Some of some of the largest HMO Manage To increase their pro

 

Monday, Apr 20,2009, 10:27:05 AM   Click:

Despite half of health plans in Michigan recording lower net profit in 2008 than the previous year, 10 of the largest overall profits rose an average 11.7 percent to $ 183.8 million from $ 164.6 million in 2007, according to the Michigan Office of Insurance and Financial Regulation.

Blue Care Network leads the pack with an increase of 72 per cent of its net income to $ 85.6 million in 2008 from $ 49.8 million in 2007. But Molina Healthcare of Michigan has the highest percentage of net gain of 323 percent to $ 16.5 million from $ 3.9 million in 2007.

Three other health plans has increased net income in 2008: Health Plan of Michigan, Midwest Health Plan and Aetna Inc.

Five others have seen earnings decline: Health Plan Great Lakes Health Alliance Plan, Health Plus of Michigan, the priority health and total health care.

Like many HMOs, Midwest Health Plan uses a variety of approaches to contain costs and improve quality. For example, employs nurses Midwest case of conduct and management of the disease on patients identified with chronic conditions such as diabetes or congestive heart failure.

"We are very good doctors and meet more often to get the cards to ensure we provide the best care possible," said Allen Kessler, Chief Financial Officer of Midwest, a Medicaid HMO founded in 1998.


Midwest's medical loss ratio, which is the amount of money it pays for claims from suppliers, is above 90 percent, he said. Midwest pays physicians under capitation, which is determined for each member per month payment.

Midwest also provides bonuses to doctors provide a variety of tests of preventive care, including mammography and blood screening, wellness examinations and vaccinations of children.

"We are very conservative plan, our membership has steadily increased and we had one (4 percent) increase in government revenue," said Kessler.

Midwest for membership rose 10 percent to 66,000 in 2008 from 60,000 the previous year, he said.

This year, Kessler projects of its members from managed care program for Medicaid and Medicare through its new special needs is people who are eligible for both Medicare and Medicaid. Approximately 300 members were signed up this year as part of the disease SNP.

"We'll do a little better this fiscal year," he said.