June 10, 2024
Payers | Tea Leaves
  • Humana and CVS, major players in the Medicare Advantage (MA) market, are anticipated to significantly reduce plan benefits and geographic coverage next year in pursuit of higher profits within the privately run Medicare program. This move could potentially lead to hundreds of thousands of MA seniors, along with billions in revenue, seeking new insurers. The extent of this transition hinges on various factors, including decisions on benefit cuts and federal regulations. UnitedHealth, as the leading MA provider, stands to benefit from this upheaval by attracting switching seniors, thereby strengthening its dominance in the market. Despite MA’s historically lucrative nature, recent financial struggles among insurers indicate a shift in its profitability, with growth rates slowing down and margins shrinking. (Article here)