InterStudy Publications

http://www.interstudypublications.com

A. Dr. Paul Ellwood founded InterStudy Publications in 1971. The organization was involved in drafting the original HMO act of 1973 and has played important roles in the development of Medicare Risk contracting, techniques for outcomes and quality management, and the emergence of managed competition as a platform for purchasing health care. For over 30 years InterStudy has been surveying the HMO industry and therefore is considered the first choice for reliable HMO market intelligence. Q. Who are your clients? A. Over 3,000 clients use InterStudy products worldwide. Our customers include such organizations as - Cigna, Kaiser Permanente, PacifiCare, Mayo Clinic, Group Health Inc., Blue Cross & Blue Shield, CMS (formally HCFA) , Merrill Lynch, Donaldson, Credit Suisse First Boston, UBS Warburg, Milliman & Robertson, Deloitte & Touche, Deloitte Consulting, Ernst & Young, Cap Gemini, PriceWaterhouseCoopers, Accenture, McKinsey & Company, Hewitt & Associates, Pfizer, Merck, Wyeth-Ayerst, GlaxoSmithKline, Sanofi-Synthelabo, UltraLink, American Medical Association, Association of American Medical Colleges, Yale University, Wharton School, Harvard School of Public Health, Stanford University and University of Minnesota. Q. Where does InterStudy get its HMO data? A. InterStudy Publications conducts primary survey research, surveying all full-service HMOs twice each year. The survey instrument, known as the InterStudy National HMO Census, collects data on key personnel, enrollment by product type, plan name and address, provider contract information, and many other topics. Our data points are January 1 and July 1 of any given year. Some InterStudy publications also use data from outside sources, such as the American Medical Association (AMA), the American Hospital Association (AHA), or the Health Care Financing Administration (HCFA). Q. What is the response rate for the InterStudy National HMO and PPO Censuses? A. InterStudy's response rates are around 90% or higher for HMOs and 80% or better for PPOs. Q. How does InterStudy address HMOs that do not return their surveys? A. If an HMO does not return their National HMO Census, we generally use enrollment information obtained from state Departments of Insurance. If we are unable to obtain state filing data, we use previously reported enrollment numbers. In either case, we always provide notation if the source is different from current National HMO Census. Q. Does InterStudy have historical data? A.Yes, InterStudy has been collecting HMO data for over 20 years and has a great deal of historical data that can help produce trends. Please contact us at 1-800-844-3351or email our sales department at sales@interstudypublications.com for specific details on historical data, including pricing information. Q. Why are the enrollment numbers published by InterStudy sometimes different from data filed with state Departments of Insurance? A. First, InterStudy collects data as of July 1 or January 1. State filing data is produced at the end of each quarter, making the closest dates June 30 and December 31. Some contracts, such as Medicare, may end on the last day of the month and an HMO may no longer be offering that product at the beginning of the next month, sometimes producing very significant differences in the number of enrollees. Second, InterStudy breaks enrollment into more categories than are generally asked for by State Departments of Insurance. Point-of-Service enrollment (also known as open-ended enrollment) is often not categorized, meaning some HMOs may not report this enrollment to state Departments of Insurance. Q. What is the difference between The Competitive Edge: Part III- Regional Market Analysis and the MSA Profiler? A. The Regional Market Analysis provides the names of HMOs that operate in any given MSA and the aggregated penetration and enrollment by MSA. The MSA Profiler provides HMO enrollment and individual HMO market share data at the MSA level. Q. Does InterStudy have any PPO data? A.Yes, InterStudy conducts an annual National PPO Census. We have highly accurate and comprehensive PPO data available on covered lives, physician networks, and employer contracts among other things.

• 12/8/2013
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