BENSALEM, Pa.--()--Health insurance expanded to cover nearly 13 million more individuals in June 2012 compared with 18 months prior, according to new research from BusinessOne Technologies, Inc. This 5.4 percent increase in total managed lives between Jan. 2011-June 2012 is due in part to already-implemented health care reform measures that are driving greater access to health care and prescription drugs ahead of the 2014 “individual mandate” roll-out.
“The combination of health care reform and a sluggish economy will have a dramatic effect on the movement of lives to state insurance exchanges, Medicaid and Medicare. Understanding this landscape is essential to developing appropriate strategies for the new managed care paradigm.”
These measures include dependent-child coverage up to age 26, small business tax credits, and early Medicaid expansion by some states. While health insurance coverage is on the rise, the national unemployment fell by almost 1 percent over the same 18-month period.
Managed Lives Trends in the Current Health Care Reform Environment is the third in BusinessOne’s series of annual managed lives trend reports. The analysis finds the number of insured Americans increased across all third-party payer segments over the 18-month study period, with the exception of State Medicaid (Fee-for-Service).
Medicare lives grew at the fastest rate (12%), followed by Managed Medicaid (10.4%) and commercial insurance (5%). The commercial channel experienced the largest increase in number of insured individuals: 7.6 million people, accounting for more than half of the increase.
Analysis is based on data from BusinessOne’s Maestro, which tracks America’s insured by commercial, Medicaid and Medicare plans, along with related benefit design, formulary, co-pay, coverage policy and other metrics.
Among the top 10 states in insured lives by channel:
- 90 percent of states added commercial lives; Ohio had the highest growth rate in this channel
- 80 percent added Managed Medicaid lives; Texas and Florida, respectively, had the highest growth rates
- 60 percent added State Medicaid lives
- All added Medicare lives; New Jersey had the highest Medicare growth rate
“It is critical for pharmaceutical and biotech manufacturers to understand the implications of health care reform on access and reimbursement,” said BusinessOne Technologies President James A. Barone. “The combination of health care reform and a sluggish economy will have a dramatic effect on the movement of lives to state insurance exchanges, Medicaid and Medicare. Understanding this landscape is essential to developing appropriate strategies for the new managed care paradigm.”
Managed Lives Trends in the Current Health Care Reform Environment shows why even small shifts in insured lives can significantly impact market share. The report:
- Provides context for the health care reform measures already driving changes across payer segments – and highlights those that will have an even greater impact in 2014 and beyond
- Examines the role key socioeconomic indicators play within the managed care arena
- Benchmarks 18-month changes in insured lives across payer segments at the national and state levels
Managed Lives Trends in the Current Economic Environment provides valuable market information to those interested in staying informed on the impact of health care reform. To obtain a copy of this report, visit BusinessOne Technologies, Inc., at www.businessonetech.com.
About BusinessOne Technologies, Inc.
Through its customizable, Web-based portal, Maestro end-users can access and analyze over 400 data elements related to formulary control, benefit design, reimbursement, demographics and utilization at the plan and physician level. BusinessOne Technologies, Inc. develops and deploys health care technology and data solutions, providing competitive, strategic analysis for biotech and pharmaceutical companies, payers, investment firms and other clients.
For more on Managed Lives Trends in the Current Health Care Reform Environment, or information about Maestro, please contact Gordon Romanas at 858.395.6367.