Wellpoint Incorporated And Now Anthem

The home health industry is highly fragmented. In fact, only 5% of home health care providers generate over $5 million in Medicare revenue (Harris Williams and Company, 2015). Amedisys’ economies of scale undoubtedly helps ensure operational efficiency, which will assist with maintaining long-term profitability. In addition, their relatively large employee population enables Amedisys to offer employees competitive wages and full benefits. This assists with attracting and retaining top talent.

“UnitedHealthcare provides network-based health care benefits for a full spectrum of customers in the health benefits market” such as students and individuals; sole proprietorships to multi-site, large national employers; promotion of health benefits to Medicare retirees and beneficiaries; and provides Medicaid and community programs (UnitedHealthcare, 2010). UnitedHealth Group 2012 revenue was $11.3 billion. The company is continuously growing through various mergers and acquisitions within the US and Europe, increasing members and revenues (Keepournhspublic, n. d.).

RECOMMENDATION  There is “an inherent conflict between best care and financial performance”. The CEO states that “Finances are not, and never have been, our primary concern.” However, the business must address its decreasing profitability to be able to continue to survive. This will become even more urgent if the reduced government spending that the CEO foresees happens.  The organizational culture is high quality care, high-performance and non-profit which must be taken into account in any solution. The healthcare business has a clear focus and is very successful at continually improving its patient care and processes.  While clinical performance improvements have resulted in revenue losses for the Intermountain healthcare business the Intermountain health plan, SelectHealth, and other health plans that buy Intermountain health care services have benefitted. Intermountain needs to translate these benefits into additional profits to support its main business, healthcare.   Its skill at providing this care should translate into significant market advantage for SelectHealth and for Intermountain when selling

Physicians were looking for assistance with HMO and PPO insurance companies and rising healthcare cost and PhyCor, Inc. was there to provide the administrative management. PhyCor, Inc. is considered a physician practice management firm, or PPM, that bought out other management firms to become one of the largest firm due to their ability to negotiate managed care contracts. What attracted physicians to PPMs was their ability to “lower cost and increase revenues” (Burns, L.R., Bradley, E.H., & Weiner, B.J., 2011). PhyCor, Inc. was able to merge large physician groups and specialty clinics creating revenue in the millions, and continued to grow. They grew for several years before the values in stock starting falling, unsatisfied physicians, and

Shortly after that in 1995, United HealthCare attained the MetraHealth Companies Inc. for $1.65 billion. During 1998, the company undertook a momentous realignment of its operations into six independent, yet strategically linked businesses. Each of the companies were dedicated to meeting the health and well-being needs of a distinctive market segment. To accurately reflect the breadth and structure of this new company, the corporate organization, United HealthCare Corporation, was renamed UnitedHealth

As a managed care organization Kaiser Permanente has served as a model for informational healthcare systems and the recent demand for affordable care has prompted the organization to lower cost in services without hindering the quality of care. Kaiser Permanente has integrated a system in which the organization assumes all financial risk and a bundled enrollment fee for service strategy. What makes Kaiser Permanente unique from other HMOs is their accountability for quality, utilization management, financial risk, and business strategies (Kaiser Permanente, 2009).

(MCOs) operating. The hospital group is the state’s largest not-for-profit organization and boasts an impressive performance plan, serving the healthcare needs of approximately 8 million citizens in Virginia. Moreover, Chesapeake Health Plans was the first organization to successfully attempt to request and obtain the highest level of accreditation from the National Committee of Quality Assurance (NCQA). Furthermore, Chesapeake health plans are structured to provide medical plans that cover services under the HMO’s, PPO’s, POS, and Medicare HMO’s. Chesapeake health plans attributes a considerable portion of their net service revenue generated to their effective HMO health plans, which realized a 46% of total revenue, while their Medicare HMO produced an impressive 39% of total revenue. Furthermore, their Preferred Provider Plan (PPO) generated 10%, and the Point of Service Plan (POS) saw a 5% figure. This case study financial analysis will effectively assess Chesapeake Health Plans: HMO financial performance, focusing on a competitive analysis, a cash flow analysis, clear profitability ratios, liquidity ratios, debt management ratios, asset management ratios, operating indicator analysis, a comprehensive financial assessment of Chesapeake’s financial state, as well as effective fiscal recommendations for their organization.

Many people are concerned about rising health care costs. In reaction to this, some individuals and companies are gravitating toward the assumed lower prices of Health Maintenance Organization (HMO) health plans. HMOs spend billions of dollars each year advertising their low cost services. While these savings look good on paper, there are many pages of small print. The explanation after the asterisk indicates that not only do the HMOs lack lower costs, but they also short-change the patient in quality care. Much of the money spent on premiums goes directly into the pockets of stockholders and less is then available for

Anthem Inc. is one of the largest health benefits company in this country. The merging of WellPoint Inc. and Anthem Inc. in 2004 was the start to this healthcare company. Anthem Inc. is a part of the Blue Cross and Blue Shield Association. They serve people primarily in 14 different states (“Company History, n.d.). At that point in time, it was the largest healthcare security breach in our history (Weise 2015). During 2015 in the month of February, Anthem Inc. announced to the public that it had suffered an attack that affected 78.8 million individuals. The Breach began around February 18, 2014 and was eventually discovered in late January 2015 leading to the announcement early February 2015. It was also concluded that the perpetrator of

IntroductionLinda Best, a Certified Financial Planner (CFP) from Sarnia, Canada is the founder and sole shareholder of Best Financial Services Inc. which was established on January 1, 2001. Sarnia, the largest city in South Ontario, bordered the United States and was heavily populated with aging baby boomers and blue-collar workers. Best Financial earned its revenues mainly from blue-collar workers nearing retirement. Best financial had formed strong relationships with many clients throughout Sarnia and managed over 1000 financial plans allowing a steady revenue and profit growth. The key services provided by Best Financial are risk management, tax preparation and professional money management. The company’s Assets under Management were

Anthem Inc, a leading health insurance company that provides health insurance for personal, business and government entities across the States. Anthem is a prosperous company, ranking within the Fortune 50 list, with total assets equaling $61.7 Billion. They have over 52,000 associates to serve over 39.8 million members. The company has presence in 14 States and continues to offer its services in growing markets (“Stats and Facts”).

Phycor’s goal was to become the best physician practice management company in the United States (Burns, Bradley, & Weiner, 2011). Their strategy was to have clinics all around the U.S. and they were going to do that by offering multiple physician offices across the nation (Burns, et. al., 2011). Initially, Phycor wanted to provide a wide variety of services to the people. Phycor’s business model was basically to provide services that included disease management, reduction to expenses, and providing work to non-physician employees. They figured that if they provided these services then they would have the potential to become successful. However, the company’s success lasted up until the late 90s. Around 1997, Phycor disclosed that there was

UnitedHealth Group continues to enjoy steady progress across its major business units. Over the past two years United has worked to strengthen and accelerate its investments in its core health insurance and health services (Optum) units. This disciplined approach has resulted in both top-line and bottom-line growth growth for the organization on a year-over-year basis, with primary growth coming from the senior and public sectors, as well as from strong results in Optum. Membership for the third quarter was unchanged sequentially from 2Q14 with medical membership holding steady at 44.9 million members.

The Remax Company’s target market is People in the middle classes who buy and sell houses. Specifically, the target market for Remax include local owners (existing owners), and investors (unions, real estate investment trusts, and pension plans).

Hospitals and health systems in the U.S. are experiencing a remarkable transformation in their business models directed from numerous influences that are projected to ultimately turn the industry around. Pressures include providers troubled with the quantity of services they are responsible for, to providers who concentrate on presenting high-cost services that give emphasis to sustaining healthy populations (Dunn & Becker, 2013).