Global Managed Health Care Services Industry

NEW YORK, April 24, 2012 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue:

Global Managed Health Care Services Industry

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The global outlook series on Managed Health Care Services provides anecdotes, market briefs, and concise summaries of research findings. The report analyzes the growth drivers and market challenges, and reviews the noteworthy strategic corporate activity of the recent past. The report also discusses various types of managed care organizations and programs. A detailed review of the United States market is provided in the report, along with brief discussions on European, Australian and Hong Kong markets among others. Also included is an indexed, easy-to-refer, fact-finder directory listing the addresses, and contact details of 262 companies worldwide.

1. INDUSTRY OVERVIEW 1

Market Overview 1

Quick Facts 1

Managed Care Market Recovers from Recession 2

Factors Impacting Managed Care Market 2

Managed Care Organizations - Impediments and Drivers 2

Healthcare System in Developing Countries 3

Sustainability Helps to Strike a Balance 3

US Health Insurers Eye Overseas Markets 4

2. PRODUCT OVERVIEW 5

Managed Health Care - A Conceptual Definition 5

Benefits 5

Managed Health Care - Historical Perspective 5

Managed Care Organizations (MCOs) 6

Managed Care Services for Healthcare Providers 6

Cost Reducing Managed Care Techniques 7

Managed Care Approaches 7

3. TYPES OF MANAGED CARE 9

Types of Network-Based Managed Care Programs 9

Health Maintenance Organizations (HMOs) - An Introduction 9

Features of HMOs 9

History of Health Maintenance Organizations 10

Types of HMOs 10

Primary Care Physician (PCP) 10

Staff/Group Model HMOs 10

Fee for Service Plan (FFS) 11

Independent or Individual Practice Association (IPA) 11

Preferred Provider Organizations (PPO) 11

Point-Of-Service Plans (POS) 12

Other Managed Care Programs 12

Physician-Hospital Organizations (PHOs) 12

Different PHO Structures 13

Prescription Drug Programs 13

Dental Specialty Programs 13

Managed Care Under Indemnity Insurance Plans 13

Stop Loss Arrangements 14

Mixed or Network Model HMO 14

Exclusive Provider Organization (EPO) 14

Consumer Driven Health Plans (CDHPs) 14

4. STRATEGIC CORPORATE DEVELOPMENTS 15

5. PRODUCT/SERVICE LAUNCHES 22

A REGIONAL MARKET PERSPECTIVE 23

1. THE UNITED STATES 23

Managed Care - An Introduction 23

Cost Control through Managed Care 23

Managed Care Vs Conventional Insurance 24

Recession and Managed Care Market 24

Managed Healthcare Market - On a Recovery Mode 24

Table 1: US Current and Future Analysis for Managed

Healthcare Services Market Analyzed with Annual Revenue

Figures in US$ Billion for the Years 2010 through 2015 25

Healthcare Costs Continue to Escalate 25

Stimulus Bill Offers Aid to Healthcare Industry 26

Impact of Healthcare Reforms 27

Managed Healthcare Providers Shift Focus to Third World Countries 27

Managed Care Enrollments Improve 28

Table 2: US Managed Healthcare Market (2010): Number of

Enrollments in Million by States - California, New York,

Pennsylvania, Texas, Florida, Illinois, Ohio, Michigan,

Massachusetts, New Jersey and Others 28

Managed Healthcare Companies Adopt New Strategies to Curb Rise

in Healthcare Costs 28

Medicaid Managed Care - Major Care Delivery System 29

Table 3: Medicaid Enrollments by Plan Type (2009): Percentage

Share Breakdown of Total MCO Members for Medicaid HMOs,

PCCMs, PHPs, and HIOs 29

Table 4: US Managed Medicaid Market (2009): Leading Health

Plans Ranked by Number of Enrollments (In Thousand) 30

South Offers Potential for Medicaid Managed Care Growth 30

Table 5: Medicaid Managed Care Enrollments by State (2009):

Percentage Share Breakdown for California, New York, Texas,

Florida, Pennsylvania, Michigan, and Others 30

Rising Medicaid Costs Drive Expansion of Managed Care 31

States Encourage Shift to Managed Care 31

Medicare Managed Care - Overview 32

Table 6: % of Medicare Expenditure Allocated to Managed Care

in the US (2006-2009) 32

Table 7: US Managed Medicare Market (2009): Leading Health

Plans Ranked by Number of Medicare Enrollments (In Thousand) 32

Medicare Advantage 33

Table 8: Medicare Advantage Enrollments in the US (2011):

Percentage Share Breakdown by State for California, Florida,

New York, Pennsylvania, Ohio, and Others 33

Table 9: Medicare Advantage Enrolments in the US (2010):

Percentage Share Breakdown by Plan Type - HMO, PPO, PFFS and

Others 33

Table 10: Medicare Advantage Healthcare Plans in the US

(2010): Percentage Share Breakdown of Number of Available

Plans for HMO, PPO, PFFS and Others 33

Table 11: Medicare HMO Enrollments by Region (2009):

Percentage Share Breakdown for Pacific, Mid-Atlantic, South

Atlantic, South Central, East North Central, Mountain, West

North Central, and New England 34

Rising Cost of Healthcare for Employers 34

Employers Strategize to Reduce Costs 34

PPACA to Benefit Medicaid Enrollees 35

PPACA Reforms Drive New Collaborations 35

Challenges Impede Hospital-Physician Integration 35

Consumer-Driven Health Plans - Gaining Prominence 36

HMO Market - An Overview 36

Disease Management Programs Propel HMOs Growth 37

HMOs' Witness Rise in Rates 37

HMOs and PPOs - A Comparison 37

Table 12: Number of Operating Plans for HMOs and PPOs (2009) 38

Competitive Landscape 38

Table 13: Leading Plans in the US HMO Market (2009): Ranked

by Number of HMO Enrollments (in Thousands) for Kaiser

Foundation Health Plan Inc., AETNA Health Inc., Blue Shield

of California, Coventry Health and Life Insurance Company,

Blue Cross Blue Shield of Massachusetts, and Blue Cross and

Blue Shield of Illinois 38

Reinsurance Market - Overview 39

Dental Managed Care Market 39

Competitive Scenario 39

Hospitals Restructure as PHOs to Become ACOs 39

Pharmaceutical Industry Places Emphasis on Efficient Marketing

Strategies 40

Competition 40

Table 14: Leading Health Plans in the US Managed Healthcare

Market (2010): Number of Enrollments in Million for

UnitedHealth Group, WellPoint, Inc., Aetna Inc., Health Care

Service Corporation, CIGNA HealthCare Inc., Kaiser

Permanente, Humana Inc., Health Net Inc., Blue Cross Blue

Shield of Michigan, and Highmark Inc. 41

Table 15: Leading PPO Networks in the US (2009): Ranked by

Number of Enrollments (In Thousand) for Blue Cross Blue

Shield of Michigan, AETNA Health Inc., Blue Cross and Blue

Shield of Florida Inc., Blue Cross and Blue Shield of

Illinois, Blue Shield of California, and CIGNA HealthCare,

Inc. 42

2. JAPAN 42

Healthcare System - Overview 42

3. EUROPE 43

Healthcare Market - An Overview 43

Managed Care Market 43

Corporate Layoffs Affects Managed Care Market 43

3a. GERMANY 44

Managed Healthcare System - Overview 44

GP Model Receives Mixed Response 44

4. ASIA-PACIFIC 45

4a. AUSTRALIA 45

Australia - A Healthcare Perspective 45

Mode of Healthcare Delivery 45

Funding of Healthcare 45

Challenges Ahead - Australian Managed Healthcare 45

The Path Ahead 46

4b. HONG KONG 47

Market Overview 47

Growth Driving Factors 47

MCOs Devise Newer Strategies 47

Other Strategies 48

Market Challenges 48

4c. SINGAPORE 49

Promising Future for Managed Care 49

5. LATIN AMERICA 49

GLOBAL DIRECTORY

To order this report:

Managed care Industry: Global Managed Health Care Services Industry

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