1 jerry vaccaro, m.d. svp, specialty health businesses.…a health and consumer services company...

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1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses .…a health and consumer services company making people’s lives better

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Page 1: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

1

Jerry Vaccaro, M.D.SVP, Specialty Health

Businesses

.…a health and consumer services company making people’s lives better

Page 2: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

2

Specialty Companies

• Best in Class Margins

• Best in Class Care and Service

• Steady Growth and Profitability

Page 3: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

PacifiCare Behavioral HealthCompany Overview

Page 4: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

4

Downward Spending Leveling Off

• 1988 - 1998– Behavioral health spending

continuously declined, reaching a total drop of 54.7%

– As a percent of premium, behavioral health dropped from 6.2% to 3.1%

• 1998 - 1999– Behavioral health spending

experienced its lowest drop in a decade of 1.5%

– Declining trend appears to have leveled off

U.S. Annual Behavioral Health Spending per Covered Life

1988 - $154.48

1998 - $69.67

Over Spending

AppropriateSpending

Under Spending

Page 5: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

5

National Competitive Landscape

MembershipUnited13%

Cigna9%

APS5%

Value Options15%

Magellan47% Comp.

1%

Horizon1%

PBHI3%

MHN6%

RevenueUnited19%

Cigna9%

APS3%

Value Options21%

Magellan35%

Comp.1%

Horizon3%

PBHI4%

MHN5%

Page 6: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

6

CA Market Share by Revenue

Magellan12%

PBHC30%

USB17% Value

Options5%

Vista1%

Avante0%

MHN24%

Concern1%

Cigna7%

H&HR1%

Holman2%

#1 in CA

Page 7: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

7

PBH Today

• In operation since 1986

• 4.3 million members in 12 states

• NCQA accredited in Western, NW Regions

– Only fully accredited MBHO in CA

• CA Knox-Keene licensed

Page 8: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

8

Internal vs. External Membership

Internal56%

External44%

As of June 2002

Page 9: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

9

PBH DifferentiatorsALERT

Best Care

IT Infrastructure& Reporting

NCQA

Health PlanExpertise

Page 10: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

10

Product Leadership

• ALERTSM

• Best CareSM

• PBH Spectrum

• PBH Caregiver

• Taking Charge of DepressionSM

• Taking ChargeSM

Health Improvement Series

• LifeStrategies

Page 11: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

11

ALERTSM

• Groundbreaking Outcomes Management Program

• Decreases medical errors (35%, year one)

• Next generation Provider Report Cards

Page 12: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

12

Growth Strategy

• Super-Regional Company

– Market Leader in California

– Selective expansion (health plans, Labor/ Trust, other niches)

– Evaluate Acquisition Opportunities

• Take advantage of Federal Parity Legislation

– PBH risk-based experience

Page 13: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

13

Steady Growth

1996 1997 1998 1999 2000 2001 2002 (est.)

116.8

194.1 200.0

71.452.3

107.6

141.8

5040 57

17.8%

13.6%

16.4%

13.3%

13.4%15.2%13.9%

$0

$50

$100

$150

$200

$250

$300

$350

$400

$450

-2%

3%

8%

13%

18%

Total Revenue

Non-PHS Revenue

Profit Margin

Page 14: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

14

Net Income Analysis(in 000s)

1999 2000 2001

PBH Revenue 116,756$ 141,786$ 194,057$

Net Income 12,267$ 13,660$ 16,129$

Margin 10.5% 9.6% 8.3%

Magellan Revenue 1,465,918$ 1,640,933$ 1,755,512$

Net Income 4,688$ (65,808)$ 24,555$

Margin 0.3 % (4.0)% 1.4 %

Page 15: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

PacifiCare Dental & VisionCompany Overview

Page 16: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

16

Market at a Glance

• Dental penetration: 50-60% purchase dental benefits

• Vision penetration: 20-40% purchase vision benefits

• DHMO growth flat, PPO expanding

Page 17: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

17

PDV Today

• Largest California DHMO network• PacifiCare Dental penetration 13%• PacifiCare Vision penetration under 5%• Product offerings in all PacifiCare states

Page 18: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

18

Growth Strategy

• Super-Regional Company• Service Excellence: #1 in Service• Maximize penetration within PacifiCare

Page 19: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

19

Steady Growth

90.19 96.24 101.88 107.73

15.4%15.0%

9.3%

8.0%

-

50.00

100.00

150.00

200.00

250.00

300.00

350.00

1999 2000 2001 2002

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

Revenue (in millions)

PBIT % of Revenue

2002 estimate

Page 20: 1 Jerry Vaccaro, M.D. SVP, Specialty Health Businesses.…a health and consumer services company making people’s lives better

20

Total Commercial Membership & Penetration

9%8%

15%

23%

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000

900,000

1999 2000 2001 2002

0%

5%

10%

15%

20%

25%

ExternalInternalTotal Commercial Penetration

2002 estimate