MANAGED CARE January 2011. ©MediMedia USA
In the first half of 2010, five of the largest for-profit managed care companies — WellPoint, UnitedHealth, Aetna, Humana, and Cigna — reported high profits, according to a KPMG report. The net income of these companies collectively increased 20.2 percent in the first half of 2010 to $6.05 billion, compared with the same period in 2009.... Almost one third of uninsured people eligible to receive subsidies to buy insurance through state-based exchanges have had no recent health problems, access to medical care, or paying medical bills, according to a national study released by the Center for Studying Health System Change. Enrolling these uninsured people is likely to be challenging but essential to avoiding adverse selection in the exchanges, according to the study. Otherwise, health insurance costs in the exchanges could be higher than expected. Many of these healthy and low-cost uninsured people view themselves as risk-averse, the study found, which could motivate them to gain coverage in the absence of health or access problems..... CMS reports that 5 of the 10 physician groups that are participating in the five-year Medicare program for quality will receive bonus payments this, the fourth year. The bonuses total $31.7 billion and are based on how much physician groups save Medicare and how well doctors perform on measures of quality.