ago. As a result, older groups with health risks are bracing for higher rate quotes and state insurance regulators are renewing their call to end Pennsylvania's lonely distinction as one of two states, including Hawaii, that have not imposed small-group rate controls on health insurers. In Medicaid, two health plans new to the HealthChoices managed care program-Aetna Better Health and Coventry Cares-will be vying for the business of new enrollees, getting some initial help from auto-assignments. In another Medicaid development, an e-prescribing project is under way for all the state's providers. Medicare Advantage enrollment has dropped sharply in Philadelphia. Enactment of Pennsylvania's new dependent coverage law of adults up to age 30 is causing a rift in interpretations. And Medicare-eligible state retirees have a new choice of HMO and PPO plans.
