Medicaid HMOs post losses
Through the first three quarters of 2016, the HMO divisions at
Last year, health insurers in
"The market greatly overcorrected, which is creating the situation where we have the losses that we do," said
The state-federal
For decades,
The state
"The final rates for 2016 were reviewed by
Last year's competitive bid focused on the "families and children" portion of state public programs.
It was a high-profile affair, since it resulted in UCare going from the biggest health plan to the smallest among four HMOs included in the contract. The nonprofit insurer lost more than 300,000 enrollees as a result, and eliminated more than 200 jobs.
Late last year, state officials released documents showing that UCare's bid was higher on price than competing bids from the HMOs at
In a statement Monday, UCare officials said: "Our 2016 ... cost bids reflected over 30 years of experience serving member needs of these important programs.
UCare continues to stand behind these figures."
Asked if UCare's bid was closer to the mark than those from the winners,
Regulatory filings this month show the
The HMO divisions at
"Through September, we're running a deficit of approximately
Current payment rates were set based on spending trends in 2014, Bartsh said, but the mix of enrollees has changed over the last few years, particularly as the state has improved its process for renewing enrollees.
Another factor, he said, is that new
"The losses this year for
Bartsh said he could not comment on contract negotiations for 2017.
In its statement,
"The plans' bids were based on 2014 data; therefore, any renewals or other eligibility changes that occurred in 2015 would not be included in the base for the 2017 rates," the department said in a statement. "Renewals or other effort to clean up eligibility could both increase and decrease the number of people covered."
A
The analysis included profits for
UCare posted the biggest chunk of income from the programs, with an operating profit of
HMOs in
Twitter: @chrissnowbeck
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