HMO benefits, claims rise 25% in Q4

Healthcare benefits and claims rose by 25 percent from October to December last year amid the prolonged pandemic, the Insurance Commission reported on Friday, March 25.

In a statement, Insurance Commissioner Dennis B. Funa said health maintenance organizations (HMOs) paid P32.72 billion in benefits and claims in the fourth-quarter, up 25 percent compared with P26.17 billion in the same period a year earlier.

Accordingly, Funa said growth in healthcare benefits and claims paid resulted in a 6.5 percent increase in the HMO’s total expenses including income tax, which also jumped from P45.18 billion to P48.14 billion.

The HMO’s total assets likewise increased year-on-year by 4.2 percent from P59.25 billion to P61.72 billion.

The increase in the industry’s total assets is attributable to increases in cash assets, investments in subsidiaries, associates, and joint ventures, as well as investment property by 13 percent, 3,749 percent, and 28 percent, respectively.

Moreover, other assets and prepayments improved 38 percent and 30.5 percent year-on-year, respectively.

The industry’s total invested assets, on the other hand, slightly contracted by 3.2 percent year-on-year, from P29.18 billion to P28.24 billion in the fourth-quarter 2021.

Meanwhile, the HMO’s total equity, total liabilities, and total Revenues also slightly grew during the quarter at 4.2 percent, 4.1 percent, and 1.9 percent, respectively.

“The HMOs’ total equity increased from P13.72 billion to P14.3 billion, primarily because of a 36 percent jump in the industry’s total capital stock.

Insofar as the growth in total liabilities from P45.53 billion to P47.42 billion is concerned, this is attributable to increases in dividends payable, deferred tax liability’ and pension obligations’ by 964 percent, 360 percent, and 131 percent, respectively.

Moreover, the slight increase in membership fees of two percent year-on-year, from P50.55 billion to P51.59 billion, led to the 1.9 percent rise in the industry’s total revenue, from P52.29 billion to P53.28 billion.

The increase in total revenue notwithstanding, the HMOs’ total net income contracted by 27 percent from P7.11 billion to P5.14 billio due to higher expenses.

It will be recalled that the regulation and supervision of the HMO industry was transferred to the Insurance Commission from the Department of Health by virtue of Executive Order No. 192 of 2015, issued by former President Benigno S. Aquino III.