News & Info Related To 2017 Open Enrollment

[somarco]

Does somebody need to explain the MLR to the Dems again?

They already know. That's why it is written into the law.

 

[taterpeeler]

If insurance companies knew how to manage their companies and dial down their ivory tower mentality they might make a profit.....

 

[tonyisme]

I don't think I'd start a business where I could only sell some of my product 2 months of the year... and have a cap on my profit... and if I make too much I have to give some of it back. If don't make enough well ..a regulator steps in...

 

[somarco]

Carriers know how to make money and overall they do, mostly via diversification. If a line isn't profitable, say like IFP, they jettison it and move on. They still have other lines where they can make money.

 

[barb12]

You are right. They are just making up the figures to pad their bottom line.

FWIW hospital claims are typically around 40 - 45% of total claim dollars. So you are only looking at partial data.



Have you examined carrier loss reports or are you just pulling this assumption out of your butt?

I was looking at the hospital financial summary reports for all hospitals in Arizona. The number of people seen in the ER, the total number of admits, the total gross patient charges and the total patient revenue (This number is after contract adjustments). Insurance carriers are not paying 40-45% of total claim dollars. They range from as little 18% to 25% of total charges for most of the hospitals in Az.
Now if insurance carriers were experiencing losses based on an increase number of sick people, it would also show an increase in the numbers seen at the ER or total admits for hospitals. No change in volume from 2013 -2015.

It would also show up in net patient revenue an increase in that amount as this amount is a combination of insurance payments and patient payments. No changes observed from 2013 -2015.

What I did notice is that hospitals increased their charges by 5 billion dollars in 2014 and 2015 compared to 2013 but it did not increase patient net revenue.
I was reviewed the financial summary of the 5 main insurance companies on the internet and they all indicated increase in profits. The losses were not because of an increase in sicker consumers, it was due to the fact that they were not getting the total amount in subsidies and they were delayed in getting them. They also complained about the expensive fees they are obligated to pay the government.
Some of them indicated that their foreign market was costing them more then expected.

 

[somarco]

Insurance carriers are not paying 40-45% of total claim dollars.

Dear, you need to look at carrier specific loss runs to get that data. Stick to what you think you know and leave the rest to the big boys who have studied this for years.

They range from as little 18% to 25% of total charges for most of the hospitals in Az.

And your point is?

hospitals increased their charges by 5 billion dollars in 2014 and 2015 compared to 2013 but it did not increase patient net revenue.

Could it be because patients are not paying their bills? Or maybe because there are more admitted patients on Medicaid?

I was reviewed the financial summary of the 5 main insurance companies on the internet and they all indicated increase in profits.

Again, your point is?

The losses were not because of an increase in sicker consumers,

And you know this because?

foreign market was costing them more then expected.

You are referencing illegal aliens that have either gamed the system or were approved by the idiots at hc.gov who have no clue about the criteria for approving eligibility?

Do you read financial statements as a livelihood or is this just part of your witch hunt vendetta to prove a vast right wing conspiracy?

 

[TN_agent]

I was looking at the hospital financial summary reports for all hospitals in Arizona. The number of people seen in the ER, the total number of admits, the total gross patient charges and the total patient revenue (This number is after contract adjustments). Insurance carriers are not paying 40-45% of total claim dollars. They range from as little 18% to 25% of total charges for most of the hospitals in Az.
Now if insurance carriers were experiencing losses based on an increase number of sick people, it would also show an increase in the numbers seen at the ER or total admits for hospitals. No change in volume from 2013 -2015.

It would also show up in net patient revenue an increase in that amount as this amount is a combination of insurance payments and patient payments. No changes observed from 2013 -2015.

What I did notice is that hospitals increased their charges by 5 billion dollars in 2014 and 2015 compared to 2013 but it did not increase patient net revenue.
I was reviewed the financial summary of the 5 main insurance companies on the internet and they all indicated increase in profits. The losses were not because of an increase in sicker consumers, it was due to the fact that they were not getting the total amount in subsidies and they were delayed in getting them. They also complained about the expensive fees they are obligated to pay the government.
Some of them indicated that their foreign market was costing them more then expected.

LMAO!!!! What an astonishing set of assumptions you are making.

No one is going to respond to you anymore, you are showing us you know absolutely nothing about this industry and you add nothing to the discussion.

As one of my young friends taught me, Bye Felicia!

 

[ARus]

Dear, you need to look at carrier specific loss runs to get that data. Stick to what you think you know and leave the rest to the big boys who have studied this for years.



And your point is?



Could it be because patients are not paying their bills? Or maybe because there are more admitted patients on Medicaid?



Again, your point is?



And you know this because?



You are referencing illegal aliens that have either gamed the system or were approved by the idiots at hc.gov who have no clue about the criteria for approving eligibility?

Do you read financial statements as a livelihood or is this just part of your witch hunt vendetta to prove a vast right wing conspiracy?

I suppose he/she is referencing the foreign market which each one of this companies is developing.


----------

LMAO!!!! What an astonishing set of assumptions you are making.

No one is going to respond to you anymore, you are showing us you know absolutely nothing about this industry and you add nothing to the discussion.

As one of my young friends taught me, Bye Felicia!

And here is one more smarty ....s! You guys can't sustain any different opinion if it doesn't sound your way? Shut your voices if it doesn't make you happy!

 

[TN_agent]

I suppose he/she is referencing the foreign market which each one of this companies is developing.


----------



And here is one more smarty ....s! You guys can't sustain any different opinion if it doesn't sound your way? Shut your voices if it doesn't make you happy!

LOL!! This has nothing to do with a difference of opinion. This has to do with someone trying to school us by completely misinterpreting reports.

Barb12 does not seem to realize that sick people can (and do) have substantial claims in non-hospital settings.

She also doesn't seem to realize that an insurance company can make a substantial amount of money in one segment, lose their butts in another, and still turn a good profit overall. This does not mean that they should be expected to keep rates the same for the segment that lost money. These carriers aren't charities.

Well, the co-ops kind of were..... where DID all those co-ops go... haven't seen any new ones open up in a while...

Now, good bye Felicia #2!

 

[ARus]

Bye dear Felix. You just can explain this, but not calling people Felicia's names, which of course creates similar responses. You obviously are insider to an ins company, or at least has a relationship with such. Whatever. The feelings between Felix and Felicia's are mutual.