Posts Tagged "managed care"

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PBM Pricing Post-AWP – An Estimate of Sustainable Earnings Power

Using Medco (MHS) as a proxy for large PBMs, we show that generic buying margins dominate PBM gross profits; PBMs appear to have sacrificed most (or even all) alternative sources of gross margin, levering the industry’s pricing structure almost completely

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ACA at the Supreme Court – What You Should Know

This note summarizes the events leading up to the Supreme Court’s likely review of the Affordable Care Act (ACA), and attempts to handicap the timing and outcome of the review We anticipate a verdict in or around June of 2012.

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UNH 3Q is less about MLR, more about PBM

UNH plainly intended to subdue 2012 EPS expectations in their 3Q release, and the market seems to have read this through to other HMOs’ earnings prospects. We suspect this read-thru is incorrect Systematic earnings pressures for HMOs tend to take

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Why Employers Are Likely to Drop Health Insurance – A Simplified View

All else equal, employers ‘compete’ for employees with compensation packages of wage + benefits, the primary benefit typically being health coverage Logically, employers will seek to produce compensation packages of net wage and health coverage as efficiently as possible; and,

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