As still more health insurers and health care providers release third-quarter earnings, more company executives are talking about what the world shaped by the Patient Protection and Affordable Care Act (PPACA) is really like.
Some hospital companies have pointed out that PPACA-driven decreases in the uninsured rate seem to have stalled.
Some carrier executives say claims still look terrible.
But Samuel Hazen, president of operations at HCA Holdings (NYSE:HCA), a big hospital company, emphasized that the company’s relationships with commercial payers look about the same as they have looked in the past.
Uninsured rates may be creeping back up, and some patients may face higher out-of-pocket costs, but, in general, “there is nothing to suggest that the economy across HCA’s 42 markets has dramatically changed, or that any other competitive dynamic has had an impact on our business,” Hazen said.
The number of commercially insured businesses increased 2 percent in the third quarter, and that looks like a good sign, Hazen said.
Even some carrier executives said they were happy with how their own companies’ blocks of individual health insurance have been doing.
1. A carrier with conservative pricing is happy with how the market looks.
In the past, Centene focused on competing hard for big managed Medicaid plan contracts with narrow anticipated profit margins.
The company is reporting $93 million in net income for the latest quarter on $5.8 billion in revenue, compared with $82 million in net income on $4.4 billion in revenue for the third quarter of 2014.
William Scheffel, chief financial officer at Centene, said his company’s experience has paid off in the PPACA exchange market.
“We were very conservative going in,” Scheffel said.
In part because the company took a conservative approach to pricing and product design, the company’s exchange business has performed better than the company expected both in 2014 and in the first three quarters of 2015, Scheffel said.
U.S. Department of Health and Human Services (HHS) officials recently said the PPACA risk corridors program, a program that’s supposed to use cash from thriving exchange plan issuers to help struggling issuers, may get enough cash from thriving issuers to pay only about 13 percent of the cash owed to struggling issuers.
Centene doesn’t have to worry about the risk corridors program funding shortfall because it’s one of the thriving issuers expecting to have to pay into the program, Scheffel said.
Executives implied that their exchange plan business has profit margins in the 3 percent to 5 percent range.