MM Curator summary
Early numbers are out for how much MCOs might have to pay back in the IL market due to pandemic-related underutilization.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
An analysis of quarterly and year-end financial statements of five Illinois Medicaid companies by the Better Government Association revealed an unprecedented increase in profits from April through December of 2020.
Meridian Health Plan of Illinois, IlliniCare Health Plan and Molina Healthcare of Illinois experienced a $282 million increase in profits from the same nine-month period in 2019.
Blue Cross and Blue Shield of Illinois and Aetna Better Health of Illinois reported large profits on a national scale, though exact numbers from the state level have yet to be determined, according to the Better Government Association’s May 24 report.
While the number of Illinois Medicaid members increased due to job loss during the pandemic, most members deferred elective treatment, a scenario that occurred across the country and resulted in larger profits for payers.
A spokesperson for the Illinois Department of Healthcare and Family Services told the Better Government Association earlier this month that “initial incomplete figures indicate HFS would recoup over $120 million” from the insurance firms for the 2020 calendar year.
“We will recoup more from the health plans than we otherwise would,” she said.
Clipped from: https://www.beckershospitalreview.com/payer-issues/illinois-medicaid-companies-made-record-breaking-profits-during-pandemic-investigation-finds.html