Strategic pricing key to some insurers' success in ACA marketplace

Despite finanical losses among some of the "big five" heatlh insurers, several smaller health plans are experiencing significant growth within their exchange plans thanks to premium price planning and comprehensive provider partnerships.  

Beth Roberts, senior vice president of enterprise sales and marketing at Harvard Pilgrim, told Healthcare Finance the insurer has found financial success with exchanges in Maine, Massachusetts and New Hampshire because it planned for "heavy healthcare needs right out of the gate," with the expectation that those healthcare costs would even out.

Over time, marketplace enrollees will behave more like a typical insured population, Roberts told the publication, adding: "In the early years, we see this blip. The idea is over time, that will flatten out,"

Centene Corp., meanwhile, saw 500,000 additional exchange enrollees this year by focusing on lower-income individuals moving up from Medicaid plans, according to LifeHealthPro. In a conference call announcing the company's first quarter earnings, Centene's chairman Michael Neidorff said the insurer has experienced financial gains because it "maintained a disciplined approach to pricing from day one."

Although critics have raised concerns about the viability of the ACA exchanges, premium increases may in fact represent "more of a market correction than a sign that the marketplaces are unsustainable,"  Kaiser Family Foundation President Larry Levitt writes in commentary published on [email protected].

To learn more:
- read the Healthcare Finance article
- here's the LifeHealthPro article
- read Levitt's commentary

Suggested Articles

A judge has dismissed the ongoing case between Oscar Health and Blue Cross Blue Shield of Florida over broker arrangements.

Expanding options for dental care in Medicare is a popular idea, but policymakers could take several avenues toward this goal, a new analysis shows.

Tennessee's proposal for a block grant brings a host of questions