Rise of self-insurance in smaller groups: opportunity and threat
Posted by Tory Wolff on May 26, 2011 in Uncategorized
Summary Self-insurance is growing among smaller groups (including those sized 50-250) From a competitive point of view, it will be hard for insurers holding attractive groups in risk products to respond given the enormous profit cannibalization of converting from risk to an ASO offering But they will need to find some solution: risk products today are expensive for many groups given continuing low levels of utilization; “peanut-butter” share nationals at the forefront of these products (Cigna and now Aetna) won’t have cannibalization worries to stop them from pushing the model The channel may provide some temporary breathing… Read More
Major health plan Q1 earnings: Profit surprise in commercial risk; multiple reasons why business prospects look good
Posted by Tory Wolff on May 21, 2011 in Uncategorized
Public health insurers startled the market with earnings ~25% above consensus expectations. A key driver was lower-than-expected utilization (particularly in the under 65 commercial lives) which kept medical costs down. Management teams offered two theories in the analyst calls: bad weather and the beginning-of-the-year reset of consumer directed (CD) deductibles; neither is compelling: A lot of discretionary care has already been squeezed out of the system by the bad economy; it is hard to imagine that bad weather would drive out a lot more. Also the utilization decline was concentrated among the commercial lives (e.g., WLP)… Read More