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National Managed Care Enrollment 2010 |
|
| Health Maintenance Organization (HMO) | 66.21 million |
| Preferred Provider Organization (PPO) | 53.20 million |
| Point of Service (POS) | 8.87 million |
| High Deductible Health Plan (HDHP) | 7.09 million |
| Total (1) | 135.37 million |
Managed Care Penetration
|
|
|
|
|
| Medicare (2) | 47.0 | 15.21% | 11.40 | 24.2% |
| Medicaid (3) | 46.87 | 15.17% | 33.28 | 71.0% |
| Military (3) | 3.8 | 1.20 | 3.8 | 100.0% |
| Commercial | 161.93 | 52.40% | 86.89 | 53.65% |
| Uninsured (4) | 49.4 | 16.0% | 0.0 | 0.00% |
| TOTAL (5) | 309.0 | 100.0% | 135.37 | 43.80% |
Key HMO Performance Measures |
||
| Non-Medicare | Medicare |
|
| Hospital Inpatient Days Per 1,000 Per Member (6) | 224 |
1,502 |
| Physician Encounters Per Member Per Year (6) |
4.0 |
9.1 |
| Rx's Utilization Per Member Per Year (6) |
9.2 |
27.2 |
| Plan Medical Loss Ratio (7) |
83.1% |
|
| Average PMPM Rates - Physician (8) | $61.69 |
$263.58 |
| Average PMPM Rates - Hospital (8) | $63.73 | N/A |
2010 Premium Rate/Cost Increase Projections by Product (9)
| Buck Consultants | Aon* | Hewitt | Segal* | |
| HMO | 10.3% | 10.6% | 8.0% | 10.0% |
| PPO | 11.1% | 11.0% | 5.5% | 10.6% |
| POS | 10.9% | 10.6% | 5.0% | 10.6% |
| High Deductible/Consumer Driven Health Plans | 10.3% | 10.6% | N/A | 11.9% |
| Rx | 10.9% | 9.4% | N/A | 9.1% |
| OVERALL | 10.0% | N/A | 6.0% | 10.8% |
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