Health Plan Weekly

Here’s how major health insurers’ stock performed in January 2023. Elevance Health had the highest closing stock price among major commercial insurers as of January 31, 2023, at $499.99. Humana Inc. had the highest closing stock price among major Medicare insurers at $511.70.

As of mid-to-late 2022, health care utilization had bounced back to levels on par with those seen at the beginning of the COVID-19 pandemic. Yet the utilization of some non-COVID health care services remained below expectations based on pre-pandemic trends, according to a recent Peter-KFF Health System Tracker analysis. The number of hospital discharges in the third quarter of 2022 was 9.1 million, or 700,000 discharges below the pre-COVID quarterly average in 2018-2019.

The share of adults who visited a doctor in the last 12 months (83.1%) recovered in 2022 after dipping in 2020-2021, but did not reach the percentage seen in early 2019 (85.3%). Similarly, emergency care utilization saw a rebound last year, yet remained below prepandemic levels. The number of physician encounters per person, however, did rebound to 2019 levels as of the third quarter of 2022.

With Democrats now in charge of both chambers of the Minnesota legislature and the governor’s office, a key priority for policymakers will be to give everyone in the state access to low-cost coverage through MinnesotaCare. Minnesota and New York are the only two states that run a Basic Health Program, which offers a coverage option for individuals who make too much to qualify for Medicaid — between 138% and 200% of the federal poverty level (FPL) — but find Affordable Care Act exchange coverage unaffordable. A bill supported by Democratic legislators in the state, which received its first hearing on Feb. 8, would eliminate that 200% FPL cutoff and effectively create a “public option” program, the Associated Press reported. The news outlet noted that under the proposed expansion of MinnesotaCare, premiums would be on a sliding scale, and the state would also develop an option for businesses with under 50 employees to participate. 

Although health insurance trade groups slammed a final rule that will cause the government to claw back billions of dollars’ worth of overpayments to Medicare Advantage organizations (MAOs), some equities analysts pointed out that the regulation was not as bad as it could have been. What remains unclear, however, is whether the industry will challenge the rule in court. 

“Our high-level takeaway is that, while some components of the rule run counter to the industry’s requirements, the absolute impact that CMS is forecasting is manageable within the context of a program that will soon approach $400 [billion],” Credit Suisse’s A.J. Rice advised investors. In fact, CMS estimates that payment clawbacks under the rule will amount to $4.7 billion through 2032, or $470 million annually over 10 years, he noted. “This would represent roughly 0.1% of annual program spend.” 

With two recently debuted product offerings, a pair of health care companies aim to solve a problem that has been thrown into sharp relief during the ongoing pandemic: highly variable — and often inadequate — access to behavioral health care services. Industry observers say that both solutions are likely a response to employer clients seeking increased care access points for their covered workers. 

One of the announcements comes from UnitedHealth Group, which in January rolled out a virtual behavioral health coaching program that’s available to UnitedHealthcare commercial plan members with mild depression, stress and anxiety. Through the Optum-administered program, 5 million eligible fully insured plan members can access support “through digital modules and 1:1 video or telephonic conferencing and messaging with trained coaches” at no additional cost. Self-insured employers may also purchase the virtual behavioral health coaching program for their employees, UnitedHealth said.