Medicaid MCOs Ponder Rates, COVID Unknowns for 2021

As select publicly traded insurers highlighted how increased Medicaid membership, rising yet still-below-normal levels of utilization, COVID-related costs and rate adjustments affected their third-quarter 2020 earnings, they appeared to approach the remainder of 2020 and full-year 2021 with equal parts caution and optimism.

Excluding one-time non-operating items such as its exit from Puerto Rico, Molina Healthcare Inc. on Oct. 29 reported adjusted earnings per share of $3.36 for the third quarter of 2020, compared with adjusted EPS of $2.83 for the third quarter of 2019. Molina’s overall membership grew sequentially during the quarter by 13%, or 478,000 members — of which approximately 473,000 were Medicaid enrollees — while premium revenue rose 17% from the prior quarter to $4.8 billion. Those results reflect Passport Health Plan’s membership and revenue, which Molina assumed in Kentucky on Sept. 1.

© 2021 MMIT

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues, including drug benefits and specialty pharmacy, for more than a decade. She served as editor of Drug Benefit News (the predecessor to Radar on Drug Benefits) from 2004 to 2005 and again from 2011 to 2016, and now manages Radar on Medicare Advantage. Lauren graduated from Vassar College with a B.A. in English.

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