As always, this year’s managed
care report card from CT’s Insurance Dept. is fascinating. Anthem has 44% of total enrollment. Anthem is
seeking
to buy CIGNA for $54 billion; together they have 64% of CT enrollment. Aetna
has 18.5% of enrollment, ConnectiCare has 9.2%, and Oxford/United Health Care
has 6.8%. Enrollment is very low in CT’s two nonprofit insurers -- Healthy CT
has only 0.3% of enrollment, and Harvard Pilgrim’s enrollment is less than a
thousand people so far. The report includes 2014 medical loss ratios (MLRs) for
each plan, including federal calculations and the more rigorous state MLR. The
MLR is the percent of premiums that go to pay for medical care (and quality
improvement in the federal calculation). Anthem’s HMO plans and all Oxford/United
Health Care plans are below 80% on the state’s MLR calculation.
The report also has a wealth of useful information for
consumers including customer service info, NCQA accreditation level, and number
of providers by county and type. The report includes several quality measures
including performance on cancer screenings, controlling high blood pressure and
cholesterol levels, prenatal and postpartum care, drug utilization with costs,
behavioral health, and member satisfaction.
