• December 1, 2021

UPMC sees 10% Medicaid enrollment development, slimmer insurance coverage margin

Nov 26, 2021

UPMC Well being Plan’s Medicaid enrollment grew nearly 10% year-over-year, whilst industrial enrollment declined, the insurer’s guardian firm disclosed Tuesday.

UPMC’s monetary assertion for the 9 months ended Sept. 30 reveals the well being plan lined 557,000 Pennsylvania Medicaid beneficiaries as of that date, which is almost 50,000 greater than a yr earlier than. In the meantime, the Pittsburgh-based firm’s industrial enrollment fell 4% to 659,000. The insurance coverage division’s Medicare buyer base grew 2.5% to 200,738. UPMC’s complete well being plan membership stood at simply over 4 million.

UPMC Well being Plan’s working revenue fell $206 million and its working margin was 1.6% throughout the first 9 months of this yr, down from 4% in comparison with the identical interval in 2020. Rising medical claims from sufferers in search of care they delayed final yr due to the COVID-19 pandemic accounts for the smaller margin, based on the corporate’s monetary report. A UPMC spokesperson stated no one was obtainable to remark Wednesday.

UPMC’s company-wide working margin nearly doubled to 4.4% throughout the first 9 months of the yr 2021 due to a stronger efficiency in its supplier division. Outpatient income grew 17% and doctor providers and admissions additionally improved.

Medicaid enrollment has spiked throughout the pandemic largely due to a federal rule that stops states from kicking individuals off their packages throughout the public well being emergency, which Well being and Human Companies Secretary Xavier Becerra renewed for one more 90 days on Oct. 15. Greater than 9 million working age adults and kids gained protection between February 2020 and January 2021 alone, and the City Institute estimates that can have grown to 17 million by the top of the yr.

Banner Well being in Phoenix equally reported nearly 14% greater enrollment in its Medicaid plans within the first 9 months of 2021. The well being system’s Medicaid plans posted an working acquire of $24 million throughout the interval, surpassing the insurance coverage division’s $16 million working acquire throughout the first three quarters of 2020.

Banner Well being misplaced $15 million on operations for its Medicare Benefit contracts and made $7 million on its industrial plan joint ventures throughout the first 9 months of 2021. The system’s total working margin was a slim 1.8%.

Giant, for-profit well being insurers have reported huge jumps in Medicaid enrollment. Centene, the most important Medicaid insurer, reported a 12% year-over-year enhance in Medicaid membership to 14.8 million as of Sept. 30. Anthem, the second largest Medicaid insurer, noticed 21% Medicaid development to about 10.4 million as of Sept. 30.

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