UnitedHealth results: positive for insurers, dismal for hospitals

UnitedHealth Group Inc.’s second-quarter results were lifted by lower costs of care that portend well for other health insurers but may be a warning sign for hospital companies.

Medical-loss ratio, a closely watched measure of the percentage of premium income spent on patient care, came in at 81.5%, down from 82.8% a year ago and roughly a percentage point below the average of analysts’ estimates compiled by Bloomberg. A lower number means the company has more money for administrative costs and profit.

That may mean good news for other insurers like Humana Inc. and Cigna Corp. UnitedHealth’s results are positive for other managed care companies, “reinforcing expectations for continued favorable utilization trends and beats & raises this quarter,” Evercore ISI’s Michael Newshel wrote in a research note Friday.

UnitedHealth rose as much as 5.2% as of 11 a.m in New York. Humana gained as much as 3%, and Cigna rose as much as 3.4%. Elevance Health Inc. – the insurer formerly called Anthem — rose as much as 4.2%.

But the implications are less cheerful for hospitals and other medical providers, whose revenues are UnitedHealthcare’s expenses. The hospital sector is facing a slower rebound in patient volume than anticipated, along with still-elevated labor costs, SVB Securities researchers wrote in a note Friday. They cut price targets on hospital operators including HCA Healthcare Inc., which rose as much as 2.2%, and Tenet Healthcare Corp., which rose as much as 3.1%. Universal Health Services Inc. also rose as much as 2.3%.

“Volume is likely as challenged as labor,” the SVB analysts wrote. “We’re less concerned on labor, which has improved, just not by a lot.”

When accounting for timing effects that influenced UnitedHealth’s medical-loss ratio in the second quarter, the outlook may not be as dire for hospitals, Bloomberg Intelligence analyst Glen Losev wrote.

What Bloomberg Intelligence Says:

UnitedHealth Group’s solid 2Q results and below-expectations medical-loss ratio (MLR) could imply that the hospitals’ admission trend declined sequentially. This isn’t correct when favorable reserve development is taken into consideration, which would translate to a 49-bp MLR increase. Coupled with the assumption that pandemic-related admissions declined vs. 1Q, that suggests medical- and surgical-care utilization rose in 2Q.

– Glen Losev, BI health care analyst

Health insurers have reported a consistent pattern throughout the pandemic: As COVID-19 medical expenses increased, patients pulled back on other forms of care, and they returned when COVID cases receded, often balancing out insurers’ costs overall. But that changed in the last quarter, UnitedHealth Chief Financial Officer John Rex said on a call with analysts.

“We are seeing what had been a balanced relationship between COVID and non-COVID care activity over the past couple of years diverge modestly, with the latter not returning quite as rapidly with lower levels of COVID care,” Rex said. Pediatric and emergency visits are below historical norms while preventive visits for seniors and colonoscopies have rebounded, he said.

COVID hospitalizations are rising, he said, but stays are shorter, and there’s no sign yet that patients are sicker for having deferred care during the pandemic.

Optum Growth

UnitedHealth executives said the company is still in the early stages of its strategy to build out medical care delivery through its Optum Health business, which already has more than 60,000 physicians and recently acquired large doctor groups in Massachusetts and Texas. The company is making progress on its goal to add 10,000 doctors and advanced practitioners this year, said Wyatt Decker, Optum’s chief executive. Discussions with physician practices the company is acquiring typically take five years, said Rex, the CFO.

The company expects double-digit revenue growth in the Optum Health business “for many years” with margins in the 8% to 10% range, Rex said. Optum Health had operating earnings of $1.4 billion in the quarter, and the company said revenue per consumer served increased 30% from a year ago.

Andrew Witty, the company’s chief executive officer, said UnitedHealth would offer patients in fully-insured plans certain drugs on the company’s preferred drug list with no copays starting next year. The program would include drugs such as insulin, epinephrine and albuterol.

“Larger and longer-term cost containment of drugs depends upon manufacturers restraining and lowering the list price of their products,” he said.

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