Fewer claims lift WellPoint, Aetna in 3Q

By Reuters
Posted Nov. 3, 2010 at 1:00 p.m.

WellPoint Inc. and Aetna Inc. raised their profit forecasts for the year as members avoided doctor visits or delayed care to save money, while the large U.S. health insurers stand to see an improved political climate for their business under the new Congress.

Both reported higher-than-expected quarterly profits Wednesday, saying they benefited from having to pay out less in medical costs.

But investors were focused on the future of U.S. health care reform after Republicans captured the House of Representatives and made gains in the Senate in Tuesday’s midterm elections.

Analysts have said health insurer stocks could rise 5 to 15 percent the next couple of months, even after gaining on expectations of a Republican win in recent weeks.

“With a Republican Congress, I think that (with) the political environment as well as the regulatory risks, we’re in a modestly improved position from earlier in the year,” Leerink Swann analyst Jason Gurda said.

Shares of Aetna rose 2.5 percent Wednesday, while WellPoint fell 1.9 percent, and the Morgan Stanley Healthcare Payor Index declined 1.1 percent.

Aetna, the No. 3 U.S. health insurer, said earnings rose as members cut their use of health care services. The industry has benefited all year from lower medical costs as patients postpone procedures in the weak economy.

“Let’s face it: the consumer has retrenched,” Aetna Chief Financial Officer Joseph Zubretsky said in an interview. “We think that has had a very, very dramatic impact on the level of utilization.”

WellPoint, the largest U.S. health insurer by membership, said lower medical costs also resulted in part from a less intense flu season and its actions to control hospital rates.

WellPoint, which like rivals has been shedding members as employers cut jobs, nonetheless lifted its year-end enrollment forecast by 200,000 members to 33.3 million due to stabilizing trends in its commercial business which serves employers. It projected a slight increase in overall enrollment next year.

“We are starting to see some stability in the unemployment levels,” WellPoint Chief Financial Officer Wayne DeVeydt said in an interview. “I wouldn’t say we’re seeing recovery, though, at this point.”

Aetna and WellPoint followed rivals this quarter in posting third-quarter results well ahead of targets, but declining to give specific forecasts for next year, keeping any positive market momentum in check.

The industry and Wall Street are waiting for the U.S. government to finalize regulations under the health reform law that will mandate how much the companies must spend on medical costs, known as medical loss ratio (MLR) regulations.

DeVeydt said the MLR regulations, which will require that insurers provide rebates should they not reach minimum spending levels, will be a significant challenge to profits next year, when the rules are set to kick in.

“The more effective we are in driving down costs, the good news is our members will get a check back for that,” DeVeydt said. “But ultimately, we no longer get to participate in the value we bring for driving down costs.”

WellPoint’s net income edged up to $739.1 million, or $1.84 per share, from $730.2 million, or $1.53 per share, a year earlier.

Excluding items, earnings of $1.74 per share topped analysts’ average estimate by 16 cents, according to Thomson Reuters I/B/E/S.

WellPoint, which serves members under Blue Cross and Blue Shield plans in 14 states, pointed to lower administrative costs resulting from a savings push and from the sale of its NextRx drug benefit unit to Express Scripts Inc.

Revenue fell nearly 6 percent, to $14.33 billion. Analysts had looked for $14.21 billion.

WellPoint said it expects a loss of $150 million this year in its business providing coverage to individuals in California, where its rate increases were delayed. The insurer’s initial bid to raise rates in the state drew sharp criticism during the healthcare reform debate.

Indianapolis-based WellPoint projected net income of  “at least” $6.60 per share for 2010, up from its prior outlook of at least $6.30. Its full-year view excluding items is $6.45.

Aetna’s net income jumped to $497.6 million, or $1.19 per share, from $326.2 million, or 73 cents per share, a year earlier.

Excluding items, the Hartford, Conn.-based company reported operating earnings of $1.00 per share, and 84 cents per share excluding further positive claim reserves from prior periods. Analysts were looking for 67 cents.

Aetna’s revenue slipped 2 percent, to $8.54 billion, reflecting a decrease in membership in its commercial plans. Analysts had looked for $8.47 billion.

Aetna also said it does not expect U.S. government sanctions on its Medicare plans for the elderly to lift before enrollment in the plans begins later this month, preventing the company from marketing to potential new customers.

Membership stood at 18.53 million at the end of September.

Aetna forecast 2010 earnings of about $3.60 per share, excluding items, up from its prior outlook of $3.05 to $3.15.

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