понедельник, 17 сентября 2012 г.

Carelink Health Plans in good company, Many HMOs lost money last year - Charleston Daily Mail

Carelink Health Plans, Camcare's health maintenance organizationisn't a loner on a nationwide page of red ink.

A new report shows that 56 percent of 576 HMOs in the country lostmoney last year.

In combination, they suffered a $490 million loss.

The list of 1998 money losers includes Health Assurance, the WestVirginia-based company of parent Coventry Health Care of Bethesda,Md.

Coventry announced earlier this month it would purchase Carelinkfor $8 million.

Martin Weiss, chairman of Weiss Ratings Inc., said the huge lossesare not good news for consumers.

'We're bound to see more HMOs dropping Medicare patients, moreHMOs going under and more rate increases as the industry tries toboost profits,' Weiss said in a news release.

Camcare has invested $35 million in Carelink over five years.

Weiss reported that, in 1998 alone, Carelink, with 58,000 members,lost $10.9 million. Thus, Weiss graded the company with an E, or'very weak,' the lowest rating given.

Ratings are based on historical profitability, liquidity andstability, not on the quality of care provided.

Health Assurance, which serves 36,000 members, was given a D-plusrating. It lost $2.1 million in 1998.

Coventry, however, is licensed to do business in several statesand had a total of 1.4 million members as of March 31, companyrecords show.

During the first quarter of 1999, Coventry posted net earnings of$8.3 million, a 77 percent increase over the same period last year,according to U.S. Security and Exchange Commission filings.

Two other HMOs in the state lost money last year.

Anthem Health Plan of West Virginia was $6.2 million in the redwhile the Health Plan of the Upper Ohio Valley posted losses of $4.2million. The latter received the highest rating of the four plansrated in the state, or a B-minus, still in the 'good' category.

But none of the West Virginia HMOs could compare to several thatlost more than $50 million. Harris Methodist Texas Health Plan,rated D, lost $99 million.

The Weiss study found that 100 of the 576 HMOs failed to meetminimum risk-based capital guidelines recently adopted by theNational Association of Insurance Commissioners.

Had the guidelines been in full effect in all states, stateregulators would have been required to take control of 18 HMOs.

The state Insurance Commission did step in to help Carelink lastyear.

Writer Therese S. Cox can be reached at 348-4874.