How payers’ finances fared in 2020: 8 things to know

The Kaiser Family Foundation released a study on how insurers performed financially during the pandemic year. Here are eight things to know:

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1. Employer-based coverage experienced a modest decrease through September, while Medicaid enrollment increased substantially.

2. Gross margins per member per month among individual plans and fully insured group plans were 4 percent and 16 percent higher, respectively, than they were in 2019.

3. Gross margins per member per month among Medicare Advantage plans were 24 percent higher in 2020 than they were in 2019. 

4. Gross margins per member per month among managed care organizations were 45 percent higher in 2020 than in 2019.

5. Annual loss ratios in the Medicare Advantage market decreased by 2 percentage points from 2019, and are now below the 85 percent minimum required by law, meaning those insurers could face penalties.

6. Annual loss ratios in the Medicaid managed care market decreased 4 percentage points from 2019, but met the 85 percent minimum requirement.

7. Many commercial insurers waived certain out-of-pocket costs and COVID-related services.

8. Overall, health insurers became more profitable during the pandemic.

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