Susan Diamond
Analyst · Goldman Sachs. Your line is open.
Sure, Nathan. As we think about 2023, there’s always a variety of puts and takes that we’ll consider. I would say in terms of utilization, and I think we commented on this last quarter, as in respect to our initial expectations, we did not contemplate the better medical cost trend that we have seen develop in 2022. And so that certainly should be something that does continue into 2023, although we would expect some offset in terms of risk adjustment given the lower utilization. So that’s certainly something that we’ll take into account as we estimate MLR for next year, which obviously, we’re not prepared to give guidance on that today, but would certainly provide guidance on our fourth quarter call. In terms of inpatient procedures, I think we’ve also commented with CMS moving to remove certain items from the inpatient-only list, we frankly expected that to be more flat this year. And frankly, we’ve been pleased to see continued inpatient to outpatient movement, particularly with orthopedic procedures. The rates of outpatient sort of service is pretty high for some of those procedures. So in theory, we should start to see some moderation in that continued shift. Just last night, CMS did release the outpatient reimbursement. And within there, there are also some additional changes to the inpatient-only list. That’s something we’ll have to review in greater detail and consider what, if any, implications we think it will have on further shifting trends for 2023. But otherwise, for utilization, I would say, we are counting on sort of normal course baseline utilization trends. As we’ve commented before, there are two items we want to continue to watch. One is flu. I mentioned in my commentary that so far that is in line with expectations, which it is early in the season, but we are anticipating lower than historical levels, given what we’ve seen in the last few years. We will want to monitor that and see if that does continue or if we start to see an uptick, which we’d have to consider for 2023. And then finally, I would just mention that we know that healthcare capacity is constrained. That’s something we continue to watch. The labor trends and other factors and is something we will continue to be mindful of as we evaluate our go-forward medical cost trend estimates if we, in fact, start to see some of that return to higher levels. And it’s a capacity as we’ve been anticipating some additional utilization as well. So again, not prepared this year guidance today on the MLR, but certainly, we’ll do that on our fourth quarter call as we normally do.