title: Financial performance indicators for health plans in Medicaid managed care.
abstract: This study is a descriptive analysis of the financial performance of licensed managed care plans that participate in Medicaid by ownership, provider-sponsorship, and the level of Medicaid focus and Medicaid enrollment. Using 2001 Interstudy data, health plan financial data for the Medicaid product line are analyzed on a national level for individual plans. Using SEC 10-K financial filings, company level analysis of two publicly traded, Medicaid-focused, managed care plans are analyzed as well. The analysis found that for-profit and non-profit plans had similar profit margins; however, for-profit plans incurred higher administrative costs ratios and lower medical benefits ratio. Plans with higher Medicaid enrollment had higher medical benefits ratios, while both provider-sponsored and non-provider sponsored plans had similar profit margins. Finally, publicly traded Medicaid focused plans achieved profit margins considerably higher than other Medicaid-focused plans.
authors.affiliation: Virginia Commonwealth University, Department of Health Administration, USA. mccue@hsc.vcu.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: McCue
authors.forename: Robert E
authors.initials: RE
authors.lastname: Hurley
authors.forename: Askar
authors.initials: A
authors.lastname: Chukmaitov
mesh_terms: D017598:Efficiency, Organizational / Q000191:economics*; D005376:Financial Management; D008329:Managed Care Programs / Q000191:economics*; D008484:Medicaid / Q000191:economics / Q000458:organization & administration*