CONCORD, N.H.-Although the two largest HMOs in New Hampshire combined for 80% of the managed-care market in 1995, only about 20% of the market has been penetrated, setting up a scramble between established HMOs and new competitors flocking to the state.
Underlying that relatively low HMO presence was a 25% increase in managed-care enrollment during 1995, according to a report from the New Hampshire Hospital Association.
Meanwhile, the number of major HMOs in the market grew to seven with the entry of Tufts Health Plan of Waltham, Mass., and Oxford Health Plans of Norwalk, Conn.
And although in 1995 Healthsource controlled 47% of the market and Matthew Thornton Health Plan held 34%, a recently enacted ban on exclusive HMO contracts with physicians promises to equalize access to a limited number of primary-care practices that had been signing up with those two market leaders, according to the report.
"It's clear that New Hampshire is fertile ground for managed care," said Mike Hill, president of the association.
Hill said the market analysis was conducted so hospitals could have data available when negotiating contracts and planning services. "There's no doubt the managed-care marketplace is becoming very competitive," he said.
The four major HMOs in the state earned less net income per enrollee per month from 1994 to 1995 but still remained profitable, according to the report, which relied on data filed with the state Department of Insurance.
Healthsource's monthly net income per enrollee was $12.86, far outdistancing Matthew Thornton's $4.68. The figure for U.S. Healthcare of Blue Bell, Pa., was $3.68, while Harvard Pilgrim Health Care posted $3.17, the report said.
The four plans generated $336 million in group premiums and posted net income of $22 million.
The list of managed-care players also included Blue Cross and Blue Shield of New Hampshire and its BlueChoice point-of-service plan, which held 15% of the market. Recent entrants U.S. Healthcare and Harvard Pilgrim held 3% and 1%, respectively.
Total managed-care enrollment in the state climbed to 240,000 in 1995 from 191,000 in 1994, a 26% increase.