Data & Analytics

MCO Stock Performance, May 2024

Here’s how major health insurers’ stock performed in May 2024. Elevance Health, Inc. had the highest closing stock price among major commercial insurers as of May 31, 2024, at $538.48. Humana Inc. had the highest closing stock price among major Medicare insurers at $358.12.

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© 2024 MMIT

Report: Led by Anti-Inflammatories, Specialty Drugs Continue Upward Trend

Specialty drugs are still taken by only a small percentage of people but represent more than half of total drug costs. Anti-inflammatory specialty therapies continue to be a huge driver of those costs, according to the recently released 2023 Drug Trend Report from PBM analytics firm Xevant. The specialty pipeline remains strong, and payers should expect these agents to continue to affect their costs, says one industry expert.

Based on Xevant’s book of business for 2022 and 2023, the company observed an 11% increase in the number of prescriptions filled for specialty drugs. The plan-paid amounts for those agents rose 19%, slightly less than nonspecialty medications’ 22% plan-paid costs. In addition, the average plan cost per specialty prescription rose from $6,100 in 2022 to $6,700 in 2023.

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Since 2010, Some Minority Groups’ Uninsured Rates Have Dropped by Half

Uninsured rates among Black, Latino, Asian and Native American communities plummeted from 2010 to 2022, as more people gained health care coverage through federal health care programs and employer-sponsored plans, according to reports released by HHS.

The uninsured rate for Black Americans under age 65 dropped from 20.9% to 10.8% between 2010 and 2022, and the rate dropped from 32.7% to 18.0% for Latino Americans during that time. Meanwhile, the uninsured rate went from 16.6% to 6.2% for Asian Americans, Native Hawaiians and Pacific Islanders (AANHPI), and from 32.4% to 19.9% for American Indians and Alaska Natives (AI/AN).

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© 2024 MMIT

Report: Led by Anti-Inflammatories, Specialty Drugs Continue Upward Trend

Specialty drugs are still taken by only a small percentage of people but represent more than half of total drug costs. Anti-inflammatory specialty therapies continue to be a huge driver of those costs, according to the recently released 2023 Drug Trend Report from PBM analytics firm Xevant. The specialty pipeline remains strong, and payers should expect these agents to continue to affect their costs, says one industry expert.

Based on Xevant’s book of business for 2022 and 2023, the company observed an 11% increase in the number of prescriptions filled for specialty drugs. The plan-paid amounts for those agents rose 19%, slightly less than nonspecialty medications’ 22% plan-paid costs. In addition, the average plan cost per specialty prescription rose from $6,100 in 2022 to $6,700 in 2023.

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© 2024 MMIT

Health Insurers May Owe $1.1 Billion in MLR Rebates in 2024

Insurers that participate in the individual, small-group and large-group markets are estimated to pay a total of $1.1 billion in medical loss ratio (MLR) rebates to their customers in 2024 — falling short of record-high $2.5 billion in rebates in 2020 but staying similar to rebates levels in 2022 and 2023, according to a KFF analysis on preliminary data filed by insurers.

Under the Affordable Care Act, insurers that spend less than a certain percentage of their premium income on health care claims and quality improvement must rebate customers. Individual/small group plans must issue rebates if their MLRs fall below 80%, while the cutoff is 85% for large group plans. About half of the total rebate amount will go to individual market enrollees this year. Nearly $12 billion in rebates in total have been issued since the ACA required insurers to pay back excess profits to customers starting in 2012.

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Aetna, Insurtechs Outpaced Medicare Advantage Peers in Quieter OEP

Medicare Advantage enrollment grew by 350,000 members during the 2024 Open Enrollment Period (OEP), according to CMS’s May data release and AIS’s Directory of Health Plans. That’s a 31% drop from last year, which saw 507,000 sign-ups from February to May, and it reflects a slowdown in MA growth also seen in the Annual Election Period (AEP).

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Under New Rule, DACA Recipients Can Sign Up for ACA Marketplaces in 2025

Under the Biden administration’s new regulations — which will allow Deferred Action for Childhood Arrivals recipients to receive federal health care coverage — more than 100,000 uninsured DACA recipients are expected to enroll in Affordable Care Act (ACA) marketplace plans next year, according to CMS.

As of Dec. 31, 2022, there were 580,000 active DACA recipients and almost 28% of them resided in California. A KFF survey showed that most people who were likely eligible for DACA lived in a family with at least one full-time worker and over half of them worked full time themselves. However, they were much less likely than U.S.-born individuals in their age group to receive health care coverage.

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CMS Minority Health Report Suggests Similar Patient Experiences, Varied Outcomes

As CMS continues efforts to advance health equity, the agency on May 2 released its annual report on disparities in the Medicare Advantage program based on race, ethnicity and sex. Racial and ethnic minorities are consistently more likely to enroll in Medicare Advantage versus the traditional, fee-for-service Medicare program. The 2024 report, released by the CMS Office of Minority Health in partnership with The RAND Corp., examined patient experience measures based on responses to the 2023 Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, as well as clinical care measures based on the Healthcare Effectiveness Data and Information Set (HEDIS) that is collected from administrative data and patients’ medical records, reflecting care received in 2022.

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© 2024 MMIT

MCO Stock Performance, April 2024

Here’s how major health insurers’ stock performed in April 2024. Elevance Health, Inc. had the highest closing stock price among major commercial insurers as of April 30, 2024, at $528.58. Humana Inc. had the highest closing stock price among major Medicare insurers at $302.09.

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HSA-Eligible Plans Have Mixed Impact on Health Care Use, No Impact on Spending

People with health savings account-eligible high-deductible health plans (HDHPs) use less outpatient services and fill fewer prescription medications than people with PPOs, but HSA plan enrollment appears to have no impact on total health care spending, according to a recent study published by the Employee Benefit Research Institute (EBRI).

As of 2022, 57.9% of employees were enrolled in an HSA-eligible health plan, while 32.3% of them were in an HDHP that was not associated with an HSA.

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© 2024 MMIT