2019-05-19 04:07:10

“Our membership at year-end 2018 was at 916,000 members which includes commercial, self-funded and Medicare members. Achieving membership gains speaks to the efforts we’ve made as a company to improve our customers’ experience and provide health insurance products that improve our members’ lives, while supporting our community.”

Kallas said BCN has cut premiums for small-business employers four times since July 2017, accounting for an average 2.6 percent premium reduction.

“Blue Care Network is an outlier here,” Pallone said. “I would say (BCN’s financial performance) is a byproduct of their market dominance and of Blue Cross as a whole. They have an ability to leverage (size to extract lower provider rates). We hope that employers and individuals will be mindful of that as they move to purchase in 2020.”

No. 2 by net income was Priority Health with $123.8 million in net income, a 57.3 percent increase from $78.7 million in 2017. Total enrollment at Priority was 514,000, a 1 percent drop from the year before.

“Priority Health’s financial performance is a reflection of the company’s commitment to enhance its product portfolio, reduce the occurrence of unnecessary health care costs and keep administrative costs low,” Mary Anne Jones, its CFO, said in an email to Crain’s. “We continue to see growth across the company, we ended 2018 with more than 782,000 members, up from 779,000 last year, and are well-positioned for continued success in the future.”

Priority Health’s total membership also includes about 268,000 enrollees from PH Insurance Co., PH Choice and self-funded employer plans.

On the other hand, Meridian Healthcare of Michigan, which was acquired last summer by WellCare Health Plans inc. for $2.5 billion, lost $87 million in 2018, mostly because of charges against its balance sheet resulting from the merger.

For example, general administrative expenses increased substantially in 2018 to $241.2 million from $184.3 million. Like most plans, prescription drug costs also rose, going up to $338 million from $311 million. Total revenue dropped to $1.99 billion last year from $2.2 billion the prior year.

Because Tampa-based WellCare is undergoing a sale to Centene Corp. for $15 billion, officials for Meridian are prohibited from discussing the 2018 financial year.

Pallone, who said he also was unable to talk with Meridian officials, said he believes Meridian incurred some one-time administrative costs, which included paying legal and consulting fees, additional staff time negotiating and closing the merger.

No. 3 in net income was Molina Healthcare of Michigan, which generated $97.5 million in net income, a 195 percent increase over $33 million in 2017. Molina’s enrollment was 369,000 as of March 30, a 3.6 percent decline from 383,000 on Dec. 31.

While Molina did not comment on Michigan results, the Long Beach, Calif.-based investor-owned company overall earned $198 million of net income on revenue of $371 million during the first quarter of 2019. Net income per diluted share increased to $2.99 from $1.64 in the first quarter of 2018.

“These results are a testament to the achievability of the second phase of our strategy, which is to sustain the attractive margin position we had built in 2018,” said Joe Zubretsky, president and CEO, in a statement. “While certainly not conclusive, our first quarter results validate our position that durable financial and operational improvement can and should allow us to sustain these margins, all while we begin to grow the top line again.”

Fourth was Blue Care Complete, a Medicaid HMO that earned $31.4 million last year, an 84 percent increase over $17.1 million in 2018. Enrollment was 209,000 in 2018, a 0.3 percent increase from the prior year.

“Blue Cross Complete’s administrative cost containment and focused interventions in our coverage area contributed to positive results in 2018,” said a statement from Blue Cross. “As stewards of taxpayer dollars, we’re mindful of the trust placed within our care and seek to invest in the communities we serve, working with providers to deliver care that is as much social as it is clinical.”

For example, our Blue Cross Complete outreach workers, called care connectors, help certain vulnerable members navigate the health care system. Care connectors assist members in their homes to understand how to use health care as well as connecting them to community resources that include transportation, housing, food, utilities and other non-medical factors that can impact an individual’s health.

In 2018, Health Alliance Plan of Michigan earned $3.5 million in net income, a 60 percent decline from $8.7 million the previous year. HAP also took a $10.5 million underwriting loss in 2018 compared with a $3.9 million gain in 2017.

Total revenue also declined by $349 million to $1.47 billion. Some of the revenue losses were attributed to dropping money-losing contracts that contributed to a drop in membership by about 70,000 lives compared with 2017.

Despite the short-term financial hit, Terri Kline, HAP’s CEO, said in an email to Crain’s that the plan added Medicare Advantage members and increases its market share for the first time since 2010.

“HAP is extremely well-positioned for growth and sustainability and has right-sized its HMO line of business to position for long-term growth,” Kline said. “Our improved financial strength can be measured by the fact that our risk-based capital is over 400 percent for each of our companies, which includes HAP ( HMO), Alliance Health & Life (PPO), and HAP Midwest Health Plan (Medicaid).”

HAP Midwest also lost money in 2018, reporting a net loss of $5.4 million, a 400 percent drop from net income of $1.8 million in 2017.

But Kline said HAP is preparing for the future by adding key personnel in such departments as actuarial and analytics, risk management, underwriting, sales and account management.

Last November, HAP began moving about 1,100 employees to a new Troy building at 1414 E. Maple Road. HAP took about 180,000 square feet of the Troy building under a sublease from parent company Henry Ford Health System.



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