Page 19 - BusinessWest September 28, 2020
P. 19

     KEITH LEDOUX
“After April, on the medical side, we saw a significant reduction in claims, but starting in probably June, we started to see that pick back up — almost back to what we would
consider to be somewhat normal.”
telehealth visits for its mem- bers versus 900 in all of 2019, accounting for $12 million in costs for Health New England.
“One reason that’s so costly for us is that we’re mandated by the government to pay
the same rate for telehealth
as we would for an in-person visit, and typically telehealth
is cheaper than in person,” Ledoux said, adding that future state negotiations will likely alter that formula as telemedi- cine continues to gain traction
last year. Humana’s second-quarter net income rose from $940 million in 2019 to $1.8 billion in 2020.
But the issue is a complex one, especially in Massachusetts, where laws governing insurance are different, said Keith Ledoux, vice president of Commercial Line of Business, Sales, Market- ing, and Business Development for Health New
Meanwhile, “after April, on the medical side, we saw a significant reduction in claims, but starting in probably June, we started to see that pick back up — almost back to what we would consider to be somewhat normal.”
At the same time, the pandemic brought about a significant increase in telehealth utiliza- tion; through April, HNE had processed 114,000
ments of the market, regardless of a person’s age or life circumstance,” Chief Financial Offi- cer Umesh Kurpad noted in a statement. “This diversity in our business translates into different financial pressures, such as significantly higher COVID-19 infection rates and treatment costs for our members, particularly those who rely on both Medicare and Medicaid.
“Year-to-date, our earnings were challenging, with the increased costs of COVID-19-related expenses across virtually all of our businesses,” he went on, projecting COVID-19 expenses to reach $220 million for the full year. “The pan- demic cost tail is anticipated to be long with
the lingering impact of COVID-19 survivors and increased morbidity from deferred care.”
In short, there’s no one trend common among health insurers in a year where they, like all industries, have learned to expect the unexpected.
Appointment Viewing
Another Massachusetts-based insurer, Har- vard Pilgrim Health Care, reported little change in second-quarter net income from 2019 ($36.2 million) to 2020 ($40.9 million). It also encour- aged members not to avoid medical services they need.
“Now more than ever, our focus remains
on the health and well-being of our members and the communities we serve,” President and CEO Michael Carson said. “Many people have deferred care over the past several months, and it is incredibly important that they not neglect their health. Healthcare providers have imple- mented stringent safety precautions, and we encourage our members to seek routine and
  England, a 166,000-member health plan based in Springfield.
For example, HNE did see lower utilization for medical services among its members in the early months of the pandemic; however, at the same time, it saw an increase in prescription- drug fills as members made sure they had their medications during stay-at-home orders.
“On the pharmaceutical side, we saw a small spike in claims and overall costs starting at
the end of March and the beginning of April because we had relaxed our rules on allowing folks to fill prescriptions early, or to get a greater supply,” Ledoux told BusinessWest.
in healthcare.
“The silver lining is not the cost, but the
behavior shift of so many members embracing the idea of telemedicine, which does broaden your ability to access non-invasive care. There’s definitely an opening for systems to adopt a new approach and potentially increase their revenue stream using telemedicine.”
Massachusetts-based Tufts Health Plan reported that COVID-19 treatment costs were one factor in actually recording a drop in net income between the first six months of 2019 to and the six months of June 2020.
“Tufts Health Plan proudly serves all seg-
 All Wallets Welcome Here
Even you, duct tape.
  (L-R): Bob Proulx, Account Executive; Paul Lesukoski, VP, Business Development; Mike Smith, VP, Insurance Producer
Business Insurance
Berkshire Insurance Group, the largest full-service agency in western Mass., offers a complete line of property
and casualty insurance products for individuals and commercial clients.
Call today: 866.636.0244
        berkshireinsurancegroup.com
 Insurance products are provided by Berkshire Insurance Group, Inc., a Berkshire Bank affiliate, and in New York by Berkshire Insurance Agency, a registered trade name for Berkshire Insurance Group, Inc., a Berkshire Bank affiliate: Insurance products are NOT FDIC-INSURED, are NOT A BANK DEPOSIT, NOT GUARANTEED BY THE BANK, NOT INSURED BY ANY FEDERAL GOVERNMENT AGENCY and MAY LOSE VALUE.
Banking products are provided by Berkshire Bank:
Member FDIC.
Rev. 9/20
BusinessWest
INSURANCE
SEPTEMBER 28, 2020 19
 






















































   17   18   19   20   21