CaptainJ47

Go frogs

So globally I am intrigued by the move here today. The number one thing I was surprised by that moved the stock was the medical loss ratio. If you look at it that will tell you a ton about the stock, lower is better. What is hard to tell here is why. UHC has started rotating back to fee for service in commercial and decreased their MA lives. That is fascinating to me and contrary to their Optum Health portfolio.

Speaking of Optum, all of their business segments are down in margin and flat in growth. Optum has made up a tremendous portion of growth the last few years. That seems to be over and in fact a sale of an unknown asset in the Uk created favorable margins in Optum or the picture would be worse.

To your questions
1) MA margins will remain compressed because hospital billing is getting stronger with new technology. It will create denials by UHC. Health systems will then fight this by leaving networks- see California. I do think UHC and MA stabilize but it isn’t a growth engine anymore.

2) What is interesting is UHC forecasts erosion in their customers served. This quarter their lives were higher than expected. Overall lives dropped by 1M yet premiums were higher. A lot of losses in lives in MA where premiums per patient are the higher. I am honestly amazed at the pricing power for the commercial side. To me that area has outperformed.

3) Interestingly enough I rarely see much of Oscar at my health system clients. I really don’t have a ton of opinions on them right this second.

Hoping someone can help explain where the money for the income comes from for this? Also if unemployment exists because of AI but there is also a decrease in the cost of goods and services does that mean we enter a deflationary timeframe? How do we protect purchasing power?

I freaking loved it. I hope it doesn’t change. Friday and Saturday were GLORIOUS. Amazing how much interaction you have with random people when not glued to a phone.

My team got asked to do an education for a large entity in Georgia about this exact topic. Providers do get a tick up but frankly it is small. The 20 year trend relative to inflation for providers sucks. Providers, especially independents, are in a tough spot.

I am seeing a lot of orgs move from value based care back to fee for service. Beckers maintains a list of those orgs.

That said, I do think the incentive structure in 2028 and beyond does start to shift harder to outcomes based on CMS guidance. Not good for big payers but signs that healthcare has to bend the cost curve. Providers are just stuck in the damn machine.

I assume you are in Arkansas?

Hate to disagree but will. Today’s after hours pop is tied to the MA rate notice from CMS. The underlying fundamentals are still not strong in the Medicare Advantage business. In fact they have outsized exposure to risk scores and the notice today essentially delays impact by a year. The earnings call on 4/21 will be important to watch.

For the record I still hold some UNH but will likely use this pop to sell off some and buy alignment health instead.

Help me understand how mid 6% interest rates are making housing unaffordable? Are you saying that the rates are too high and are therefore causing payments to be too high?

Perfect thank you!

Or if people wouldn’t show up at 4am for a 9am flight because the media has them in a panic. What happens is there needs to be a balanced flow. People showing up earlier than needed adds strain to a system that can only push a certain number through the machines. This leads to backups and the media saying arrive even earlier. It is circular.

We should. We were 12-1 against non SEC teams. Coach Mc just sucks against the SEC.