According to a recent Wall Street Journal article, health insurers are struggling to offset rising costs and are proposing big premium increases for coverage in 2017. Humana, Providence Health Plan, Anthem, UnitedHealth Group and Aetna, are just a few of the insurers considering rate hikes for 2017.
Challenges with their Affordable Care Act business were cited as a primary driver for premium increases. A number of insurers say the enrollees who bought plans through exchanges have had higher health costs than they originally predicted—resulting in lower profits. Rate increases will vary by state and by company, and not all insurers will have increases but as Sam Glick, a partner with consulting firm Oliver Wyman, a unit of Marsh & McLennan Cos. said, “It’s a pretty good bet if a plan lost money in 2016, it will adjust pricing in 2017.”
- Providence Health Plan, the largest insurer for people buying coverage through the Oregon health exchange, is seeking an average increase of 29.6%.
- Anthem Inc. is asking for an average increase of 15.8%.
- UnitedHealth Group Inc. said last month that it will withdraw from all but a handful of the 34 states where it was offering exchange plans next year.
- Humana said it would make changes to its exchange offerings for next year “to retain a viable product for individual consumers, where feasible,” and its moves may include “statewide market and product exits both on and off exchange, service area reductions and pricing commensurate with anticipated levels of risk by state.
- Moda Health Plan Inc., once the largest insurer on the Oregon exchange, says it will need to hike premiums by an average of 32.3% in 2017. That is coming on the heels of an increase of around 25% last year.
- Kaiser Foundation Health Plan of the Northwest asked for an increase of 14.5%
- CareFirst BlueCross BlueShield’s proposed average increases are around 25%
It is important for practices to pay attention to rate changes within your major insurers. In most cases, rate hikes will mean higher out-of-pocket expenses for your patients and, as a result, more challenges for you in collecting patient-owed balances. It is more important than ever to make sure your practice has developed core competencies in collecting co-pays, co-insurance, and deductibles a the point of service.