Today, we reported adjusted earnings per share of $4.83 for the third quarter of 2021, slightly above consensus estimates.
As Susan will share in more detail, this reduction of approximately $1 in adjusted earnings per share is a direct result of COVID and corresponds to our current expectation of the total Medicare Advantage utilization inclusive of COVID costs will run 1% below baseline in the fourth quarter, which is a 150 basis points less than our previous assumption of 2.5% below baseline.
This update reflects a more conservative posture going into the final months of the year and notably $21.50 remains the baseline of which to grow for 2022.
Our adjusted earnings per share guidance has been above our long-term growth target at the midpoint throughout the year at 16% growth.
Our Medicare Advantage individual above market growth in 2021 of 11% can be in part contributed to our industry-leading quality and consumer satisfaction scores.
We are pleased to be recognized by CMS for having 97% of our members in 4-Star or higher rated contracts for 2022.
And notably $21.50 remains the baseline of which to grow for 2022.
Our adjusted earnings per share guidance has been above our long-term growth target at the midpoint throughout the year at 16% growth.
Our Medicare Advantage individual above market growth in 2021 of 11% can be in part attributed to our industry-leading quality and consumer satisfaction scores.
We are pleased to be recognized by CMS for having 97% of our members in 4-Star or higher contract for 2022.
Examples of those impactful areas include respite care distributing 1.5 million meals during COVID, sending fans to seniors with COPD during a heat wave and providing support for financial need impacting a senior's health and well-being.
As you've seen in our D-SNP plans designed for dual eligible members where we have grown our membership approximately 40% in both 2022 and 2021.
We've expanded our D-SNP offerings for 2022 to cover nearly 65% of the dual eligible population nationally.
To reduce food and security, 97% of our members enrolled in our D-SNP plans, and we'll have a healthy foods cart, which provides a monthly allowance to purchase approved food and beverages at various national chains.
We have the largest senior-focused, value based primary care organization in the country, which by year end will include approximately 200 clinics serving 300,000 patients across 24 markets in nine states.
We are accelerating organic and inorganic growth nationally and plan to open a total of 30 de novo senior focused centers in 2022, up from 24 in 2021.
At our more mature centers hospitalizations and ER visits are down 12% year-to-date versus 2019 pre-COVID Stars performance tracking to 4.5 Stars and NPS score of 90.
We will also continue to expand through inorganic growth completing seven acquisitions through the third quarter of this year bringing 21 newly, wholly owned centers to our portfolio.
We currently care for approximately 270,000 Humana members under value-based home care models in South Florida and Southeast Texas where we have seen improved outcomes including emergency room usage being 100 basis points better than Humana's national average.
We expect to begin the rollout in the second quarter of 2022 with the goal of covering nearly 50% of Humana Medicare Advantage members under this value-based home health model within the next five years.
We've seen increased nurse satisfaction and engagement in pilot markets where we have deployed value-based concepts, with voluntary nursing turnover improving nearly 10% among home health nurses in 2021.
Given that today more than 40% of Medicare beneficiaries, over 27 million seniors and those with disabilities are enrolled in Medicare Advantage, we were encouraged to see that the package did not include any payment reductions to the program.
Today we reported adjusted earnings per share of $4.83 for the third quarter and updated full year 2021 adjusted earnings per share guidance to approximately $20.50 to reflect a net unmitigated COVID headwind resulting from our current view of utilization levels for the balance of the year.
As of our second quarter call, full year guidance assumed non-COVID Medicare Advantage utilization was around 2.5% below baseline in the second half of the year, with a further assumption of minimal COVID testing and treatment costs for the same period.
In September 2021 as a result of the surge in COVID cases due to the Delta variant, we updated our commentary on full year guidance to indicate we expected non-COVID Medicare Advantage utilization to be 5.5% below baseline in the back half of the year, while being partially offset by 3% of COVID costs, therefore, again assuming total utilization would be 2.5% below baseline in the back half of 2021.
What we've seen develop for the third quarter is that total utilization is running 1% below baseline versus the previously anticipated 2.5%.
COVID costs have been higher than initially anticipated as the Delta Variant resulted in hospitalization levels on par with what we experienced in January of 2021 and were overwhelmingly driven by the 20% of our Medicare Advantage members believed to be unvaccinated.
As COVID hospitalizations increased or decreased we continue to see an approximate 1-to-1 offset in non-COVID hospitalization levels.
However, for the third quarter, in total we saw 1% incremental reduction in utilization beyond the level needed to offset COVID costs versus the 2.5% contemplated in our previous guide.
As a result, we have adjusted our full year guide to now reflect the fourth quarter running similarly with total Medicare Advantage utilization running 1% below baseline inclusive of estimated COVID costs, consistent with what we experienced in the third quarter.
Taken together, our updated full year 2021 adjusted earnings per share guidance takes a more conservative posture going into the final months of 2021, and it's important to note as we've consistently shared throughout the year the midpoint of our original guidance range of $21.50 remains the correct baseline for 2022 given our approach to pricing.
We have refined our full year individual Medicare Advantage membership guidance to up approximately 450,000 members consistent with the midpoint of our previous guidance of up 425,000 to 475,000 members.
This outlook represents above market growth with an increase of 11.4% year-over-year.
We now expect to add 125,000 to 150,000 Medicaid members in 2021, up from our previous expectation of up 100,000 to 125,000 members.
From a membership perspective, we have increased our expected Group medical membership losses from 100,00 to 125,000 reflecting the expectation of additional losses in the fourth quarter as a result of rating actions taken to account for the expected impact of COVID in 2022.
We expect to grow our individual Medicare Advantage membership in a range of 325,000 to 375,000 members in 2022 or approximately 8% year-over-year reflective of our prudent approach we took to pricing for 2022 and the competitive nature of the market.
As previously mentioned, I want to reiterate that the $21.50 midpoint of our original 2021 guide continues to be the appropriate jumping-off point for 2022 adjusted earnings per share growth given our approach to pricing.
Provider interactions and documentation of clinical diagnoses that we anticipate will impact 2022 revenue are approximately 92% complete to-date, in line with both our expectations for 2021 as well as the estimated completion rate for the same time period in 2019.
Given the ongoing uncertainty surrounding the COVID-19 pandemic we expect to enter the year with an appropriately conservative view of our initial 2022 financial outlook.
Accordingly, we anticipate that our initial earnings per share guidance will target the low end of our long-term growth range of 11% to 15%.

Summary:
Today, we reported adjusted earnings per share of $4.83 for the third quarter of 2021, slightly above consensus estimates.
As Susan will share in more detail, this reduction of approximately $1 in adjusted earnings per share is a direct result of COVID and corresponds to our current expectation of the total Medicare Advantage utilization inclusive of COVID costs will run 1% below baseline in the fourth quarter, which is a 150 basis points less than our previous assumption of 2.5% below baseline.
This update reflects a more conservative posture going into the final months of the year and notably $21.50 remains the baseline of which to grow for 2022.
And notably $21.50 remains the baseline of which to grow for 2022.
Today we reported adjusted earnings per share of $4.83 for the third quarter and updated full year 2021 adjusted earnings per share guidance to approximately $20.50 to reflect a net unmitigated COVID headwind resulting from our current view of utilization levels for the balance of the year.
In September 2021 as a result of the surge in COVID cases due to the Delta variant, we updated our commentary on full year guidance to indicate we expected non-COVID Medicare Advantage utilization to be 5.5% below baseline in the back half of the year, while being partially offset by 3% of COVID costs, therefore, again assuming total utilization would be 2.5% below baseline in the back half of 2021.
What we've seen develop for the third quarter is that total utilization is running 1% below baseline versus the previously anticipated 2.5%.
As COVID hospitalizations increased or decreased we continue to see an approximate 1-to-1 offset in non-COVID hospitalization levels.
However, for the third quarter, in total we saw 1% incremental reduction in utilization beyond the level needed to offset COVID costs versus the 2.5% contemplated in our previous guide.
As a result, we have adjusted our full year guide to now reflect the fourth quarter running similarly with total Medicare Advantage utilization running 1% below baseline inclusive of estimated COVID costs, consistent with what we experienced in the third quarter.
Taken together, our updated full year 2021 adjusted earnings per share guidance takes a more conservative posture going into the final months of 2021, and it's important to note as we've consistently shared throughout the year the midpoint of our original guidance range of $21.50 remains the correct baseline for 2022 given our approach to pricing.
We have refined our full year individual Medicare Advantage membership guidance to up approximately 450,000 members consistent with the midpoint of our previous guidance of up 425,000 to 475,000 members.
As previously mentioned, I want to reiterate that the $21.50 midpoint of our original 2021 guide continues to be the appropriate jumping-off point for 2022 adjusted earnings per share growth given our approach to pricing.
Given the ongoing uncertainty surrounding the COVID-19 pandemic we expect to enter the year with an appropriately conservative view of our initial 2022 financial outlook.