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Michigan Health Market Review 2016, Part One

  • ID: 3807715
  • July 2016
  • Region: United States
  • Allan Baumgarten
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Medicaid Plans Had Underwriting Income of $298 Million in 2015 and a 3.9% Margin

FEATURED COMPANIES

  • Blue Care Network
  • Consumers Mutual
  • HAP Midwest Health Plan
  • Humana
  • Meridian Health
  • Molina Healthcare
  • MORE

The Healthy Michigan Medicaid expansion has given coverage to 600,000 Michigan residents and created a large and profitable business opportunity for health insurers. These findings and others are reported in Part One of Michigan Health Market Review 2016, released here today. This is the 20th edition of the report that has been published analyzing the health care payer and provider markets in Michigan.

The Part Two report, to be released later this year, will analyze the revenues, profitability and inpatient utilization of the state’s hospital systems based on 2015 data, and compare their strategies under health reform.

Key findings in this new report include:
- After increasing by 21% in 2014, enrollment in Medicaid HMOs grew by 8.5% in 2015 and another 3.4% in the first quarter of 2016. Meridian Health is the largest Medicaid HMO, with 468,000 enrollees, followed by Molina Healthcare. The state has launched demonstration projects in several key counties to enroll aged and disabled Medicaid recipients in managed care, another source of future growth.

- Medicaid plans had underwriting income of $298 million in 2015 and a 3.9% margin. That compares to underwriting income of $163.1 million in 2014 and a 2.8% margin. HMO Medicaid grew by 32% in 2015. HAP Midwest Health Plan and Molina Healthcare were the most profitable of the Medicaid HMOs, but HAP Midwest lost most of its state contracts and revenues at the beginning of 2016.

- The strong profitability is largely due to payments to the health plans growing faster in the past two years than the underlying medical expenses. Anticipating that the new enrollees would be higher utilizers of READ MORE >

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FEATURED COMPANIES

  • Blue Care Network
  • Consumers Mutual
  • HAP Midwest Health Plan
  • Humana
  • Meridian Health
  • Molina Healthcare
  • MORE

1. Introduction

2. Market Structure

3. Health Plans

4. Provider Systems

5. Trend Review

6. Health Plan Enrollment

7. Medicaid Managed Care

8. Medicare Plans

9. Net Income

10. Financial Results by Line of Business

11. Provider Payments

12. Health Plan Capital

13. A Look Ahead

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- Blue Care Network
- Blue Cross Blue Shield Mutual
- Consumers Mutual
- HAP Midwest Health Plan
- Humana
- Meridian Health
- Molina Healthcare
- Priority Health
- Sparrow PHP
- UnitedHealthcare

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