Rising utilization rates may spell trouble for payers

Increased utilization rates for medical services and an easing hospital labor shortage could mean smaller profit margins for payers, The Wall Street Journal reported Nov. 29. 

Advertisement

UnitedHealth Group’s projected earnings per share for 2023 are between $24.40 and $24.90, slightly below analysts’ predictions of $24.92. The slight miss in the prediction is due to a higher medical loss ratio, which is currently 82.6 percent. 

Raymond James analyst John Ransom told the Journal that as more physicians and nurses return to work, medical service utilization rates could increase. Mr. Ransom added the “tripledemic” of flu, COVID-19 and RSV could also cut into profit margins. 

Though utilization could increase, Mr. Ransom told the newspaper there is no “long-dated” backlog of elective procedures put off during the pandemic that will emerge in the coming months. 

“We think we would have seen it by now,” he said.

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.

Register to Attend Webinar

Read. Deleted. Ignored. What It Takes to Drive Behavior Change and Lower the Cost of Care

Tuesday, August 4
11:00 AM - 12:00 PM CDT

Presenters: Koleen Cavanaugh, Independence Blue CrossBukata Hayes, HMO Minnesota (Blue Plus)Nathan Foco, Select HealthTrish Cox, SCAN Health PlanJonas Puente, ZS Associates

Advertisement

Next Up in Payer

Advertisement

Comments are closed.