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Santa Ana-based PacifiCare Health Systems Inc. has taken sort of a back-door approach to selling its Secure Horizons (Medicare) package in states where it previously couldn't go.
Until recently, managed care groups fell under what's called the 50/50 rule, meaning they could only sell Medicare plans in areas where they already offered traditional commercial plans.
But under the 1997 Balanced Budget Act, PacifiCare is now able to team up with provider-sponsored organizations and other HMOs to sell its Secure Horizons package.
According to Brad Bowlus, president and CEO of Cypress-based PacifiCare of California, the Secure Horizons package is going gangbusters in Southern California, with a projected growth of 8% in the region this year. PacifiCare, whose Secure Horizons package is the largest managed care-backed Medicare program in the U.S. with one million members, is hoping for similar growth throughout the nation.
"The landscape will change dramatically, almost overnight, because the federal statutes that required an HMO to have as many Medicare members as it has commercial members goes away in 1999," said Craig S. Schub, who will head the Secure Horizons program. * * *
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