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Health Insurers Outline Medicare Expansion Plans

Margaret Dick Tocknell, for HealthLeaders Media, May 30, 2012

In March, Aetna realigned its Medicare, Medicaid, public and labor, and federal benefit planned businesses into a single operating unit, Government Services. Aetna officials say the change will help the insurer better serve its government customers, advance its retiree solutions and position it for the dual-eligible market.

Although Aetna continues to look at acquisition targets, officials say they haven't seen anything in a price point that makes sense for Aetna.

CIGNA
CIGNA now provides real-time pricing for more than 200 common medical procedures, which represent 80% of its medical claims.

Its collaborative accountable care program (CAC) is a physician engagement program that provides physicians with actionable patient information to close gaps in care, financial incentives, and assistance from care coordinators to help patients follow prescribed treatments and improve their overall health by participating in coaching and lifestyle programs. Humana has 22 of these initiatives in place in 13 states. It plans to have 100 in place by 2014.

CIGNA acquired HealthSpring, a Medicare plan, in 2011 and is leveraging its larger business footprint to expand HealthSpring's senior offerings into new markets.

CIGNA is also preparing for an increase in utilization in 2012, although the first quarter increase was "muted" according to company officials. The insurer continues to see targeted increases in what it calls "good utilization," including some prevention, wellness, and diagnostic procedures as well as higher medication compliance around evidenced-based care for members in chronic programs.

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