Tag Archive: health


INDIANAPOLIS – Health insurer Aetna Inc.’s fourth-quarter net income jumped 73 percent, as it continued to benefit from low use of health care and some key expenses fell.

The Hartford, Conn., insurer’s earnings and revenue topped Wall Street expectations due in part to slower-than-expected growth in health care use, a trend that has helped insurers routinely outperform the past several quarters. Many analysts expect this trend to continue into 2012.

Aetna said Wednesday that it earned $372.6 million, or $1.02 per share, in the three months that ended Dec. 31. That’s up from $215.6 million, or 53 cents per share, in the 2010 quarter. Revenue climbed slightly to $8.57 billion.

Earnings excluding capital gains and other items were 97 cents per share.

Analysts surveyed by FactSet expected, on average, earnings of 96 cents per share on $8.43 billion in revenue. Analysts typically exclude one-time items from their estimates.

Aetna is the third largest commercial health insurer based on both enrollment and revenue, trailing WellPoint Inc. and UnitedHealth Group Inc.

Health care costs, or the amount Aetna paid in medical claims, fell 2 percent in the quarter to $5.59 billion. The insurer also saw an after-tax benefit of about $63 million because claims leftover from prior periods came in lower than expected.

Aetna’s operating expenses also fell 3 percent to $1.83 billion.

Health insurance is Aetna’s main product, but the company also sells dental, group life and disability coverage. Its medical membership fell slightly, to about 18.5 million people, compared with the 2010 quarter.

Aetna reaffirmed its forecast for 2012 adjusted earnings of $5 per share. Analysts expect $5.08 per share.

Many say a pullback in consumer spending due to the sluggish economy is behind the slower medical use growth.

WellPoint said last week that health care use rose in the fourth quarter but remained lower than normal, and trends were affected more by the cost of care than the number of people receiving it. The insurer saw bigger hospital bills from more acute cases rather than more people heading to the hospital.

WellPoint missed analyst expectations with its performance, but that was largely due to a hit it took from its Medicare Advantage business.

UnitedHealth said its medical costs climbed in the quarter, but price increases for inpatient hospital care, not use, were the biggest reason behind it. Even so, UnitedHealth expects use to climb steadily through 2012.

Six former employees filed suit with the U.S. District Court for the District of Columbia against the Food and Drug Administration alleging the agency monitored their personal emails warning Congress that risky medical devices had been approved, The Washington Post has reported.

The scientists and doctors claimed the information gathered on them contributed to harassment and wrongful termination by FDA, the Post reported Sunday.

All six former employees worked in the office of device evaluation and beginning in 2007 brought concerns about FDA approval of potentially ineffective medical devices to Congress, the White House, and the Health and Human Services Department’s inspector general.

FDA monitored their correspondence and twice asked the HHS inspector general to launch an investigation, stating doctors and scientists had improperly disclosed confidential business information about the devices, according to documents obtained through a Freedom of Information Act request filed by the former agency workers.

“We have obtained new information confirming the existence of information disclosures that undermine the integrity and mission of the FDA and, we believe, may be prohibited by law,” Jeffrey Shuren, director of FDA’s Center for Devices and Radiological Health, wrote in a document in June 2010.

The HHS IG declined to pursue the investigation, finding no evidence of criminal conduct both times it was requested.

The six former employees denied sharing information improperly, but still did not have their contracts renewed, suffered harassment or were fired.

An FDA spokewoman told the Post the agency does not comment on litigation.

The Military Health System identified Symantec’s Veritas Storage Foundation storage software as the cause of a shutdown of the AHLTA clinical data repository, which stores 9.7 million electronic records for active-duty and retired military personnel and their families. Read the whole story at Nextgov.com.

Health and Human Services Secretary Kathleen Sebelius made a first major stop on her tour to promote health care reform on the Daily Show with Jon Stewart Monday night. It was long on jargon and short on laughs as Stewart dug into the policy weeds, focusing on how health insurance exchanges will work and the balance of oversight between federal and state government.

Sebelius could have, but didn’t, glow as Stewart asked about HHS’ latest bulletin on essential health benefits, which gave states more flexibility to determine what a health insurance plan should include.

Sebelius argued that the federal government still helps frame the benefits: Congress set 10 categories of benefits that must be covered. But “the flexibility should be at the state level,” she said.

“Isn’t that Mitt Romney’s argument?” Stewart asked. Romney has said his Massachusetts health care law isn’t a model for the 2010 health reform legislation because what works for one state doesn’t necessarily work for another.

“Actually, the way the law was written in the first place is that states get to take the lead,” Sebelius said. “States can set up their own exchanges, around a set of rules, and insurance companies for the first time have to play by a set of rules.”

She said it was ironic that some states are expressing their opposition to health reform by saying they won’t play at all. “That’s the only time the federal government steps in,” Sebelius said.

Stewart asked whether the exchanges will become “a sort of back door” to greater government involvement in health care, by decoupling insurance from employment and instead tying insurance to tax credits.

“I think what we’ll have is filling in the gaps of the private market,” Sebelius answered.

Sebelius also said that she doesn’t believe the Supreme Court will strike down the individual mandate. Even if it does, she said, “I think we keep going. We find ways to encourage people to become enrolled, and become insured.”

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WASHINGTON – Builders ended 2011 with a third straight year of dismal home construction and the worst on record for single-family home building. But improvement at the end of the year lifted hopes for an eventual recovery.

In December, builders broke ground on a seasonally adjusted annual rate of 657,000 homes, the Commerce Department said Thursday. A third straight increase in single-family home building was offset by a drop in volatile apartment construction. Building permits, a gauge of future construction, were essentially unchanged.

The housing market still appears years away from full health.

For the entire year, builders began work on 606,900 homes. That’s slightly better than in the previous two years. But it’s only about half the number that economists equate with healthy markets.

Construction began on 428,600 single-family homes in 2011. It was the fewest on records dating back a half-century. In a good economy, builders tend to break ground on roughly twice as many. Single-family homes are key to a housing rebound because they account for roughly 70 percent of the market.

Still, analysts said the final months point to improvement.

“We expect further sustained gains in starts and permits over the next few months; a real recovery is getting started,” said Ian Shepherdson, chief U.S. economist at High Frequency Economics.

Homebuilders have grown slightly less pessimistic because more people are saying they might be open to buying a home this year. The National Association of Home Builders/Wells Fargo builder sentiment index rose in January to its highest level since June 2007.

The number of actual purchases remains weak. Among new homes, sales last year are likely to turn out to be the worst on records dating back half a century. But the rising interest from would-be buyers, along with record-low mortgage rates, is lifting optimism for stronger sales ahead

Builders are struggling to compete with deeply discounted foreclosures and short sales. (Short sales occur when lenders allow homes to be sold for less than what’s owed on the mortgage.)

Though new homes represent just 20 percent of the overall home market, they have a big impact on the economy. Each home built creates an average of three jobs for a year and generates about $90,000 in taxes, according to the National Association of Home Builders.

After previous recessions, housing accounted for at least 15 percent of U.S. economic growth. Since the recession officially ended in June 2009, it has contributed just 4 percent.

Another reason new-home sales have fallen is that previously occupied homes have become a better deal. The median price of a new home is about 30 percent higher than the median price for a re-sale. That’s nearly twice the markup typical in a healthy housing market.

“The report shows the housing industry is still in a holding pattern,” said Mitchell Hochberg, principal of Madden Real Estate Ventures in New York. He said fewer foreclosures and a drop in unemployment would help spur a turnaround.

DAVENPORT, Iowa – Lee Enterprises Inc., publisher of the St. Louis Post-Dispatch and other daily newspapers, on Tuesday reported a 23 percent drop in profit for its fiscal first quarter compared with a year ago, when it posted a large gain after curtailing retiree health benefits.

The company reported net income of $14.6 million, or 32 cents per share, for the quarter that ended Dec. 25. That compares with a profit of $18.9 million, or 42 cents per share, for the same period a year ago.

However, earnings rose 18 percent when one-time gains and losses during both quarters were excluded. The company earned $16.9 million, or 38 cents per share, compared with $14.3 million, or 32 cents, a year ago, excluding one-time items.

Revenue was $199.6 million, down 3.9 percent from a year ago. Advertising declined 6.1 percent, while circulation revenue rose 2.7 percent. Digital advertising revenue rose 10 percent to $16.2 million.

“We continue to expect revenue trends to improve slowly in 2012, as we press forward with more digital and print initiatives,” said Lee Enterprises chairman and CEO Mary Junck.

Also last quarter, Lee did a prepackaged Chapter 11 bankruptcy filing to allow it to complete a restructuring of its debt. A prepackaged filing usually results in a speedy exit from bankruptcy court protection, and Lee said Tuesday that it plans to ask the court to let it exit on Jan. 30.

Shares of the Davenport, Iowa, company rose 1 cent to 75 cents in morning trading.

About 41 percent, or 3.3 million, veterans enrolled in the Veterans Affairs Department health system live far from a VA hospital, so last week the department added another 20 vehicles to its fleet of 50 mobile vet centers packed with sophisticated communications gear to bring medical care and other services to rural veterans. Read the whole story at Nextgov.com.

NEW YORK – You can usually tell a lot about the health of the U.S. economy by looking at the financial results of banks. They’re the people who finance new factories, plant expansions and fatter payrolls.

But don’t count on that over the next two weeks, when banks report their results from the last three months of the year.

Americans ran up credit card balances, businesses borrowed more, and historically low mortgage rates encouraged people to refinance mortgages. All good for the economy, and for banks, too.

But the banks took a hit because the European debt crisis made stock and bond markets jumpy.

A rule restricting debit card fees that took effect Oct. 1 will take another bite out of revenue, as will an obscure accounting rule that requires banks to take a loss when the value of their debt rises.

JPMorgan Chase will be the first major bank to report results Friday, followed by Citigroup, Wells Fargo, Goldman Sachs, Bank of America and Morgan Stanley next week.

Wells Fargo, the only major commercial bank without a large investment banking division, is expected to come out ahead of its peers Citi and JPMorgan. Traditional investment banks Goldman and Morgan probably found it hard to escape a hit to the bottom line because of market volatility.

Big banks are under pressure from international regulators to hold on to more cash and reduce riskier lending so they can weather sharp economic downturns or a financial crisis.

On Monday, the 19 largest U.S. banks submitted to their annual stress test, with results due in March. The Federal Reserve will determine whether they have enough cash and cash-like securities on their balance sheets to offset potential losses from risky loans. The Fed can order unhealthy banks to raise more cash or preserve some by not paying dividends.

Moshe Orenbuch, a bank analyst for Credit Suisse, says American banks have become resilient and expects all the banks to pass their stress tests this year. Orenbuch expects both JPMorgan and Citi to increase their dividends later this year.

Banks brought in $13.9 billion in investment banking revenue, down 37 percent from the year before and the lowest since the first quarter of 2009, the depths of the financial crisis, according to Dealogic, a provider of financial data.

Weaker investment banking results should also mean smaller bonuses for Wall Street bankers, something investors — not to mention Occupy protesters and political scientists — will watch closely.

Also hurting the banks’ bottom line, a law championed by Sen. Dick Durbin, D-Ill., caps the amount banks can charge stores for debit card transactions at 24 cents. Before the law, the average debit card transaction netted the bank 44 cents.

Major banks also had planned to impose debit card fees — as much as $5 per month from Bank of America. They backpedaled after a public backlash, but it will hurt quarterly earnings. Bank of America expects $475 million in lost revenue, JPMorgan $300 million and Wells Fargo $250 million.

Banks will also take a loss from an accounting rule that applies to the value of their own corporate debt. If the value of debt they have issued rises, it would cost the banks more to buy back that debt in theory. Corporate debt prices bounced back late last year after falling in the summer, when one agency stripped the United States of its top-notch credit rating.

Here’s what to expect as the major banks report. Expectations are compiled from analysts surveyed by FactSet, another data provider.

JPMORGAN CHASE

Reports: Friday.

Forecast: Profit of 93 cents per share on revenue of $23 billion.

What to watch for: JPMorgan is considered the strongest and most stable of the major banks. But JPMorgan and other banks are being forced to repurchase soured loans that government agencies Fannie Mae and Freddie Mac bought from them during the real estate boom. David Konrad, analyst at Keefe, Bruyette & Woods, expects the bank to get hit by higher costs from the buybacks.

CITIGROUP

Reports: Tuesday.

Forecast: Profit of 62 cents per share on revenue of $18.6 billion.

What to watch for: Mike Mayo, a bank analyst at the brokerage CLSA and author of the book “Exile on Wall Street,” says Citi’s results will be hurt by a $400 million charge related to 4,500 job cuts and a $300 million tax-related charge in Japan.

WELLS FARGO

Reports: Tuesday.

Forecast: Profit of 72 cents per share on revenue of $20 billion.

What to watch for: Wells is one of the largest issuers of home mortgages in the country, and will probably benefit from lower mortgage rates.

GOLDMAN SACHS

Reports: Wednesday, Jan. 18.

Forecast: Profit of $1.45 per share on revenue of $6.8 billion.

What to watch for: Goldman lost money from July through September, only its second quarterly loss since going public in 1999. Investors worry that Goldman’s heyday, when it made big gains on bold trades, is over. Howard Chen, an analyst with Credit Suisse, says the investment bank’s trading results will suffer because it has less of an appetite for risk these days.

BANK OF AMERICA

Reports: Thursday, Jan. 19.

Forecast: Profit of 22 cents per share on revenue of $23.8 billion.

What to watch for: Investors expect the results to show a bank under duress. It’s fighting lawsuits from investors for poorly written mortgages. The bank closed down a division that financed mortgage loans from small lenders such as credit unions, meaning reduced quarterly revenue. But the bank should make money overall because of a $1.8 billion gain from selling its stake in a Chinese bank. CEO Brian Moynihan has been shedding assets and businesses that aren’t essential to Bank of America.

MORGAN STANLEY

Reports: Thursday, Jan. 19.

Forecast: Loss of 40 cents per share on revenue of $6 billion.

What to watch for: Weaker sales and trading will hurt earnings at the investment bank, says Credit Suisse’s Chen. Morgan Stanley’s earnings will also take a $1.2 billion hit after it agreed to write off a portfolio of soured mortgage investments after a settlement with insurer MBIA Inc.

WASHINGTON (NEWS.GNOM.ES) – U.S. healthcare spending barely rose in 2010 from record-low recession levels, as high unemployment and the loss of private health insurance forced many Americans to delay or forego medical treatment, government officials said on Monday.

Spending edged up 3.9 percent, bringing the total size of the U.S. healthcare system to $2.6 trillion, or $8,402 per person, according to a report released by the U.S. Centers for Medicare and Medicaid Services, or CMS, and published in the journal Health Affairs. For a graphic, see: http://link.NEWS.GNOM.ES.com/but85s

Growth in 2010 was only a slim 0.1 percentage point higher than the 3.8 percent recorded in 2009, which was the lowest rate recorded in half a century. Per capita health spending in the United States is still the highest worldwide.

“It’s absolutely clear what’s going on,” said William Galston of the Brookings Institution. “People’s budgets have been hard-hit, and even if they have 20 percent co-pays from their insurance companies, that 20 percent may still be too much.”

The data are likely to play prominently in the political debate over U.S. government spending as President Barack Obama’s 2010 healthcare reform law approaches challenges from the Supreme Court and he fights for reelection in November.

The healthcare industry’s share of the U.S. economy was unchanged for the first time since 2006 at 17.9 percent as output from other sectors recovered from the downturn that ended in June 2009.

But even as recession-ravaged consumers avoided prescription drugs, hospitals, doctors and clinics in 2010, medical prices remained on an upward trajectory that slowed only marginally during the 2007-2009 recession.

It was not clear how consumers might have fared in 2011 as the recovery gathered pace and unemployment declined. But some analysts said the durability of healthcare prices and pent-up demand for services could suggest a sharp increase in costs down the road.

Federal spending for Medicare and Medicaid, which benefit the elderly and the poor, respectively, is also a key issue in partisan political wrangling in Congress over the mounting federal debt and deficit that is widely expected to gather momentum after the 2012 elections.

WHITE HOUSE CITES PREMIUM JUMP

The White House welcomed the report as evidence healthcare could be tamed but said it demonstrated the need for consumer protections set out in the Affordable Care Act health reform law, including a requirement that insurance companies justify large premium increases.

“In 2010, the net cost of health insurance – which includes the overhead and insurance company profits – increased by 8.4 percent. That’s more than twice the increase in the cost of health care,” deputy White House Chief of Staff Nancy-Ann DeParle said in an official blog posting.

Analysts also noted that insurance premiums grew faster than benefits for the first time in seven years.

The healthcare reform law, Obama’s signature domestic policy achievement, accounted for only 0.1 percent of the rise in spending in 2010. But much of the law is not scheduled to take effect until 2014, when it is expected to extend coverage to more than 30 million uninsured Americans by expanding Medicaid and setting up state-run health insurance exchanges.

The federal government’s $743 billion healthcare bill climbed to 29 percent of total spending, while other spending sources from businesses and households to state and local governments saw their shares of spending decline.

“The greater federal burden contributes more to the deficit, and so in early 2013 there will be even more pressure to cut back, specifically on Medicare, and the promises made to the uninsured through the Affordable Care Act,” said Joseph Antos of the conservative American Enterprise Institute.

Federal spending in dollar terms rose mainly as a result of the Obama administration’s efforts to help cash-strapped state governments by paying a greater share of Medicaid, which saw enrollment rise as 3.7 million people lost their private health insurance. The Medicaid assistance ended last July.

But the rate of spending growth slowed for both Medicaid and Medicare as Medicaid enrollment decelerated from recession levels and fewer senior citizens signed up for Medicare Advantage, which allows the elderly to purchase private insurance through Medicare.

Medicaid, which is jointly funded by federal and state governments, spent $401 billion, an increase of 7.2 percent. Medicare program costs grew 5 percent to $525 billion.

Prescription drugs, which accounted for 10 percent of healthcare spending, saw historically low growth due largely to the use of generic drugs, a drop in new product introductions and an increase in Medicaid prescription drug rebates.

Hospital services registered a fourth consecutive year of slower growth as consumers postponed medical care even at emergency rooms. Doctors and clinics also saw historically low spending growth, despite stable price increases, due to fewer visits and a less-severe flu season.

(Additional reporting by Anna Yukhananov)

The top spenders of stimulus money over the past three years are the Health and Human Services, Education, and Treasury departments, according to a Congressional Budget Office blog post Thursday.

CBO’s purpose in evaluating progress on the 2009 American Recovery and Reinvestment Act was to compare its own estimates done soon after the law’s passage against actual agency outlays as of September 2011. It concluded that total spending under the act — $494 billion over three years — was $20 billion, or 4 percent, higher than CBO’s original projection.

“The higher than anticipated spending resulted primarily from the costs of two programs that were noticeably affected by economic developments that differed from projections: unemployment-related benefits administered by the Department of Labor, and nutrition assistance administered by the Department of Agriculture,” analysts wrote in the post.

CBO was closest in its projections for spending by the Treasury, Transportation and Energy departments, it said. After HHS, Education and Treasury, the next highest-spending departments were Labor and Transportation. The modest gap between estimates and actual spending was attributed in part to lower than expected food prices and higher than expected spending on unemployment benefits.

Programs accounting for the lion’s share of stimulus act spending — which peaked in 2010 and has slowed considerably — included “temporary authority for assistance to states through increases in the federal matching rate for Medicaid spending and for education-related expenses, payments to individuals in the form of refundable tax credits, increased funding for unemployment compensation, and increased funding for transportation and other infrastructure projects,” CBO said. About 78 percent of the stimulus law’s funds had been spent as of September 2011.

CBO’s latest update on the long-term budgetary impact compiled one year ago, puts “the cumulative impact of [the Recovery Act] at $821 billion over the 2009-2019 period, reflecting $637 billion in spending increases and $184 billion in revenue reductions,” the blog post stated.

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