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Managed Care Information Center  
1913 Atlantic Ave., Suite 200
Manasquan, NJ  08736
(732) 292-1100
fax: (732) 292-1111

MCIC Press Release

March 24, 2009

MCIC Study Finds HMOs Outnumber PPOs

MANASQUAN, NJ -- March 24, 2009: Health maintenance organizations (HMOs) outnumbered preferred provider organizations (PPOS) by slightly over 13 percent in 2007, according to a new study by the Managed Care Information Center (MCIC).

The study also found that specialty HMOs outnumbered specialty PPOs in some areas by margins of 3- and 2-1.

The study looked at data from the National Directory of Managed Care Organizations Database, an extensive source of managed care market statistical information.

Nationwide, HMOs and specialty HMOs totaled 879 compared to 761 PPOs and specialty PPOs, a difference of 13.42 percent. There were 655 non-specialty HMOs compared to 575 non-specialty PPOs. There also were 224 specialty HMOs compared to 186 specialty PPOs.

PPOs did not outnumber HMOs in any region.

The North Central section, which includes Iowa, Michigan, Ohio and South Dakota, contained the most PPOs, 191 and the most HMOs, 213.

The South Central region, which includes Arkansas, Texas and Kentucky, had the second highest number of PPOs, 118 and the fourth highest number of HMOs, 123.

New England had the fewest PPOs, 42 and the fewest HMOs, 46.

More Non-Speciality HMOs

Only one region had more non-specialty PPOs than HMOs, the South Central which had 95 HMOs compared to 98 PPOs. Across the board, HMOs stood out strong. The three top regions for non-specialty HMOs were: the North Central with 166 HMOs compared to 147 PPOs; the South Atlantic with 115 HMOs compared to 86 PPOs; and the Mid-Atlantic with 91 HMOs compared to 85 PPOs.

More Speciality HMOs

Only one region has more specialty PPOs than HMOs and that was the Mid-Atlantic with 29 specialty PPOs compared with 22 specialty HMOs

Five regions had more speciality HMOs than specialty PPOs. These were: Pacific: 57 specialty HMOs compared to 37 specialty PPO; South Central: 28 specialty HMOs compared to 20 specialty PPOs; South Atlantic: 34 specialty HMOs compared to 27 specialty PPOs; Mountain: 28 specialty HMOs compared to 24 specialty PPOs; and North Central: 47 specialty HMOs compared to 44 specialty PPOs.

The states with the most PPOs, specialty and non-specialty combined, were California (61), Pennsylvania (55), New York (50) and Texas (46).

The states with the most non-specialty PPOs were Pennsylvania (39), Texas (37) and California (33).

The states with the most specialty PPOs were California (28), Florida (12), Pennsylvania (11) and New Jersey (11).

As for HMOs, the states with the most specialty and non-specialty combined were California (108), New York (59), Texas (46) and states with the most specialty HMOs were California (52), Texas (19) and Florida (14).

States with the most non-speciality HMOs were California (51), New York (49) and Florida (48).

Address: The Managed Care Information Center, 1913 Atlantic Ave., Suite 200, Manasquan, NJ 08736; (732) 292-1100, www.themcic.com.