UPMC sees 10% Medicaid enrollment growth, slimmer insurance margin

UPMC Health Plan’s Medicaid enrollment grew nearly 10% year-over-year, even as commercial enrollment fell, the insurance company’s parent company revealed Tuesday.

UPMC’s accounts for the nine months ended Sept. 30 show that the health plan covered 557,000 Pennsylvania Medicaid recipients from that date, nearly 50,000 more than a year earlier. Meanwhile, the Pittsburgh-based company’s commercial enrollment fell 4% to 659,000. The insurance division’s Medicare customer base grew 2.5% to 200,738. UPMC’s total membership of the health plan was just over DKK 4 million.

UPMC Health Plan’s operating income decreased by $ 206 million and its operating margin was 1.6% during the first nine months of this year, a decrease of 4% compared to the same period in 2020. Increasing medical requirements from patients who sought care, postponed in recent years due to the COVID-19 pandemic accounting for the smaller margin, according to the company’s financial report. ONE UPMC spokesman said none one was available to comment Wednesday.

UPMC’s total operating margin almost doubled to 4.4% during the first nine months of the year 2021 due to a stronger performance in its provider division. Outpatient revenue grew by 17%, and medical services and admissions also improved.

Medicaid enrollment has increased during the pandemic, largely due to a federal rule preventing states from kicking people out of their public health emergency programs, which Health and Human Secretary Xavier Becerra renewed for another 90 days on October 15. More than 9 million Adults and working-age children received coverage alone between February 2020 and January 2021, and the Urban Institute estimates that it will have grown to 17 million by the end of the year.

Similarly, Banner Health in Phoenix reported nearly 14% higher enrollment in its Medicaid plans in the first nine months of 2021. The health system’s Medicaid plans had an operating profit of $ 24 million during the period, exceeding the insurance division’s operating profit of $ 16 million during the first three quarters of 2020.

Banner Health lost $ 15 million on the operation of its Medicare Advantage contracts and earned $ 7 million on its commercial joint ventures during the first nine months of 2021. The system’s overall operating margin was small 1.8%.

Large, for-profit health insurance companies have reported large jumps in Medicaid enrollment. Centene, the largest Medicaid insurance company, reported a 12% year-over-year increase in Medicaid membership to $ 14.8 million per year. 30th of September. Anthem, the second largest Medicaid insurance company, saw Medicaid growth of 21% to around 10.4 million in September. 30.

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