Despite Hardball Tactics With Home Health Providers, MA Plans Have High Gross Margins

Insurers are reporting much higher gross margins per enrollee in the Medicare Advantage (MA) market than in other health insurance markets, according to a new Kaiser Family Foundation analysis.

At the same time, many Medicare Advantage plans continue to play hardball with home health providers by rationing utilization and offering low rates, Home Health Care News reports.

In 2021, MA insurers reported gross margins averaging $1,730 per enrollee. That was at least double the margins reported by insurers in the individual/non-group market ($745), the fully insured group/employer market ($689) and the Medicaid managed care market ($768).

The KFF analysis took a look at financial data in four insurer markets: Medicare Advantage, Medicaid managed care, individual (non-group) and fully insured group. Read more.

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