Humana: COVID-19 hospitalizations driving higher Medicare Advantage costs

An increase in COVID-19 inpatient admissions is one factor driving higher utilization rates in Medicare Advantage, Humana executives said. 

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The company published its third-quarter results Nov. 1, reporting an uptick in its benefits cost ratio in its insurance segment, up 1.9 percentage points year over year. In its earnings report, the company said Medicare Advantage utilization rates were “modestly higher than anticipated.” 

The company expects its benefits cost ratio to reach 89.5% in the fourth quarter, up from 87.6% in the third quarter. 

“We continue to experience an increase in COVID admissions in the third quarter, whereas our forecast previously assumed that this would occur in the fourth quarter,” CFO Susan Diamond told investors on a Nov. 1 call. 

The uptick has not been offset by a decline in non-COVID-19 utilization, Ms. Diamond said.

In outpatient care, pent-up demand for surgical procedures, especially orthopedic care, continues, a trend the company reported in the second quarter, Ms. Diamond said. 

Humana expects its 2024 growth rate to be at the low end of its 11% to 15% estimate if increased utilization continues, Ms. Diamond said. 

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