The Dirigo Health Board of Directors has determined that the state-run Dirigo Health program will save the state’s health care system $78 million in its third year of operation.
An organization representing the state’s four major health insurers — Aetna, Anthem Blue Cross and Blue Shield, Cigna HealthCare of Maine and Harvard Pilgrim Health Care — called the number excessive and unreasonable.
The savings determination is the starting point by which the controversial “savings offset payment,” or SOP, is determined. That payment, which is an assessment on insurers based on savings created by the Dirigo program, is the current funding mechanism for Dirigo’s insurance subsidies.
The Dirigo Health Agency in early July calculated that Dirigo Health would save the health care system $92.7 million this year. That number was later revised to $88 million, and the board lowered it another $10 million on Thursday.
Maine’s superintendent of insurance will now review the estimate and come up with his own number before the final SOP is decided upon.
The Maine Association of Health Plans, a nonprofit that represents that state’s major health insurers, said the savings estimate is excessive and not credible.
The fact that this year’s savings figure is roughly double last year’s final figure with only a modest increase in membership in the DirigoChoice insurance program shows that the methodology is unreliable, the organization said.
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