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Type | Public |
---|---|
NYSE: UAM | |
Industry | Health Insurance |
Headquarters | White Plains, New York |
Website | universalamerican |
Universal American is a Fortune 500 [2] company with offices throughout the United States, and headquarters in Rye Brook, New York. The company offered health insurance, and also deals in Medicare managed care plans, and Medicare prescription drug benefits. Its CEO is Richard A. Barasch.
The company was incorporated as a stock health insurance company on September 22, 1945, under the name American Progressive Health Insurance Company of New York. [3] In 1991, Richard Barasch was elected to chairman of the board and chief executive officer.
In 1998 Universal American Financial Corporation (Universal American) agreed to a Share Purchase Agreement with Capital Z Financial Services, a NYC based Private Equity Firm. Capital Z acquired approximately a 59.7% controlling interest in the company for approximately $81 million. [4]
The company, then known as American Exchange, utilized the proceeds from the Capital Z transaction to acquire various subsidiaries of the former PennCorp Financial Group, Inc: Pennsylvania Life Insurance Company (“PLIC”), Constitution Life Insurance Company, Union Bankers Insurance Company, Marquette National Life Insurance Company, PennCorp Life Insurance Company (Canada), and Peninsular Life Insurance Company. [3]
In 2007, Universal American acquired MemberHealth, LLC a privately held pharmacy benefit manager and sponsor of Community Care Rx, a national Medicare Part D plan with more than 1.1 million members. [5] In conjunction with the acquisition, Universal American Financial Corporation changed its name to Universal American Corporation (UAM) in December 2017 [6] and listed on the New York Stock Exchange. [6] CEO Richard Barasch remarked: "“We are delighted to be making the move to the Big Board. As our business grows and diversifies, especially following the completion of our recent merger with MemberHealth, raising Universal American's visibility among the population we serve and in the financial markets becomes increasingly more important. We are proud of the performance we’ve delivered to shareholders and view our listing on the Exchange as an important milestone in the evolution of our company.” [6]
In 2011, CVS Caremark acquired Universal American's Medicare Part D business for $1.25 billion. At the time, Universal American's Part D business served about 1.9 million members, more than doubling CVS Caremark's members to a combined 3.1 million. Per Lofberg, president of Caremark Pharmacy Services, said the deal further highlights the company's position as "a significant player in one of the nation's fastest-growing segments of the Pharmacy Benefit Management industry." [7] [8]
In 2016, WellCare acquired Universal American in a deal worth an estimated $800 million. [9]
Aetna Inc. is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid insurance and benefit programs, and through Medicare. Since November 28, 2018, the company has been a subsidiary of CVS Health.
CVS Pharmacy, Inc. is an American retail corporation. A subsidiary of CVS Health, it is headquartered in Woonsocket, Rhode Island. Originally named the Consumer Value Stores, it was founded in Lowell, Massachusetts in 1963.
Health Net, LLC, a subsidiary of Centene Corporation, is an American health care insurance provider. Health Net and its subsidiaries provide health plans for individuals, families, businesses and people with Medicare and Medicaid, as well as commercial, small business, and affordable care insurance.
UnitedHealth Group Incorporated is an American multinational health insurance and services company based in Minnetonka, Minnesota. Offering insurance products under UnitedHealthcare, and health care services and care delivery aided by technology and data under Optum, it is the world's eleventh-largest company by revenue and the largest health care company by revenue.
Longs Drugs is an American chain owned by parent company CVS Health with approximately 70 drugstores throughout the state of Hawaii and formerly in the Continental US.
Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. Express Scripts had 2016 revenues of $100.752 billion. Since December 20, 2018, the company has been a direct subsidiary of Bloomfield, Connecticut-based Cigna.
CVS Caremark is the pharmacy benefit management subsidiary of CVS Health, headquartered in Woonsocket, Rhode Island.
WellCare Health Plans, Inc. is an American health insurance company that provides managed care services primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug plans for members across the United States.
In the United States, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. According to the American Pharmacists Association, "PBMs are primarily responsible for developing and maintaining the formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims." PBMs operate inside of integrated healthcare systems, as part of retail pharmacies, and as part of insurance companies.
Centene Corporation is a publicly traded managed care company based in St. Louis, Missouri, which is an intermediary for government-sponsored and privately insured healthcare programs. Centene ranked No. 25 on the 2023 Fortune 500.
CVS Health Corporation is an American healthcare company that owns CVS Pharmacy, a retail pharmacy chain; CVS Caremark, a pharmacy benefits manager; and Aetna, a health insurance provider, among many other brands. The company is the world's largest healthcare company, and its headquarters are in Woonsocket, Rhode Island.
Molina Healthcare, Inc. is a managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare.
Blue Cross and Blue Shield of Alabama (BCBSAL) is a nonprofit health insurance company headquartered in Birmingham, Alabama. The company was founded in 1936, provides coverage to more than 3 million people and is a member of the Blue Cross and Blue Shield Association (BCBS). BCBSAL employs nearly 5,000 people, which includes almost 3,500 people at its corporate headquarters in Birmingham. The company also operates Cahaba Government Benefit Administrators and Cahaba Safeguard Administrators, both headquartered in Birmingham. It commands over 90 percent of the health insurance market in Alabama, a state with half a million uninsured people, one of the highest uninsured rates in the nation at 10 percent of the population.
Elevance Health, Inc. is an American health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Empire BlueCross BlueShield in New York, Anthem Blue Cross in California, Wellpoint, and Carelon. It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within its affiliated companies' health plans.
Change Healthcare is a provider of revenue and payment cycle management that connects payers, providers, and patients within the U.S. healthcare system. The name also refers to a company founded in 2007 which subsequently became part of the current conglomerate. The company operates the largest financial and administrative information exchange in the United States.
Surescripts is an American information technology company based in Arlington, Virginia that supports e-prescription, the electronic transmission of prescriptions between health care organizations and pharmacies, as well as general health information exchange (HIE) of medical records.
Specialty pharmacy refers to distribution channels designed to handle specialty drugs — pharmaceutical therapies that are either high cost, high complexity and/or high touch. High touch refers to higher degree of complexity in terms of distribution, administration, or patient management which drives up the cost of the drugs. In the early years specialty pharmacy providers attached "high-touch services to their overall price tags" arguing that patients who receive specialty pharmaceuticals "need high levels of ancillary and follow-up care to ensure that the drug spend is not wasted on them." An example of a specialty drug that would only be available through specialty pharmacy is interferon beta-1a (Avonex), a treatment for MS that requires a refrigerated chain of distribution and costs $17,000 a year. Some specialty pharmacies deal in pharmaceuticals that treat complex or rare chronic conditions such as cancer, rheumatoid arthritis, hemophilia, H.I.V. psoriasis, inflammatory bowel disease (IBD) or Hepatitis C. "Specialty pharmacies are seen as a reliable distribution channel for expensive drugs, offering patients convenience and lower costs while maximizing insurance reimbursements from those companies that cover the drug. Patients typically pay the same co-payments whether or not their insurers cover the drug." As the market demanded specialization in drug distribution and clinical management of complex therapies, specialized pharma (SP) evolved. Specialty pharmacies may handle therapies that are biologics, and are injectable or infused. By 2008 the pharmacy benefit management dominated the specialty pharmacies market having acquired smaller specialty pharmacies. PBMs administer specialty pharmacies in their network and can "negotiate better prices and frequently offer a complete menu of specialty pharmaceuticals and related services to serve as an attractive 'one-stop shop' for health plans and employers."
Optum, Inc. is an American healthcare services provider with business interests encompassing technology and related services, pharmacy care services and various direct healthcare services. It has been a subsidiary of UnitedHealth Group since 2011. UHG formed Optum by merging its existing pharmacy and care delivery services into the single Optum brand, comprising three main businesses: OptumHealth, OptumInsight and OptumRx. In 2017, Optum accounted for 44 percent of UnitedHealth Group's profits and as of 2019, Optum's revenues have surpassed $100 billion. Also in early 2019, Optum gained significant media attention regarding a trade secrets lawsuit that the company filed against former executive David William Smith, after Smith left Optum to join Haven, the joint healthcare venture of Amazon, JPMorgan Chase, and Berkshire Hathaway.
PillPack, Inc. is an American online pharmacy which is a subsidiary of Amazon.com. It is based in Manchester, New Hampshire, United States. The company was founded in 2013.