HMO industry 2018 income up 63%

Credit to Author: ANNA LEAH E. GONZALES| Date: Tue, 28 May 2019 16:20:28 +0000

The health maintenance organization (HMO) industry reported a 63 percent increase in net income last year, Insurance Commissioner Dennis B. Funa said on Tuesday.

Insurance Commissioner Dennis B. Funa. FB Photo

In a statement, Funa said data submitted by 29 HMO companies showed the industry’s net income during the period amounted to P1.65 billion from P1.01 billion in 2017.

Reported assets of the industry, on the other hand, amounted to P38.96 billion, also up 18 percent from P32.91 billion in the same period in 2017.

Funa said total revenue of the industry was also up 15 percent to P45.30 billion from P39.32 billion a year ago. Of the total revenue, P43.57 billion were generated from fees paid by members in exchange for the assumption of the risk funding members’ health care services and related administrative costs.

Total membership fees paid in 2018 was also up. “The total membership fees paid in 2018 is 14 percent higher than the P38.16 billion membership fees collected in 2017,” Funa said.

The Insurance Commission is currently finalizing the Standard Chart of Account (SCA) for HMOs which will serve as the financial reporting framework for HMO to ensure transparency in their financial conditions and the consistent application of existing regulations.

Funa said the SCA will provide a logical framework in the determination of the allocation and use of funds of HMOs in compliance with the rules and regulations promulgated by the IC.

He said the IC will also implement additional reporting requirements for HMO companies. “In order for the Commission to have a complete picture of the HMO industry, HMO companies are now required to submit comparable data relating to enrollment of members. Specifically, HMOs are now required to provide data on the number of clients, policies, members, principals, and dependents,” said Funa.

He said data to be collected will help in understanding the role of HMOs and their effect on the market for health services.

The IC is also currently drafting a regulation which seeks to require HMOs to establish and maintain a claims register which shall contain details of all claims made under HMO contracts.

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