HMO’s in Texas are experiencing somewhat of a comeback with enrollment hitting four million members. Interestingly enough, the dominant drivers are Medicaid and Medicare Advantage plans; HMOs have been broadening their markets and setting up networks so that they can gain a larger membership share of the federal programs. Enrollment is increasing for Medicaid plans, which are the largest HMOs in the Texas.
According to experts, Texas has been transitioning its elderly and disabled Medicaid recipients into managed care arrangements for the past few years. In addition, baby boomers in Texas are enrolling in Medicare where Medicare Advantage HMO enrollment has increased significantly. However, Medicaid HMO plans in Texas have lost millions of dollars on their operations in 2012, perhaps due to expansion costs. Experts say expanding provider networks and operations into new markets is costly.
In the near future, this expansion could boost profitability and jump start commercial HMO enrollment.
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