News Briefs: UnitedHealth Reports Higher MLR, Driven by Member Mix, Coding Intensity

Oct 17
Oct 17, 2024

UnitedHealth Group’s third-quarter 2024 revenues grew nearly $8.5 billion to $100.8 billion, while medical loss ratio (MLR) for the recent quarter was 85.2%, compared to 82.3% in the year-ago quarter. The insurer attributed the higher MLR to “previously noted CMS Medicare funding reductions, medical reserve development effects and business and member mix.” During the company’s earnings conference call, Chief Financial Officer John Rex — who also became president of UnitedHealth Group in April — added that the results reflected the persistence of certain utilization patterns at higher levels than anticipated, “the still pronounced upshift in coding intensity by hospitals” and “the continued timing mismatch between the current health status of Medicaid members and state rate updates.” For the quarter ending Sept. 30, the UnitedHealthcare segment reported revenues of $74.9 billion — a year-over-year increase of $5 billion, reflecting membership growth. For the full year, the company narrowed its adjusted net earnings guidance to a range of $27.50 to $27.75 per share, “even as it absorbs an estimated $0.75 per share of business disruption impacts for the affected Change Healthcare services,” which increased by approximately 10 cents per share from the estimate provided in the second quarter, stated the insurer. Read more
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Lauren Flynn Kelly

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.