Total revenues for the Western Region in the fourth quarter of 2012 were $2.6 billion compared with $2.5 billion in the fourth quarter of 2011.
Net investment income for the Western Region was approximately $19.1 million in the fourth quarter of 2012 compared with $10.0 million in the fourth quarter of 2011 and approximately $16.4 million in the third quarter of 2012.
Health Plan Services ExpensesHealth plan services expenses in the Western Region were $2.3 billion in the fourth quarter of 2012 compared with approximately $2.2 billion in the fourth quarter of 2011. Commercial Premium Yield and Health Care Cost Trends In the Western Region, commercial premiums per member per month (PMPM) increased by 4.3 percent to approximately $376 in the fourth quarter of 2012 compared with $360 in the fourth quarter of 2011. Commercial health care costs PMPM in the Western Region increased by 7.5 percent to approximately $328 in the fourth quarter of 2012 compared with approximately $306 in the fourth quarter of 2011. Medical Care Ratios (MCR) The health plan services MCR in the Western Region was 88.1 percent in the fourth quarter of 2012 compared with 86.3 percent in the fourth quarter of 2011. The full year 2012 Western Region health plan services MCR was 89.1 percent compared with 86.5 percent for the full year 2011. The Western Region commercial MCR was 87.4 percent in the fourth quarter of 2012 compared with 84.8 percent in the fourth quarter of 2011 and 86.7 percent in the third quarter of 2012. The full year 2012 Western Region commercial MCR was 88.6 percent compared with 85.3 percent for the full year 2011. “The commercial MCR increased 70 basis points sequentially in the fourth quarter of 2012, primarily due to two factors. First, utilization increased among members in large group accounts that terminated on December 31, 2012. This was expected as part of the repositioning of the commercial book,” said Woys. “Also, risk-sharing adjustments with certain providers impacted the commercial MCR. These risk-sharing factors are a result of better than expected performance in our tailored network products throughout 2012.”
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