Heightened Medical Costs Cloud Startup Payers’ Second Quarter

The return of some deferred care and an uptick in COVID-19-related utilization weighed on the financial results of a variety of managed care companies during the second quarter of 2021 — a trend that was also evident among a quartet of newly public startup insurers. However, the performance of Alignment Healthcare, Inc., Bright Health Group, Inc., Clover Health Investments Corp. and Oscar Health, Inc. across various metrics paints a more complicated picture.

All four insurers posted net losses in the second quarter and saw their medical loss ratios (MLRs) increase — some dramatically so (see infographic, p. 8). Oscar’s MLR, for example, jumped from 60.7% in the second quarter of 2020 to 82.4% in the most recent quarter. Medicare-focused Clover saw its net loss increase from $5.4 million in the second quarter of 2020 to $317.6 million during the same period in 2021, while its MLR rose year over year from 70% to 111%. And fellow Medicare Advantage startup Alignment Healthcare went from posting an $8.3 million profit during last year’s second quarter to losing $44.7 million in the most recent quarter.

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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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