Montana's Unique, Evolving Healthcare Landscape Favorable For Pharma
Point-of-Service Plans Grew 78 Percent during Last Census Period, According to a New Report from HealthLeaders-InterStudy
NASHVILLE, Tenn., Nov. 7, 2013 /PRNewswire/ -- HealthLeaders-InterStudy, the leading provider of managed care market intelligence, identifies the rising popularity of point-of-service (POS) plans as an opportunity for the pharmaceutical industry in its first-ever Montana Health Plan Analysis report. POS plans provide flexibility in states like Montana, where the bulk of the population is more rural and points of access to care are separated by large distances. Such plans are generally priced between the more restrictive HMO plans and PPO plans, which usually have broader provider networks and fewer restrictions. Unlike an HMO offering, the POS product does not prohibit self-referral to specialists—and it also offers an out-of-network option for a higher cost, though the out-of-network options are not as great as with a PPO.
HealthLeaders-InterStudy's newly released Montana Health Plan Analysis report finds that POS products increased their market share by 78 percent between January 2012 and January 2013. POS plans are now the third most popular plan model in Montana's commercial segment, capturing 18 percent of the commercial market. In contrast, PPO plans—still the most popular products in Montana—declined in market share by three percent during the same period. Overall commercial enrollment for Montana increased seven percent, indicating a healthy economic outlook for the state.
"The exponential growth of point-of-service, or POS, plans in Montana will allow pharmaceutical companies to take advantage of the freedom of choice and fewer restrictions associated with these plans. Montana's unique and evolving healthcare landscape will also offer some challenges for Pharma—for instance, the competition brought about by a growing economy will require a focus on pricing strategies in order to take advantage of the health insurance exchange," explains HealthLeaders-InterStudy Analyst Jacqueline Cavnar. "Montana has a federally-facilitated health insurance exchange with three participating carriers: Blue Cross and Blue Shield of Montana, PacificSource Health Plans, and Montana Health CO-OP. The state's benchmark plan for essential health benefits has a fairly generous drug formulary, which means that drug companies will face a favorable environment in this new sales channel."
About Health Plan Data & Analysis
NEW: Health Plan Analysis reports are now released on an event-driven schedule, so you can tap into updated data and insights when you most need them.
Health Plan Data & Analysis is the tool for understanding the competitive managed care organization landscape, providing state health plan information that drives meeting preparation, strategic planning, and sales strategy development. It provides insights into the latest state health plan trends that drive local-level sales and planning strategy development and includes updates on:
- Commercial Carriers
- Managed Medicare Markets
- Managed Medicaid Markets
- Pharmacy Benefits
- Patient Care Management
- Healthcare Reform
- Key Market Events
HealthLeaders-InterStudy, a Decision Resources Group company, is the authoritative source for managed care data, analysis, and news. HealthLeaders-InterStudy is part of the Market Access Business Unit at Decision Resources Group which also includes Abacus International, Fingertip Formulary, Pinsonault, and PharmaStrat. Find out more at 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.
More by this Source
Health Reforms Prompt Major Changes For WellPoint
Oct 03, 2013, 11:30 ET
Browse our custom packages or build your own to meet your unique communications needs.
Learn about PR Newswire services
Request more information about PR Newswire products and services or call us at (888) 776-0942.