We’re seeing year-over-year-over-year, age coming down slightly, which I think supports our view that we’re seeing a younger pool, we’re seeing a healthier pool, and we’re seeing some of those gig workers coming in. We’re seeing the distribution in gender between male and female shift a little bit, so more men coming into the marketplace, which we see as a signal of digging deeper into that uninsured population, because women tend to move sooner out of that population. Then we’re also seeing the gold tier as an industry pick up a little bit, which we see as supporting our view that there’s small group migration coming into the market – obviously we’ve got anecdotal evidence around that, but that’s true in our book, that’s true in the overall industry, and again I think very consistent with what we think is driving 31% overall market growth, but pleased as well with the fact that within that growth, we were able to grow our market share within footprint.
The relative to ICRA, obviously that’s still very much a nascent market. The Indiana pilot is very new. I’m happy to say that we sold our first customer in January, so good early proof point; but the goal there for us is really to test and learn and gather data, and we’re pretty confident that we’re going to be incrementally smarter about how that market is evolving as we go throughout the year.
Operator: Thank you. Our next question today comes from Gary Taylor at TD Cowen. Please go ahead.
Gary Taylor: Hey, good morning. One clarification and one question. I just want to clarify, Drew, on the negative 1.3% ’25 advance notice for Centene, does that exclude stars or basically for Centene no different stars impact than the negative 15 basis points that CMS sized for the industry? Then my question is, I just wanted to see if you could just balance these very diverse views on MA. Your MA MLR first nine months was down 110 basis points year-over-year, fourth quarter was up 310 excluding the entire PDR, and you only boosted the PDR by $50 million or 30 basis points on ’24. You said your MA outlook looks unchanged, so there’s two camps this quarter: there’s Centene and United saying the sharp fourth quarter MA MLR spike means nothing for ’24, and then there’s Humana, who said the sharp spike in the quarter is the new baseline heading into ’24.
It’s been a while since I’ve seen such divergent views across the industry, that all had sort of the same cost acceleration, so can you just explain again why you’re landing where you’re landing on 2024 MA?
Drew Asher: All right, so let me take the first one first. Of the 1.3–of the minus 1.3%, our star rating change is minus-0.5, so absent that we’d be at minus-0.8, so it’s a little bit heavier than the industry as a whole, which I believe CMS was at minus-0.2, so hopefully that helps with the math there. On Medicare, Sarah said look, we’re looking hard at our outpatient trend, which we’re not happy with but it’s steady at that elevated level relative to May-June timeframe, and that’s sort of what we’d built into the forecast, so that would be a change year-over-year. Inpatient, we talked about that – I mean, no uptick, as we said earlier. Maybe one of the elements that may be a little bit unique with us is that as we see the year developing, and there’s a dial we have on quality spend and initiatives, and there’s a lot of quality initiatives that we’re going to do regardless of what our aggregate EPS result is, but we really stepped that up in Q4 and that triggered a heavier level of office visits, which is a good thing, getting our members in to see their physicians.
It triggered RSV vaccines, which is a good thing, and we saw that coming through in December. As Sarah mentioned, we did have ILI. The only area of the business where ILI, an influenza-like illness, was heavier year-over-year was in Medicare, and obviously that’s transitory, it’s already come down in January, so those are the other elements that you should think about when evaluating Q4. But we feel good about our forecasts. We had another bite at the apple on the PDR, Gary. If we thought trend was going to be $50 million higher than the $250 million next year, the PDR would have been $300 million and we would have reported $6.61, or something like that, so feel good about our forecasts. We’ve got work to do in Medicare to improve the macro, but we’re ready to tackle 2024.
Operator: Thank you. Our next question comes from George Hill with Deutsche Bank. Please go ahead.
George Hill: Yes, good morning guys. I actually want to ask Gary’s question kind of a slightly different way and focusing on what seems to be two different narratives as it relates to the utilization trend. I guess asking it more broadly, and one is kind of the–it’s like there’s the seasonal utilization that’s come through that now needs to be–that now we’re referring to a baseline trend that is normal ex-the seasonality or the bolus, and there’s another narrative that trend is running below baseline, call it off [indiscernible] adjusted basis because of the impact of COVID, and now we have kind of a three-year heightened utilization trend to get back to baseline. Sarah, I guess I’d ask you if you kind of have a preferred utilization narrative that you guys are seeing, like are we kind of working through this short term backlog as it relates to utilization that should normalize, or are we running below a longer term trend that we need to return back to, likely [indiscernible] to your basis?
