To: Raptor who wrote (1263 ) 3/11/1998 10:00:00 PM From: Raptor Read Replies (1) | Respond to of 2068
Missed a few days there, but glad to see we've been busy since.....I'm not seeing quite as much after hours trading analysis today as yesterday.....must have been a little butter on those fingers that were "tightly holding" the shares yesterday...but look, I'm not here to handicap daily activity... Soemeone mentioned recently that they thought Medicare was a profitable business, and why would Oxford de-emphasize it? Interesting story, that Medicare. It's basically another version of the old government bait and switch, health care style. A few years back, when the US realized that Medicare spending, fueled by unfavorable demographics, would be spiraling forever upwards, they hatched a plan to enroll seniors in HMOs. In order to induce the HMOs to market to seniors, the US agreed to pay HMOs 95% of the average cost of treating Medicare patients under the existing system. The theory being, of course, that HMOs could more efficiently dispense the care when given their systems and methods and such to reduce the costs, and therefore make a profit even while saving the US money. A win win all around. Well, the HMOs mostly rushed in and indeed were making money in the early days of Medicare, but over time two things have happened, one natural, the other man-made. We are discovering that after the initial surge of senior sign-ups, it has become increasingly difficult to grow Medicare rolls, as seniors seem to be reluctant to change, after the 'early adopters' if you will. This means, the old people in the HMOs are getting older as a group, and at that age, each year brings more problems and higher costs at a greater rate than any other demo group! So do the HMOs get some price increases to offset this bracket creep? NO!! Enter the government, who now says they will pay 90% of the average costs existing previously!! This is how the government saves money on health care. In addition, marketing to Medicare patients is tough, in the trenches, one by one selling. Not very efficient. This is why HMOs don't like the Medicare business. The problem is, you can't just sell your Medicare business or walk away. But by no means is the Medicare business so critical to Oxford that it can cause a big problem by itself. Oh no, they have plenty of problems in the commercial side as well, contrary to what I sense some here believe. After all, you don't run a combined ratio of 115% (4th qtr numbers- 95% med loss ratio plus 20% admin costs) unless you've got broad based problems, like, er, maybe your computer systems don't work or something? By the way, it IS indeed an Oracle system that has been so wonderful to Oxford. Gee, I think I'll short ORCL after they report their "good" February quarter soon. That's another company with some problems. But that's another story. Have a nice evening.