Poised for Medicare Market Success, Humana to Face Commercial Sector Challenges With Healthcare Reform MLR Provisions

NASHVILLE, Tenn., July 12 /PRNewswire/ -- HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that with the passage of healthcare reform, national publicly traded insurer Humana Inc. is well-positioned to be a continued force in the Medicare market; however, reform provisions regarding medical loss ratio minimums will challenge Humana in the commercial sector. According to the new National MCO Analyzer: Humana Inc., Humana has built a strong network for its Medicare Advantage PPO, putting it in a good position to maintain or grow membership when pricing and regulatory changes around healthcare reform are in effect in 2011. However, reform regulations requiring a minimum medical loss ratio of 85 percent for large groups and 80 percent on small-group and individual plans will challenge Humana's operations in the commercial market.

"Healthcare reform plays into Humana's hands with Medicare Advantage because of the company's experience, depth of product lines and 50-state footprint," said HealthLeaders-InterStudy Analyst Rick Byrne. "On the commercial side, Humana is a pioneer in the consumer-driven plan movement, and will have opportunities with high-deductible and account-based plans among small employers looking for affordable solutions. However, reform provisions on minimum medical loss ratios will require Humana to prove its consumer-engagement strategy can deliver benefits without skimping on member service."

HealthLeaders-InterStudy Introduces the National MCO Analyzer

National MCO Analyzer: Humana Inc. is the first report from HealthLeaders-InterStudy's new National MCO Analyzer series. Profiling the country's largest managed care organizations, each report includes:

• Market analysis from HealthLeaders-InterStudy's managed care market experts, along with a forecast of opportunities and challenges for a plan in the year ahead.
• Competitive analysis outlining a managed care organization's strengths, challenges and opportunities.
• Plan dashboard providing national-level enrollment mix and trends.

The following managed care organizations will be profiled in the National MCO Analyzer series in 2010:

• Aetna
• Amerigroup
• Centene
• CIGNA
• Coventry
• Health Care Services Corporation
• Health Net
• Humana
• Kaiser Permanente
• United Health Group
• WellCare
• WellPoint

"The National MCO Analyzer provides a big-picture view of national insurers' corporate strategies, key markets and plan designs, delivering the intelligence managed care marketing teams need for successful business planning in today's evolving managed care environment," said HealthLeaders-InterStudy New Product Director Carol Barry.

About HealthLeaders-InterStudy

HealthLeaders-InterStudy, a Decision Resources, Inc. company, is the authoritative source for managed care data, analysis and news. For more information, please visit www.HL-ISY.com.

About Decision Resources, Inc.

Decision Resources, Inc. 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, Inc. at www.DecisionResourcesInc.com.

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SOURCE HealthLeaders-InterStudy