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Weiss Ratings: 10 HMOs Weak, Nearing Failure

MANAGED CARE December 1999. © MediMedia USA
News and Commentary

Weiss Ratings: 10 HMOs Weak, Nearing Failure

MANAGED CARE December 1999. ©1999 MediMedia USA

Ten HMOs, covering more than 500,000 members, are in serious danger of collapsing, according to Weiss Ratings Inc. Of the 10 HMOs all rated E-minus ("very weak"), two — PriorityPlus of California and Rio Grande HMO, of Texas — have over 100,000 members.

Weiss counts 14 health plans that have failed this year. Only one plan achieved Weiss's top rating of "A," Blue Shield of California. Three others earned A-minus ratings.

On the upside, Weiss says most larger health plans have returned to profitability, and the end of the industry's financial decline may be in sight.

Oxford Health Plans is a case in point, turning its first profitable quarter in two years. Cost-cutting helped Oxford post third-quarter net income of $28 million. Two days before its announcement, Oxford President William Sullivan resigned to "pursue other interests." Sullivan was the last senior manager left from the HMO's heyday, which ended on an October 1997 day that saw its stock plummet 62 percent in a single trading session.

The bleeding is almost over for Kaiser Permanente, which has lost half a billion dollars in the last two years. Kaiser posted a $29 million net loss for the third quarter, down from its $89 million third-quarter loss last year. The company says if its North Carolina and Northeastern operations — which are being sold — were removed from the equation, it would have turned a $107 million surplus.

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