Molina Healthcare Inc (MOH) |
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Molina Healthcare Inc 's Comment on Competitors and Industry Peers
The Medicaid managed care industry is fragmented, and the competitive landscape
is subject to ongoing changes as a result of health care reform, business consolidations
and new strategic alliances. We compete with a large number of national, regional,
and local Medicaid service providers, principally on the basis of size, location,
quality of provider network, quality of service, and reputation. Our primary
competitors in the Medicaid managed care industry include Centene Corporation,
WellCare Health Plans, Inc., UnitedHealth Group Incorporated, Anthem, Inc.,
and Aetna Inc. Competition can vary considerably from state to state. Below
is a general description of our principal competitors for state contracts, members,
and providers:
Multi-Product Managed Care Organizations - National and regional managed care
organizations that have Medicaid members in addition to numerous commercial
health plan and Medicare members.
Medicaid HMOs - National and regional managed care organizations that focus
principally on providing health care services to Medicaid beneficiaries, many
of which operate in only one city or state.
Prepaid Health Plans - Health plans that provide less comprehensive services
on an at-risk basis or that provide benefit packages on a non-risk basis.
Primary Care Case Management Programs - Programs established by the states through
contracts with primary care providers to provide primary care services to Medicaid
beneficiaries, as well as to provide limited oversight of other services.
We will continue to face varying levels of competition. Health care reform proposals
may cause organizations to enter or exit the market for government sponsored
health programs. However, the licensing requirements and bidding and contracting
procedures in some states may present partial barriers to entry into our industry.
We compete for government contracts, renewals of those government contracts,
members, and providers. State agencies consider many factors in awarding contracts
to health plans. Among such factors are the health plan’s provider network,
medical management, degree of member satisfaction, timeliness of claims payment,
and financial resources. Potential members typically choose a health plan based
on a specific provider being a part of the network, the quality of care and
services available, accessibility of services, and reputation or name recognition
of the health plan. We believe factors that providers consider in deciding whether
to contract with a health plan include potential member volume, payment methods,
timeliness and accuracy of claims payment, and administrative service capabilities.
Molina Medicaid Solutions competes with large MMIS vendors, such as HP Enterprise
Services, ACS (owned by Xerox Corporation), Computer Services Corporation, and
CNSI.
Overall company Market Share Q4 2023 |
*Market share is calculated based on total revenue.
News about Molina Healthcare Inc Contracts |
Molina Healthcare, Inc. (NYSE: MOH) recently announced that its subsidiary, Molina Healthcare of Virginia, has not been selected as an awardee in the Commonwealth of Virginia's Cardinal Care Managed Care program. This news comes as a setback for the company, which currently serves approximately 140,000 members in the state. In this article, we will delve into the implications of this decision and compare Molina Healthcare's recent performance with that of its competitors.Molina Healthcare's Virginia Cardinal Care Contract UpdateMolina Healthcare of Virginia's current contract is expected to continue until the summer of 2024. However, the non-renewal of the contract in the Cardinal Care program poses challeng...
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Who are Molina Healthcare Inc 's Competitors?
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