Enrollment gains in government-sponsored health insurance business for the top seven health plans in the nation have out- paced gains in Commercial business according to a new report by Mark Farrah Associates (MFA).
In fact, MFA found that for every Commercial member gained, the top plans added nearly five in government-sponsored programs. According to the report, as growth in the Commercial segment staggers, with a poor prognosis for recovery in the near future, many of the leading plans' corporate strategies call for pursuing more business in the Senior and Medicaid segments. Acquisitions of companies specializing in these segments have been prevalent among top plans.
Total medical membership for the leading U.S. health insurance plans increased 2.6 percent from 128.3 million as of September 2011 to 131.7 million as of September 2012. Overall, Commercial business increased by 1.0 percent from September 2011 to September 2012. Medicare and Medicaid enrollment increased 17.2 percent and 6.2 percent respectively during the same period. Enrollment in administrative services only (ASO) funding arrangements grew year- over-year and enrollment in fully-insured (Risk) business declined during the period. Primarily all of the Commercial sector growth is from ASO business. Profitability saw a slight downturn for the majority of leading health plans for the first nine months of 2012 when compared to the first nine months of 2011. Top health plan profitability was impacted by several factors from shifts to lower margin ASO and government-sponsored businesses, to increased administrative costs due to acquisitions, to implementation of health reform regulations.
In the latest Healthcare Business Strategy report, MFA reviewed enrollment and financial trends for Aetna, Cigna, Health Care Service Corp. (HCSC), Humana, Kaiser Permanente, UnitedHealth Group and WellPoint. Membership data, financial statistics and observations were gleaned from the January 2013 Health Insurer Insights series, a Mark Farrah Associates publication. To read the full text of "Health Plan Enrollment Shifting Toward Government- Sponsored Programs," visit the Analysis Briefs library on Mark Farrah Associates' website markfarrah.com.
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