That modest financial outcome, though, would be welcomed by Sendero executives and
"We're excited," Sendero President and CEO
The final numbers will be a key harbinger of Sendero's future, as
As part of the plan launched this fall to save Sendero, the health district set a goal of enrolling enough high-need patients into the insurance plan to trigger increased payments received through the Affordable Care Act's risk adjustment program. The program attempts to create an even playing field by requiring insurers with healthier members to make payments to insurers covering sicker members. Sendero, which had a higher ratio of healthy to sick patients, was paying into the system, rather than receiving payments from it, which Durkalski said sapped its finances.
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It will be a couple weeks before officials know exactly how many people signed up during open enrollment for the Affordable Care Act program this year because existing members are auto-enrolled and have until the end of January to make their first premium payments. But preliminary data show that 205 people from other subsidy programs decided to move to Sendero this year.
An actuarial report created for
Though Sendero brought in fewer subsidy program enrollees than that estimate outlined,
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"Our initial indication is that they (the risk scores) are high enough," Geeslin said in regard to what the enrollees might mean for Sendero's financial health.
Sendero's preliminary analysis projected that in 2019 it would make about
Overall membership also was projected to be higher in the report, which assumed Sendero would attract 15,000 members in 2019 beyond the new ones brought over from the subsidy programs. About 14,250 total members were signed up as of Thursday, Durkalski said. He estimated the annual average will be closer to about 15,000 members.
That would be in keeping with national and statewide trends of lower enrollment in the ACA marketplace. In
Experts attributed the slight decline to the lack of a financial penalty in 2019 for people who opt to go without health insurance; less support and outreach regarding the ACA from the Trump administration; increased availability of short-term health plans that don't have to comply with the ACA's coverage requirements; and lower unemployment that might have contributed to more people having employer-provided health insurance.
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