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FOR IMMEDIATE RELEASE
OLDWICK - MARCH 02, 2015 11:59 AM (EST)
Although the health insurance industry has experienced significant headwinds in recent years with the slow economic recovery and sweeping changes in the health care environment due to the implementation of the Patient Protection and Affordable Care Act (ACA), provider-owned plans have been able to keep up with the rest of the industry in terms of membership expansion, profitable premium growth and risk-adjusted capitalization, according to a new A.M. Best special report.
The Best's Special Report, titled, "Provider-Owned Plans Fare Well In Wake of the Patient Protection and Affordable Care Act," states that provider-owned plans encompass regional provider-owned, -sponsored and -founded health plans. While A.M. Best had previously indicated that the provider-owned health plan segment could see renewed interest, it appears providers and carriers alike have sought other options besides buy/build and there is now a significant health care focus on alignment.
In 2014, the ACA brought with it a flood of regulatory and environmental changes; nevertheless, the industry has stood strong; and national, regional and local plans were able for the most part to successfully manage through the implementation and execution of strategies designed for the new landscape. A few instances of financial issues were experienced by smaller local carriers due to excessive growth, mispricing and/or earnings and capitalization concerns. However, these were in the minority, and for 2014, A.M. Best has again reported more ratings affirmations and upgrades than downgrades in the health sector. While results have fluctuated on a year-over-year basis, provider-owned plans in this study reported favorable trends in aggregate and have fared even better in some metrics than some of their industry peers.
In 2013, provider-owned plans in this study saw:
For a full copy of this special report, please visit: http://www3.ambest.com/bestweek/purchase.asp?record_code=234043 .
A.M. Best Company is the world's oldest and most authoritative insurance rating and information source.