4th Annual Investor Conference May 16, 2001 HEALTH PLANS DIVISION Cora Tellez President.

Slides:



Advertisements
Similar presentations
Annual Benefit Changes (ABCs) Ohio. 22 Agenda 2  Back ground on changes  Review of portfolio changes  Selling Strategy  Communication dates  Consultative.
Advertisements

Solution in Drug Plan Management 2011 September 8, 2011 Basil Rowe Vice President, Total Rewards and Shared Services Shoppers Drug Mart
Humana, Healthcare Reform and You Dave Vanden Heuvel Director, Medical Products.
By the numbers: Total Employees – 16,746 Employees on the Plan – 7,768 Total Lives – 15,411 Tulsa Employees on the Plan – 1,187 Total Lives in Tulsa –
Government Influences on Cigna Business Acumen Course August 27 th, 2014.
CENTERS OF EXCELLENCE The Way Health Care Gets Better™
2006 Retiree MIP Overview October 2006 Rajiv Nundy & Kent Humphries HR Compensation Management.
Supplementing PACE through Medicare Part D
4th Annual Investor Conference May 16, 2001 HEALTH PLANS DIVISION Panel Discussion: Contributing Value to Cost of Care.
Health Net Steve Sell President, Health Net of California & Western Region Health Plan 2010 Health Care Forecast Conference Irvine, CA February 25-26,
This presentation contains confidential and proprietary information of Caremark and cannot be reproduced, distributed or printed without written permission.
Making Health Care Decisions B. Lee Green Texas A&M University.
1 Managed Health Care Pricing for Provider Arrangements Presented by Vanessa Olson Seminar on Health and Managed Care October 18, 1999.
Market-Based Management
Commercial (Non Government Sponsored) Health Plan Medical Cost and Premium Trends Pharmaceuticals15%14% 12% 11%1.8% Hospital Inpatient Outpatient2515.
Health Care Financing and Managed Care. Objectives  To understand the basics of health care financing in the United States  To understand the basic.
Access Health Closing the Gap Between Public and Private Insurance Coverage.
This presentation is a high-level summary and for general informational purposes only. The information in this presentation is not comprehensive and does.
Company Confidential Information The National Consumer Driven Health Care Summit Washington, DC October 19, 2008 "Implementation Issues and Future Opportunities.
Merrill Lynch Health Services Investor Conference The Waldorf Astoria, New York City December 3, 2003 Gregory W. Scott Executive Vice President and CFO.
Interviews Conducted Prior to MissionPoint Launch Network Physicians Significant behavior change will only occur with “payer” control of 30 – 50%
4th Annual Investor Conference May 16, 2001 BUSINESS TRANSFORMATION AND INNOVATION SERVICES Gary Velasquez President.
New York’s only CO-OP. Consumer Operated and Oriented Plan 501(c)29 non-profit organization, a signature program of the Affordable Care Act Over half.
1 Fourth: Health Care Plans: 1. 2 The Economics of Health Care: Price rationing occurs because buyers base purchasing decisions on the relative quality.
1 Public Employees Benefits Board 2006 Medical Procurement July 12, 2005 Richard Onizuka, Health Care Policy Washington State Health Care Authority.
Bank of America High Yield Bond & Leveraged Finance Conference May 22, 2002.…a health and consumer services company making people’s lives better.
D E L T A Health Systems MCOL Health Web Summit New Directions in Managing Health Care Costs December 2002 Self Funding: Emphasis on Benefits & Costs Delivering.
Impact of ACA, CMS and Exchanges to Cigna Clarifying the Government Sector.
Stretching Scarce Resources: State Strategies to Design Effective, Affordable Benefit Packages Anne Markus, J.D., Ph.D. Senior Research Scientist The George.
Purdue University Senate September 10, 2012 Health Care Strategy.
Health Care Cabinet March 10, Agenda A.Open Enrollment Update B.Benefits available for individuals using Methadone or other opioids C.Anticipated.
“Convenient Care on the Corporate Campus: What Works” Christopher W. Kersey, MD MBA Chief Business Development Officer and Chief Medical Officer Convenient.
Bear Stearns 15 th Annual Healthcare Conference Waldorf Astoria, New York City September 19, 2002 Gregory W. Scott Executive Vice President, Chief Financial.
PRESENTATIONOF ANNUAL INSURANCE CONTRACTS October 25, 2011.
Health Insurance Why the Need? Protects consumers from the high costs of medical bills due to illness or injury & against the law not to have it.
Humana Insight Humana About:
Page 1 Overview of Self-Funded Health Plans a step ahead McNeary, Inc.
1 Healthcare Group of Arizona Director Anthony D. Rodgers State Coverage Initiatives - Summer Workshop ‘Pressing Forward: Cuts, Coverage, and Creativity’
Public Employees Benefits Board February 18, 2003 DIS Forum Building Board Room 605 E. 11th Olympia, Washington.
All CIGNA Medicare 2009 plan designs described in this document are pending government approval and are therefore subject to change. For producer use only.
Lehman Brothers 9th Annual Global Healthcare Conference March 8, 2006.
PEBB Meeting - August 6, Public Employees Benefits Board Meeting August 6, 2002 Procurement Overview & Medical Benefit Decisions for 2003.
1 Karen Benson, Healthcare Network Program Manager, SHBP State Health Benefit Plan Update Presentation to HomeTown Health, LLC Department of Community.
Banc of America Securities Health Care Conference May 21, 2004 The Four Seasons Hotel, Las Vegas PacifiCare Health Systems Howard G. Phanstiel Chairman.
Health Net, Inc. Presentation to: Deutsche Bank Alex.Brown Cora Tellez President Health Net, Inc. Health Plans Division May 9, 2001.
1 Brad Bowlus President, CEO PacifiCare Health Plans James Frey President PacifiCare of California.…a health and consumer services company making people’s.
2015 Washington State of Reform Health Policy Conference Hilton Seattle Airport Conference Center January 8, 2015.
Health Net, Inc. Merrill Lynch Health Services Investor Conference Merrill Lynch Health Services Investor Conference Steven P. Erwin EVP and Chief Financial.
1 The Role of Managed Care in Strengthening Medicaid 2 nd Annual Medicaid Congress June 15, 2007 John Monahan President, State Sponsored Business.
Smith Barney Citigroup Small & Mid-Cap Conference May 6, 2004 Allmerica Financial Corporation Ed Parry Executive Vice President Chief Financial Officer.
FY Budget Worksession July 17, 2007 ORANGE COUNTY MEDICAL & DENTAL PLAN RENEWALS.
Introducing PlanAdvisor™. PlanAdvisor At Commercial Insurance Services, we see a simplified way for you to approach the benefits plan design process.
Sierra Health Services, Inc. A Managed Care Company Updated 10/25/06.
August 4, 2009 ORANGE COUNTY 2010 MEDICAL PLAN CHANGES.
Health Care Service Corporation, a Mutual Legal Reserve Company 2015 FHLB INSURANCE CONFERENCE.
The Business of Managed Care. Plan for Today Introduce section of course that focuses on plans Internal organization of an HMO Overview of managed care.
Offensive Strategies Chapter Twelve M arket-Based Management, 4 th edition.
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Finding the path to a healthier plan choice Aetna Medicare.
Providing Insights that Contribute to Better Health Policy Patient Cost Sharing: An Overview Joy M. Grossman, Ph.D. December 3, 2003.
Overcoming the Risk Adjustment Payment Challenge John G. Lovelace, President July 2010.
Geographic Variation in Healthcare and Promotion of High-Value Care Margaret E. O’Kane November 10, 2010.
UCare Dual Eligibles – MSHO Experience Ghita Worcester Sr. VP, Public Affairs and Marketing SNP Leadership Forum November 2,
Changing Nature of Managed Care Organization-Provider Relationships
Personal Finance Health Insurance
“The Integrator” Optimal Care for All our Members and Patients
The State of Healthcare Benefits
Chapter 3 Managed Health Care.
San Mateo County Uninsured Feasibility Analysis
Cover area with cropped image.
Presentation transcript:

4th Annual Investor Conference May 16, 2001 HEALTH PLANS DIVISION Cora Tellez President

2 Positioned for Profitable Growth  Solid Operating Performance in 2000 and Entering 2001  New Products Introduced in 2000 and More Planned for 2001  Medicare Strategy That Focuses on Profitable Performance

3 Positioned for Profitable Growth  Solid Operating Performance in 2000 and Entering 2001  New Products Introduced in 2000 and More Planned for 2001  Medicare Strategy That Focuses on Profitable Performance

4 Health Plan Membership Health Plan Membership By State

5 Health Plan Membership Health Plan Membership By Line of Business

6 Health Plan Revenue Health Plan Premium Revenue By Line of Business

Operating Performance Health Plans Division

8 Drivers of Membership Growth  Diversify the Product Portfolio  Diversify Market Segments  Pursue Niche Products  Provide Flexible Benefit Designs to Meet Consumers at the Price They Want to Pay  Expand Choice and Access  Price Ahead of Cost Trends

9 Membership Results By Line of Business Membership* Growth Between Q and Q * Excludes Florida, Washington and Colorado Medicare Supp is in Medicare

10 Membership Results By Product Commercial Membership* Growth Between Q and Q * Excludes Florida, Washington and Colorado Medicare Supp is in Medicare

11 Membership Results By Market Segment Commercial Membership* Growth Between Q and Q * Excludes Florida, Washington and Colorado Medicare Supp is in Medicare

12 Gradual and Planned Shift in Risk Health Net of California HMO Membership By Risk Type

13 Inpatient Utilization Under Control As Risk Shifts

14 Inpatient Utilization Under Control As Risk Shifts

15 Successfully Managing the Shift in Risk  Pricing Ahead of Medical Cost Trends  Claims Processing Under Control –Claims Volume Increased 25% from 1999 to 2000 and is Projected to Increase 27% in 2001 –Successfully Managing Inventory - “Work on Hand” Consistently Under Five Days –Increased Staff 25% Over Past 12 Months –Expanded Outsourced Adjudication Capabilities –Implemented Technology Enhancements - EDI, Auto Adjudication

16 Positioned for Profitable Growth  Solid Operating Performance in 2000 and Entering 2001  New Products Introduced in 2000 and More Planned for 2001  Medicare Strategy That Focuses on Profitable Performance

17 Market Position: A Platform For Growth HMO Market Position in Largest Markets

18 Consistently Profitable Medicaid Program  Strong Growth Between Q and Q –California: 100,000 Members (21% Growth) –Northeast: 12,000 Members (12% Growth)  Stable Performance –Consistent Profitability –Demographic Profile

19 Maintaining Affordability: California Copay Strategy  New Copays & Copay Increases Across All Services –$250-$350 Inpatient and Outpatient Surgery Copay –$75 Emergency Room Copay and Option to Increase Physician Visit Copay  Maintains Product Affordability Through Cost Sharing –Will Mitigate Premium Increases –Should Stem Shift to Self-Insurance

20 Maintaining Affordability: Northeast Copay Strategy  Introduced “Split Copay” Product - Differentiates Primary and Specialty Physician Copay –Will Mitigate Premium Increases –Well Received by the Market  Three-Tier Pharmacy Plans Offered on Every Renewal in 2000 –About 47% of Eligible Members Converted to 3-Tier in Q –Will Mitigate Premium Increases

21 Positioned for Profitable Growth  Solid Operating Performance in 2000 and Entering 2001  New Products Introduced in 2000 and More Planned for 2001  Medicare Strategy That Focuses on Profitable Performance

22 Medicare Product Line & Strategy  Medicare Profitability is Improving  Diligently Track Performance - Judicious in Evaluating Market Exits  Medicare Strategy: –High AAPCC Counties –Cost Effective Networks –Medicare Supplemental Plans

23 Medicare - West  24 Counties in the West –20 Counties in California –4 Counties in Arizona  Exited Five Counties: Fresno, Sonoma, Cochise, Gila and So. Pinal Impacting 11,000 Members  Benefit Reductions in 16 Out of 22 Counties –Copay Increases –Generics Only –Lower Pharmacy Caps  MCR Improvement Seen in Q1 2001

24 Medicare - Northeast  12 Counties in the Northeast  Exited Four Counties: Litchfield, Middlesex, Nassau and Suffolk Impacting 4,800 Members  Benefit Reductions in Connecticut –Generics Only  MCR Improvement Seen in Q1 2001

25 Health Net, Inc. Health Plans - Well Positioned For Growth  Solid Products  Strong Financial Base  Benefit Flexibility  Management Depth  Focus and Discipline Around Our “Vital Few”  Investment in Branding