As CMS Seeks Utilization Data, Supplemental Benefits Drove 3Q MLRs

November 16

Rising utilization in Medicare Advantage caught the attention of investors earlier this year after UnitedHealth Group disclosed an increase in outpatient care utilization in June, followed by Humana Inc.’s revelation that it was also seeing elevated medical costs due to an increased use of services. When reporting second-quarter 2023 earnings this summer, several insurers indicated that they were able to factor such trends into their bids for the 2024 plan year. Now, it appears that insurers’ rich supplemental benefit offerings continue to drive costs, as both CVS Health Corp. and Humana attributed elevated medical loss ratios (MLRs) in the third quarter to higher-than-normal uptake of benefits such as dental and flexible spending cards.

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Radar on Medicare Advantage

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

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.