Triple-S Management Corp. managed care company announced Tuesday consolidated revenue of $584.8 million and consolidated operating income of $10 million for the three months ended Mar. 31, 2014.
Net income was $7 million, or $0.25 per diluted share, for the first quarter of the year, the Puerto Rico-based company said.
Other quarter highlights include a consolidated loss ratio of 82.9 percent and a medical loss ratio (MLR) of 86.6 percent, while managed care member monthly enrollment increased 28.4 percent year over year.
Medicaid self-insured enrollment was up 58.1 percent from the prior year, and Medicare enrollment increased 4.1 percent year over year, the company said.
“Earnings for the first quarter were better than expected and reflect sequential improvement in our business,” said company President Ramón Ruiz-Comas. “Our MLR decreased from 88.8 percent to 86.6 percent; our consolidated loss ratio fell by 220 basis points and we generated $4.1 million in managed care operating income during the period, compared with a $5 million operating loss in the fourth quarter of 2013.”
“Overall, we are seeing progress, but we recognize that there is still more work ahead in light of the year-over-year earnings decline,” he said. “Triple-S has initiated a comprehensive strategic review designed to position us more appropriately for the changing healthcare market.”
Triple-S saw progress in MLR trends in the USVI, which it said supports its objective of reaching break even there by the end of the year, he said.
Meanwhile, the company has taken several steps to control its costs, including implementing a new model to reduce specialty pharmacy costs and launch a revision of its pricing structure and underwriting policies to increase profitability in its commercial business.
“Our efforts to reduce administrative expenses are also producing results. Net of the increase in Medicaid expansion costs and the implementation of new taxes and regulatory fees, Triple-S saw a decline of more than $6 million in administrative expenses compared with the prior quarter,” Ruiz-Comas said.
In its Medicare Advantage business, Triple-S acquired approximately 6,000 Part D lives from Pharmacy Insurance Company of America (PICA) with no additional personnel, consolidated all Medicare Advantage under one pharmacy benefit management company and continued the transition to a pay-for-performance model, which should be completed by year-end.
“Our management team remains steadfastly committed to taking the corrective actions needed to achieve further improvement in the organization’s overall performance,” said Ruiz-Comas.
Finally, Ruiz-Comas noted that Triple-S continues to actively participate in the Medicaid bid process.
“Based on public information provided by the Puerto Rico Health Insurance Administration (ASES), Triple-S and two other entities are currently in conversations to potentially provide services under an at-risk model. We will provide an update as soon as we have definitive news from ASES,” he said.