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…
Ohio has decided to carve out Medicaid pharmacy in anticipation of the passage of a new federal law, the Drug Rebate Equalization Act. The Act will give managed care companies the same rebates – aroun…
Chronic pain is a multi-billion dollar market saturated with well-established branded and generic analgesics that are only partially effective. While drugs with novel mechanisms of action that offer g…
Three major insurers — Anthem Blue Cross and Blue Shield, Humana and UnitedHealthcare — have teamed up with 11 local physician group practices and a local organization to pilot a patient-centered m…
As many as seven patient-centered medical home projects have cropped up throughout Ohio with CareSource working with providers on a Medicaid-focused PCMH. A medical-home initiative in Cincinnati inclu…
Humana Inc. is making a splash in both Ohio and Kentucky with provider relations issues. In Louisville, the insurer's introduction of a narrow network of providers for the Ford Motor Co. has raise…
Health insurers in the Midwest are coping with the recession by laying off employees, holding the line on pricing and adjusting benefit design to allow employers to take advantage of additional cost-s…
The list of health plans leaving the Ohio Medicaid managed care program continues to grow with WellPoint Inc. leaving the program entirely and WellCare and Centene Corp. pulling their managed care org…
Healthy Indiana Plan, which was created in 2007, is experiencing one of the fastest launches of any Medicaid-expansion program in the country. By mid-2008, the program had more than 14,000 Hoosiers en…
Managed care plans participating in one of the nation's largest Medicaid managed care programs – in Ohio – are experiencing difficulties in maintaining their profit margins, highlighted by the dep…
Health plans operating in the Toledo area largely have deserted a holdover of 1980s managed-care contracts by eliminating “steerage,” which sent patients to a single, large hospital system….