Aetna 4Q profit sinks 49 pct, medical costs climb

The Hartford, Conn., company said Thursday the amount it paid in medical claims grew more than 9 percent in the quarter to $6.12 billion as a rise in flu-related expenses countered a drop in use when Superstorm Sandy swept up the East Coast last fall.

This flu season has stirred worry among managed care investors about a rise in claims due to its early start and rapid spread. Aetna Chairman and CEO Mark Bertolini said earlier this month the insurer had seen a spike in flu intensity following two very mild seasons, but he didn't expect claims to exceed the insurer's normal range of $40 million to $50 million.

Aetna officials said their medical costs also climbed in the final quarter of 2012 because employer-sponsored health insurance coverage is changing. Enrollment in high-deductible plans is growing, and people with that coverage often rush to get medical care in the final months of the year before their deductibles reset.

Deductibles are the annual amounts a person must pay out of pocket before most insurance coverage starts.

"As that grows as a percentage of your book of business, the slope of utilization just gets steeper and steeper, and that's been happening every year for the past five," Chief Financial Officer Joseph M. Zubretsky said, adding that Aetna expected the increase.

Aetna also booked after-tax charges totaling more than $134 million in the quarter due to the settlement of litigation, the early retirement of some debt and severance costs.

The insurer also had nearly $13 million in costs related to its acquisition of fellow insurer Coventry Health Care, a $5.7 billion deal Aetna expects to close in the middle of this year.

All told, the company earned $190.1 million, or 56 cents per share, in the three months that ended Dec. 31. That's down from $372.6 million, or $1.02 per share, in the 2011 quarter.