Fri, May 22, 11:14 AM
- Major health insurers in some states are proposing rate increases of as much as 51% for plans sold under the federal health law, according to a WSJ analysis, setting the stage for an intense debate over the law’s impact.
- All the insurers cite high medical costs incurred by people newly enrolled under the Affordable Care Act, saying their proposed rates reflect the revenue they need to pay claims now that they have had time to analyze their experience with the law’s requirement that they offer the same rates to everyone regardless of medical history.
- Some insurers are trying to catch up with the impact of expensive drugs such as Sovaldi, foreseeing significant pent-up demand from the newly enrolled, says a fellow at the Society of Actuaries.
- Relevant tickers: IHF, HNT, UNH, MOH, CNC, UAM, AET, CI, HUM, HCA, WCG, GTS, EMCI, MGLN
Thu, Apr. 30, 6:32 AM| Comment!
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Wed, Mar. 18, 7:12 AM
- Magellan Health (NASDAQ:MGLN) acquires Troy, MI-based 4D Pharmacy Management Systems, a privately-held full-service pharmacy benefits manager serving managed care organizations, employers and government-sponsored benefit programs.
- The base purchase price is $55M in cash, with up to an additional $30M based on future milestones, including $10M for the achievement of certain growth targets in the underlying dual eligible membership served by 4D and up to $20M for the retention of certain business through 2018. The transaction should close in Q2.
- For 2015, 4D should generate ~$400M in revenue. It currently serves ~670K members. Magellan does not expect the transaction to materially impact its segment profit guidance.
- Magellan Chairman and CEO Barry M. Smith says, "4D will increase Magellan's PBM scale and provide the company with inroads in Medicare Pat D, managed Medicaid, dual eligibles and exchanges. With the capabilities that this acquisition brings, combined with our sales momentum, we are well positioned to exceed our long-term growth goal objective of $2.5B of pharmacy revenue by 2018."
Wed, Mar. 4, 12:11 PM
- Hospitals rally on comments from Supreme Court Justice Anthony Kennedy, often a swing vote in important cases. He says there is a powerful point to the Obama administration's argument that the Affordable Care Act would fall apart if the subsidies were ruled invalid.
- The Court is currently hearing arguments in the case King v. Burwell, which challenges federal subsidies in states that did not create their own health insurance exchanges. Its final decision will not be announced until June, though.
- Hospitals and health insurers have the most at stake. They have benefited greatly since the law was signed in 2010. To date, 11.4M Americans have signed up for coverage in 2015, giving both groups more paying customers and potentially cutting the number of non-paying emergency room visits. If the subsidies were ruled invalid then many people would drop coverage due to the higher cost.
- Related tickers: (HCA +6.2%)(THC +5.4%)(UHS +2.6%)(CYH +5.4%)(LPNT +3.3%)(SEM -0.9%)(SSY)(HUM +0.1%)(CI -0.4%)(CNC)(MOH +0.3%)(ANTM +0.5%)(UNH +0.3%)(MGLN +0.3%)(WCG +0.3%)
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Wed, Feb. 25, 5:30 PM
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Wed, Jan. 28, 4:03 PM
- A study done by researchers from New York and Columbia Universities found that premiums were slightly higher for policies offered on state-run health exchanges where there were higher numbers of competitors, precisely the opposite effect that supposedly characterizes more intense competition.
- Overall, average monthly premiums were $5.71 higher per additional insurer (p<0.001). In addition, average monthly premiums were $3.18 higher per additional insurer for identical plans offered.
- The analysis focused on the prices for each unique insurance plan offered on the exchanges in each geographic rating area. The number of rating areas varied widely in the 34 states examined, from only one in NJ, NH and DE to 67 in FL.
- The authors acknowledge that the higher premiums may be due to higher cost areas (urban vs rural) where more insurers are located rather than a lack of competition.
- Related tickers: (NYSE:AFL) (NYSE:AIG) (NYSE:AET) (NYSE:CI) (NYSE:CNC) (NYSE:UNH) (NYSE:ANTM) (NYSE:MOH) (NYSE:HNT) (NYSE:HUM) (NYSE:WCG) (NASDAQ:MGLN)
Dec. 16, 2014, 10:32 AM| Comment!
Oct. 24, 2014, 10:17 AM
- Magellan Health (MGLN +1.3%) Q3 results: Net Revenue: $923.2M (+5.7%); Managed Care: $703M (-8.7%); PBM & Dispensing: $220.2M (+112.8%); Cost of Care: $495.2M (-12.3%); COGS: $202.2M (+107.4%); Net Income: $25.8M (-45.3%); EPS: $1.00 (-41.2%); CF Ops: $194.2M (13.4%).
- 2014 Guidance: Net income: $63M - $77M from $53M - 69M; Segment profit: $243M - $258M from $238M - 258M; CF Ops: $207M - $226M from $204M - 226M; diluted EPS: $2.30 - $2.81 from $1.90 - $2.47; fully adjusted net income: $88M - $102M from $74.5M - $92.5M; adjusted EPS: $3.21 - $3.72 from $2.67 - $3.32.
Oct. 24, 2014, 6:39 AM
Oct. 23, 2014, 5:30 PM
Aug. 26, 2014, 1:55 PM
Jul. 25, 2014, 11:05 AM| 2 Comments
Jul. 25, 2014, 7:07 AM
- Magellan Health (NASDAQ:MGLN) Q2 results: Net Revenue: $888.0M (+5.4%), Managed Care: $682.3M (-8.6%), PBM & Dispensing: $205.7M (114.3%); Cost of Care: $481.6M (-10.4%); COGS: $192.6M (+113.5%); Net Income: $5.0M (-84.1%); EPS: $0.18 (-84.3%); CF Ops: $137.1M (+57.8%).
- 2014 Guidance: Net income: $53M - 69M; Segment profit: $238M - 258M; CF Ops: $204M - 226M; diluted EPS: $1.90 - 2.47; fully adjusted net income: $74.5M - 92.5M; adjusted EPS: $2.67 - 3.32.
Jul. 25, 2014, 6:46 AM| Comment!
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