It has happened to almost three million people in New York City, one third of those in Los Angeles and almost two thirds of those in Portland, Oregon. No, it's not another Godzilla movie, or the attack of the 50 foot woman, but Health Maintenance Organizations (HMOs) gobbling up enrollees faster than most studies can track them.
The figures are even more substantial when you look at the job force. Some areas of the U.S report as many as 80 percent of employees covered by managed care. The most recent figures (that are already two years old) show HMOs growing at an incredible rate. Between 1993 and 1994, many HMOs saw increases as great as 35 percent.
The largest preferred provider organization (PPO), Multiplan in New York City, boasts 6,521,739 eligible employees. The runner up, AFFORDABLE Medical Networks, covers almost four million employees.
The largest specialty PPO, Medco Behavioral Care Corp., covers 14,175,000 health care lives. The largest chiropractic PPO, American Chiropractic Network (ACN), has 5,217,391 enrollees, with Preferred Chiropractic Care (PCC) not far behind.
The largest U.S. managed care firm is Blue Cross and Blue Shield with a total enrollment of 8,118,412. Kaiser Foundation Health Plans come in second with 6,665,717 enrollees.
The largest utilization management company is Intracorp. In 1993 they reviewed a total of 618,103 cases out of a total population of 26,422,822 covered lives.
All of this information is a bit startling, considering the U.S. population is about 250,000,000. More importantly, the influence of managed care organizations in your own community is probably quite substantial.
What percentage of your patients today are enrolled in some type of managed care organization? How does that compare with five years ago? What do you expect the situation to be in the year 2000?
Reference: Managed Healthcare, Dec. 1995.
