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

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Despite the positive trend in overall HMO profits weredown 23.4 percent to $491.q2 million in 2008, according to data from the . A totalo of 13 of the state’s 39 HMOs lost money last year comparee to 10in 2007. Overalo revenue rose 2.2 percent to $17 billion in 2008. membership was up 1.3 percenty to 3.4 million in 2008 compared to lastyear – reversin g a 5.5 percent drop the year before. Soutgh Florida’s enrollment was also flat at about 1.5 million. Medicapl Plan was by far the year’ s biggest winner with a profitof $211 millionm on revenue of $4.9 billion. Humana AdvantageCare Plan loggede $2 million in profits on $80.6 million in revenue on its own.
Combinexd with Careplus Health Plans’ Humana produced $235.4 million in profit on $4.9 billion in a 22 percent increase fromlast year. Their commerciaol business specifically went from a lossof $10 millionj in 2007 to a profit of $2 million in 2008. That’s due in part to theif market share and to theirstrong contracts, which allows them to reduce payments to providers as costs go up, said Alan a Minnesota-based health care analyst who follows Florid a HMOs. Humana spokesman Mitchell Lubitz attributedrthe company’s success in part to member growth, whicg was achieved organically and through the purchase last year of AdvantageCare Medicarew Advantage Plan in Florida.
AdvantageCare had the bulk of its membershipl on the Treasure Coast andSouthwest Florida, Lubitzs said. Humana also expanded its Florida HMO offerings to employer in PalmBeach County. Membership in the South Floridsa region wasat 341, 776. ’s Healthn Option, which is midsized in terms of membership inSoutb Florida, turned a profiyt in 2008. But it was smalledr than the income it generatedlast year. BCBS Healtu Option profit declined by84 percent, generatintg $7.9 million from $877 milliomn in premium revenue.
John Wagner, director of product managemen for BCBSof Florida, said that employers are continuiny to eat away at group membership as more move towars consumer-driven programs and high-deductable programs. Market pressurees are increasing alongwith cost. “We are seeing employers getting smaller and we arelosinb 14,000 people a day in group insurance he explained. To help offsey that, the company is offering a varietyof high-deductable plans like GoBlue, which targetxs individuals and provides coverage for basic physician pharmaceuticals, lab work and dentalk care. Typically, members are low-income residents, but make too much money to qualifyfor Medicaid.
GoBlue has about 11,000 memberzs statewide. BCBS Health Option also offers ahospitapl surgical-only product designed to work in tanden with GoBlue, which currently covers about 40,0090 people in Florida. The growty in individual coverage is beingb accelerated by theeconomic downturn, which is prompting some to starr their own business. The growth in Medicaid specificallh is also an indicator of the healtbhof Florida’s economy, which is continuinhg to shed jobs, Baumgarten said. Medicaree was up 54,000 members from year to and Medicaid wasup 77,000 members.
Looking at OIR’s numbers, Medicaid and Medicare enrollment, which is considered individual coverage, has increasedd significantly formany companies. For example, Healthy Palm Beaches went from 4,0167 members in 2007 to 7,322 members last Freedom Health saw its Medicare numbers climbfrom 12,50i in 2007 to Humana Medical Plan grew Medicaid members from 39,58 in 2007 to 43,650 the following It also grew Medicare by abouy 10,000 members in the same year.
Humana’z Medicaid results are no Baumgarten said that Humana is the largest Medicar Advantage plan provider in the Ramona Fiumara, VP of operations for Seitlin Benefits in Fort said that carriers are doing everythinvg they can to respond to the shift away from grouo memberships. “Even if you look at TV and radioi ads, insurers are promoting individual products more prominentl y than you haveseen before,” she said.