Anthem warns of 2018 ACA marketplace exits

Indianapolis-based Anthem will consider pulling back its 2018 ACA exchange footprint if it continues to financially underperform in the program next year, reports Bloomberg.

On a Wednesday conference call discussing the insurer's third quarter results, Anthem CEO Joseph Swedish said, "If we do not see clear evidence of an improving environment and a path toward sustainability in the marketplace, we will likely modify our strategy in 2018."

Mr. Swedish said 2017 will be "a critical year as we continue to assess the long-term viability of our exchange footprint," according to the report. He said Anthem will be "surgical" in its market-by-market assessment of where to sell ACA plans for 2018 coverage.

The payer forecasts a slim profit margin in its 2017 exchange plans following "disappointing" losses, according to the report. The payer's third quarter profit for fiscal year 2016 dropped 5.7 percent from the same period last year. While Anthem intends to improve profits with plan changes and more than 20 percent premium increases on average, the payer said further regulatory action is needed to stabilize the market.  

John Gorman, founder of Washington, D.C.-based health plan consult firm Gorman Health Group, told Bloomberg Anthem's challenges "should be an alarm bell to policymakers. They're real trend-setters in the individual market."  

More articles about payer issues:
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