Investors Nervous About Anthem’s Medical Loss Ratio As Insurer Forecasts Earnings Below Expectations
Anthem said its medical loss ratio was 89% in the fourth quarter, higher than the 88.1% figure that a consensus of analysts had estimated. Investors closely watch the MLR as a gauge of health spending and insurers’ operational profitability. In other health industry news: short-term plans, Walmart's bet on primary care, job cuts, worker shortages, and more.
The Associated Press:
Insurer Anthem Underwhelms Wall Street With 2020 Forecast
Anthem is starting the new year by forecasting earnings that could miss expectations even after the health insurer books gains from a new business. The Blue Cross-Blue Shield insurer also reported on Wednesday earnings from the final quarter of 2019 that missed forecasts, and its stock dropped in midday trading. (1/29)
The Wall Street Journal:
Anthem Falls On Weak Metric, Disappointing 2020 Guidance
The health insurer recorded a profit of $934 million, or $3.62 a share, in the fourth quarter of 2019 compared with $424 million, or $1.61 a share, in the year-ago quarter. Adjusted earnings were $3.88 a share, matching analysts’ expectations. Revenue was $27.41 billion, up from $23.37 billion. Anthem Chief Executive Gail Boudreaux said in a conference call that the company was delivering on its promised growth and was “poised for another year of success in 2020.” (Wilde Mathews and Sebastian, 1/29)
Modern Healthcare:
Healthcare Earnings Reports From The Fourth Quarter Of 2019
Earnings reports from providers, insurers and health technology companies for the quarter ended Dec. 31, 2019. (1/29)
North Carolina Health News:
Short-Term Health Insurance Complaints Rise
On the heels of the Trump Administration relaxing its rules surrounding short-term health insurance plans, the North Carolina Department of Insurance said it saw an uptick in consumer complaints surrounding these low-cost, but limited, plans. The department logged 75 complaints related to short-term insurance in 2019, up from 48 the previous year, according to data obtained by NC Health News. More than half of the complaints involved issues surrounding denied claims, exclusions of pre-existing conditions and delayed payments to consumers. The DOI processes thousands of complaints per year, a spokesman said in an email, but the rise in consumer complaints indicates that more North Carolinians are opting for these plans. None of these complaints, he noted, have yielded violations. (Engel-Smith, 1/30)
Stat:
Walmart Places A Big Bet On Cheaper, Less Intimidating Primary Care
The spectacle of the grand opening underscores the central role Walmart is hoping its new clinics will play in its expanding health business. Interviews with Slovenski and other leading Walmart health executives revealed new details about the company’s strategy for the clinics, which it sees not only as a low-cost, less intimidating way to get primary care, but also as a way to help pull in an entirely new customer base. So far, Walmart’s health care efforts haven’t drawn as much attention as the acquisition of insurer Aetna by its rival retail giant CVS, nor garnered as much intrigue as Haven, the mysterious health care startup promising to transform care for employees of Amazon, JPMorgan Chase, and Berkshire Hathaway. (Thielking, 1/30)
Stat:
Medical Data Startup Syapse Cuts 10% Of Workforce As It Shifts Strategy
Syapse, among the highest profile companies in a wave of startups seeking to mine patient data stored in electronic medical records and other portals, last week laid off 18 of its San Francisco-based employees — a move the company attributes to a shift in focus toward data analytics and insights and away from its software business. The layoffs — which primarily affected Syapse’s engineering division, along with its product management and operations teams — represented about 10% of its workforce. The realignment comes just weeks after the pharma giant Roche prematurely terminated a precision medicine deal with Syapse centered around oncology data. (Robbins, 1/29)
Modern Healthcare:
Direct-Care Worker Shortage Expected To Disrupt Staffing In Post-Acute Care
Loretto Health & Rehabilitation in Syracuse, N.Y., was struggling with a nearly 65% turnover among certified nursing assistants, home health aides and licensed practical nurses, many of whom faced difficult challenges with transportation, child care and other issues. That’s a chronic and growing problem for nursing homes, home-care agencies and hospital systems, which rely on these staffers to provide the bulk of hands-on, nonclinical care for patients. Good post-acute and home care are key factors in achieving quality outcomes in value-based care, but research shows that high turnover hurts quality. (Meyer, 1/25)
Kaiser Health News:
Appendicitis Is Painful — Add A $41,212 Surgery Bill To The Misery
Joshua Bates knew something was seriously wrong. He had a high fever, could barely move and felt a sharp pain in his stomach every time he coughed. The 28-year-old called his roommate, who rushed home that day in July 2018. The pair drove to the nearest emergency room, the Carolinas Medical Center in Charlotte, North Carolina. After several tests, including a CT scan of his abdomen, the emergency team determined Bates had acute appendicitis. (Appleby, 1/29)
