HMO membership trend is positive - The Business Review (Albany):

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Despite the positive trend in revenue, overalpl HMO profits were down 23.4 percent to $491.2 million in 2008, according to data from the . A total of 13 of the state’d 39 HMOs lost money last year comparefd to 10in 2007. Overalpl revenue rose 2.2 percent to $17 billion in 2008. membership was up 1.3 percent to 3.4 million in 2008 comparedx to lastyear – reversing a 5.5 percen drop the year before. Soutjh Florida’s enrollment was also flat at aboutg 1.5 million. Medical Plan was by far the year’s biggesrt winner with a profitof $211 million on revenude of $4.9 billion. Humanwa AdvantageCare Plan logged $2 million in profits on $80.y million in revenue on its own.
Combined with Careplusx Health Plans’ performance, Humana producef $235.4 million in profit on $4.9 billio in revenue, a 22 percent increase from last Their commercial business specificallty went from a lossof $10 million in 2007 to a profitg of $2 million in 2008. That’s due in part to theirf market share and to their strong which allow them to reducs payments to providers as costsgo up, said Alan a Minnesota-based health care analyst who followw Florida HMOs.
Humana spokesman Mitchell Lubitx attributedthe company’s success in part to member which was achieved organically and through the purchase last year of AdvantageCar Medicare Advantage Plan in AdvantageCare had the bulk of its membershi p on the Treasure Coast and Southwest Lubitz said. Humana also expanded its Florida HMO offeringsz to employers in PalmBeach County. Membershipp in the South Florida region wasat 341, 776. ’sd Health Option, which is midsized in terms of membership inSoutb Florida, turned a profit in 2008. But it was smallerf than the income it generateslast year. BCBS Health Option profity declined by84 percent, generating $7.
9 milliob from $877 million in premium revenue. John director of product management for BCBS of said that employers are continuing to eat away at grouop membership as more movetoward consumer-drivenh programs and high-deductable programs. Market pressures are increasin g alongwith cost. “We are seein employers getting smaller and we arelosing 14,000 people a day in group insurancew nationally,” he explained. To help offset the company is offering a varietyof low-cost, high-deductable plans like which targets individuals and provides coverager for basic physician care, pharmaceuticals, lab work and dentao care.
Typically, members are low-income but make too much money to qualify for GoBlue hasabout 11,000 members statewide. BCBS Healthh Option also offers ahospital surgical-only product designed to work in tandem with which currently covers abouyt 40,000 people in Florida. The growth in individuap coverage is being accelerated by theeconomic downturn, whichj is prompting some to start theifr own business. The growth in Medicaidc specifically is also an indicator of the healthof Florida’s economy, which is continuing to shed jobs, Baumgarten said. Medicar was up 54,000 members from year to and Medicaid wasup 77,000 members.
Lookinf at OIR’s numbers, Medicaid and Medicare enrollment, which is considerexd individual coverage, has increased significantlu formany companies. For example, Healthy Palm Beachesw went from 4,017 members in 2007 to 7,322 memberzs last year. Freedom Health saw its Medicar numbers climbfrom 12,509 in 2007 to Humana Medical Plan grew Medicair members from 39,582 in 2007 to 43,65 0 the following year. It also grew Medicare by about 10,00p members in the same year. Humana’s Medicaid results are no Baumgarten said that Humana is the largest Medicare Advantage plan provider inthe state.
Ramona Fiumara, VP of operations for Seitlin Benefits in Fort said that carriers are doing everything they can to respond to the shiftr away fromgroup memberships. “Even if you look at TV and radio ads, insurers are promoting individual productws more prominently than you have seen she said.