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Anatomy of a suddenly sick Obamacare insurer

by:QY Precision      2019-10-21
Headlines about big insurance companies like Aetna have been screaming for months. AET)
Joint Medical (UNH)and Humana (HUM)
Get out of Obamacare because they can\'t make the exchange business profitable.
As a result, dozens of counties across the country have only one or no insurance option left in exchange.
In this context, the two small insurance companies mainly focus on the Medicaid market-
Health care (MOH)and Centene (CNC)--
As a company that can successfully navigate uncertain and complex exchange operations, this is often noticed.
Many states seek help from them and small regional or local insurers to fill the growing gaps left by big companies.
So it was a bit shocking when Molina announced it on August.
It will withdraw from exchanges in Wisconsin and Utah, cut back on exchanges in Washington state, and open its doors to exit other exchanges in the near future.
Trending girl survived the shark attack. In addition, in the market in which it will continue to operate, Molina has submitted an average premium increase of 55% to state regulators, in part due to the uncertainty of the future of federal cost-sharing payments.
What happens next in health care?
The news came when Morina reported second place.
Quarterly earnings lost $4.
Compared with 58 cents per share in the same period last year, earnings per share were 10.
Followed by ceo Mario Molina and chief financial officer John Molina, the son of company founder David Molina.
In the earnings report, Molina also announced a major restructuring, including layoffs of about 1,500 people, accounting for about 7% of the total number of employees.
Before all this bad news came out, Molina was one of the main examples of an insurance company that could actually make the exchange work. (
Centene is still expanding its foreign exchange business. )
Major insurance companies such as Antai Insurance and joint health insurance are used to more stable employers --
The sponsored health insurance market has suffered losses in the exchange business, in part because of their high
The cost of registration.
Molina\'s business focuses on implementing Medicaid programs for low-income people
Patients with income and disability.
As a result, the company has experience in managing small networks
The cost of health care providers.
\"Our idea is low arbitrage.
Reimbursement providers for exchanges where competitors pay more, \"explains Robert laszski, president of the Association for Health Policy and Strategy, a consulting firm.
\"There are opportunities for profit.
\"Morina found out that it can compete.
The decoration of the exchange market ends and enjoys a strong patient logo-ups.
According to Laszewski\'s estimate, Molina registered up to 70% of qualified participants in various markets in which it participated.
The large pool provides enough healthy individuals to help stabilize risks, he added. What happened?
According to Joseph White, Molina\'s interim CEO, the company is overwhelmed by the ACA business, including medical expenses and unexpected increases in claims.
\"We have not adjusted for the growth of the ACA market,\" White told analysts during a conference call last week . \".
He explained that the company focused its resources on existing processes and technologies, rather than a complete redesign, which would help it better cope with the growth of the ACA.
\"This is a mistake,\" White said . \"
\"The market shares the fundamentals of the Medicaid market, but there is a big difference,\" he added . \".
Health insurance saved lives, the study found. In addition, raszeski speculated that as Molina expanded into a new market and became a more dominant participant in other markets, it may
Revenue customers increase the cost and risk that cannot be dealt.
\"Every company has to analyze every market to make sure they make money in every market,\" said Dan Mendelson, chief executive of Avalere Health . \".
He added that, for example, a risky plan to exit the market.
\"When you pick up these customers, you may be dragged down by this risk.
\"Morina\'s bad news left exchange consumers with fewer choices and more uncertainty than they already face, as the Republican effort to repeal and replace Obamacare failed, trump for the system.
As the period of commitment of insurance companies approaches, the national insurance commissioner is trying to persuade them to stay on the exchange and at least keep the minimum coverage.
Also, small, local, and often non-profit players like Los Angeles. A.
Health care plans are doing what they can to fill the gaps while learning from Morina\'s recent chaos.
Are these efforts enough?
Consumers may have to wait until November to open their registration. 1 to find out.
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