News Briefs: Medicare Advantage Insurers Continue to Collect Higher Gross Margins

Insurers in 2021 continued to command higher gross margins in the Medicare Advantage market than in other health insurance markets, according to a new Kaiser Family Foundation (KFF) analysis. Using financial data reported by insurers to the National Association of Insurance Commissioners (NAIC) and compiled by Mark Farrah Associations, KFF estimated that MA gross margins — or the amount by which total premium income exceeds total claims costs per enrollee per year — averaged $1,730 per enrollee in 2021, $2,257 in 2020, $1,819 in 2019, and $1,727 in 2018. Across all four years, MA insurers earned markedly higher gross margins than insurers in the individual, group and managed Medicaid markets, reported KFF. As seen in other markets, MA gross margins spiked in 2020 due to low utilization during the first year of the COVID-19 public health emergency.

© 2024 MMIT
Lauren Flynn Kelly

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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