Health plans in Minnesota lost less on Medicaid in 2017
The business generates more than
The financial improvement in 2017 for insurers comes amid hints that for-profit HMOs such as
The latest numbers suggest big losses in 2016 were "a one-year blip in a decadelong or longer record of strong profitability for the Minnesota HMOs contracting with the state," said
But
As opposed to a one-year blip, Schowalter said: "I think 2016 was a learning year -- a low point that both the [health plans and state] are learning from and trying to get to a sustainable place, so that enrollees can count on the same care and the same providers every year."
In April, the
A big part of the improvement came in the market where individuals buy health insurance, which has generated considerable losses for insurers since major Affordable Care Act changes kicked in during 2014. But there also was financial improvement for carriers from the state contract for managing care in MinnesotaCare and the largest chunk of Medicaid, which is called the
A
"They didn't lose as much in public programs," Schowalter said of the 2017 results, although the trade group says the collective loss from PMAP and MinnesotaCare last year was
Over the years, HMO profits on the Medicaid business have been controversial at the State Capitol, with some lawmakers arguing that insurers have made too much money on the state contract.
State caps profits
For 2018, the state is capping profits, but for a somewhat different reason than a cap in 2011, said
The goal for the cap is to make sure "that those dollars are going to the medical expenses, and they're not going into excess health plan profits," Zimmerman said.
In early 2017, state lawmakers eliminated a 40-year ban on for-profit HMOs that had effectively reserved the state government's public programs for
In late 2017, UnitedHealthcare applied for an HMO license in
A department within
Mayer's work "is focused on initiatives to better serve people across many states," said
Direct contracts
Across all lines of business,
Across all lines of business,
One reason
UCare's Medicaid numbers also improved due in part to a reserve created in 2016. The HMO added 230,000 enrollees during 2017 by making a big return to the Medicaid and MinnesotaCare contracts. For 2016, competitive bidding results meant that UCare lost about 300,000 enrollees in the programs.
UCare last year saw net income of
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