UnitedHealthcare plans bigger presence on Obamacare exchanges

UnitedHealthcare plans to expand its footprint on the Affordable Care Act exchanges next year after exiting the marketplace in all but a handful of states in 2017.

The insurer filed an application to sell individual plans in Maryland in 2021, Gov. Larry Hogan said last week. Its entrance would inject more competition into the state’s ACA marketplace, where two insurers are selling plans.

UnitedHealthcare hasn’t yet said where else it will sell exchange plans next year, but has hinted that the expansion may not be limited to Maryland.

“As the exchanges have matured and stabilized, we intend to offer exchange plans in those states where we can provide an efficient network and competitive product capable of driving sustainable value for consumers and our state and federal partners,” a UnitedHealthcare spokesman said in an email.

The spokesman declined to say what other states the company may enter but said it would “evaluate opportunities on a market-by-market basis.”

UnitedHealthcare sold exchange plans in 34 states in 2016 but withdrew from nearly all of them after losing hundreds of millions of dollars on the plans. Since then, it has continued to sell exchange plans in only Massachusetts, Nevada and New York.

Other large insurers, including Aetna and Humana, also exited the exchanges during the volatile early years, when insurers lacked information to set accurate premiums and ended up pricing too low.

But now the COVID-19 pandemic and related job losses could drive higher enrollment in the exchanges and Medicaid as the newly uninsured search for new forms of health coverage. Some states have launched special enrollment periods in response to the crisis to allow the uninsured to sign up for a health plan, and early reports show the uninsured are taking advantage of the opportunity.

During a first-quarter earnings call in April, UnitedHealthcare CEO Dirk McMahon told analysts the company had been mulling participating in more exchanges even before the COVID-19 pandemic, but would have more information about its intentions during the second-quarter call.•

Memorial Sloan Kettering Cancer Center in New York City provided more cancer treatment in the first three months of 2020, despite postponing many surgeries in the latter part of March as a result of the pandemic. Sloan Kettering reported chemotherapy infusions were up 7.3% in the quarter ended March 31 compared with the prior-year period, and radiation oncology increased 9% during that time. Radiology services grew 20%.

Still, Sloan Kettering reported a nearly $62 million operating loss in the quarter, a 4.4% loss margin. That’s compared with $65.3 million in operating income for the same period in 2019.

Sloan Kettering’s operating revenue grew 8.2% to $1.4 billion in the recently ended quarter. The cancer center said volume reductions related to COVID-19 hindered its volume growth in the quarter. Grant and contract revenue dropped 4.7%, also due to COVID19’s effect on clinical trials. At the same time, the cancer center’s operating expenses spiked 19% in the quarter year-over-year, to almost $1.5 billion, which the provider said was due to the increased cost of treating COVID-19 patients.