Snaebjorn Gunnsteinsson

eHealth (EHTH), a Medicare eBroker, released Q2 '24 results last week. Here are 12 important financial metrics: 1\ MA LTV up 4% YoY -current Q: $927 -prior year same Q: $891 2\ MS LTV up 27% YoY -current Q: $1,112 -prior year same Q: $875 3\ IFP LTV mixed YoY Non-qualified Health Plans up 7%: -current Q: $353 -prior year same Q: $329 Qualified Health Plans down 1%: -current Q: $354 -prior year same Q: $357 Note: “IFP” stands for Individual and Family Plans 4\ Medicare Customer Acquisition Costs (”CAC”) down 4% YoY Made up of 2 components: Customer Care and Enrollment (”CC&E”) per approved policy down 15% -current Q: $599 -prior year same Q: $706 Marketing per approved policy up 15% -current Q: $457 -prior year same Q: $396 5\ IFP Acquisition Costs (”CAC”) up 20% YoY Made up of 2 components: Customer Care and Enrollment (”CC&E”) per approved policy up 23% -current Q: $284 -prior year same Q: $230 Marketing per approved policy up 5% -current Q: $59 -prior year same Q: $56 6\ Total Approved policy counts down 7% YoY -current Q: 56,568 -prior year same Q: 60,768 7\ MA Approved policy counts up 6% YoY -current Q: 37,638 -prior year same Q: 35,597 8\ MS Approved policy count down 33% YoY -current Q: 1,954 -prior year same Q: 2,923 9\ Total Revenue down 1% YoY -current Q: $65.86 million -prior year same Q: $66.77 million -includes $9.0 million non commission revenue 10\ Operating Loss increased 7% YoY -current Q: $(27.96) million -prior year same Q: $(26.15) million 11\ Commission Receivable Balance up 5% -current Q: $832 million -prior year same Q: $790 million 12\ Valuation Metrics -Market Cap: $127 M ____ Like, comment and share! I post Medicare market insights daily. P.S. -> sign up for my free weekly newsletter. Designed to keep busy leaders informed and up-to-date. https://lnkd.in/gmv65ipM

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Our landing page for Verisk NGM [Next Generation Models] features product materials, published papers & articles on industry best practices, which define our view of natural catastrophe risk. https://lnkd.in/egMmF5TF In the interest of knowledge sharing & peer review, we have done the due diligence to have industry associations & journals take record of innovation by Verisk Extreme Event Solutions. The selected items tell the story how at times of excess #insurance & #reinsurance hazard & #claims #volatility we bring to market #statistical and #actuarial methodologies to equip our clients with the right approaches for the tasks at hand.

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As monopolies expand their power and influence in healthcare, they grow complacent. And when that happens, innovation dies. Ultimately, Americans pay the price with their wallets and their health. Make no mistake, insurance companies know how to assert control. Ask practicing physicians about their experiences with the big five, and they’ll passionately criticize the “prior authorization” process, which requires that insurance companies approve, in advance, nearly all expensive medical tests, treatments and procedures. And in communities with multiple hospitals, insurers often pit one against the other to keep daily rates down. That’s why, in recent years, hundreds of hospitals have been forced to file for bankruptcy, particularly in underserved and rural areas. With so much influence over medical professionals and their workplaces, the nation’s insurance giants have enough clout to rewrite the rules of healthcare and drive vastly better performance at the care-delivery level. Insurers, in theory, could use their size and influence to simplify an overly complicated (and increasingly dysfunctional) medical system while dramatically lowering prices. But they haven’t. As a consequence, the U.S. spends nearly twice as much on healthcare as every other nation but ranks last among the 12 wealthiest nations in medical outcomes. https://lnkd.in/gNWnpxhK

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Dave Chase's post below is something every health plan sponsor needs to be aware of, but I felt compelled to include comments from Keith Smith, Medical Director at Surgery Center of Oklahoma, because he is spot on. As Kevin pointed out, “I struggled to understand why carriers would not want cheaper and better after posting our prices. This skimming, re-pricing scam explains it completely and why currently no carriers want any part of reasonable and visible pricing. Hospitals are happy to participate in this scam, as you well know, Dave, as they claim these uncollected, conjured write-offs as losses, justifying their ‘not-for-profit’ fiction. This ‘uncompensated care’ forms the basis then for the DSH (disproportionate share hospital) kickbacks from Uncle Sam. What a racket.” The U.S. healthcare system is not broken. It is performing exactly the way it was built to perform, to the benefit of the Big Health Insurance companies and healthcare providers/systems, not the patients. Managed care introduced numerous tools for them to hide the true cost from the public and allow them to use smoke and mirrors to con us into believing we're getting a good deal. The truth is coming out, but we still need more people understand what's really going on. Employers can do their part by not settling for the status quo con from the BUCAs, but instead embracing a health plan that works for their company and its employees and makes healthcare affordable and their plan sustainable.

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The future of Medicare Advantage is evolving fast, with major shifts affecting payers. Demographic changes, regulations, and member preferences are shaping the landscape. Payers need to adapt quickly. Read more in this insightful article. #Medicare #Healthcare

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Price Transparency Jan 2021: Hospital Price Transparency Rule was passed which requires hospitals to publish their contracted rates for procedures and services online. July 2021: Transparency in Coverage Rule was passed which requires insurers to disclose their contracted rates for procedures and services online. Over the last 18 months, I've been focused on this price transparency movement plus quality to bring this data forth to employers, hospitals, stop loss entities, independent TPA’s, and policy makers. Most, if not all, of these verticals have a high interest in this data to make better informed decisions. Times are changing. Two months ago, I had the absolute pleasure of meeting one of the individuals who was responsible for the Hospital Price Transparency Rule. It was my fan boy moment ;) Since then, we continue to converse on the future ahead. What's the reason for this post? This individual has spent his whole career in this space and 3 years dedicated to this rule. Since then, he has not fully seen the fruits of this rule. While he knows a lot more work needs to be done, he was excited to hear the momentum happening in the industry. Going up against the status quo can be challenging, but when you know this is making a difference in the lens of affordability and accessibility for all Americans, it aligns to a bigger purpose than any one individual. Doing the right thing is never the wrong thing. Keep going. #pricetransparency

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