The Big Picture V: New York's Private and Public Insurance Markets, 2012
Read the related press release.
The Big Picture is the Fund’s series of reports presenting enrollment and financial results in New York’s public and private insurance markets. This edition, fifth in the series, gives a snapshot of these markets in 2012, highlighting several shifts occurring in advance of the Affordable Care Act’s full implementation.
A major shift in 2012 was the dramatic growth of the Prepaid Health Services Plans (PHSPs), in terms of enrollment, revenue, net income, and overall market share. Overall operating revenues for New York health plans grew by about 16 percent from 2010 to 2012. Much of that increase is attributable to the growth in PHSP revenues spurred by new enrollment and the “carve-in” of the drug benefit for Medicaid Managed Care. Profits for commercial health plans declined from $1.43 billion to $1.2 billion from 2011 to 2012, but a successful year for PHSPs ($504.8 million) pushed overall net income for New York health plans to $1.7 billion in 2012.
Other topics covered—in charts, tables, and explanatory analysis—are the growth in Medicaid Managed Care enrollment, the decline in commercial group coverage, and the relative profitability of health plans’ different lines of business.