This edition looks at the collective financial performance of a large group of MCOs across the 2018-2021 timeframe. Our key findings are that the health plans performed quite well during the COVID-impacted years of 2020 and 2021 – better than they had performed during the pre-COVID years of 2018 and 2019. Revenues and operating margins grew particularly sharply across these health plans’ Medicaid line of business during 2020 and 2021.
Our July 2018 edition conveys summary data regarding the Medicaid MCO industry’s overall financial performance during CY2016 and CY2017.
Our June 2018 edition summarizes the recent financial performance and quality performance for Georgia’s health plans, as an example of the information we often provide our clients using these datasets.
The October 2017 edition summarizes an analysis of Medicaid MCO financial performance of Medicaid MCOs in each state, showing the degree to which the health plans are collectively experiencing gains or losses. During 2015 and 2016, about two-thirds of states with MCO capitation programs landed in what we would consider an optimal place – with the health plans collectively earning a positive margin on their Medicaid business but with that margin not exceeding 5%.
The August edition tabulates information from the Medicaid MCO financial statements we collect and compile, showing the overall profitability among plans whose revenue is primarily (and often entirely) obtained through serving Medicaid populations.
The April edition provides Medicaid MCO financial performance statistics for 2015 – a compilation of 199 MCO financial statements. Collectively the industry earned a 2.4% operating margin on Medicaid business during 2015 with 71% of the MCOs achieving a positive margin and 29% experiencing a loss. An interesting finding was that the health plans’ percent operating margins were not correlated with plan size.
This month’s edition aggregates the financial performance of the nine largest US health insurers and presents these companies’ revenues, expenses, taxes, and net income from 2012 to 2015. This comparison reveals substantial growth in the health insurance industry with consistent yearly profit margins, even after paying sizeable amounts of income taxes.