Are Private Insurers Avoiding High-Cost Members?

Private insurance companies are finding themselves with lower profit margins due to the Affordable Care Act. According to MedCityNews, this is leading some of these insurers to avoid high-cost members. These insurers have told brokers that they will not receive commission on many new customers who wouldn’t previously qualify.

Additionally, other big insurers are instructing brokers to focus on lower-benefit plans, which are more profitable for the insurance company.

This impact may mean more patients taking plans that don’t pay as much, or alternatively may mean patients opting to take the fine and go uninsured. In either case, it means that hospitals will need to focus on closing self-pay accounts in order to keep their revenue cycle managed efficiently.


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