Minnesota Health Market Review 2018

  • ID: 4575964
  • Report
  • Region: United States
  • 52 Pages
  • Allan Baumgarten
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Minnesota Health Plans, Including HMOs, Other Insurers like Blue Cross Blue Shield, and County-Based Purchasing Plans, Posted Profits of $296.1 Million in 2017, or 1.7% of Underwriting Revenue

FEATURED COMPANIES

  • Blue Cross Blue Shield
  • Group Health
  • Medica
  • UCare
  • UnitedHealthcare
  • MORE

Minnesota HMOs and health insurers returned to strong profitability in 2017, recovering from a year of large losses in 2016. Minnesota seniors are being offered a variety of new Medicare plans from old and new competitors.

These findings are reported in Part One of Minnesota Health Market Review 2018. This is the 29th edition of the report, in which the research analyzes key trends and competitive strategies for organizations in Minnesota’s health care markets. Part Two of the Minnesota report will analyze the state’s provider systems and their strategies, financial performance and inpatient utilization.

The new report finds that:

  • Minnesota health plans, including HMOs, other insurers like Blue Cross Blue Shield, and County-Based Purchasing plans, posted profits of $296.1 million in 2017, or 1.7% of underwriting revenue. Large losses by two HMOs and Blue Cross Blue Shield in 2016 gave the industry overall losses of $523.2 million. In other words, health plans had a swing of $819.3 million to the good. To put their losses behind them, Blue Cross Blue Shield shed its money-losing individual plans, while Medica Health Plans terminated its major Medicaid contract.
  • Health plan enrollment grew in 2017, but not in all lines of business. Enrollment in Medicaid and other state programs grew by more than 54,000, or 6%, while enrollment in HMO commercial plans, individual and employer groups, grew by 61,000. However, many of the individual enrollees came to HMOs after Blue Cross Blue Shield ended its individual plans.
  • Enrollment in HMO and PPO individual plans dropped again in the first quarter of 2018. Individual enrollment peaked at about 311,000 at the beginning of 2015, but has dropped every year since, and dropped another 16.4% to 163,000 in the first quarter of 2018. Minnesota’s reinsurance program for individual plans enabled insurers to hold down or reduce premiums, but that program’s future funding is not assured.
  • Seniors have several new Medicare health plan options for 2018, and more are planned for 2019. Three of the largest Medicare plans in Minnesota - Blue Cross Blue Shield, Group Health and Medica - are Cost plans in which the health plan does not take risk for inpatient care. Those are going away, and those three companies introduced new full-risk Medicare Advantage plans for 2018. UCare already has a full-risk plan with 86,000 lives, and UnitedHealthcare is expected to market new senior plans here. About 60% of Medicare recipients here are in a health plan, among the highest rates in the country.
  • Another new Medicare plan is expected to be the new joint venture insurer, Allina-Aetna Health Insurance. The transition from Cost plans is creating opportunities for new entrants. The Allina-Aetna plan is a joint venture of the state’s largest hospital system and a national insurer. It is already marketing to employer groups and seeking approval to offer Medicare Advantage plans for 2019.
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FEATURED COMPANIES

  • Blue Cross Blue Shield
  • Group Health
  • Medica
  • UCare
  • UnitedHealthcare
  • MORE

Part One:

1. Introduction 

2. Market Structure  

  • Health Plan Companies
  • Network Arrangements and Provider Systems

3. Trend Review 

  • Health Plan Enrollment
  • Individual Markets and MNsure
  • State Healthcare Programs
  • Medicare Health Plans
  • Health Plan Net Income
  • Financial Results by Line of Business
  • Administrative Expenses
  • Health Plan Capital

4. A Look Ahead    

Part Two:

1. Introduction

2. Hospitals and Provider Systems

3. Twin Cities Area Hospitals and Systems

  • Revenues and Net Income
  • Occupancy and Payer Mix
  • Performance Bonuses and Penalties

4. Outstate Systems and Hospitals

  • Revenues and Net Income
  • Occupancy and Payer Mix
  • Performance Bonuses and Penalties

5. Health Plan Trends

  • Enrollment by Region
  • Utilization and Effectiveness of Care and Enrollee Satisfaction

6. A Look Ahead

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  • Allina-Aetna Health Insurance
  • Blue Cross Blue Shield
  • Group Health
  • Medica
  • UCare
  • UnitedHealthcare
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