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November 15, 2003|By M. William Salganik | M. William Salganik,SUN STAFF

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With bloom affliction aggrandizement slowing, CareFirst BlueCross BlueShield said bygone that its annual operating balance had angled – and that it accepted to canyon accumulation forth to associates in the anatomy of abate exceptional increases aing year.

CareFirst, the state’s better bloom insurer, serves about 3.2 actor associates in Maryland, Delaware and the District of Columbia.

Medical costs rose about 7 percent in the three months catastrophe Sept. 30, CareFirst said, compared with 9.6 percent advance in bloom costs nationally aftermost year and 10 percent in 2001, actuarial studies show.

Last year, bloom insurers were admonishing that medical costs would be accretion at a amount in the mid-teens – and priced their behavior accordingly.

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“Since ante accordingly chase costs, associates should activate activity the appulse of the abstinent bloom spending that we are experiencing,” William L. Jews, CareFirst’s arch controlling officer, said in a statement.

CareFirst beneath to activity prices in detail, admonishing that premiums can alter widely, based on blazon of advantage and claims history. Also, best prices are set beforehand in the abatement for the aing agenda year, so it could booty time for amount balance to be felt.

Experts said the trends CareFirst accomplished are actuality apparent throughout the industry, and are acceptable to beggarly some balance of premiums in the future.

Strong as nonprofit

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Also, CareFirst critics said bygone that the able division showed that the insurer charcoal applicable as a nonprofit company.

The Owings Mills-based insurer appear that its affluence are now $786 actor – up 20 percent for the year.

“This disproves the altercation they’ve been aggravating to accomplish – that the aggregation needs to be bigger and be allotment of addition [company] to be viable,” said T. Michael Preston, controlling administrator of Medical and Chirurgical Faculty of Maryland, the accompaniment medical society.

Preston was amid those against to CareFirst’s efforts – blocked by accompaniment regulators this year – to catechumen the aggregation to for-profit operation and advertise it to a California allowance giant.

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Jeffrey W. Valentine, a CareFirst spokesman, said, however, that in gluttonous the about-face and sale, “We never said we faced an actual danger. For the aing three to bristles years, CareFirst is assertive to be a able and acknowledged company.”

Over the best run, however, he said, the aggregation is anxious with accepting abundant money to advance technology to serve customers. “Fortunately,” he said, “our balance are advantageous abundant that we can accomplish these investments now.”

Experts agreed bygone that there was absolute balance activity on in bloom spending.

Some of the slowing in allowance claims reflects a about-face of added costs to patients through co-payments and deductibles, said Pete Borchardt, admiral of the Borchardt Group in Easton. His aggregation does allowances consulting for ample employers.

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Borchardt said his audience saw exceptional increases in the 10 percent ambit this abatement for premiums alpha in January, bottomward from 12 percent a year earlier.

But that hardly agency that bloom amount problems are solved. Even in the mid-to-high distinct digits, bloom aggrandizement is active “way above” accepted aggrandizement and allowance growth, said Paul Ginsburg, a bloom economist who is admiral of the Washington anticipate catchbasin Center for Studying Bloom System Change.

“Next year is a abeyant year for a turn” to slower increases in premiums, Ginsburg predicted, “but I don’t anticipate it will be a aciculate turn.”

Other insurers accept additionally appear a slowing of medical inflation.

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Mid Atlantic Medical Services Inc. (MAMSI), the state’s second-largest bloom insurer, with about 2 actor associates in a seven-state region, appear agnate trends for the quarter. Its exceptional acquirement was up 11.7 percent for anniversary member, while claims for anniversary affiliate were up alone 5.4 percent – a aciculate slowing from the 9.5 percent access accomplished aftermost year. Like CareFirst, MAMSI appear a acceleration of its profits for the quarter, compared with the third division of aftermost year.

CareFirst appear bygone $54.4 actor in balance for the division which concluded Sept. 30 – acceleration the $27.1 actor acquaint in the year-earlier quarter. Although CareFirst is a nonprofit organization, its balance (what’s larboard from its acquirement bare its costs) are captivated as affluence or acclimated for purposes such as affairs new equipment.

Revenue, $1.9 billion for the quarter, was 9 percent college than the year-earlier period, outpacing the advance in medical costs and accidental to the college earnings.

While CareFirst beneath to accomplish projections on approaching trends, MAMSI told banal analysts Nov. 6 that it accepted exceptional increases of about 11 percent aing year, with a medical trend in the 10-to-11-percent range. That reflected a balance in costs beyond all above areas of bloom spending, as MAMSI projected increases of about 11 percent in payments to doctors, 9.5 percent to hospitals for inpatient and outpatient care, and 9 percent for decree medications.

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