Managed Care Organizations See Medical Enrollment Growth for the First Time in Four Years

Employment Growth and Lower Health Care Costs Boost Managed Care Medical Enrollment in 2010, According to New Data from HealthLeaders-InterStudy

NASHVILLE, Tenn.--(BUSINESS WIRE)-- HealthLeaders-InterStudy, the leading provider of managed care market intelligence, reports that managed care organizations (MCOs) saw an increase in enrollment in the second half of 2010 for the first time in four years. Factors in this enrollment increase include: employment growth, slower healthcare cost increases and tax credits under healthcare reform.

The findings are from the newest release of Managed Market Surveyor-Rx, a database product that delivers medical and pharmacy benefit enrollment by MCO and geography.

“Tax credits for small businesses seeking health insurance coverage have begun under healthcare reform,” said HealthLeaders-InterStudy Senior Health Plan Analyst Rebecca Waller. “This is driving some employers back into the market as well as welcoming some for the first time.”

A variety of options are allowing employers and employees to keep up with healthcare costs including:

  • High-deductible health plans
  • Narrow physician and pharmacy networks
  • New focus on HMO and POS products

This growth in Medical enrollment means that health plans may have found the necessary benefit designs and pricing to continue on an upward climb in enrollment, according to Waller.

On the commercial MCO pharmacy side, enrollment continued to fall at a reduced pace. Between July 2010 and January 2011, commercial pharmacy benefit enrollment fell 110,000 to 115.65 million, according to the data. Medicare grew by 670,000 beneficiaries or 1.43 percent. Medicare Advantage also grew during the same period by 44,000 members or 3.75 percent.

The data also shows growth in Medicaid and managed care in Medicaid.

A complete overview of the new data and what it means for health plans and pharmaceutical companies will be presented by analyst Rebecca Waller on July 27th. Click here to register for this webinar.

The medical and pharmacy enrollment data in the report are updated twice annually. The commercial enrollment figures come directly from MCOs, while the Medicaid and Medicare enrollment figures are obtained from state agencies and the Centers for Medicare and Medicaid Services.

Why Pharmaceutical Companies Need Managed Market Surveyor-Rx

Managed Market Surveyor-Rx delivers medical and pharmacy benefit enrollment data by managed care organization and geography (national, state, MSA, county) to better inform strategic planning and resource allocation. Relying on primary research and HealthLeaders-InterStudy’s proprietary validation methodology, Managed Market Surveyor-Rx provides the most accurate managed care database available.

About HealthLeaders-InterStudy

HealthLeaders-InterStudy, a Decision Resources, Inc. company, is the authoritative source for managed care data, analysis and news. For more information, please visit

About Decision Resources, Inc.

Decision Resources, Inc. is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources, Inc. at

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Kristi Guillemette, 781-993-2618
[email protected]
Decision Resources, Inc.
Elizabeth Marshall, 781-993-2563
[email protected]

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