Tuesday, April 10, 2012

Ohio Drops Molina Healthcare As Medicaid Provider As Big Insurance Carriers Aetna and United Healthcare Move In


Blue Cross is also losing some business here as far as big carriers go but we are seeing the reimbursement efforts specifically being worked by both Aetna and United who both have subsidiary companies in the Health IT business as well.  Sometimes with United one may wonder if you are insured by an insurance company or a Health IT company since their daisy chain listings of subsidiaries is so long and complex to day encompassing everything from owning a bank to low income housing to a subsidiary in China that works to promote more Chinese drugs and devices worldwide and in the US.

A couple years ago Molina made big news with offering telemedicine in the state of California with a big meeting with the governor at the time. 

Cisco Systems and Molina Healthcare HMO Announce Telemedicine Pilot Program – Long Beach, California

As you can read on Molina was the hardest hit as they have been the largest carrier in the state.  BD
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A surprise decision by Ohio to shake up the providers of its Medicaid health plan marked a sharp setback for incumbent insurer Molina Healthcare Inc., MOH -26.74% which lost its contract.

Fellow incumbents Centene Corp., CNC -15.41% Amerigroup Corp. AGP -4.85% and WellCare Health Plans Inc. WCG -7.35% are also losing business in Ohio, but the loss is "most problematic for Molina," which gets about 20% of its revenue from Ohio, according to Citigroup analyst Carl McDonald. Molina's stock plunged 27% Monday, to $25.65.

Aetna Inc., AET -1.71% meanwhile, was a winner as the Ohio Department of Job and Family Services picked five managed-care organizations to serve the state's Medicaid recipients starting Jan. 1. The others are UnitedHealth Group Inc., UNH -1.47% plus nonprofits CareSource, Paramount Advantage and Meridian Health Plan.

Ohio is among the states pushing to start coordinating care for dual-eligible patients next year. But the Medicaid insurers that have been dropped in Ohio could now be at a disadvantage in that process, Goldman Sachs analyst Matthew Borsch said.

http://online.wsj.com/article/SB10001424052702303772904577334030644545196.html

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