44% of HMOs in Florida report 2014 losses – Database – South Florida Business Journal

44% of HMOs in Florida report 2014 losses – database

via 44% of HMOs in Florida report 2014 losses – Database – South Florida Business Journal.

Of the 34 HMOs in Florida listed in a report from the Florida Office of Insurance Regulation, 15 reported losses in 2014.

Losses ranged from $14.6 million to $165.1 million, while profits ranged from $138,555 to $333 million. In total, the combined 34 HMOs reported net income of $66.5 million in 2014, which is a 90 percent decrease from the collective $648 million profit reported by 39 HMOs in 2013.

The 15 HMOs reporting losses in 2014 account for 44 percent of the HMOs in Florida.

The Business Journal combined 2014 net incomes, 2013 net incomes, and the change in 2014/2013 net incomes in a searchable database. Click here to see which HMOs reported the highest profits, the biggest losses, and who saw the greatest change year-over-year.

Sunshine State Health Plan and UnitedHealthcare of Florida reported the biggest negative changes in net income between 2013 and 2014 at over $125 million for each HMO. Medica Healthcare Plans and Health Palm Beaches reported the largest positive change in net income between 2013 and 2014, at $14.3 million and $13.6 million, respectively.

HMOs in Florida has a tumultuous year in 2014 partly due to an influx of new members, Minn.-based insurance analyst Allan Baumgarten previously told theBusiness Journal. “That can be tied to problems in adding new providers to the network when the HMO is under a time crunch to get hospitals and physicians under contract,” he said. “Sometimes the providers sense weakness and try to boost their prices.”

It’s likely that 2015’s Affordable Care Act enrollment numbers will dramatically affect HMOs performance in Florida, which topped the nation among states using federally-facilitated marketplaces to enroll people in the ACA, also known as Obamacare. More than 1.3 million Floridians enrolled in a plan during the 2015 ACA open enrollment period.

In addition, merger and acquisition activity among health plans could affect net income in the short term. Humana Inc. agreed to a $37 billion buyout by Aetna Inc. on Monday. That acquisition will amount to a potential move of more than 900,000 Humana members as of 2014 in Florida to Aetna, which itself had just over 220,000 members at the end of last year in the state.

For the Business Journal’s previous coverage on this topic, and for what the HMOs themselves are saying about the net income issue, click here.


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