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 has been reporting and editing in various journalism roles for nearly a decade. Most recently, she was the senior editor of FierceHealthPayer, an e-newsletter covering the health insurance industry. A graduate of Penn State University, she previously served in editing roles at newspapers in Pennsylvania, Virginia and Colorado.

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