Pennsylvania | Fall | 2008 | Health Plan Analysis

The war of words over the proposed merger of Highmark Inc and Independence Blue Cross reached continued with testimony from Highmark officials that they would not move into IBC's Philadelphia service region should the merger fail. They used the company's $132 million operating loss from its foray into Central Pennsylvania as evidence the Pittsburgh-based Highmark would not try such a move again. Meanwhile, the merger could give rise to one of the nation's largest pharmacy benefits managers. That's because Highmark's pharmacy management would switch from Medco Health Solutions to the IBC-owned Future Scripts, which was founded in 2006 and now manages about $1.3 billion on drug purchases. Meanwhile, Pennsylvania will let 2008 go without adoption of a healthcare reform plan, which most recently was presented under the guise of Access to Basic Care. On the Medicare front, seniors in Pennsylvania have the most benefit design options for stand-alone Part D plans than those in any other state, but vendors are cutting options for the coverage gap and raising prices. Some Medicaid plans are posting financial losses in particular areas of the state, but the agency operating the HealthChoices program says the program as a whole remains profitable for MCOs. Aetna is eliminating copays on all preventive services for its small-group clients in Pennsylvania-the first state in Aetna's footprint that will test the model for small businesses.