Health Plans in California Look for Differentiation and Innovation to Drive Growth, According to New Health Plan Analysis from HealthLeaders-InterStudy
NASHVILLE, Tenn.--(BUSINESS WIRE)-- HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that managed care organizations (MCOs) are looking to differentiate their products with value-based designs.
Commercial enrollment in California declined slightly for many MCOs during the first half of 2011. MCOs in the state are finding organic growth of their business difficult which is fueling differentiation and innovation through new plan designs, according to HealthLeaders-InterStudy.
For example, Anthem Blue Cross and Blue Shield of California has launched a line of commercial PPO products tied to its accountable care organizations and plans to expand such programs state wide. Blue Shield of California followed suit with its own ACO-based portfolio, which includes PPO and HMO options.
This could create an opportunity for drug companies that can emphasize the value proposition of branded drugs.
Other MCO strategies, such as high-deductible health plans, could limit these opportunities. Deductibles have long been a useful tool for MCOs to affect prescription drug utilization and cost. Health plans in California are upping the stakes by imposing higher deductibles on branded and non-preferred drugs. Brokers are beginning to see deductibles as high as $750 on individual policies where $150 had been the norm.
“As MCOs look for strategies to preserve enrollment and control costs, continued emphasis on prescription drug benefits is likely and higher deductibles on those benefits could increase generic drug utilization,” said Laura Beerman HealthLeaders-InterStudy Analyst.
More information can be found in the recently published California Health Plan Analysis report as well as the Executive Briefing entitled: “All eyes on California as Healthcare Reform Gears Up”. A copy of the Executive Briefing can be downloaded here: http://hl-isy.com/News-and-Events/White-Papers-and-Executive-Briefings
HealthLeaders-InterStudy, a Decision Resources Group company, is the authoritative source for managed care data, analysis and news. For more information, please visit www.HL-ISY.com.
About Decision Resources Group
Decision Resources Group 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 Group at www.DecisionResourcesgroup.com.
All company, brand or product names contained in this document may be trademarks or registered trademarks of their respective holders.
KEYWORDS: United States North America California Tennessee
INDUSTRY KEYWORDS: Technology Data Management Health Other Health Professional Services Consulting Insurance General Health Managed Care