Volume coding payments between hospital operators and insurance companies do not show signs by 2025. And according to the results of the fourth quarter and the 2025 perspectives of UnitedHealth Group Inc., it seems that suppliers have the advantage by now.
The leaders of UnitedHealth Group, based in Minnesota, father of Unitedhealthcare, said on January 16 that the company’s medical care rate, the proportion of premiums used to pay medical expenses, ended 2024 with 85.5 percent, 40 basic points higher than analysts expected. . The MSC of the company’s fourth quarter reached more than 87 percent and the Andrew Witty CEO and its team predict that it will be around 86.5 percent in 2025.
In statements to analysts after informing the results of the fourth quarter: the main numbers of Unitedhealthcare were $ 5.8 billion in net income on revenues of almost $ 101 billion Compared to $ 5.7 billion and $ 94.4 billion, respectively, in the same period of 2023, Witty and his lieutenants said that a handful of factors contributed to the highest medical costs than expected. Among them there was greater use, Medicare Advantage benefits the changes and hundreds of millions in the expense in the cybernetic change of medical care for almost a year.
The CFO John Rex also pointed out “an aggressive ascending change in the hospital coding intensity”, since a United headache has had to drive during several quarters. Rex said the “hospital coding intensity” represented approximately a seventh of the increase of 1.5 percentage points in the United MCR since 2023. That dynamic, he added, stabilized in the fourth quarter and his team hopes that suppliers continue to present claims to claims to A similar rate.
“We had noticed in the third quarter that was something that has just moved faster in ’24 of what we expected,” Rex said. “But in terms of the levels we are seeing and how we anticipate that in our ’25 [forecasts]We feel very good with that. “
United has not been alone to face higher medical costs than expected, since consumers have returned to the health system from the Covid-19 Pandemic peak. The past fall, the directors of CVS Health Corp. showed that the president and executive director Karen Lynch the door after the bad results in the company’s insurance division of the company and the leaders of Elevance Health reduced their prognosis of profits due to the Increase in Medicaid cost trends.
On the other side of the currency, hospital operators have been optimistic about use trends. HCA Healthcare Inc. executives and Tenet Health Corp. Last year said they expect patients to continue using their facilities to the rhythm they have been at approximately 2023. They and their classmates have also expressed the attempts of insurers to limit or Limit dene the coverage, and at least one does not see that changes soon.
Speaking at the 43rd JPMorgan Healthcare Conference on January 14, Ardent Health Partners Inc. Alfred Lumsdaine also used the word “aggressive” to describe the practices of the insurer, which according to him took a great step in 2024 while they wanted to stop Growing cost trends. Lumsdaine said the burning team, which executes 30 hospitals and more than 200 attention sites in six states, has more of the same.
