Key drivers of financial performance of insurers in the Affordable Care Act market exchange.

While most publicly-traded insurers have experienced losses and exited the Affordable Care Act individual insurance market exchange, insurers specializing in Medicaid managed care have been profitable in this market. Accessing individual market data, this study compares the financial performance of...

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Publicado en:Health Services Management Research Vol. 33; no. 3; pp. 130 - 136
Autores principales: McCue, Michael, Hall, Mark A, Palazzolo, Jennifer
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. Aug2020
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Key drivers of financial performance of insurers in the Affordable Care Act market exchange.
      aug:
        au:
          McCue, Michael
          Hall, Mark A
          Palazzolo, Jennifer
        affil: College of Health Professions, Virginia Commonwealth University, Richmond, USA
      sug:
        subj:
          Patient Protection and Affordable Care Act
          Insurance Carriers Economics
          Health Insurance Exchanges
          Insurance, Health Economics
          Medicaid Economics
          Managed Care Programs Economics
          Profits
          Human
          Wilcoxon Rank Sum Test
          Descriptive Statistics
          Sign Test
          Health Care Costs
          Funding Source
      ab: While most publicly-traded insurers have experienced losses and exited the Affordable Care Act individual insurance market exchange, insurers specializing in Medicaid managed care have been profitable in this market. Accessing individual market data, this study compares the financial performance of 20 state insurers owned by two publicly-traded companies that historically focused on insuring Medicaid members compared to 40 insurers owned by other publicly-traded companies. Medicaid-focused insurers incurred a significantly lower medical loss ratio of 83.3% compared to the medical loss ratio of 93.7% of other publicly-traded insurers, and they earned a significantly higher profit margin of 4.6% compared to the operating loss of 6.5% incurred by other publicly-traded insurers. This superior financial performance of Medicaid-focused insurers could be due to one or a combination of: their care management experience with the Medicaid population, other cost reducing strategies such as provider contracting, or the enrollment of a healthier than average population.
      pubtype: Academic Journal
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        research
        tables/charts
        Journal Article
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    language: English
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