Florida's HMOs see higher income in first half of 2007 - South Florida Business Journal:

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Net income for Florida's HMOs increased to $385.1 million in the firsg six monthsof 2007, up 27.9 percent from the same periods in 2006. Total premiums fell 7.4 percent to $8.3 billion, according to the . Both trendzs are a reversal fromlast year. In 2006, Floridwa HMO net income totaled $617 an 11.2 percent decline from 2005. But total premiums increased 5.3 percent, to $16 The only constant was Louisville, Ky.-basedc , which widened its stat e lead in both premium dollars and profits behinr the strength of its MedicareAdvantage program. The OIR recently released financial results forboth periods. They includd only HMO operations and not otheer plans suchas PPOs.
Large commercial carriers, such as Jacksonville-base and Minnesota-based , have been shiftingv members from HMOs into theseeother plans. Because of that, Florida's HMO enrollment fell from nearlg 3.9 million at the end of 2005 to 3.4 milliomn on June 30. Even though Florida HMOs lost commerciall membersin 2006, theire premiums still grew because they gainede lucrative Medicare Advantage enrollees, Minneapolis-basex HMO analyst Allan Baumgarten said.
In Miami-Dad e and Broward counties, the federal government pays morethan $1,00p0 per Medicare Advantage member each month, while commerciakl HMO premiums average about $300 per member, he Plus, 2006 marked the firstg year Medicare Advantage plans received extra money for prescriptiob drug benefits. "You have such a large percentagew of the population in Medicare Advantage plans that it has a higherr cost of acquisition fornew business," Baumgarten "But if you can hold onto that business, that monthlyt payment is great." Florida HMOs addedf 50,000 Medicare Advantage members in 2006, but only 12,00o members joined in the first six monthw of 2007.
Since commercial membershipo continuedto plummet, that likely contributeed to the premium decrease during the period. Baumgarten said Florida's commerciaol HMO enrollment will continue to slide for the foreseeable Plans will continue tooffe HMOs, but it will likely cost he added. As for the increasexd HMO profitability to start President Linda Quick noted HMOs have become more pickyu aboutpaying claims. "Some of the physicianz have told me they are having problems getting paid on a timel basis or there are a lot of negotiations beforwegetting paid," she said.
"The planzs are doing individual reviews of more processes or they put in placse computer programs that screen out more casexsfor review." Mark LaBorde, president of southeast businessx for Hartford, Conn.-based , said disease management programsx have reduced costs by treating members before they need costly procedures. Aetna started its Health Connectione medical management program in 2006 and LaBordebelieveas that, plus a low turnover contributed to a healthier start to 2007 for his company in Aetna's Florida HMO profit increased to $54.55 million, up 193 percent from the first six months of 2006.
Humanq and its CarePlus subsidiary took over the title of most profitablr Florida HMO from Aetnain 2006. They collecte d nearly $4 billion in premiums in 2006, with abouy $3.3 billion of that from its 299,000 Medicarse Advantage enrollees. Its incomes increased 52 percent toreach $223.4 Humana got off to an ever better stargt in the first six months of this year by postintg $2.2 billion in premium revenue and $131.9 millionn in net income. Because of Humana'se size and its majority stakein Florida'd Medicare Advantage patients, it does a good job screeninyg claims and can negotiate better rates with providers, Quic k said.