Wednesday, February 24, 2016

ObamaCare Exchanges give Providers Higher profits.

Update: The media played up UnitedHealth Groups publicity seeking threat to leave the ObamaCare Exchanges because they couldn't make as much money as they thought, boohoo, but as you can see here, they've been whining for some time.
Insurance giant UnitedHealth Group seemingly took another step closer to bailing out of Obamacare in 2017 ... UnitedHealth Group is the master of health care for profit. In 2004, United’s CEO William McGuire (an MD, woefully enough), received compensation of $125 million, obtained, you may be sure, by tens of thousands of denials .... UnitedHealth and CIGNA, funneled $86.2 million into the U.S. Chamber of Commerce in 2009 to pay for the Chamber’s multifaceted campaign to kill President Obama’s health reform legislation.
UnitedHealth Group was never a big player in the exchanges. Those that are do well. Insurers are making more in Wisconsin because the Walker administration isn't trying to control premium increases like other states...Minnesota is one. 

ObamaCare Marketplace Health Care Providers Profits Up: Providers are doing well, patients are doing well, so there's a lot to celebrate in southeastern Wisconsin. Remember, these are providers not insurers. JS Guy Boulton:
Health systems in the Milwaukee area have seen a sharp increase in profits since the expansion of health insurance through the Affordable Care Act. So far, the law has helped the bottom lines of health systems in the Milwaukee area. The same trend overall can be seen throughout the country. A key reason: Health systems are providing less charity care and incurring fewer bad debts. A slew of other factors — including health systems' work to control costs and become more efficient — contributed to the increase in profits in the Milwaukee area. Still, the numbers are telling:
■ Aurora Health Care's operating income was up 221% in 2014, increasing to $503 million from $156.8 million in 2013. For the first nine months of 2015, operating income fell slightly to $337.5 million when compared with the same period in 2014. But that was more than triple the operating income of $92.4 million reported for the first nine months of 2013.■ Wheaton Franciscan Healthcare's operating income was up 158%, increasing to $69.2 million compared with $26.8 million in its 2014 fiscal year.■ ProHealth Care's operating income was up 125%, increasing to $37.8 million compared with $16.8 million for its 2014 fiscal year.■ Froedtert Health's operating income was up 79%, increasing to $149 million compared with $83.4 million in its 2014 fiscal year.■ Columbia St. Mary's operating income was up 26%, increasing to $26.1 million compared with $20.7 million in its 2013 fiscal year.
At least some of those gains have come from the increase in people with health insurance, either through the subsidized health plans sold on the federal marketplaces or the state's partial expansion of its Medicaid program. For example:
■ Froedtert Health's bad debt expense fell by $40.2 million, to $33.2 million, while the cost of providing charity care fell by $14.2 million, to $7.6 million.■ Wheaton Franciscan's bad debt expense fell by $29.6 million, to $44.9 million, while the cost of providing charity care fell by $15 million, to $34.5 million.
At the same time, the health systems are seeing more patients, in part because people previously uninsured are likely to schedule an appointment with a doctor. Many people who have gained coverage have commercial insurance, which pays higher rates.
While Republican health care plans focus on supposed free market principles that maintain the expensive and abuse prone fee-for service model, real reform in logically moving away from that:
Health systems also are preparing for the expected move away from so-called fee-for-service — in which they are paid based on the services they provide — to new payment models that could put more focus on costs and quality.

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