HMOs suffer P320 million loss in QI

MANILA, Philippines — The health maintenance organization (HMO) industry swung to a net loss of P320 million in the first quarter of the year as benefits and claims by its members soared.

Latest data from the Insurance Commission showed that the HMO sector incurred a net loss of P319.03 million in January to March as against an income of P864 million in the same period last year.

This, even as revenues improved 12 percent to P15.55 billion as the industry increased its membership fees, which comprise 99 percent of the sector’s total revenues.

The first quarter’s net loss was attributed to the higher benefits and claims released by 29 HMO firms covered in the report, which jumped by 35 percent to P12.83 billion from P9.48 billion in 2022.

Nine of the 29 HMO firms incurred net losses, led by Medicard Philippines Inc. with P251.04 million, although Medicard only ranked third in terms of benefits and claims during the quarter at P2.05 billion.

Maxicare Healthcare Corp. also recorded a P226.06 million loss in bottomline after disbursing the largest number of benefits and claims at P5.42 billion.

Other HMO firms that suffered losses include Forticare Health Systems International Inc., Health Care and Development Corp. of the Philippines, Health Delivery System Inc., Health Maintenance Inc., MetroCare Health Systems Inc., Optimum Medical and Health Care, and Pacific Cross Health Care Inc.

Further, total assets handled by HMOs declined by seven percent to P64.79 billion while total invested assets dropped 38 percent to P16.36 billion.

Liabilities, on the other hand, inched down by a percentage to P52.96 billion.

HMO equity slipped 26 percent to P11.83 billion while the industry’s total capital stock increased 26 percent to P5.66 billion.

Firms regulated by the IC have issued P22.36 billion in COVID claims since the start of the pandemic, with HMOs accounting for over a third of that.

HMOs are the second largest contributor to COVID-19-related payouts by IC’s regulated entities since COVID started.

HMOs used to be monitored by the Department of Health until the late president Benigno Aquino III transferred regulation to the IC eight years ago.