This report presents our analysis of enrollment trends, market share, financial metrics and strategies for Michigan HMOs and health insurers. Part One is 26 pages of data tables, trend graphics and analysis. Driven by very strong results for Blue Cross Blue Shield and its HMOs, Michigan health plans reported record high profits in 2017. These findings and others are reported in this report. This is the 22nd edition of his report analyzing Michigan’s health care payer and provider markets.
Key findings in the new report:
- Michigan HMOs recorded their highest profits in history: net income of $452.1 million in 2017 or 2.6% of underwriting revenues. That was 50% higher than their net income in 2016. The Blue Cross Blue Shield HMOs (Blue Care Network and Blue Cross Complete for Medicaid) had combined net income of $257.4 million, or 5.8% of underwriting revenues. Priority Health, which now covers the entire Lower Peninsula and is the second largest HMO, improved its net income to $91.5 million, or 2.6%.
- Blue Cross Blue Shield Mutual of Michigan, which had lost $226 million in 2016, enjoyed a swing of nearly half a billion dollars, posting net income of $295.2 million. While it still lost money on its commercial plans, it was very profitable on its Medicare Advantage and Medicare Supplement plans.
- Premiums grew faster than medical expenses for commercial plans (employer groups and individuals), and HMOs improved underwriting income on those plans from $12 million in 2016 to $203.2 million in 2017. Blue Care Network reported commercial plan profits of $155.9 million, up from $29.2 million in 2016.
- Medicaid plans, now the largest line of business for Michigan HMOs, though still profitable, saw their underwriting income drop by 25% in 2017. Underwriting income for Medicaid HMOs fell from $298 million in 2015 to $165.4 million in 2016 and $122.5 million in 2017. Still, Molina Healthcare posted a 3.8% margin on its Medicaid business, and Blue Cross Complete and McLaren Health had 2.8% margins on their Medicaid plans.
- Enrollment growth for Michigan HMOs slowed in 2017. After increasing by 4.9% in 2016, enrollment in Michigan HMOs grew 1.4% in 2017, reaching 3.4 million. HMO Medicare plans added 36,000 new members, and 42.7% of Medicare enrollees are now in a Medicare Advantage plan. Medicaid plans added almost 23,000 lives, and Meridian Health, Molina Healthcare and UnitedHealthcare Community Plan are the three largest Medicaid plans.
- After significant growth in 2014, 2015 and 2016, enrollment in individual plans here has begun to decline in 2017. Individual enrollment grew to 426,000 at the beginning of 2017, but declined during the year to 358,000, most of them in HMOs now. Blue Care Network, Blue Cross Blue Shield and Priority Health are now the largest individual plans here. Premium increases for individual plans for 2018 averaged 27.6%, much higher than in previous years. While some plans have exited that market, including Humana, some others have expanded their service regions, including Meridian Health and McLaren Health.
2. Market Structure
- Health Plans
- Provider Systems
3. Trend Review
- Health Plan Enrollment
- Medicaid Managed Care
- Medicare Plans
- Net Income
- Financial Results by Line of Business
- Provider Payments
- Health Plan Capital
4. A Look Ahead