CVS Reports Strong Overall 3Q Results Despite High MA Utilization

In the third quarter, CVS Health Corp. performed well overall, but the firm’s health insurance division was a drag on profits due to higher-than-expected utilization, especially in Medicare Advantage. However, a big gain in MA Star Ratings could bode well for the firm’s health benefits division going forward.

CVS faced a higher-than-expected medical loss ratio (MLR) in its health benefits division, Aetna, exceeding the Wall Street consensus by 140 basis points. That high utilization primarily took place in Aetna’s MA book of business, according to CVS executives.

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Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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