threats-to-profitMany of the large, publicly traded insurers are receiving pressure to decrease participation in the ACA marketplaces in order to satisfy investors. According to a recent ModernHealthcare article, it is predicted that the marketplaces will continue to trend toward high-deductible, narrow-network plans in order to be more financially attractive. A quick overview of the second quarter results published last week explains why many insurers are not only opting not to expand their footprint in the exchanges but to decrease.

  • UnitedHealth Group, who reported earlier this year that they will be exiting most markets, reported an additional $200 million in losses.
  • Aetna expects to lose $300 million on the marketplace this year and won’t expand its exchange footprint in 2017.
  • Humana will be significantly decreasing participation following the blocked merger with Aetna.
  • Anthem experienced higher than expected enrollment of chronically ill members and its expansion is dependent on the pending Cigna Corp acquisition.

There are a few insurers that have reported profit due to successfully attracting healthy people with low monthly premiums. However, most insurers reporting losses attribute it partially to enrolling people that were sicker than originally expected. Without enough healthy people enrolling to offset, insurers have been unable to make the marketplace plans sustainable. For those insurers that continue to offer plans in the ACA marketplaces, the plans are anticipated to contain high deductibles. While high deductible plans are more sustainable for insurers, they are not ideal for people that encounter unexpected medical bills. This is when it is critical that patients have an option to pay toward their deductibles with manageable, monthly payments, instead of requiring a lump sum at the time of service. Rather than expecting medical providers to manage these payment plans, MyLoans Patient Account Financing can be utilized to relieve the provider of these responsibilities, while still providing an option for patients to pay their bills over time.

About MyLoans™

By providing patients with fast access to medical loans at a fair and unchanging interest rate, the MyLoans™ software by Epic River enables financial institutions to ease the financial stress of health care through collaboration with medical providers. Not only can medical providers offer patient financing for medical care needs, but doctors and hospitals alike can finally get immediate funding of their patient’s outstanding balances. Additionally, financial institutions gain new customers and interest income with little administrative overhead in exchange for servicing the loan. For more information, visit www.myloans.co.

About Epic River, LLC
Since its inception in 2005, Epic River has been providing high quality software services aimed at solving process-intensive problems. With a focus on high quality and rapid delivery, Epic River’s methodology accelerates the process of innovation while keeping a firm grasp on the business case behind the application, enabling our partners to grow their market leadership. The company’s unique approach to the agile methodology and user experience ensures both parties work closely together every step of the way. Whether you’re looking to expand into new technologies or markets, need a custom internal tool, assistance with architecture, or simply need someone you can trust to make technology decisions, Epic River is at your service. For more information, visit www.epicriver.com.