Managed Healthcare Executive - December 2008 - (Page 16)

{EX EC U T I V E PROFIL E} Puerto Rico Governor: Aníbal Acevedo Vilá John Dakers/Life File/Getty Imgaes Population: 3,944,000 (July 2007) GDP: $89.7 billion (2007 estimate) Unemployment: 11.7% (Sept. 2008) Mean Annual Wage: $23,910 (2007) Dominant Industries: Pharmaceuticals, biotechnology, computers, scienti c instruments, nance, insurance, real estate, wholesale, retail and tourism History: Puerto Rico came under U.S. sovereignty in 1898 pursuant to the Treaty of Paris. Taxes and Beneﬁts: Only federal employees pay federal income taxes. Residents are eligible for Social Security. It receives less Medicaid funding than it would be allotted as a state, and Medicare providers receive only partial reimbursements. Representation: Puerto Rico has a nonvoting delegate in the U.S. House of Representatives, the Resident Commissioner (currently Luis Fortuño). Residents cannot vote in U.S. presidential elections, but can vote in the primaries. Government Programs: The Puerto Rico Health Reform (Reforma de Salud de Puerto Rico) is government-run and provides healthcare services to indigent and impoverished citizens through private health insurance companies, similar to Medicaid. Additionally, Puerto Rico’s seniors qualify for Medicare and Medicare Advantage plans. Sources: Bureau of Labor Statistics; Wikipedia page 248180738 Salud! cian ranks 63% in the next 15 years, and Puerto Rico’s commonwealth status al- bilingual providers are especially in delows it certain bene ts as a U.S. territory mand. Because of their U.S. citizenship, but does not provide the same involve- Puerto Rican doctors could become inment with national decision making that creasingly more attractive recruitment statehood would bring. There are groups targets in the near future. that advocate Puerto Rico’s statehood and equally enthusiastic groups that call Dual-class stock for total independence. Triple-S is one of the largest Puerto RiIts economy is distinctly separate from can-owned businesses and serves 1 milthe United States. In fact, the average lion managed-care members, claiming weekly wages in the rst quarter of this 25% market share. year ($489) were 46% lower than the U.S. Members include more than 90% of the average weekly wage ($905), according population of federal employees in Puerto to the Department of Labor Statistics. Rico, Ruiz-Comas says. In commercial The cost of living is also lower. populations, Triple-S covers about 40% Operating in a lower-cost region cer- of the market, serving large employers in tainly could provide the plan a nancial telecommunications, banking and pharadvantage when competing with players maceuticals. The Reform plans and Medibeyond Puerto Rico. care Advantage plans—including Part D Román says he is keeping an eye on and Medigap—also hold strong footing the provider trends in the United States in the local market. because physicians could be drawn away from Puerto Rico, “Because of the relationattracted to the higher pay scale. ship with Puerto Rico and Right now, Puerto Rico does not have a shortage of primary care the U.S., people can move physicians as is predicted for the the next day because they United States soon, but there are a are U.S. citizens and they few specialties, such as neurology for example, that could use more speak English and Spanish.” providers, he says. “Puerto Rican physicians can be a target, and we saw that in nurses,” According to CFO Román, in prepahe says. “We’ve seen nurses go to the ration for the company’s initial public States because pay is signi cantly dif- o ering, management conducted a comferent. Because of the relationship with prehensive review to lay the groundPuerto Rico and the U.S., people can work for the critical levels of e ciency move the next day because they are U.S. required to be an attractive buy for incitizens and they speak English and vestors. Unpro table accounts were terSpanish. So we are a little worried, but minated in 2006 and 2007. there is no huge trend of people moving “We were talking about changing the to the United States.” mentality since 2000 when we started According to the Orlando Sentinel, the the process,” Román says. “We nally president of Florida Emergency Physi- got the shareholders’ approval in January cians, a privately held practice group, 2006 and told the public. That’s really regularly visits Puerto Rico to recruit when the clock started running for us.” doctors for the Florida Hospital System. One year ago this month, the orThe state must increase its total physi- ganization released $233.5 million in 16 DECEMBER 2008

Table of Contents Feed for the Digital Edition of Managed Healthcare Executive - December 2008

Managed Healthcare Executive - December 2008 For Your Benefit Editorial Advisors Contents News Analysis Politics & Policy Letter of the Law Puerto Rico’s PLAN State Report Bundled Payment Technology Drug Class Overview Managed Care Outlook Desktop Resource Ad/Edit Index

Managed Healthcare Executive - December 2008

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