Managed Care

 

Excessive profits — where?

MANAGED CARE August 2013. © MediMedia USA
Snapshot

Excessive profits — where?

Raking health plans over the coals can be a recreational and popular blood sport enjoyed by senators on both sides of the aisle in Washington. Sometimes it’s even warranted. But when critics alleged that insurers make excessive profits and pay excessive bonuses to their CEOs, they’d better have the facts — and they don’t.

A recent review by America’s Health Insurance Plans suggests that other industries in the health care group had much greater profits in 2010. AHIP found that of the 14 health plans included in the Fortune 500 list, profit margin averaged 3.6 percent. Last year, that figure was 3.2 percent. Four of the 14 companies actually saw a decline in their profit margin — averaging a decline of 79 percent in profit margin from 2009 to 2010.

Molina, Health Net, Coventry, and Universal American reported margins below 1 percent, and Humana, Magellan, WellCare, and Centene reported margins between 1 and 2 percent.

In contrast, the average profit margin for the pharmaceutical industry is 16 percent.

And where on the Fortune 500 list does the industry “Health Care Plans” (which includes Humana, Aetna, WellPoint, Magellan, etc.) reside? Firmly in slot #86 — not exactly strong evidence of excessive profits.

Profit margins for health care industry groups, 2010

Source: Fortune 500 groupings

Average profit margin for five of the largest health plans (by market cap)

Source: America’s Health Insurance Plans, “Putting Health Plans’ Profits in Perspective”

Meetings

Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014