National Commercial Managed Care Enrollment Continues Shift From HMO to PPO Business...

National Commercial Managed Care Enrollment Continues Shift From HMO to PPO
Business Lines
Aetna is Among National Plans Following the Trend Demonstrating 9.8 Percent
PPO Enrollment Growth, According to Data from HealthLeaders-InterStudy

NASHVILLE, Tenn., Sept. 15 /PRNewswire/ -- HealthLeaders-InterStudy, the
leading provider of managed care market intelligence, reports that across
commercial managed care, HMO enrollment continues to decline, falling 5.8
percent to approximately 44.3 million between July 2007 and January 2008. At
the same time, PPO lines of business have grown 4.4 percent to 109.7 million.
Details of this trend are revealed in the latest release of Managed Market
Surveyor-Rx, a database product from HealthLeaders-InterStudy that delivers
medical and pharmacy benefit enrollment and market share data in a single,
easy-to-use interface.
"There are a number of factors that are driving PPO growth, and cost is
one of them," said Jane DuBose, Director of Health Plan Analysis for
HealthLeaders-InterStudy. "PPO products have become less costly for consumers
relative to HMOs, yet maintain broad access to providers, which is attractive
to members. Additionally, state and local government purchasers of health
insurance have increasingly shifted to self-insured options, which in most
instances have been built on PPO platforms."
According to analysts from HealthLeaders-InterStudy, the growth of PPO
plans is also a result of consolidation among provider-owned HMO plans.
Among national health plans demonstrating the PPO growth trend is Aetna.
While a majority of Aetna's enrollment growth through the end of 2007 was from
its self-insured line of business, the fully-insured PPO business experienced
enrollment increases. Through the end of 2007, its PPO enrollment grew 9.8
percent, while HMO enrollment fell 3.4 percent.
"Whether there is an interest in national plans or a particular geographic
area, Managed Market Surveyor-Rx provides the detail needed to accurately
evaluate managed care opportunities at the state, county and MSA level to
enable better resource allocation," said Russell Workman, Principal Director
of Data Operations for HealthLeaders-InterStudy. "The inter-operability of the
database reveals trends that users may otherwise not identify. But what really
sets the data apart is that primary research is conducted to ensure our data
is not only the most accurate, but also the most comprehensive."
Managed Market Surveyor-Rx is currently available with enrollment data
from January 2008.
About Managed Market Surveyor
Managed Market Surveyor offers the most comprehensive description of how
managed care lives in a geographical region are insured: HMO, PPO, managed
Medicare, managed Medicaid, uninsured, or privately insured. This enrollment
database provides detailed plan and market share data at the state, county and
MSA levels.
About HealthLeaders-InterStudy
HealthLeaders-InterStudy is the authoritative source for managed care
data, analysis, and news. For more information, please visit
www.HealthLeaders-InterStudy.com.
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
www.DecisionResourcesInc.com.
All company, brand, or product names contained in this document may be
trademarks or registered trademarks of their respective holders.
For more information, contact:

Lisa Osgood Elizabeth Marshall
HealthLeaders-InterStudy Decision Resources, Inc.
781-296-2606 781-296-2563
losgood@hl-isy.com emarshall@dresources.com

SOURCE HealthLeaders-InterStudy

Lisa Osgood of HealthLeaders-InterStudy, +1-781-296-2606, losgood@hl-isy.com;
or Elizabeth Marshall of Decision Resources, Inc., +1-781-296-2563,
emarshall@dresources.com