Payers mostly reported upticks in non-COVID-19 care during the second quarter that, for many, came back sooner than expected. During the same time last year insurers turned record profits as systems and patients overwhelmingly put elective surgeries and other medical care on hold.
As a result, net incomes fell significantly year over year while medical cost ratios rose. Humana, UnitedHealth, Molina, Anthem and Cigna all reported net income down significantly year over year, by 67%, 35%, 33%, 22% and 16%, respectively.
And Centene reported a net loss of $535 million, down from $1.2 billion in profit during the same quarter last year.
But insurers in the period also benefited from policy decisions that boosted some of their membership. The extension of Medicaid coverage through the duration of the public health emergency led to large increases in Medicaid membership. And the special enrollment period for Affordable Care Act plans enacted by President Joe Biden in response to fallout from the pandemic is helping payers pick up more marketplace members.
So far, more than 2 million people nationwide have signed up during the period, which ends Aug. 15.
Anthem added 1.9 million members in the second quarter, a 4.4% increase year over year, fueled entirely by government programs while its commercial membership declined slightly.
Centene's membership increased 3% year over year, spurring revenue growth of 12% for the quarter.
Both payers and providers reported a bounce back in utilization and volumes during the second quarter, though it remains to be seen when the patchy rally in deferred care will come to push them past pre-pandemic levels.
Anthem executives said on a call with investors that inpatient and emergency room visits were still trailing pre-pandemic levels, while outpatient utilization and doctors visits were a bit above baseline as patients returned for checkups and annual visits.
More care shifted from inpatient settings to outpatient, and from emergency rooms to urgent care centers in the second quarter for Cigna, which it viewed as positive changes.
But the rest of the year could look different, with cases of the delta variant on the rise. Rapidly increasing hospitalizations in some areas have hospitals like AdventHealth in central Florida deferring new inpatient elective surgeries to avoid stretching resources too thin.
"It remains clear that the pandemic is not over, and the environment could remain choppy for the balance of the year," Centene CEO Michael Neidorff said on a call with investors.