Floridians Moving from HMOs to PPOs, Cost May Reverse Trend

Oct. 24, 2005 – A study of the Florida market – often a good indicator of the senior citizen market in the U.S. – shows HMO enrollment has slipped as the line blurs between HMOs and PPOs. But, more HMOs are entering the state and the HealthLeaders-InterStudy suggests the swing by employers may return to HMOs as pressure increases to control costs.

The survey also found eighteen different companies are offering 43 different Medicare prescription drug plans to Florida’s senior citizens.

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"Florida is a big and varied healthcare market," said Jan Shuxteau, HealthLeaders-InterStudy analyst. "Insurers see it as fertile ground for growth. Aetna, for example, is re-entering market segments it had previously left, like Medicare."

Florida's varied market shows HMO market penetrations as high as 95 percent in the Tallahassee/Panama City area, and as low as 15 percent around Gainesville/Ocala. These shares are driven by local market conditions, and overall, analysts expect the situation in Florida to remain stable for the next two or three years.

Other health plan news in Florida:

-- Aetna contracted with Immediate Medical Care Services to add 29 urgent care centers to its South Florida network. Urgent care, which serves as an alternative to emergency rooms for non-critical treatment, is the fastest-growing sector of the U.S. healthcare system.

-- Capital Health Plan (CHP) is establishing a nonprofit corporation to subsidize healthcare premiums for small employers who would not otherwise be able to offer health insurance to their employees. Despite their seeming advantages, such "3-share" programs have not shown much growth, "but if anyone has enough market influence to make one work, it is CHP."

About HealthLeaders-InterStudy

HealthLeaders-InterStudy, a company of Decision Resources, Inc. (http://www.decisionresources.com/), is the authoritative source for managed care data, analysis, and news. For more information, please visit http://www.healthleaders-interstudy.com/.

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