Health Net, Inc. Health Plans Positioned for Profitable Growth PowerPoint PPT Presentation

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Title: Health Net, Inc. Health Plans Positioned for Profitable Growth


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Health Net, Inc. Health PlansPositioned for
Profitable Growth
  • Solid Operating Performance in 2000 and Entering
    2001
  • New Products Introduced in 2000 and More Planned
    for 2001
  • Diligent Focus on Pricing Discipline and
    Product/Market Profitability

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2001 Operating PerformanceHealth Plans Division
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Drivers of Membership Growth
  • Diversify the Product Portfolio
  • Diversify Market Segments
  • Explore Niche Products
  • Provide Flexible Benefits Designs to Meet the
    Consumer at the Price They Want to Pay
  • Expand Choice Access
  • Price Ahead of Cost Trends

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Membership Results By Line of Business
Membership Growth Between Q1 2000 and Q1 2001
Excludes Florida, Washington and Colorado
Medicare Supp is in Medicare
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Membership ResultsBy Product
Commercial Membership Growth Between Q1 2000
and Q1 2001
Excludes Florida, Washington and Colorado
Medicare Supp is in Medicare
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Membership ResultsBy Market Segment
Commercial Membership Growth Between Q1 2000
and Q1 2001
Excludes Florida, Washington and Colorado
Medicare Supp is in Medicare
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Successfully Managing The Shift in Risk
  • Pricing That Reflects Medical Cost Trends
  • Claims Processing Under Control
  • Claims Volume Increased 25 from 1999 to 2000 and
    Projected to Increase 27 in 2001
  • Successfully Managing Inventory - Days Work on
    Hand Consistently Under 5 Days
  • Increased Staff 25 Over Past 12 Months
  • Expanded Outsourced Adjudication Capabilities
  • Implemented Technology Enhancements - EDI,
    Auto-Adjudication

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Successfully Managing The Shift in Risk (Cont)
  • Enhanced Medical Management Capabilities
  • Adding Staff
  • Focus on High Risk Physician Groups
  • Improved Reporting
  • Keeping Providers in Risk Arrangements Where
    Feasible

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Health Net, Inc. Health PlansPositioned for
Profitable Growth
  • Solid Operating Performance in 2000 and Entering
    2001
  • New Products Introduced in 2000 and More Planned
    for 2001
  • Diligent Focus on Pricing Discipline and
    Product/Market Profitability

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Product Strategy Will Deliver Diversified Growth
  • Product At Every Price Point - Meet the Customer
    Where They Want To Be
  • Diversification
  • Choice Products
  • Niche Markets
  • New Customer Segments
  • Affinity Marketing
  • Benefit Designs That Maintain Affordability
  • Profitable Growth
  • Pricing Ahead of Cost Trends
  • Medicare Changes

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Offering More Choice ProductsPPO Strategy - West
  • California PPO Projected to Grow to 100,000
    Members
  • Initial Focus on Individual and Small Group
  • Competitive Pricing and Benefit Design
  • Strong Alternative to Market Leader
  • Product Well Received By Brokers and Consultants

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Offering More Choice ProductsPPO Strategy -
Northeast
  • July 1, 2001 Product Effective Date
  • Over 70 Plan Designs Will Be Introduced
  • Product Flexibility Allows For All Combinations
    of Plan Design
  • Focus on Middle Market (50 to 1,500 Lives) Where
    Margins Are Strong
  • Products Will Appeal to Price Sensitive Segment
  • National Network Access - Leveraging Provider
    Relationships of Sister Plans
  • Collaborating With West on National Opportunities

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Maintaining AffordabilityCopay Strategy
  • New Copays Copay Increases Across All Services
  • Inpatient and Outpatient Surgery Copay
  • Emergency Room Copay
  • Option to Increase Physician Visit Copay
  • Maintains Product Affordability Through Cost
    Sharing
  • Expect Price Savings From 3 to 7
  • Should Stem Shift to Self-Insurance
  • Recent Study(1) Shows More Than Half of Employers
    Will Increase Cost Sharing In Response to Rising
    Costs

(1) Watson Wyatt, Changing Role of Health
Benefits, 2001
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Product Focus in 2002
  • National Accounts
  • Operations Aligned Across Health Plans
  • Internet Capabilities
  • ASO and PPO
  • National Practice Leaders for National Accounts
    and Labor Trust
  • Continued Growth in PPO Membership
  • Products at all Price Points
  • Significant Win in Large Group Segment
  • Niche Products
  • Operations Enhancements

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Health Net, Inc. Health PlansPositioned for
Profitable Growth
  • Solid Operating Performance in 2000 and Entering
    2001
  • New Products Introduced in 2000 and More Planned
    for 2001
  • Diligent Focus on Pricing Discipline and
    Product/Market Profitability

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CalPERS
  • Proposal Accepted - Maintains Key Account for
    Health Net of California (200,000 Members)
  • CalPERS Increased Copays on All Plans, Shaving
    143 Million Off Original HMO Bids
  • 13 Rate Increase in Line With Medical Costs
  • Benefit Buy-down Reduces Premium Rate Increase to
    7.4 With Same Margin Results
  • Gave the Least Credit Moving to the Low Option
    Plan Compared to 3 Largest HMOs

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CalPERS (Cont)
  • Five County Exit Will Improve Account
    Profitability - Impacts 21,000 CalPERS Members
  • Enrollment Frozen for 2002
  • EPO Approach Will Retain Provider Relationships
    For Our Other Members in the Five County Area
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