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Monday, November 06, 2017

Insurers make billions off Medicaid

Medicaid is rarely associated with getting rich. The patients are poor, the budgets tight and payments to doctors often paltry.

But some insurance companies are reaping spectacular profits off the taxpayer-funded program in California, even when the state finds that patient care is sub-par.

Health Net, a unit of Centene Corp., the largest Medicaid insurer nationwide, raked in $1.1 billion in profit from 2014 to 2016, according to state data obtained by Kaiser Health News. Anthem, another industry giant, turned a profit of $549 million from California’s Medicaid program in the same period.

Overall, Medicaid insurers in the Golden State made $5.4 billion in profits from 2014 to 2016, in part because the state paid higher rates during the inaugural years of the nation’s Medicaid expansion under the Affordable Care Act, or Obamacare. Last year, they made more money than all Medicaid insurers combined in 34 other states with managed care plans.

“Those profits are gigantic — wow,” said Glenn Melnick, a health economist and professor at USC.

Alan Sager, a health-policy professor at Boston University, was surprised — and dismayed.

“California is being wildly open handed and excessively generous with insurers,” he said.

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3 comments:

Anonymous said...

Just think about how many fire departments rip off Medicare. BC/BS, etc.

The Salisbury Fire Department alone rips off insurances companies by the millions annually by charging for patients that do not need to be transported. They train the paramedics how to write a report so that the insurance companies will pay the claim.

Most patients, nearly 100% do not need or require an ambulance transport. Most patients don't need an IV or an EKG or even oxygen, but they get them so that the charge can be much larger.

You people need to start calling a neighbor or driving yourself to the hospital instead of ripping off insurance companies.

Anonymous said...

Anonymous said...
Just think about how many fire departments rip off Medicare. BC/BS, etc.

The Salisbury Fire Department alone rips off insurances companies by the millions annually by charging for patients that do not need to be transported. They train the paramedics how to write a report so that the insurance companies will pay the claim.

Most patients, nearly 100% do not need or require an ambulance transport. Most patients don't need an IV or an EKG or even oxygen, but they get them so that the charge can be much larger.

You people need to start calling a neighbor or driving yourself to the hospital instead of ripping off insurance companies.

November 6, 2017 at 10:32 AM

You are correct. I work for the City and I have been watching it for several years.

Chris said...

In fact lifestar will have you rewrite your reports to make it so they can charge the max amount... Patients can walk but don't write that in the report or they don't get paid for ambulance transport they get paid for wheelchair van. Then they charge about 800 bucks per transport and only pay the emts 12 bucks an hour to care for someone's life. Yet burger flippers in Montgomery county are making 15 an hour with no responsibility near as serious as a loved ones life