HMOs return to profit after 2 years of losses

March 3, 2025 | 12:00am

MANILA, Philippines — The health maintenance organization (HMO) industry finally returned to profitability in 2024 after two years of losses as membership fees increased.

Latest data from the Insurance Commission (IC) showed that the sector’s net income reached P979.8 million last year, a significant recovery from the P4.3 billion loss in 2023.

HMOs last recorded a profit in 2021 as the industry reeled from higher releases of benefits and claims among its members in 2022 and 2023.

HMO provider Philhealth Care Inc. president and CEO Jaeger Tanco said the industry’s performance in 2024 was a matter of pricing.

“There is an increase in premiums, therefore they are able to cover the medical cost. Medical costs, however, are still increasing,” Tanco said in a Viber message.

Last year, data showed that revenues jumped by 20 percent to P79.37 billion as the industry increased its membership fees to reach P75.64 billion, up by 18 percent.

This comprises 95 percent of the sector’s total revenues.

The higher membership fees managed to offset the increase in benefits and claims released by 28 HMO firms, which rose by 10 percent to P61.05 billion from P55.46 billion in 2023.

Maxicare HealthCare Corp. led the firms in terms of net income with earnings at P352.1 million. It also disbursed the biggest benefits and claims worth P27.88 billion.

It was followed by Asalus Corp. (Intellicare) with profit at P351.66 million and Insular Health Care Inc. with P349.73 million.

Only nine of the 28 HMO firms incurred net losses led by Medicard Philippines Inc. with P547.23 million. But Medicard only ranked third in terms of benefits and claims last year at P9.22 billion.

Other HMO firms that suffered losses include Pacific Cross Health Care Inc. (P79.67 million), Getwell Health Systems Inc. (P30.4 million), Forticare Health Systems International Inc. (P16.32 million), Medicare Plus Inc. (P15.02 million), Health Plan Philippines Inc. (P7.46 million), MI Healthcare Inc. (P3.6 million), Health Care and Development Corp. of the Philippines (P2.7 million) and Optimum Medical and Health Care (P1.9 million).

Further, total assets handled by HMOs went up by 24 percent to P75.13 billion while total invested assets inched up by 10 percent to P17.86 billion amid rise in cash equivalents and growth in government securities.

Liabilities, however, also increased by 26 percent to P63.73 billion due to the growth in membership fee and claims reserves while HMO equity picked up by 11 percent to P11.4 billion, driven by better share capital, retained earnings and reserve for appraisal increment.

On the other hand, the industry’s total capital stock improved by four percent to P9.18 billion.