Insurers see slow uptick in medical utilization

As insurers continue to determine medical utilization patterns, hoping that patients will start seeking more care, their first-quarter earnings show there may be a slow uptick in use, reported American Medical News.

Aetna, for example, projected physician service spending would increase at a rate "in the high single digits" for the year. But that's only a growth of 1 or 2 percentage points. WellPoint predicted physician service spending to rise at a rate in the "mid-single digits," while Cigna said it's seeing continued "muted" utilization trends thus far this year.

Although Humana said it still expects a utilization increase, it hasn't yet seen any signs of that forecast. Meanwhile, Coventry's first-quarter report showed signs a slight increase in outpatient physician service spending, and UnitedHealth said outpatient spending appeared to increase while inpatient spending remained flat.

"Everybody is sort of feeling for the bottom here, where a trend stops decelerating and starts to tick up," Aetna CEO Mark Bertolini told Goldman Sachs analyst Matthew Borsch during the company's first-quarter earnings conference call. "[Q]uite frankly, we don't have enough information in the first quarter to come up with a prediction as to where that trend number is right now."

Indeed, patient visits to doctor offices declined 4.7 percent in 2011, the fourth decline in five years, according to an IMS Institute of Healthcare Informatics survey, which attributed the drop to the slow economy, amednews noted and FiercePracticeManagement previously reported.

Although some insurers have begun to see an increase in patient utilization, they generally couldn't overcome any higher health spending with money not spent previously. Humana, for example, last year reported a $112 million reserve development that helped its profits soar 86 percent, but its net income actually dropped by 21 percent this year, FierceHealthPayer reported earlier this month. And although WellPoint's per-share earnings increased, its first-quarter profit fell almost 8 percent amid dropping enrollment and rising expenses.

"While we expect that utilization volume growth will remain moderate, cost trends are no longer a source of positive surprise for most companies," Borsch said in a note to investors, adding that he foresees a "somewhat tougher earnings environment," amednews reported.

To learn more:
- read the amednews article