Managed Health Care Services

Managed Health Care Services published by Global Industry Analysts, Inc. in October, 2009. This report consists of Pages: 71 and the price starts from US $ 950.

Introduction

Abstract

The global outlook series on Managed Health Care Services provides anecdotes, market briefs, and concise summaries of research findings. The report analyzes the growth drivers and market challenges, and reviews the noteworthy strategic corporate activity of the recent past. The report also discusses various types of managed care organizations and programs. A detailed review of the United States market is provided in the report, along with brief discussions on European, Hong Kong, and Nigerian markets. Also included is an indexed, easy-to-refer, fact-finder directory listing the addresses, and contact details of 310 companies worldwide.

Table of Contents

1. INDUSTRY OVERVIEW 1

• Market Overview 1
• Quick Facts 1
• Recession Hits Managed Care 1
• Factors Impacting Managed Care Market 1
• Health Care Expenditure in Developed Nations 2
• Health Care System in Developing Countries 2
  • Affordability and Equitable Access Ensures Balanced Health Care 2
  • Government Initiatives 3
• Sustainability Helps to Strike a Balance 3

2. PRODUCT OVERVIEW 3

• Managed Health Care - A Conceptual Definition 3
• Benefits 4
• Managed Health Care - Historical Perspective 4
• Managed Care Organizations (MCOs) 5
• Managed Care Services for Healthcare Providers 5
• Cost Reducing Managed Care Techniques 5
• Managed Care Approaches 5

3. TYPES OF MANAGED CARE 6

• Types of Network-Based Managed Care Programs 6
  • Health Maintenance Organizations (HMOs) - An Introduction 6
    • Features of HMOs 6
    • History of Health Maintenance Organizations 6
    • Types of HMOs 7
      • Primary Care Physician (PCP) 7
      • Staff/Group Model HMOs 7
      • Fee for Service Plan (FFS) 7
      • Independent or Individual Practice Association (IPA) 7
  • Preferred Provider Organizations (PPO) 7
  • Point-Of-Service Plans (POS) 8
• Other Managed Care Programs 8
  • Physician-Hospital Organizations (PHOs) 8
    • Different PHO Structures 8
  • Prescription Drug Programs 9
  • Dental Specialty Programs 9
  • Managed Care Under Indemnity Insurance Plans 9
  • Stop Loss Arrangements 9
  • Mixed or Network Model HMO 9
  • Exclusive Provider Organization (EPO) 9
  • Consumer Driven Health Plans (CDHPs) 9

4. MERGERS & ACQUISITIONS 10

5. OTHER STRATEGIC CORPORATE DEVELOPMENTS 19

A REGIONAL MARKET PERSPECTIVE

1. THE UNITED STATES 22

• Managed Care Market - An Outlook 22
• US Health Care Industry - An Overview 22
  • Table 1: Health Care Expenditure in the US - Annual Figures in US$ Trillion for Year 2008 through 2012 23
  • Table 2: Health Care Market in the US (2008): Percentage Share Breakdown of Expenditure by Health Care Segment 23
  • Health Care Costs Continue to Escalate 24
• Challenges Faced by the US Healthcare Industry 24
• Medical Costs - Future Growth 24
  • Table 3: Managed Care Medical Costs in the US: Percentage Growth of by Category (2008) 24
  • Table 4: Health Care Market in the US (2008): Percentage Breakdown of Medical Costs by Category 25
• A Peek Into Noteworthy Trends & Issues 25
  • Economic Recession and Managed Care Market 25
    • Stimulus Bill Offers a Promise or a Threat? 25
  • Managed Care Medicaid Enrollments Improve 26
    • Table 5: Managed Care Market in the US (2008): Percentage Breakdown of Enrollments by Plan Type 26
    • Table 6: Number of Managed Care Enrollments in the US by State (2008) (In Million) 27
    • Table 7: Managed Care Market in the US (2008): Leading PPO Networks Ranked by Number of Lives with Network Access (In Million) (In Million) 28
  • Rising Rate of Unemployment Impacts Managed Care 28
  • Medicaid Managed Care - Major Care Delivery System 28
  • Commercial Enrollment Remains Challenging 29
    • Table 8: Percentage of Managed Care Providers Offering Health Benefits in the US (2005-2008) 29
    • Table 9: Managed Care Market in the US (2009E): Number of Enrollments by Health Plan (In Million) 30
  • Rising Costs of Health Care for Employers 30
    • Employers Strategize to Reduce Operating Costs 30
  • Insurance Companies Turn to Managed Care 31
• Competition 31
  • Table 10: Managed Care Market in the US (2008): Percentage Share Breakdown of Total Enrollments by Provider 31
  • Large Health Plans Dominate Managed Care Market 32
    • Table 11: Managed Care Market in the US by Number of MCOs and Number of Health Plan Members (2008) 32
    • Table 12: Managed Care Market in the US (2008): Number of Health Plan Members by Health Plan 33
• HMO Market - An Overview 33
  • Competitive Landscape 33
    • Table 13: Managed Care Market in the US (2008): Number of HMO Enrollments by Leading Health Plans (In Million) 34
  • Disease Management Programs Propel HMOs Growth 34
    • Table 14: Percentage of HMOs Offering Disease Management Programs in the US by Disease Type 35
• Reinsurance Market Overview 35
• Provider Excess Market 35
• Dental Managed Care Market 36
  • Competitive Scenario 36

2. EUROPE 36

• Healthcare Market - An Overview 36
• Managed Care Market 37
  • Market Features 37
• Corporate Layoffs Deter Managed Care Growth 37

3. HONG KONG 37

• Market Overview 37
  • Table 15: Managed Care Market in Hong Kong (2008): Percentage Share Breakdown of Compensation to Physicians (Operating Individually) by Type 38
  • Table 16: Managed Care Market in Hong Kong (2008): Percentage Share Breakdown of Compensation to Physicians (Working in Group) by Type 38
• Growth Driving Factors 39
• MCOs Devise Newer Strategies 39
  • Other Strategies 39
• Market Challenges 39
  • Managed Care Facing Backlash 40
• Lack of Government Support Hampers Growth 40
  • The Need to Establish a Regulatory Body 40

GLOBAL DIRECTORY

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