Managed Care Report
Managed Care Report
• Humana (Louisville, KY) reported 1Q99 ended March 31 operating earnings of 20 cents per share, compared to 30 cents per share in 1Q98. 1Q98 earnings, Humana said, were impacted by increased medical cost trends. The operating results exclude a $12 million gain from the sale of a tangible asset and the previously announced $90 million additional medical claims expense recorded during 1Q98. Excluding the tangible asset gain and the additional medical claims expense, net income in 1Q99 was $33 million, compared to $50 million in 1Q98. Including these items results in a net loss in 1Q98 of $16 million, 10 cents per share. Total revenues in 1Q99 were $2.5 billion, a slight increase from 1Q98 revenues of $2.4 billion. Humana’s total medical membership was 6.1 million members as of March 31.
• PacifiCare Health Systems (Santa Ana, CA) saw revenues of $2.5 billion in 1Q99 ended March 31, compared to 1Q98 revenues of $2.4 billion. The company recorded a net income available to common shareholders in 1Q99 of $74 million, $1.62 per share, compared to a net income available to common shareholders in 1Q98 of $38.7 million, 93 cents per share. The strength of the quarter, PacifiCare said, was driven by a favorable commercial premium pricing environment; reductions in the commercial medical care ratio, both on a sequential basis and compared to last year; lower marketing, general, and administrative expenses; and a lower effective tax rate.
• RightChoice (St. Louis) reported 1Q99 ended March 31 net income of $4.7 million, 25 cents per share, compared to 1Q98 net income of $968,000, 5 cents per share. Revenues totaled $200 million in 1Q99, compared to 1Q98 revenues of $191.9 million.
• The Kentucky Association of Health Plans (Frankfort, KY), which includes Advantage Care, Anthem Blue Cross/Blue Shield, Bluegrass Family Health, CHA Health, Cigna/Healthsource, Humana, and PacifiCare, has adopted a voluntary external review process for its more than 1 million health plan members. The review process will allow quick resolution to any disputes over covered treatments, procedures, and services, as well as non-excluded experimental or investigational treatments that meet the definition of medically necessary contained in the member’s certificate of coverage.
• SunStar Healthcare (Heathrow, FL) announced its results for the five-month period ended Dec. 31, recording total revenues of $23.1 million, compared to 2.8 million in the same period in the previous year. The company recorded a net loss of $2.2 million, 74 cents per share, compared to a net loss of $2.1 million, 88 cents per share, in the same period a year ago.
• Trigon Healthcare (Richmond, VA) has decided to get out of the Medicare business, resulting in a cut of 145 jobs with the managed care company, reported the Associated Press. Trigon President/CEO Thomas Snead said the company decided to get out of the business because "it does not afford us the growth opportunities we are seeking."
• Aetna (Hartford, CT) has named Edward Shaw general counsel and a member of the management group of Aetna. Shaw will be responsible for corporate legal and regulatory matters.
• Maxicare Health Plans’ (Los Angeles) 1Q99 ended March 31 revenues totaled $179.2 million, down from 1Q98 revenues of $182 million. The company recorded a net loss of $7.7 million, 43 cents per share, compared to a net loss in 1Q98 of $2.7 million, 15 cents per share. Last year, Maxicare implemented a strategic restructuring program to exit unprofitable markets by assets sales or plan closings and concentrate on its healthcare businesses in California, Indiana, and Louisiana. These three states have generated virtually all of Maxicare’s membership growth in recent years.
• MedicalControl (Dallas) recorded 1Q99 ended March 31 results, which include the operations of Business Health Companies (BHC), acquired on Sept. 1, 1998. BHC is the manager of the Houston Healthcare Purchasing Organization, a preferred provider organization in Houston. Revenues in 1Q99 totaled $3.8 million, up 12% from $3.4 million in 1Q98. The company incurred a net loss in 1Q99 of $204,000, 5 cents per share, compared to a net loss in 1Q98 of $95,000, 2 cents per share.
• Foundation Health Systems’ (Los Angeles) board has unanimously elected fellow board member Richard Hanselman as non-executive chairman, a post that had been vacant since March 1 when Malik Hasan retired. As chairman, Hanselman will also serve as a non-voting, ex-officio member of each committee of the board.
• Aetna U.S. Healthcare (Blue Bell, PA) has selected Garry Cutting as its first recipient of the Aetna U.S. Healthcare professorship in medical genetics at Johns Hopkins University School of Medicine. Aetna U.S. Healthcare pledged $1.5 million to endow the professorship at Hopkins’ Institute for Human Genetics.
• Mid Atlantic Medical Services (MAMSI; Rockville, MD) reported 1Q99 ended March 31 revenues of $313.2 million, compared to 1Q98 revenues of $289.5 million, an increase of $23.7 million. The company recorded a net income of $5.9 million, 14 cents per share, compared to a net income in 1Q98 of $6.7 million, 14 cents per share. Medical and home health patient services expenses for 1Q99 were $266.4 million, compared to $245.2 million in 1Q98.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.