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MCIC Press Release

For more info, contact MCIC:
Phone: (732) 292-1100
Fax: (732) 292-1111
Email: info@themcic.com

Hot Off The Press

Study Finds More PPOs Than HMOs Regionally

Manasquan, N.J. -- HMOs nationwide outnumbered PPOs by about 3 percent in 2001, and specialty HMOs outnumbered specialty PPOs in some areas by margins of 3- and 2-to-1, according to a study by the Managed Care Information Center.

Yet in some regions the total number of specialty and non-specialty PPOs outnumbered their HMO counterparts by as much as 10 percent, researchers found.

The findings support predictions early in the year that PPOs would gain in popularity over HMOs, especially as some HMOs quit unprofitable markets.

Nationwide, HMOs and specialty HMOs totaled 1,003, while PPOs and specialty PPOs totaled 974, a difference of 2.89 percent. There were 791 non-specialty HMOs compared to 787 non-specialty PPOs, and 212 specialty HMOs compared to 187 specialty PPOs.

Specialty HMOs accounted for 21.14 percent of all HMOs, while specialty PPOs accounted for 19.2 percent of all PPOs.

Regionally, PPOs outnumbered HMOs in four of seven regions nationwide — Mid-Atlantic, Mountain, New England and North Central. Two regions, Pacific and South Central, had more HMOs than PPOs. One region, the South Atlantic, had the same number of PPOs and HMOs.

The North Central section, which includes Iowa, Michigan, Ohio and South Dakota, contained the most PPOs, 254 (26.08 percent) and the most HMOs, 252 (25.12 percent).

PPOs and HMOs by Region

(Includes Specialty HMOs and PPOs)

Region

Total PPOs

Total HMOs

Difference

Mid-Atlantic

129

115

10.85%

More PPOs

Mountain

105

98

6.67%

More PPOs

New England

50

46

8%

More PPOs

North Central

254

252

0.79%

More PPOs

Pacific

127

142

10.56%

More HMOs

South Atlantic

144

144

No Difference

South Central

165

206

19.9%

More HMOs

TOTALS

974

1,003

2.89%

More HMOs

Source: The National Directory of Managed Care Organizations, Third Edition, 2001.

* Note: Mid-Atlantic: New Jersey, New York, Pennsylvania.

Mountain: Arizona, Colorado, Idaho, Montana, New Mexico, Nevada, Utah, Wyoming.

New England: Connecticut, Maine, Massachusetts, New Hampshire, Vermont.

North Central: Iowa, Illinois, Indiana, Kansas, Michigan, Minnesota, Missouri, North Dakota, Nebraska, Ohio, South Dakota, Wisconsin.

Pacific: Alaska, California, Hawaii, Oregon, Washington.

South Atlantic: Delaware, District of Columbia, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia.

South Central: Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma, Tennessee, Texas.

The South Central region, which includes Arkansas, Texas and Kentucky, had the second highest number of PPOs, 165 (16.94 percent), and the second highest number of HMOs, 204 (20.34 percent). HMOs in the South Central region outnumbered PPOs by 19.90 percent.

New England had the fewest PPOs, 50 (5.13 percent), and the fewest HMOs, 46 (4.59 percent).

More Non-Specialty PPOs

Four regions had more non-specialty PPOs than non-specialty HMOs. These were:

* Pacific — 97 PPOs, compared to 83 HMOs, a difference of 14.43 percent;

* Mountain — 82 PPOs, compared to 72 HMOs, a difference of 12.2 percent;

* South Atlantic — 128 PPOs, compared to 120 HMOs, a difference of 6.25 percent; and

* New England — 44 PPOs, compared to 42 HMOs, a difference of 4.55 percent.

The South Central region had 168 HMOs, compared to 142 PPOs, a difference of 15.48 percent, while the North Central region had 210 HMOs, compared to 198 PPOs, a difference of 5.7 percent.

The Mid-Atlantic region had the same number of PPOs and HMOs, 96.

More Specialty HMOs

Four regions had more specialty HMOs than specialty PPOs. These were:

* Pacific — 59 specialty HMOs, compared to 30 specialty PPOs, a difference of 49.15 percent;

* South Central — 38 specialty HMOs, compared to 23 specialty PPOs, a difference of 39.47 percent;

* South Atlantic — 24 specialty HMOs, compared to 16 specialty PPOs, a difference of 33.33 percent; and

* Mountain — 26 specialty HMOs, compared to 23 specialty PPOs, a difference of 11.54 percent.

Three regions had more specialty PPOs than specialty HMOs:

* North Central — 56 specialty PPOs, compared to 42 specialty HMOs, a difference of 25 percent;

* Mid-Atlantic — 33 specialty PPOs, compared to 19 specialty HMOs, a difference of 42.42 percent; and

* New England — six specialty PPOs, compared to four specialty HMOs, a difference of 33.33 percent.

Most PPOs in Texas, Pennsylvania

The states with the most PPOs, specialty and non-specialty combined, were Pennsylvania (68), Texas (64) and Ohio (51).

The states with the most non-specialty PPOs were California (55), Pennsylvania (53) and Texas (52).

The states with the most specialty PPOs were California (23), Illinois (16) and Pennsylvania (15).

As for HMOs, the states with the most HMOs, specialty and non-specialty combined, were California (104), Texas (82) and New York (59).

The states with the most specialty HMOs were California (51), Texas (22) and Arizona (11).

The states with the most non-specialty HMOs were Texas (62), California (53) and New York (49).

Address: The Managed Care Information Center, 1913 Atlantic Ave., Suite F4, Manasquan, NJ 08736; (888) 843-6242, www.themcic.com.


For more information contact The Managed Care Information Center, 1913 Atlantic Avenue, Suite F4, Manasquan, NJ, 08736, toll-free telephone 1-888-THE-MCIC (1-888-843-6242), fax 1-888-FAX-MCIC (1-888-329-6242), e-mail info@themcic.com or online at http://www.themcic.com.

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