UnitedHealth Group said revenues will hit between $243 billion and $245 billion in 2019. Year-to-date, profits are up 29 percent to $8.9 billion when compared to the first nine months of 2017. Excerpt pulled from the this Becker Hospital Review article.
That’s the magnitude of the health care industry for payers. And the payer pie will only get larger as consolidation such as recent – Aetna/CVS continues.
Digital health company, Clover which offers insurance to seniors in New Jersey, and now to parts of Georgia, Pennsylvania and Texas posted a $22M loss in 2017.
The company serving the lucrative and stable Medicare Advantage market made revenue of $267M that year according to Bloomberg
It only takes a quick reading of the chart from the Kaiser Family Foundation below to note why this market is lucrative. The Medicare Advantage market is now 33% of Medicare – that’s 19 million people served from just 7 million people in 1999. Average premiums are $36 per person.
With almost 50% of the market dominated by United Health and Humana per Figure 6 KFF,
Clover has some work to do. On the immediate list for the firm include focusing on it’s sickest customers – to drive down ER costs/use, getting it’s Medicare Stars Rating up towards the perfect ‘5’ score and negotiating narrow-er networks.