Abstract
Introduction
With commercial enrollment stalled, the managed care industry is looking for
creative ways to grow business. Five years of profi ts have given health
insurers the wherewithal to make deals and invest in new ventures. Mergers and
acquisitions, joint ventures, and even emerging international markets such as
China offer tremendous opportunities to the managed care industry as it blazes
new trails in the quest for continued growth. This report, based in part on
interviews with industry insiders, tracks select efforts and ambitions of the
industry.
Get the Answers You Need to Shape Your Strategy
- M&A activity among managed care organizations (MCOs) declined in 2006 but
began ramping up in 2007 as profi table plans seek ways to grow revenue.
What are the drivers of this surge in M&A activity among MCOs? How are
regional health plans shaping this national trend? What profi table
opportunities can insurance-market players fi nd in partnerships with the
government as Medicare and Medicaid expand? What are the implications of
increased MCO consolidation for employers and the pharmaceutical industry?
- Taking a page from the playbook of their national competitors that have
become one-stop shops for health care services, Blue Cross Blue Shield
companies are developing joint ventures to become as integrated as forprofi t
plans. What activities are fueling the growth and integration of Blue-owned
companies? How are the Blue plans increasing their stake in the
consumer-driven health plan market segment?
- Rapidly growing middle-class populations in many countries are presenting
signifi cant opportunities to U.S.- based health insurers. Which
insurance-market players are entering emerging markets? What are the potential
barriers to success in such an endeavor?
Scope
- Merger & acquisition activity in the managed care arena: Medicare
Part D, Medicaid, provider-owned plans, marketing partnerships, small regional
health plan expansions, and federal/state partnerships all have an impact on
consolidation activities in the managed care market.
- Blue plans break ground: Blue Cross Blue Shield establishes a bank;
its pharmacy benefi ts management company continues to grow; and it is
building what will be the largest database of health claims information in the
United States.
- U.S. insurers forge partnerships in risky markets: insurance-market
players investigate global opportunities in emerging markets such as China and
India.
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