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Insurers brace for continued Medicare Advantage medical costs
The big question coming out of the health insurance earnings season is how much elevated utilization among seniors is carrying over into 2024.
Humana’s Diamond said recent government regulations requiring MA payers to comply with coverage determinations in traditional Medicare could be a potential driver of the higher inpatient spend. The rule requires insurers to cover an inpatient admission if the patient is expected to require hospital care for at least two midnights.
Other insurers said they had planned for the so-called “two-midnight rule.”
On Feb. 6, Centene CFO Drew Asher told investors that the payer had factored the rule into its planning for 2024. Meanwhile, CVS CFO Tom Cowhey said one day later the company had adjusted internally in response to the rule.
