CareSource No. 2 health insurer in Ohio

CareSource, a downtown Dayton-based Medicaid managed care provider, was the No. 2 health insurer in the state by premium revenue in 2013, according to a recent report from the Ohio Hospital Association.

The non-profit health plan recorded profit of $135 million last year on premium and other revenue of $4.2 billion. That was second only to Anthem Blue Cross and Blue Shield of Ohio, which posted profit of $392.5 million on total revenue of $5.2 billion last year, according to the trade group’s annual report.

Rounding out the top five by premium revenue were Aetna Health Inc. ($3 billion); Medical Mutual of Ohio ($2.5 billion); and Molina Healthcare of Ohio Inc. ($1.2 billion).

The total gain last year for the 22 health insurers who submitted financial statements to the Ohio Department of Insurance was $939 million on premium revenue of $23 billion, according to the OHA report. Premium revenue was up 2 percent over 2012, and profit margin was up 4.2 percent for the group.

Total membership grew by 2 percent, but the numbers did not include new members gained through the expansion of Medicaid in Ohio and plans sold directly to consumers through the Affordable Care Act’s health insurance marketplace.

CareSource has added more than 107,000 new members through the expansion of Medicaid eligibility to anyone earning up to 138 percent of the federal poverty level, and the company has enrolled more than 35,000 in its CareSource Just4Me brand health plans that it began selling in the marketplace for the first time this year.

The company expects total enrollment to grow by 20 percent from about 1.3 million by the end of year, and premium revenues to grow 38 percent to $5.7 billion.

“A 38 percent growth rate is substantial and it surprised us a little bit. Revenue growth means a greater opportunity to serve those who need coverage. We knew we were going to be close to $5 billion, but we didn’t expect $5.7 billion this year,” said CareSource President and CEO Pam Morris.

The bulk of the growth in membership and revenues will come from new product lines, including expanded Medicaid, Just4Me plans and MyCare Ohio, which combines Medicare and Medicaid into a single health plan for dual eligible members. Together, new products will account for just over $1 billion in revenues by the end of the year, company officials said.

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