Membership in HMOs drops dramatically in 3Q

Filed under: Health Care |

HMO membership dropped below 1 million during the third quarter of last year, according to the latest HMO quarterly filings with the Colorado Division of Insurance.

HMO membership was about 990,287 — down from 2,049,247 at the end of June 2006. Colorado Access no longer participates in the acute care portion of the Medicaid program, leading to the decline.

Colorado employers also are considering other types of health plans because of the rising cost of HMO premiums.

Despite the loss of members, HMO total revenue continues to grow, according to the Colorado Managed Care newsletter. In 2003, revenue was $2.6 billion, while in 2006, it was $2.8 billion.

Industry profits also grew on a “before tax” basis, up 48.16 percent, or nearly $50 million and after taxes by 54.64 percent or $40 million.

Centura program recognized

The Centura transplant program at Porter Adventist Hospital in Denver is among only 59 programs in the United States to obtain Cigna’s Lifesource’s Kidney Center of Excellence designation.

The program is the largest in the Rocky Mountain region and is available to more than 10 million Cigna Lifesource participants. Members who live outside Denver have access to travel benefits through Cigna, as well as access to Porter’s transplant house, a residence for family members accompanying the transplant patient.

The center has performed nearly 800 transplants since its inception in 1986.

Founded in 1930, Porter Adventist Hospital is a full-service 368-bed, acute care facility located in the University of Denver/Harvard Park area of Denver.

Supply firm accreditation

Major Medical Supply has earned the Joint Commission on Accreditation of Healthcare Organization’s Gold Seal of Approval.

The award of accreditation is for a three-year period, ending October 20, 2009.

Major Medical Supply is a full-service oxygen, respiratory and medical equipment and supply company.

Kids need flu shots

The Board of County Commissioners has declared January as “Flu Shots for Kids Month” in El Paso County.

“During the 2005-2006 flu season, more than 380 children in Colorado were hospitalized and two children died,” said Commissioner Jim Bensberg, who sponsored the resolution. “This is why it is so important to make sure everyone is vaccinated, especially our children.”

Each year more than 200,000 Americans are hospitalized and 36,000 die from flu-related complications.

Influenza vaccination is the single most effective means for preventing infection from the flu virus and associated complications. Vaccination can also reduce health care costs, hospitalization and death associated with the illness.

For more information about influenza, visit El Paso County Department of Health and Environment’s Web site at www.elpasocountyhealth.org or the Colorado Influenza and Pneumococcal Alert Coalition at www.immunizecolorado.com.

Care misconceptions

According to an AARP survey, Americans who are 45 and older, are not aware of the costs and funding sources of long-term care options — including nursing homes, assisted living residences and in-home care.

It is estimated that about 9 million Americans age 65 or older will need long-term care this year and that the number could increase to 12 million by 2020.

Although 60 percent of respondents said that they are at least somewhat familiar with long-term health care services, that familiarity was not supported by respondents’ knowledge of costs, the survey said.

For example, less than one in 10 estimated the cost of nursing homes within 20 percent of the national average, while 17 percent said they didn’t know. For assisted living, less than a quarter came within 20 percent of the correct cost, with 23 percent saying they didn’t know.

Respondents had no real consensus for the cost of an in-home visit from a skilled nurse. About one in four said they didn’t know.

They also did not know whether Medicare, Medigap supplemental insurance or Medicaid cover various type of long-term care, believing that the funding sources are available when they are not.

AARP officials say the survey shows the difficulty many Americans will have in planning for their long-term care needs. The survey shows that 29 percent of respondents believe they have long-term care insurance, and seven in 10 say they are prepared to meet the challenge of paying for long-term care.

“Although it is difficult to know how many Americans currently have long-term care insurance policies, Johnson and Uccello (2005) estimate that about 9 percent of adults ages 55 and older (or 5.3 million people) had private long-term care insurance coverage in 2002,” the survey said. “We have not been able to find a comparable estimate for the 45-plus population. However, since 29 percent of our sample says they have long-term care insurance, it appears that a substantial proportion of Americans age 45-plus think they have long-term care insurance when they probably do not. We suspect that many people are confusing long-term care insurance with other types of coverage, for example disability insurance provided by employers or Medicare. If this is the case, some Americans may think they have long-term care insurance when they do not.”

Amy Gillentine covers health care for the Colorado Springs Business Journal.