1. Employer-based coverage experienced a modest decrease through September, while Medicaid enrollment increased substantially.
2. Gross margins per member per month among individual plans and fully insured group plans were 4 percent and 16 percent higher, respectively, than they were in 2019.
3. Gross margins per member per month among Medicare Advantage plans were 24 percent higher in 2020 than they were in 2019.
4. Gross margins per member per month among managed care organizations were 45 percent higher in 2020 than in 2019.
5. Annual loss ratios in the Medicare Advantage market decreased by 2 percentage points from 2019, and are now below the 85 percent minimum required by law, meaning those insurers could face penalties.
6. Annual loss ratios in the Medicaid managed care market decreased 4 percentage points from 2019, but met the 85 percent minimum requirement.
7. Many commercial insurers waived certain out-of-pocket costs and COVID-related services.
8. Overall, health insurers became more profitable during the pandemic.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
