Specialist background
- Over 30 years’ experience in the underwriting and corporate sectors and has worked as a subject matter expert with one of the big five consulting firms
- Well-versed with the healthcare competitive landscape, including its opportunities and threats and players' competition, margins and pricing
- Knowledgeable on the overall growth of and demand in the healthcare industry, Medicare Advantage and new, smaller entrants that are offering additional benefits
Questions
1.
The first thing I wanted to get your thoughts on is the competitive environment within the MA market. It has been the last 3-4 years an intensifyingly [sic] competitive market, particularly on the PPO side, and with some of the start-ups that have gotten a lot of funding and growth. Both United and Humana have grown quite nicely as well. Just curious about your thoughts on how that's changing or evolving here, given the growth might be a little slower, the rate environment in '24 might be a little slower, the (?) environment is a little slower and the risk coding is a little bit more tenuous.
2.
Would you expect the next couple of years, like '24-25, to see a material change in competitive intensity vs '21-23, or would you expect only modest changes in the competitive intensity?
3.
One of the things that United has spent a lot of time talking about this year is the utilisation environment and there's a hypothesis that it's United specifically having some problems in MA with their MLR and cost management and utilisation. If that were the case, let's say they mispriced the debit card they issued this year or missed some sort of expectation in MLR payment, much higher than they thought it was and they had to recently talk about higher utilisation, how would you expect United to fare next year because of that? They have a history of significant out-performance and when we had a year of issues in under-performance, I'd expect some sort of reversal or bounce-back. I'm just curious, how do you think they would react in '24, if they had done something that was an unforced error, or an error for '23 where they'd mispriced the card or something, that had driven MLR to above their expectations?
4.
Who would you think would have had the second-best timeline to capture that, of the other major carriers?
5.
How do you think, with all the challenges in the next year, Humana fares in the MA market? Growth-wise, margin-wise.
6.
How would you characterise United's Optum strategy and how successful they've been and how successful they are likely to be in that business?
7.
How big do you think Optum can get? Optum has been extraordinarily successful over the last decade. Any thoughts for the next 3-5 years?
8.
How about the commercial insurance pricing environment for 2024? How much rates are going up on the commercial side for the risk-bearing guys in 2024, where that is? Is that 5%, 10%, any guess?
9.
How about MA retention rate? Any idea if, for instance, United starts with 100 members at the beginning of the year, how many they end with, what the retention rate would be (talking over each other) or anything else?
10.
Any idea whether or not United would be better than everybody else at retention or whether Humana would rank well on retention? I would assume United ranks the best or one of the best, I'm just curious if you have any qualitative thoughts.
11.
If you were a United or Humana shareholder, what would you worry about for the next 12-24 months? What would keep you up at night?
12.
Is there anything in particular there that you would worry about specifically like rumours about XYZ legislation that could be disruptive? Just curious if there's anything specific here? I totally agree with you that MA is a government programme and so there are zero fee (talking over each other).
