UPMC Forecasts 10% Medicaid Enrollment Growth, Lower Insurance Margin

UPMC Health Plan’s Medicaid participation increased nearly 10% year-over-year, even as commercial enrollment declined, the insurer’s parent company said Tuesday.

UPMC financial statements for the nine months ended 30 September shows that 557,000 Medicaid recipients were covered by the health plan at that date, nearly 50,000 more than a year earlier. Meanwhile, the Pittsburgh-based company’s commercial reach fell 4% to 659,000 people. Medicare’s customer base grew 2.5% to 200,738. The total number of UPMC health plan enrollments is just over 4 million.

UPMC Health Plan’s operating income fell $ 206 million and its operating margin was 1.6% in the first nine months of this year, up from 4% over the same period in 2020. A rise in patient requests that they postponed last year due to lower profits from the COVID-19 pandemic, according to the company’s financial report. A UPMC representative said No one It was accessible To a comment Wednesday.

UPMC’s company-wide operating margin nearly doubled to 4.4% in the first nine months of 2021 due to stronger performance in the service provider division. Outpatient revenues rose 17%, and physician services and hospital admissions also improved.

Medicaid enrollment skyrocketed during the pandemic, largely due to a federal rule that prohibits states from excluding people from their programs during a public health emergency, which Health and Human Services Secretary Xavier Becerra extended for another 90 days October 15th. Between February 2020 and January 2021 alone, more than 9 million adults and children of working age received health insurance, and the Urban Institute estimates that figure will rise to 17 million by the end of the year.

Banner Health Phoenix also reported a nearly 14% increase in enrollment in its Medicaid plans in the first nine months of 2021. The health care system’s Medicaid plans posted an operating profit of $ 24 million for the period, more than the insurance division’s operating profit of $ 16 million in the first period. three quarters of 2020.

Banner Health lost $ 15 million in Medicare Advantage contract operations and raised $ 7 million in commercial plan joint ventures during the first nine months of 2021. The total operating margin of the system was only 1.8%.

Large commercial health insurance companies are reporting dramatic surges in Medicaid participation. Centene, the largest Medicaid insurer, reported 12% growth over the same period last year Medicaid members to 14.8 million as of September 30. Anthem, the second largest Medicaid insurer, saw 21% growth on Medicaid to about 10.4 million as of September 30.

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