Health Plans' Commercial Enrollment Losses Diminished Over Second Half of 2009

Medicaid Enrollment Continues to Climb, According to New Data from HealthLeaders-InterStudy

Jun 16, 2010, 08:00 ET from HealthLeaders-InterStudy

NASHVILLE, Tenn., June 16 /PRNewswire/ -- HealthLeaders-InterStudy, the leading provider of managed care market intelligence, reports that while managed care organizations continued to lose commercial health plan membership between July 2009 and January 2010, end-of-year decreases were only about half the size of commercial losses experienced in the first six months of 2009. According to new data available from HealthLeaders-InterStudy, commercial medical enrollment declined by 1.23 million over the last six months of the year, compared with a 2.54 million drop over the preceding six months. As of January 2010, national commercial medical benefit enrollment stands at 162.88 million.

The findings are from the newest release of Managed Market Surveyor-Rx, a database product that delivers medical and pharmacy benefit enrollment by managed care organization and geography.

On the pharmacy benefit side, commercial enrollment also continued to fall at a reduced pace, though experienced greater decreases than medical benefits. Between July 2009 and January 2010, commercial pharmacy benefit enrollment fell 1.66 million to 115.22 million. Over 2009, commercial pharmacy benefit enrollment dropped by a total of 5.12 million members.

"While the rate of commercial benefit enrollment losses declined over the second half of 2009, enrollment decreases nationwide will likely continue. Group health insurance premiums continue to rise, and some employers can not retain group insurance coverage, or do so at noticeably lower benefit levels," said Rebecca Waller, a senior health plan analyst with HealthLeaders-InterStudy. "For instance, pharmaceutical coverage is often an expense that is excluded to reduce insurance costs, which is why commercial pharmacy benefit coverage has seen more losses than medical coverage."

Nationwide Medicaid enrollment rose nearly 3.89 million in 2009, or 7.77 percent, to 54.41 million. Approximately 2.10 million members were added over the first half of the year, with another 1.79 million added between July 2009 and January 2010. There are two key factors contributing to Medicaid growth: continued unemployment levels and the economic downturn have increased the number of people who qualify for Medicaid services and many states have changed eligibility rules for state Medicaid programs, expanding the eligible pool.

Why Pharmaceutical Companies Need Managed Market Surveyor-Rx

Managed Market Surveyor-Rx delivers medical and pharmacy benefit enrollment data by managed care organization and geography (national, state, MSA, county) to better inform strategic planning and resource allocation. Relying on primary research and HealthLeaders-InterStudy's proprietary validation methodology, Managed Market Surveyor-Rx provides the most accurate managed care database available.

About HealthLeaders-InterStudy

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Decision Resources, Inc.



SOURCE HealthLeaders-InterStudy