Wisconsin | Summer | 2008 | Health Plan Analysis

When Congress passed the Medicare Improvements for Patients and Providers Act this summer, health plans operating in the Medicare arena began to brace for the changes. Wisconsin health plans operating special needs plans are giving the new law favorable reviews while eyeing expansion plans. Commercial health plans in Wisconsin are seeing HMO enrollment continue to decline in pockets of the state, while the larger national insurers concentrate their efforts on PPO offerings. Wisconsin's local provider-owned plans, centered mostly around the Madison area, are still seeing strong HMO enrollment, retaining their traditional business. The first significant data is coming in reflecting the success of a partnership between Humana and the Business Health Care Group in the southeastern Wisconsin market. The partnership has produced a slowdown in medical-cost trends for members and boosted transparency and competition in the highly competitive Milwaukee-area market. Network Health Plan is launching a new wellness suite that offers premium rate relief and guaranteed caps on rate increases for employers.