Monthly Archive: April 2016

Citing Losses, UnitedHealth to Pull Back From Obamacare – The New York Times

The UnitedHealth Group, one of the nation’s largest health insurers, told investors on Tuesday that it continued to lose hundreds of millions of dollars selling individual policies under the federal health care law. The company said it planned to pull out of the majority of states where it offered coverage and would offer policies on the public exchanges in “only a handful of states” for 2017.UnitedHealth, which was a late and seemingly reluctant participant in the public exchanges, surprised investors last year when it announced its sizable losses, now estimated at more than a combined $1 billion for 2015 and 2016, because of its poor performance in the public exchanges. Policy analysts have been watching UnitedHealth closely as an indicator of whether the new individual market developed under the Affordable Care Act is sustainable.Addressing investors, Stephen J. Hemsley, the company’s chief executive, continued to offer a pessimistic view. “The smaller overall market size and shorter term, higher risk profile within this market segment continue to suggest we cannot broadly serve it on an effective and sustainable basis,” he said.

Source: Citing Losses, UnitedHealth to Pull Back From Obamacare – The New York Times

Health plan issuers were supportive of the Patient Protection and Affordable Care Act’s individual and small group market reforms including public health benefit exchanges when the law was being enacted six years ago. The thinking was the reforms would stabilize these troubled market segments and grow the individual segment in particular by aggregating and subsidizing purchasers via the exchanges. Apparently the numbers aren’t adding up for UnitedHealth per Hemsley’s complaint that the individual market is too small and churn too high.

This development comes at the same time UnitedHealth is revamping its approach to the individual and small group segments with its Harken Health subsidiary. According to media accounts, UnitedHealth will continue to offer Harken Health plans in some state health benefit exchanges from which it is withdrawing other individual plan offerings.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

UnitedHeathcare’s Harken Health redefines the HMO in the age of Obamacare

AUSTELL, Ga. — UnitedHealthcare is betting $65 million that it can profit by making primary care more attractive.With little fanfare, the nation’s largest health insurer launched an independent subsidiary in January that offers unlimited free doctor visits and 24/7 access by phone. Every member gets a personal health coach to nudge them toward their goals, such as losing weight or exercising more. Mental health counseling also is provided, as are yoga, cooking, and acupuncture classes. Services are delivered in stylish clinics with hardwood floors and faux fireplaces in their lobbies. Harken Health is available only in Chicago and Atlanta, where it covers 35,000 members who signed up this winter on the Affordable Care Act’s insurance exchanges. UnitedHealth still sells traditional plans in those cities, too.

Source: UnitedHealth wagers $65 million on ounce of primary-care prevention

This individual and small group health plan offering appears primarily aimed at boosting health literacy and appreciation for healthy lifestyles among those new to health insurance following the expansion of coverage under the Patient Protection and Affordable Care Act. Since this cohort can be frequent users of care and who because they lack pre-existing provider relationships tend to rack up costly emergency room visits for non-emergent care, Harken Health aims to reach them — and reduce ER visits — by offering unlimited primary care visits without out of pocket costs.

An apparent goal here is that by improving health literacy of its members and instilling in them an appreciation for maintaining healthy lifestyles — key health determinants — Harken Health will build a long term relationship that will pay future dividends in avoided high cost care. It’s redefining the health maintenance organization for the Obamacare era.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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