This week, health insurance Centene announced that it is meeting its profit targets in the ACA marketplace. That's in marked contrast to United Healthcare, which expects to have lost a billion dollars in the marketplace by year's end -- and is withdrawing most of its offerings there in 2017.
I've previously noted that Centene is primarily a managed Medicaid company and has acted like one in the marketplace, fielding plans with low premiums, high deductibles and narrow networks. UHC, the nation's largest provider of employer-sponsored plans, put up more robust networks at higher prices in large markets.
While the contrast seems clean, there's more to the story. UHC is also a major managed Medicaid provider, and in many smaller markets its plans are price competitive. That's the case in most of Iowa, from whence it is nonetheless withdrawing. In a post on healthinsurance.org, I examine why that might be -- and wonder why, more broadly, UHC is withdrawing most of its marketplace offerings, instead of replicating the low-cost narrow network model.
I've previously noted that Centene is primarily a managed Medicaid company and has acted like one in the marketplace, fielding plans with low premiums, high deductibles and narrow networks. UHC, the nation's largest provider of employer-sponsored plans, put up more robust networks at higher prices in large markets.
While the contrast seems clean, there's more to the story. UHC is also a major managed Medicaid provider, and in many smaller markets its plans are price competitive. That's the case in most of Iowa, from whence it is nonetheless withdrawing. In a post on healthinsurance.org, I examine why that might be -- and wonder why, more broadly, UHC is withdrawing most of its marketplace offerings, instead of replicating the low-cost narrow network model.
Your "blogroll" is really an invaluable service. You deserve a lot of credit for aggregating all those sources and grabbing their latest offerings.
ReplyDeleteYour article on UHC and Iowa had good data, however I think it spent too much time on pricing, at least for me.
What interests me is why UHC lost so much money on the exchanges, apparently over $1,000 a person per year.
I realize that claims data is proprietary, so I sure do not have the answer,
Did United get stuck with more premature babies, hep C cases, transplants, et al.??
Or did United just attract less healthy people because it was almost always a PPO and not an HMO?
United is considered a slow payer and even a deceitful payer by many providers, so I think we can say that generosity did not cause their losses.
I help people choose insurance plans, and when I see Ambetter as the low price entity, I tell people that it is a very narrow HMO. Healthy people say "fine with me," but older people want to explore further.
Let me know your views on this.