State Medicaid Profiles offer a dashboard of key MCO players and enrollment, recent policy actions, and pharmacy trends for all 50 states, the District of Columbia, and Puerto Rico. This profile is ba…
If all goes as planned, Medicaid manged care organization Amerigroup will cease to exist as a stand-alone company in late 2012 when it is acquired by WellPoint, the second-largest health insurer in th…
Texas employers are making only minor benefit changes to retain grandfathered status, including small increases to drug copays. The next state budget includes a major expansion of managed Medicaid and…
Although it appears unlikely there will be widespread, dramatic design changes in 2011 as plan sponsors attempt to understand the full implications of healthcare reform, there will be some adjustments…
Health reform could completely change the landscape of Texas healthcare, bringing new people into the system while challenging smaller plans to meet requirements on their spending on medical care. Med…
Through its full carve-out of the pharmacy benefit for Medicaid and CHIP, the Texas Health & Human Services Commission has saved billions of dollars through drug rebates. Texas' public-sector…
The Illinois and Iowa commercial health insurance markets took hits through much of 2009 as rising unemployment resulted in fewer insured residents. The issue was more severe in Illinois where the man…
Scott & White Health Plan has leveraged its vertical integration to keep proton pump inhibitor costs at a fraction of the national average. For the first time, Texans who have received out-of-netw…
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…
Texas' Medicaid program is on the verge of considerable change with the potential for expansion of managed care into both adult and children's programs. At the same time, the Texas Legislature…
Texas possesses the worst uninsured rate in the nation not just for adults, but children. One in five Texas children lacks health benefits, even though many qualify for Medicaid and the Children's…
Blue Cross Blue Shield of Texas is the immovable behemoth of the Texas market with more than 4.2 million members, but the race for second place is hotly contested, and Aetna has earned silver by leapi…
PPOs may come under more regulatory scrutiny from the Texas Department of Insurance. Proposals being floated would require PPOs operating in Texas to have a certificate of authority and allow the TDI…
Texas' health plans have long benefitted from the Lone Star State's mandatory generic dispensing law, but have gone beyond that to achieve significant generic utilization and subsequent saving…
Medicare Advantage special needs plans are popping up like wildflowers after a rain in Texas, growing in membership and diversity as plans tailor themselves to local and regional needs. Texas' bus…