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Managed Care Trends: MCOs and Disease Management Companies Continue To Form Partnerships

Manasquan, N.J. -- Managed care organizations are continuing to enter into contracts with demand and disease management companies, according to Managed Care Information Center (MCIC) researchers.

The deals between MCOs and demand and disease management companies, along with other healthcare market activities, are highlighted in MCIC's twice-monthly publication Competitive Healthcare Market Reporter.

Some of the recent deals, highlighted in the publication, include:

* An agreement between Horizon Blue Cross and Blue Shield of New Jersey and CareWise Inc. for CareWise to provide telephone nurse counseling for 30,000 Medicare risk members of HMO Blue. CareWise was already serving 225,000 non-Medicare HMO Blue members;

* Horizon Blue Cross and Blue Shield of New Jersey also is offering an asthma management program to members of its HMO Blue and Medicare risk plan through AirLogix, a disease management company that focuses on chronic diseases, inlcuding asthma and chronic obstructive pulmonary disease;

* Highmark Blue Cross Blue Shield partnered with Diabetes Treatment Centers of America for a comprehensive diabetes disease management program for 1.2 million Highmark enrollees in Pittsburgh, Erie and Johnstown, Pa., and surrounding areas in the western part of the state;

* Humana Inc. signed an agreement with Accordant Health Services Inc. for Accordant to provide disease management services to Humana members with such complex chronic diseases as multiple sclerosis, myasthenia griavis, hemophilia, systemic lupus and cystic fibrosis. The program is expected to roll out in nine states over the next few months;

* Blue Cross Blue Shield of Delaware signed an agreement with Health Decisions for telephone nurse counseling. Some 85,000 members are expected to have access to the counseling by early 1999; and

* The Blue Cross and Blue Shield Federal Employee Program selected Access Health and Cardiac Solutions to provide diabetes and congestive heart failure disease management programs under a two-year pilot.

Competitive Healthcare Market Reporter monitors developments in the healthcare market with comprehensive coverage of market partnerships, acquisitions, mergers, contracts awarded, network creations and developments, new market expansions, market growth trends, new products, innovative programs and strategic plans. The newsletter also reports on the types of information systems/information technology that managed care and healthcare organizations are using, as well as trends and industry studies within the industry. In each issue of Competitive Healthcare Market Reporter, researchers at MCIC profile a managed care organization, looking at strategic direction, enrollment, percent increase or decrease in enrollment and key financial statistics, such as total revenues, total expenses, net income, revenue and expenses per member per month and assets and liabilities. The introductory price for the newsletter is $397.

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