Medicare Lives By Plan

Medicare has been a big area of focus for a lot of plans and subsequently for a lot of PBMs who manage the PDP plans.  The biggest area of discussion is around the STAR Ratings.  And, that’s important because if you look at data from the WilsonRx reports there is certainly a correlation between PBM satisfaction and health plan satisfaction. 

So, the question is who has the Medicare lives today and who are the big winners YTD (source – CMS and Citi Investment Research and Analysis – summarized by Carl McDonald and team at Citi):

For a detailed breakout of PDP lives and the huge win by Humana going into 2011, I would suggest reading Adam Fein’s post from a few months ago on DrugChannels. 

And…if you haven’t been following it, it looks like Medicaid is the green field that everyone is eyeing.  The savings from managed Medicaid are getting discussed in multiple states especially around pharmacy.  I just had a call today where the executive predicted that managed Medicaid would be the feather that finally broke the back to get limited networks more traction (interesting!).