Elevance, CVS, UnitedHealth Struggle With Rising Medical Costs After COVID-19 Medicaid Policy Ends
Elevance, CVS, UnitedHealth Struggle With Rising Medical Costs After COVID-19 Medicaid Policy Ends
Several large insurers have reported higher-than-expected medical costs, particularly in their government-sponsored Medicaid plans, following the end of a pandemic-era policy that required insurers to keep members enrolled.
一些大型保險公司報告稱，醫療成本高於預期，特別是在政府資助的醫療補助計劃中，這是因爲流行病時代結束後，要求保險公司保持會員註冊的政策結束了。
The Details: The end of the COVID-19 public health emergency triggered significant changes to Medicaid coverage, including the end of the continuous enrollment provision, which prevented states from disenrolling members during the pandemic. Beginning on April 1, 2023, states began the process of redetermining eligibility for all Medicaid enrollees, which created a disparity between payments from states and rising trends in medical expenses for insurers.
詳情：COVID-19公共衛生緊急情況的結束引發了對醫療補助覆蓋範圍的重大變化，包括連續註冊規定的結束，該規定阻止了各州在流行病期間取消成員資格。從2023年4月1日開始，各州開始重新確定所有醫療補助參與者的資格，這導致了各州付款和保險公司醫療費用上升趨勢之間的差距。
Analysts at William Blair recently noted that large managed care organizations (MCOs) seem to be facing pressure regarding Medicaid utilization. At the same time, outdated data often determine the premiums they receive from states.
威廉·布萊爾的分析師最近指出，大型託管保健組織（MCOs）似乎面臨着有關醫療補助利用率的壓力。與此同時，過時數據通常決定了它們從各州獲得的保費。
Effects on Insurers: Elevance Health, Inc. (NYSE:ELV) lowered its annual profit forecast Thursday due to persistently high medical costs tied to its Medicaid plans, which account for 20% of the company's total medical membership.
對保險公司影響：聯合健康董事會因其醫療補助計劃的持續高醫療成本而於週四下調了年度利潤預測，這些計劃佔公司總醫療成員的20%。
"The issues impacting the Medicaid business are time-bound," Elevance CEO Gail Boudreaux said on the company's earnings call.
「影響醫療補助業務的問題是有時限的，」聯合健康CEO蓋爾·佈德羅說道。
CVS Health Corp. (NYSE:CVS) replaced its CEO on Friday and cut its third-quarter outlook to earnings of between $1.05 and $1.10, compared to the consensus estimate of $1.70. The company cited "elevated medical cost pressures in the Health Care Benefits segment" as a cause of the revision.
CVS醫療保健公司（NYSE：CVS）週五替換了首席執行官，並將第三季度的展望下調至1.05至1.10美元的盈利，而市場預期爲1.70美元。該公司以「醫療成本在醫療保健福利部門中持續上升」爲修訂的原因。
UnitedHealth Group Inc. (NYSE:UNH) reported its third-quarter results on Tuesday and also lowered its annual profit forecast as challenges across its government-supported health insurance businesses continue.
聯合健康集團（NYSE：UNH）於週二公佈了第三季度業績，並因其政府支持的醫療保險業務始終存在挑戰而下調了年度利潤預測。
UnitedHealth's president and CFO John Rex pointed to "the continued timing mismatch between the current health status of Medicaid members and state rate updates" as an ongoing pressure point for the company.
聯合健康的總裁兼首席財務官約翰·雷克指出，「當前醫療補助成員的健康狀況與各州費率更新之間持續不匹配」是公司的持續壓力點。
"As a result of the lagging care activity data, as well as the annual rate cycle timing, updates remain well short of current care activity, a factor that for us was more pronounced through the period than anticipated," Rex said on the company's post-earnings conference call.
「由於落後的醫療活動數據以及年度利率週期的時間，更新仍然遠低於當前的醫療活動，對我們而言，在這一時期比預期更加顯著，」雷克斯在公司的業績會發帖中說道。
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譯文內容由第三人軟體翻譯。
