Health Plan Weekly

During its investor update on June 17, Centene Corp. announced it had increased its adjusted diluted full-year earnings per share (EPS) guidance to between $5.55 and $5.70, up from its April range of between $5.40 and $5.55. The health insurance company also raised its projected annual premium and service revenues by $2 billion to between $134.3 billion and $136.3 billion.

Centene’s executives attributed much of the increase to its better-than-expected performance, particularly in the health insurance exchange market, as well as the delay in the restart of Medicaid eligibility redeterminations.

AHIP’s annual conference — AHIP 2022, convened in Las Vegas — was the first in-person gathering of the health insurance trade group since COVID-19 arrived in the United States — so the health care professionals who gathered there had even more than usual to discuss. AHIP 2022 featured dozens of panels on a variety of subjects, but two themes stuck out: social determinants of health (SDOH) and the digital transformation wrought by interoperability and transparency mandates.

SDOH are the factors outside the health care system and clinical care that impact patient health — a group of social ills like racism, hunger and housing insecurity. Those needs are usually more pronounced in disadvantaged groups with limited access to health care. Presenters from health plans and other areas of the health care sector discussed how strategies like data analytics, community health workers and modifications to benefit design can improve health outcomes related to SDOH. Some 14 panels addressed issues like social health, equity and hunger directly, and many other panelists made mention of SDOH challenges during their presentations or answered audience questions on the subject.

Grappling with rising premiums, a tough labor market and COVID-fueled health challenges, plan sponsors are focusing on key benefits as they prepare for the 2023 benefits cycle. That includes a concerted focus on behavioral health services and health equity, working to improve telehealth access and implementing strategies aimed at managing the total cost of care.

As adverse mental health conditions have increased sharply during the pandemic, behavioral health solutions, such as expanded access via network design and an expansion of virtual channels, figure to be prominent among purchasers’ needs, according to purchasing experts and benefits consultants interviewed by AIS Health.