Most provider-owned health plans weather economic downturn


Although almost all businesses were touched by the slowdown, some weathered the recession better than others. In particular, large health insurers flush with cash had been buying up regional provider-owned plans — but that buying spree is slowing down, says A.M. Best, the credit rating company.

The company says that in the wake of health reform, there may be renewed interest by providers in creating or acquiring health plans. (See also the interview with Jeff Goldsmith, the consultant.)

A.M. Best says provider-owned plans have remained disciplined, with seven plans reporting a more favorable membership trend over the past five years than the rest of the industry and a relatively stable underwriting margin, except for the decrease in 2009. A.M. Best says these regional provider-owned plans focused on spending reductions and controlled growth. Profit margins for industry-owned plans dropped 11 percent from 2007 to 2008, more than their provider-owned counterparts. The company says industry-owned plans usually have riskier investments and experienced larger realized losses.

Provider-owned health plans — underwriting and profit margins (%)

Source: A.M. Best’s Special Report. “Segment under pressure; but may see renewed interest.” September 2010

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

Subscribe to Our Newsletters

Monthly table of contents

Be notified as each issue of Managed Care is available online.

Biweekly newsletter

Recent topics have included:

PTCommunity news

New drug approvals, clinical trials, drug management. Three times per week.