- Intermountain Healthcare reported losses of $392.5 million last year related to the Affordable Care Act’s risk-corridor program.
- The shortfall came as Medicaid expansion also cut into the health system’s bottom line, Modern Healthcare reported.
- Overall revenues were up 9.6% to $6.06 billion from 2014, but the company’s operating margin dropped by 5.5% to 3.8%.
Contributing to the disappointing results was Intermountain’s insurance division, SelectHealth, which offers health plans on the Utah and Idaho health exchanges. Uncertainties with government funding and very ill patients hurt the unit’s performance.
The risk-corridor program is meant to protect payers participating in ACA exchanges by shifting money from qualified health plans whose premium income outpaces claims to QHPs whose medical claims are far higher than premiums.
The Centers for Medicare and Medicaid Services agreed to pay just 12.6% of risk-corridor requests in 2014, and plans to limit payments for 2015 as well, though the rate has not been disclosed.
As of December, Intermountain had recouped only $11.9 million through the program, leading to the $392.5 million loss, according to the firm’s latest financial filing.
“Management intends to aggressively pursue all available means to collect any risk corridor receivables that it believes are fully valid under existing law,” Intermountain officials said.