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  Cook County Hospital fills more outpatient prescriptions every day than are filled at 26 Walgreen's drug store combined.

Cook County proposes to sweeten drug contract with Catamaran

Thursday, November 14, 2013
Crain's Chicago Business
by Kristen Schorsch

 Catamaran Corp.'s contract to manage pharmacy benefits for Cook County's Medicaid expansion would jump nearly ninefold, to $26.8 million, according to a proposal from the Cook County Health & Hospitals System. The 11-month contract, which began as a $3 million agreement Feb. 1, is mushrooming as Cook County Health & Hospitals officials rush to accommodate the roughly 55,000 people who have enrolled in CountyCare, a managed care network for Medicaid recipients. Schaumburg-based Catamaran is one of the largest companies in the nation that runs prescription benefits for health plans, bargaining with drug companies to get better deals for its customers. At the start of the contract, the company provided only administrative services, a spokeswoman for Cook County Health & Hospitals said, with the county paying for the drugs. In May, the county expanded the scope of the contract so that Catamaran would pay for the drugs and be reimbursed. That increased the value of the contact, which ends Dec. 31, to about $15 million. “As our membership increased over time, the costs of medication did as well,” she said. The health system wants to expand the contract a second time, tacking on an additional $11.8 million. That would bring the total contract to $26.8 million. CountyCare, made possible under the Affordable Care Act, was launched in 2012. The program expanded Medicaid eligibility early for up to 115,000 people and is a key part of the health system's plan to generate revenue to lessen the burden on taxpayers. Catamaran's stock price has been battered a bit amid investors' worries that the rise of employer-run private health benefits exchanges will hurt revenue, which last year totaled $9.94 billion. The rise of those exchanges is expected to change who hires a prescription benefits manger, replacing Catamaran's typical client — company-sponsored health plans — with insurance companies and consulting firms, some analysts say. CEO Mark Thierer has dismissed those concerns. “We see great opportunities to participate in the expansion of health coverage in this country,” he told analysts during an Oct. 31 conference call to discuss third-quarter earnings, according to a transcript. Catamaran's shares, which peaked this year at $58.32 a share Aug. 6, closed yesterday at $48.20 a share, a 17.4 percent decline. Amid the uncertainty about private customers, the expansion of the Cook County contract demonstrates the growing importance of Medicaid to Catamaran. The company has contracts with eight state fee-for-service Medicaid programs, Mr. Thierer told analysts. Despite the risk of losing some big clients, Catamaran is likely to benefit from the growing number of people who will gain some form of coverage through the government-run health insurance exchanges, analyst Amanda Murphy of Chicago-based investment firm William Blair & Co. wrote in a Nov. 1 report. “Our analysis suggests that over the long term the benefit of added lives through the public exchanges at least offsets the risk of lives moving into private exchanges,” Ms. Murphy wrote. A spokeswoman for Catamaran declined to comment. The finance committee of the Cook County Health board is scheduled to consider the proposed contract increase tomorrow. The full hospital board, which is scheduled to meet Nov. 22, would have the final say.

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