Managed Healthcare, HMOs, and PPOs – Industry Research, Analysis, Statistics, and Forecasts

See the following sections listed below to view available resources by category:

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Industry Analysis, Statistics, Trends, and Forecasts

• Market size and major product and service segments
• Key industry statistics, trends, and financial ratios
• Operating conditions and current performance
• Competitive landscape and environment
• Major company profiles and market shares
• Five-year outlook and growth forecasts

UBM Medica, LLC
Managed Healthcare Executive Magazine
https://www.managedhealthcareexecutive.com/

Monthly publication features news and information for managed healthcare executives, with special features including the annual "State of the Industry" report (December) which identifies some of the top challenges faced by healthcare executives and provides advice from industry experts on how to deal with and overcome these challenges. Digital editions of the magazine are available free online.

Sanofi-Aventis U.S. LLC
Payer Digest
https://www.managedcaredigest.com/

Annual report provides detailed data and analysis for commercial, Medicare, and Medicaid managed healthcare plan models including HMO, PPO, Medicare Advantage, and Medicaid MCO plan models, with topics covered in the commercial, Medicare, and Medicaid sections including demographic data, utilization measures, financial metrics, and retail prescription spending and out-of-pocket drug costs.

MCOL | HealthQuest Publishers
Resources available from this organization include:

Managed Care Fact Sheets
http://www.mcol.com/
Fact sheets section provides a statistical overview of key aspects of this industry, with topics covered in this section including enrollment and penetration by provider type, top national plans by enrollment, key performance measures, healthcare cost components, premium increase trends, tax-advantaged health savings and spending accounts, and Medicare Advantage and Part D prescription drug plans.

Managed Care Training Manual
https://healthexecstore.com/
E-learning application provides an introductory overview of various aspects of the business including structure, financing, delivery systems, care management, and legal and regulatory environment, and also features an advanced topics section which addresses premiums and benefits, financial metrics, data and analytics, care management, and provider and consumer issues on a more detailed basis.

National Leadership Directory
https://healthexecstore.com/
Annual publication provides information on over 1,000 managed care organizations, including health plans, provider networks, pharmacy benefits managers, administrative organizations, and specialty organizations, with information provided for each organization including contact information, parent company, company type, and executive and management personnel by name, job function, and title.

BizMiner Market Analysis Reports
HMOs / Health & Medical Insurance Providers
https://www.bizminer.com  Search for "524114" to see available reports

Market analysis reports provide industry statistics for a user-defined area on a national, state, county, metro area, or zip code level, with data provided including number of companies, market volume and sales trends, average company sales, sales per employee, staffing and employment trends, average employee wage, and business start up activity and failure rates. Sample report can be viewed online.

Financial Statements and Financial Ratios

https://www.bizminer.com  Search for "524114" to see available reports

• Income and expenses in dollars and percentages
• Balance sheets in dollars and percentages
• Profitability and return on investment ratios
• Liquidity and working capital ratios
• Asset turnover and efficiency ratios
• Capital structure and debt service ratios

(see links for individual reports)  (sample spreadsheet)

Key statistics section of these reports provides detailed income statements and balance sheets on a common-size basis and over twenty-five industry financial ratios, with financial ratios provided for the each of the four most recent calendar years and on a historical average basis for 3-year, 5-year, and 10-year time periods. Sample spreadsheet with breakdowns by asset size can be viewed free online.

Compensation and Salary Surveys

Culpepper and Associates, Inc.
Healthcare Compensation Survey
https://www.culpepper.com/

Online subscription service provides compensation data for executive, operations, and administrative personnel employed by hospitals, insurance companies, and other organizations provided healthcare services, with job classifications covered for health insurance plan providers including top executives, plan operations and underwriting, service operations and claims, and quality and utilization personnel.

PayScale, Inc.
HMO / PPO / Managed Care Providers
https://www.payscale.com/

Free online service provides median salary, bonus, and hourly wage rate data for job positions in this sector such as managed care manager, case manager, care coordinator, registered nurse, licensed practical nurse, and social worker, with employers for which compensation data is provided including Molina Healthcare, Inc., UnitedHealth Group, Inc., Centene Corporation, and Kaiser Permanente, Inc.

U.S. Bureau of Labor Statistics
Health & Medical Insurance Carriers
https://www.bls.gov/oes/

Annual employment and wage survey provides hourly and annual wage data for personnel employed by health insurance companies on a national, state, and metropolitan area basis, with managed care providers such as health maintenance organizations (HMOs) that provide health insurance coverage without providing medical care services included in the survey. All information is available free online.

BV Guides and Databases

BVMarketData
Private Company Sales Transaction Databases
https://www.bvresources.com/

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