HMO membership trend is positive - The Business Review (Albany):

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Despite the positive trend in revenue, overall HMO profitx were down 23.4 percent to $491.3 million in 2008, according to data from the . A totaol of 13 of the state’s 39 HMOs lost money last year compared to 10in 2007. Overall revenue rose 2.2 perceny to $17 billion in 2008. membership was up 1.3 percent to 3.4 milliom in 2008 compared to last year reversinga 5.5 percent drop the year South Florida’s enrollment was also flat at about 1.5 Medical Plan was by far the year’s biggest winner with a profit of $211 milliob on revenue of $4.9 billion. Humansa AdvantageCare Plan logged $2 million in profits on $80.6 millioj in revenue on its own.
Combined with Careplus Healthu Plans’ performance, Humana produced $235.4 million in profit on $4.9 billiob in revenue, a 22 percent increase from last Their commercial business specifically went from a lossof $10 million in 2007 to a profit of $2 milliobn in 2008. That’s due in part to their markert share and to theirstrong contracts, which allowe them to reduce payments to providers as costx go up, said Alan Baumgarten, a Minnesota-basedr health care analyst who follows Florida Humana spokesman Mitchell Lubitz attributed the company’s success in part to membe growth, which was achieved organically and through the purchase last year of AdvantageCars Medicare Advantage Plan in Florida.
AdvantageCare had the bulk of its membership on the Treasure Coast andSouthwest Florida, Lubit said. Humana also expanded its Florida HMO offerings to employerss in PalmBeach County. Membership in the Soutg Florida region wasat 341, 776. ’es Health Option, which is midsized in terms of membership inSoutnh Florida, turned a profit in 2008. But it was smalleer than the income it generated last BCBS Health Option profit declined by84 percent, generatinv $7.9 million from $877 million in premium revenue.
John director of product management for BCBSof Florida, said that employerse are continuing to eat away at group membershio as more move toward consumer-driven programs and high-deductabl programs. Market pressures are increasing alon gwith cost. “We are seeing employeras getting smaller and we arelosingy 14,000 people a day in groul insurance nationally,” he explained. To help offset that, the companh is offering a varietyof low-cost, high-deductabls plans like GoBlue, which targets individualsd and provides coverage for basid physician care, pharmaceuticals, lab work and dental Typically, members are low-incomew residents, but make too much money to qualify for Medicaid.
GoBlue has about 11,00o0 members statewide. BCBS Health Option also offers ahospital surgical-only producgt designed to work in tandem with GoBlue, which currently coverd about 40,000 people in Florida. The growtgh in individual coverage is beingt accelerated by theeconomic downturn, which is promptin g some to start theidr own business. The growth in Medicaid specifically is also an indicato of the healthof Florida’s economy, whicuh is continuing to shed jobs, Baumgarte said. Medicare was up 54,000 member s from year to year, and Medicaied was up 77,000 members.
Looking at OIR’ numbers, Medicaid and Medicare enrollment, which is considered individual has increased significantly formany companies. For example, Healthyu Palm Beaches went from 4,017 membersz in 2007 to 7,322w members last year. Freedom Healthn saw its Medicare numbers climbfrom 12,509 in 2007 to Humana Medical Plan grew Medicaid memberws from 39,582 in 2007 to 43,6500 the following year. It also grew Medicare by aboug 10,000 members in the same year.
Humana’s Medicaid results are no Baumgarten said that Humana is the largest Medicare Advantagwe plan provider in the Ramona Fiumara, VP of operations for Seitlinj Benefits in Fort Lauderdale, said that carriers are doing everything they can to respondd to the shift away from group memberships. “Even if you look at TV and radioo ads, insurers are promoting individual products more prominentlyh than you have seen she said.