Massachusetts hospitals to spotlight payers' record pandemic profits

The Massachusetts Health and Hospital Association is planning to release its semiannual health plan performance report next month and will focus on payers' finances and enrollment in 2021. 

In a May 23 newsletter, the association highlights the 22 percent increase in payers' net worth during the COVID-19 pandemic, which totals $6.1 billion for all plans in the state. The newsletter also points to the combined $1.2 billion profit made in 2020 and 2021, which exceeds the previous five years combined.

The newsletter does point to the important role insurers played during the pandemic, including providing coverage of medical care, new therapies, vaccinations and COVID-19 testing. Under federal law, payers also provided rebates to premium payers as healthcare utilization decreased significantly. Some payers independently provided financial support to stabilize providers and used their resources to support the pandemic response.

"Despite these new expenses and efforts related to the COVID-19 emergency, health insurance company profits were substantially higher than at any point in recent history given the overwhelming effect of decreased medical utilization," the newsletter said.

The association also criticized the decrease in claims payouts during the pandemic, arguing surplus revenue should have been used to increase payouts and not increase profits. 

The hospital group stated that four specific payers, Harvard Pilgrim Health Care, UnitedHealthcare of New England, Tufts Associated HMO and HMO Blue from BCBS Massachusetts have risk-based capital ratios that approach or exceed 600 percent.

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