FINANCE
According to the US 2020 census-'55 million people are 65 and over. One-fourth of these older Americans live in one of three states: California, Florida, and Texas. Seven other states—Georgia, Illinois, Michigan, New York, North Carolina, Ohio, and Pennsylvania—account for roughly another quarter of the 65+ population'.
These are primarily the states Humana plans to be making serious deletions/eliminations to their Medicare Advantage Plans.
The 'logic' that reducing benefits, accepting the anticipated loss of 300,00 policyholders, will be made up thru the expansion of 23 more clinics, is, what... 'Common Core Projection'?
They are complaining over the loss of reimbursement for services, the increased number of people using their services, makes no sense. dropping people and expanding. The public isn't going to be paying 'more for less'.
In Las Vegas at least ONE of their 'Community Centers' has closed. According to an Office Manager associated with CenterWell, they closed all of them in Las Vegas. Most logical reason that one can extrapolate is to 'reduce costs/increase profits'. Doesn't matter that it was 'supposed' to be part of their 'holistic' prong of 'social'.
This is the antithesis of 'Field of Dreams', 'if you build/rent it they will come'. Reality is if you remove benefits, they won't come to your newly acquired CenterWell locations. You will no longer be any noticeably different than traditional Medicare!
Susan Diamond Humana's Chief Financial Officer: notifying shareholders of the loss of potentially 300,000 members over decrease in Medicare Advantage benefits.
CenterWell Announces Plans to Open 23 Senior Primary Care Centers at shuttered Walmart locations in Florida, Georgia, Missouri and Texas, three of the states they are reducing benefits.
Humana and CVS, two of the largest Medicare Advantage insurers in the country, are poised to seriously downgrade their plan benefits and geographic presence next year as they chase profits in the privately run Medicare program…However, it will be months before the industry knows how much turbulence Humana and CVS might cause in their drive to bolster profits next year, and which insurers might benefit….growth has been a font of profits for insurers, which are paid a per-member, per-month fee based on their beneficiaries’ health needs. MA is an unusually lucrative program: Gross margins, which can serve as a proxy for profitability, are substantially higher in MA than other insurance markets.
“Medicare Advantage” is the misleading name given to the privatized portion of Medicare — the portion in which tax dollars are funneled through insurance companies so they can take 15% off the top to pay for administrative costs and profit before sending the other 85% to doctors and hospitals with strings attached. The traditional Medicare program — the unprivatized portion – does not funnel money through insurance companies; it pays doctors and hospitals directly, and it devotes around 2% of its expenditures to administrative costs. Today half of all Medicare beneficiaries are insured by insurance companies and the other half are insured by traditional Medicare.
At the end of 2023, gross margins per enrollee ranged from $753 in the Medicaid managed care market to $1,982 in the Medicare Advantage market. Gross margins per enrollee in the group and individual markets were $910 and $1,048, respectively, roughly half the level observed among Medicare Advantage plans on average.