Best news from today's PR:
1. 4,600 HMO members as of Feb 1st, 2007 (totalling 30,300 with the 25,700 PSN).
2. PSN still bring $20M plus before corporate overhead and income tax in 2006.
3. Revenue up 24% from previous year.
What they need to do for 2007:
1. If PSN business continue to decline (PSN member down 200 members from 25,900 last quarter instead of growing), they need to start controlling/reducing the overhead cost.
2. If the PSN business continue to decline then it is even more important to have HMO becoming a successful division (and someday will besome bigger than the PSN business, in terms of members. I sure hope when that number crossed it will still be over 20,000 members)
3. Same way for HMO if it takes longer to breakeven, they should control the overhead, but not reducing marketing since it's the vehicle to get new members which will help the HMO to survive.
4. Control the MER better (making sure outside the uncontrollable factors like the flu season etc, are under control). I believe 2007 will be a tough/interesting test for them especially coming from the Q406 result (many people will say that will be easy comparison that Q406 is bad so it isn't hard to beat that but peopel don't realize that they have to improve to move away from those bad result).
Overall, it's not a bad year (2006), bad quarter Q406, and hope by Nov 15th, 2007, HMO will hit its inflection point (on losses) and moving towards breakeven run-rate.
It's good to know that they have PSN subsidizing the HMO effort. I can't imagine if they (or someone else) have to build HMO without any other division supporting (and have to raise equity or debt while continue to incur the net loss overall year in and year out)
Time, all great questions and I wish I knew the answers. The one I can answer is why they have not gone to other HMO's and I can guess since the hUmana contract is an evergreen contract they do not want to piss off Humana. I thought at one point they were doing business with Vista and I think Humana squashed that relationship. I think a top guy from Humana left and went with Vista. If Humana gets upset they can pull the entire PSN contract and then what does MDF have to fund its start up HMO?
Good morning. I have a question regarding their PSN network:
Why isn't MDF subcontracting to other HMO's beside Humana?
It they have the expertiese, staff and doctors, are they limited to Humana by their contract? Can they contract with other growing HMO's for contract services?
My other question is why limit themselves to Medicare. Why not offer HMO services thru the Chamber of Commerce for small local businesses? Self/employed individuals?
I'm an employer, I have 23 employees in one of my businesses
I am reviewing HMO's in Massachusetts (Taxachusetts)(Fallon, Tufts, BC/BS ...). The Chamber of Commerce has a wide variety of HMO's and related service companies available.
This market is huge, less sick people with longer lifespans.
Just food for thought.
1. no need for name calling. I have never and don't expect that from you. This board is about opinion and all of my post are my opinion and right to express them
2. Male or Female does not matter to me as long as they are qualified to lead a start up HMO
2. I am on the same page with hiring mid level people with little or no experience but not the leader of the company. It is you that seems to be to close to ME because you are blinded by this. All I want is the best for the hMO and the best is to be lead by an experienced guy. Let''s make it even more of a challenge for MDF to start an HMO, let's give them a leader with ZERO experience, take away their computers and phones too and give them a REAL challenge
I must be an AWFULL SHAREHOLDER just because I want an experience guy to lead the company GOD FORBID Humana pulls the plug on MDF this is ALL we got and we don't time for someone to learn the healthcare industry
good point I will be careful of my wording. I am fine with the fact that the PSN financed this. In fact they have to because one day Humana can wake up and say sorry MDF is over. I am all for the HMO and think it is FAR better than the pharmacy business. I just want our best shot at a successful HMO that's all and a guy with experience is our best shot
Perhaps skibum you should read your 3 points again....what was the purpose of your first point....you wrote "I just said they are doing the exact same thing, sucking the PSN dry to create another revenue source."
I pointed out I think you are disappointed in the way this was financed.
This point has nothing to do with ME lack of experience....and your asking me if we're on the same message board?
Skibum, you are a TOTAL IDIOT! I've hired hundreds of people
in my lifetime to include both managers and employee's, some
with experience in a particular field and some without. Bottomline, a good manager of people, projects and yes
entire business's needs to be a good manager first and foremost. ME could be the best person for the job and
do to your short sightedness, he wouldn't have been afforded
this opportunity. Thank god you're NOT running the show,
and MDF's board of directors are calling the shots.
This is OBVIOUSLY personal with you Skibum as I've known
all along. You've seen this companies collapse, and I
wouldn't be at all suprised that you weren't involved
somehow. You're to close to the situation not to have been.
ps. BTW, you mentioned a "guy" with experience from Humana,
BC/BS, Aetna or United. First off, could that "guy" have been you or someone you know that was passed by? And what's
wrong with a gal, or are you from the OLD school?
Sounds to me like you are, especially with your views on
hiring and management.
Anderson, are we on the same message board? How the financed the start up is not the problem. LEADERSHIP WITH ZERO EXPERIENCE IN THE HEALTHCARE INDUSTRY is a problem!!!!! Maybe MDF should starta car dealership and fast food chain too since they trust ME in industries that he has no experience in. All I want is MDF to have its BEST shot at a successful HMO and going with a man that has zero experience CAN'T be better than a guy with 30 years experience plucked from Humana, BC/BS, Aetna, or United. We are at risk EVERY day hoping ME does not hit a learning curve that can cause a major OOPPS
Medical Expense Ratio (MER) -- Medical expenses divided by premiums for the same period.
PSN - read the co. description below.
Metropolitan Health Networks, Inc., incorporated in January 1996, provides healthcare benefits to medicare beneficiaries in Florida through its provider service network (PSN) and its health maintenance organization (HMO). As of December 1, 2005, the PSN and the HMO provided healthcare benefits to approximately 26,200 and 1,400 Medicare Advantage beneficiaries, respectively. The HMO's membership grew to approximately 1,800, during the year ended December 31, 2005.
Provider Service Network
Pursuant to two contracts with Humana, Inc., the second largest participant in the Medicare Advantage program, Metropolitan's PSN provides healthcare services to medicare beneficiaries in Flagler and Volusia Counties (Central Florida) and Palm Beach, Broward and Miami-Dade Counties (South Florida), who have elected to receive benefits from Humana's Medicare Advantage Plan. As of December 1, 2005, the Humana Agreements covered approximately 19,600 Humana Plan Members in Central Florida and 6, 600 Humana Plan Members in South Florida.
The PSN comprised both medical practices owned by the Company, as well as independently owned medical practices and providers (IPs) with whom it has contracted. Metropolitan owns and operates eight primary care physician practices and a medical oncology physician practice. The Company also contracts with 29 primary care IPs. Through its Humana contracts, Metropolitan has established referral relationships with a number of specialist physicians, ancillary service providers and hospitals throughout South Florida and Central Florida.
Humana directly contracts with the centers for medicare and medicaid services (CMS), and is paid a fixed monthly premium payment for each member (Humana Plan Member) enrolled in Humana's Medicare Advantage Plan. The monthly amount varies by patient, county, age and severity of health status. Pursuant to the Humana Agreements, the PSN provides or arranges for the provision of covered medical services to each Humana Plan Member, who selects one of the Company's affiliated providers as his or her primary care physician (a Humana Participating Member). In return for the provision of these medical services, the PSN receives from Humana a monthly fee, also known as a capitated fee, for each Humana Participating Member. The fee rates are established by the contracts between the PSN and Humana, and comprise a vast majority of the monthly premiums received by Humana from CMS with respect to Humana Participating Members.
The vast majority of the Company's PSN revenues come from the Humana Agreements. The Company does receive additional revenue for providing primary care services to non-Humana Plan Members on a fee-for-service basis in the medical practices it owns and operates.
You state "1. When did I say I want MDF to be int he pharm biz? I just said they are doing the exact same thing, sucking the PSN dry to create another revenue source. I asked what the difference was?"
OK,So your now more concerned with how we finance the operations of the HMO. Is it better we go to the bank and borrow money to do this or maybe issue more shares...are you not concerned with our balance sheet?
Maybe a better question to ask is how would you have financed a startup HMO. Or else show us how we could have been breakeven day 1 of operations?
1. When did I say I want MDF to be int he pharm biz? I just said they are doing the exact same thing, sucking the PSN dry to create another revenue source. I asked what the difference was?
2. I am a huge fan of the HMO I am just not understanding how a man with ZERO experience is picked to start up an HMO? With sooo much money, MDF could hire themselves an experienced healthcare leader but would rather risk thier future with aman with ZERO experience.
3. As for proving to you I am not interested in doing the research on failed HMO's but there are plenty out there. Never said ME is not doing his job but said he is not capapble of doing the right job do to limited experience in this industry. He may work very hard but how does he gain 30 years of experience others have?