Due to poor performance in the Affordable Care Act's health insurance exchange's, UnitedHealth Group is considered pulling its plans from the exchanges in 2017.
Due to poor performance on the Affordable Care Act’s health insurance exchanges, UnitedHealth Group has revised its expected earnings for 2015. In addition, UnitedHealthcare has pulled back marketing efforts for the individual exchange products and is evaluating whether it will continue to serve the public exchange markets in 2017.
“In recent weeks, growth expectations for individual exchange participation have tempered industrywide, co-operatives have failed, and market data has signaled higher risks and more difficulties while our own claims experience has deteriorated, so we are taking this proactive step,” Stephen J. Hemsley, chief executive officer of UnitedHealth Group, said in a statement.
The company’s revised earnings are driven by projected losses on products in the individual exchange related to 2015 and 2016. UnitedHealth had previously expanded exchange offerings to 11 new states for 2016, bringing it to a total of 24 states and covering about half a million people in these plans.
Although, UnitedHealth hasn’t made the decision to exit the public insurance exchanges just yet, Hemsly seemed bearish on the outlook for the exchanges.
“We cannot sustain these losses," he said in a conference call. “We can't really subsidize a marketplace that doesn't appear at the moment to be sustaining itself.”
This announcement is a sharp departure from just a month ago when the company’s chief financial officer gave no indication in a conference call that performance in the exchanges was deteriorating, as the company now claims.
“We will expand to 11 new markets in 2016, and we continue to expect exchanges to develop and mature over time into a strong, viable growth market for us,” David Wichmann said in October.
Despite UnitedHealth’s concerns over the public exchanges, it has seen strong growth momentum and performance in all other benefit market segments and remains committed to its Medicaid business.
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Need for Pharmacogenomic Testing in Mental Health Care Explored at AMCP 2024
April 17th 2024Presenters from Mayo Clinic discussed the benefits of implementing pharmacogenomic testing in mental health care for the betterment of patient outcomes, reducing medical costs, and more at the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting.
Read More
Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
Listen
Study Highlights Disparities in Access to In-Network Mental Health Care vs Medical Care
April 17th 2024While health plans often employ reimbursement rates as a tool to incentivize provider participation within their networks, study results showed reimbursement rates for office visits with medical/surgical clinicians were on average 22% higher than behavioral health clinicians.
Read More