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WIKI ANALYSIS
COMPANY OVERVIEW Magellan Health Solutions is a specialty managed healthcare company offering an array of management services to health plans, insurance companies, corporations, labor unions, and carious government entities comprising more than 62 million members. Services offered by the company fall broadly into three categories: (1) managed behavioral healthcare, which encompasses both commercial and public sector contracts, (2) radiology benefits management, and (3) specialty pharmaceutical management.
Magellan offers its services to health care payers on either an at-risk or ASO (administrative services only) arrangement. Under at-risk contracts, Magellan assumes responsibility for the cost of providing treatment services in exchange for a fixed monthly fee. Under ASO contracts, Magellan provides an array of support services on a fee-for-services basis, such as utilization review, claims administration, and provider network management, but does not assume responsibility for the actual cost of treatment. Magellan also offers employee assistance programs (EPSs) in which the company provides short-term counseling.
Segment Overview
Magellan offers its services to health care payers on either an at-risk or ASO (administrative services only) arrangement. Under at-risk contracts, Magellan assumes responsibility for the cost of providing treatment services in exchange for a fixed monthly fee. Under ASO contracts, Magellan provides an array of support services on a fee-for-services basis, such as utilization review, claims administration, and provider network management, but does not assume responsibility for the actual cost of treatment. Magellan also offers employee assistance programs (EPSs) in which the company provides short-term counseling.
Managed Behavioral Healthcare
Magellan’s managed behavioral healthcare business provides coordination and management of the delivery of behavioral healthcare treatment services that are contracted through the company’s network of third-party treatment provides, including psychiatrists, psychologists, psychiatric hospitals, and residential treatment centers. With the exception of 24 facilities obtained through the company’s contact with the Maricopa County Behavioral Health Authority, which are in the process of being divested, Magellan does not own or operate treatment facilities, but rather contracts with behavioral health providers at favorable reimbursement rates.
Magellan provides managed behavioral healthcare service to the customers, through the following two segments
Commercial: The segment represents the services provided under the contract with managed care companies, health insurers and other health plans, Medicaid and Medicare members, as well as with employers, including corporation and governmental agencies and labor unions.
Public Sector: The segment represents the services provided to Medicaid recipients under contract with state and local governmental agencies.
Radiology Benefits Management
Magellan entered the radiology benefits management sector in January of 2006 through the acquisition of National Imaging Associates (NIA). The company’s Radiology Benefits Management segment manages the delivery of diagnostic imaging services on behalf of health plans to ensure that usage of imaging is both clinically appropriate and cost effective.
Specialty Pharmaceutical Management
Magellan entered the Specialty Pharmaceutical Management sector in July of 2006 through the acquisition of ICORE Healthcare, LLC. Magellan’s Specialty Pharmaceutical Management segment distributes and manages high-cost drugs used in the treatment of serious, chronic medical conditions, including cancer, multiple sclerosis, hemophilia, infertility, rheumatoid arthritis, and hepatitis, among others.
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