Experts are keeping an eye on whether more insurers will report an uptick in hospitalizations among the seniors they cover following a recent disclosure from Humana.
Last week, the payer, the nation's second largest Medicare Advantage insurer, reported a rise in hospitalizations among its Medicare Advantage members.
"I think we have to pay attention to it. We have to watch it closely," Dean Ungar, vice president of Moody's Investors Service who covers health insurers, told Healthcare Dive.
In a filing with the U.S. Securities and Exchange Commission, Humana provided an MA utilization update and said, "In recent weeks, the Company has experienced increased COVID hospitalizations in connection with the current surge in COVID cases in the U.S."
It's potentially troubling because people 65 and older, who are eligible for Medicare, have a higher vaccination rate than the rest of the population. Humana's report raises questions about what's driving the uptick in hospitalizations among this cohort.
About 82% of those 65 and older have been fully vaccinated compared to nearly 65% of adults 18 and older, according to figures from the Centers for Disease Control and Prevention.
"This could be troubling, depending on the numbers, which I did not see. I've not seen numbers reported by other Medicare Advantage firms either," Tricia Neuman, executive director on Medicare policy for the Kaiser Family Foundation, told Healthcare Dive.
Humana's disclosure did not provide any additional data on the hospitalizations among its senior members. However, in an email, the payer said its "Unvaccinated members are currently being hospitalized for COVID-19 at a rate of approximately 10 times the rate of vaccinated members."
Humana is scheduled to give a presentation Wednesday as part of Morgan Stanley's Healthcare Conference and may provide more detail at that time.
The disclosure is interesting in light of three studies the CDC published by Friday that provide an important update on vaccine effectiveness.
In one study that examined medical encounters including hospitalizations across nine states, researchers found that while vaccines are highly effective against severe illness that requires hospitalization or even a visit to the emergency room or urgent care, that effectiveness was lower among those 75 and older.
Researchers warned that "this moderate decline should be interpreted with caution," explaining that the decline could be due to a combination of factors, including waning vaccine immunity.
Bob Wachter, chair of the University of California San Francisco's department of medicine, said the results are important.
Thx, Eric. We need to grapple with 2 mutually compatible facts at once: vaccines remain highly effective vs cases (& especially severe cases), AND effectiveness has fallen, placing vulnerable folks at ⬆ risk – which likely can be rectified (at very low risk/cost) with a booster. https://t.co/WyHM8swI5n— Bob Wachter (@Bob_Wachter) September 10, 2021
The reports were widely touted as they showed unvaccinated Americans are more than 10 times as likely to require hospitalization and die from COVID-19. They came on the heels of President Joe Biden's vaccine mandate announcement as he acknowledged his patience for unvaccinated Americans was wearing thin.