Stock Performance

Insurer Groups Object, but Analysts View RADV Rule Headwinds as ‘Manageable’

Although health insurance trade groups slammed a final rule that will cause the government to claw back billions of dollars’ worth of overpayments to Medicare Advantage organizations (MAOs), some equities analysts pointed out that the regulation was not as bad as it could have been. What remains unclear, however, is whether the industry will challenge the rule in court.

“Our high-level takeaway is that, while some components of the rule run counter to the industry’s requirements, the absolute impact that CMS is forecasting is manageable within the context of a program that will soon approach $400 [billion],” Credit Suisse’s A.J. Rice advised investors. In fact, CMS estimates that payment clawbacks under the rule will amount to $4.7 billion through 2032, or $470 million annually over 10 years, he noted. “This would represent roughly 0.1% of annual program spend.”

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Elevance Sees Double-Digit Percentage EPS Growth for Fifth Consecutive Year

Elevance Health, Inc. on Jan. 25 reported adjusted earnings per share (EPS) of $29.07 in 2022, representing a 12% increase from 2021. Gail Boudreaux, the company’s president and CEO, told analysts on a conference call that it was the fifth consecutive year in which Elevance’s adjusted EPS had hit or exceeded its 12% to 15% annual target increase. That came as the insurer, which was known as Anthem, Inc. until last year, ended the year with more than 47.5 million medical members, up nearly 2.2 million from the end of 2021.

David Windley, a Jefferies analyst, wrote in a note to investors on Jan. 25 that Elevance’s fourth quarter “was solid (maybe not exceptional),” citing the company’s 89.4% medical loss ratio (MLR) and adjusted EPS of $5.23, which beat the Wall Street consensus estimate of 90.1% and $5.19, respectively. Windley noted that Elevance “still has a long way to go” with improving its full-year 5.4% operating margin, although he noted the 3.4% fourth-quarter operating margin was a 10 basis-point improvement from the fourth quarter of 2021.

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Startup Insurer CEOs Talk Profitability Goals at J.P. Morgan Conference

During the J.P. Morgan Healthcare Conference on Jan. 11, chief executives of Bright Health Group, Inc., Clover Health Investments Corp. and Oscar Health, Inc. discussed their companies’ aims to achieve profitability this year or next year. Thus far, however, the companies have not had a profitable quarter since they went public in 2021.

For the first three quarters of 2022, the companies collectively had a net loss of more than $1.3 billion: Bright Health lost $691.3 million, Clover Health lost $254.8 million and Oscar Health lost $383 million.

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MCO Stock Performance, December 2022

Here’s how major health insurers’ stock performed in December 2022. UnitedHealth Group had the highest closing stock price among major commercial insurers as of December 30, 2022, at $530.18. Humana Inc. had the highest closing stock price among major Medicare insurers at $512.19.

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MCO Stock Performance, November 2022

Here’s how major health insurers’ stock performed in November 2022. UnitedHealth Group had the highest closing stock price among major commercial insurers as of November 30, 2022, at $547.76. Humana Inc. had the highest closing stock price among major Medicare insurers at $549.90.

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Health Insurance Startup CEOs’ Sky-High Compensation Figures Are Deceiving

In AIS Health’s annual roundup of health insurer executive compensation data, four newly public startup insurers stand out because their CEOs’ total compensation in 2021 easily outstrips that of chief executives at major firms like UnitedHealth Group and Cigna Corp. However, experts tell AIS Health that the startups’ filings with federal regulators paint an unintentionally deceiving picture, as the CEOs of those not-yet-profitable firms are highly unlikely to collect hundreds of millions of dollars’ worth of stock awards listed there.

“They’re never going to realize, in one year, that much compensation,” says Ari Gottlieb, a principal at A2 Strategy Group who has been closely tracking the performance of the four startup insurers that went public in 2021: Alignment Healthcare, Inc., Bright Health Group, Inc., Clover Health Investments Corp. and Oscar Health, Inc.

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Executive Compensation Data for Top Health Insurers, 2021

See a full list of director compensation for top health insurers at https://bit.ly/3gR963N, compiled by AIS Health.

N/A = Not Available.

Compensation data for Jared Short includes payments allocated to Regence insurance operations in Washington state, Oregon and Utah but not Idaho.

SOURCE/METHODOLOGY: All data is compiled from individual health insurance companies, state insurance department documents and U.S. Securities and Exchange Commission filings.

Health plans selected based on commercial medical risk enrollment as of the beginning of 2022, per AIS’s Directory of Health Plans. All publicly traded companies are included except Aetna, which was acquired by CVS Health Corp. in 2018.

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MCO Stock Performance, October 2022

Here’s how major health insurers’ stock performed in October 2022. UnitedHealth Group had the highest closing stock price among major commercial insurers as of October 31, 2022, at $555.15. Humana Inc. had the highest closing stock price among major Medicare insurers at $558.08

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IngenioRx, Centene Contract Switch Take Spotlight in PBMs’ 3Q Earnings Calls

Although Centene Corp.’s decision to contract with Cigna Corp. rather than CVS Health Corp. for PBM services loomed large during major health insurers’ third-quarter earnings conference calls, it wasn’t the only PBM-related discussion worth noting.

For example, during Elevance Health, Inc.’s earnings call on Oct. 19, executives offered some insights about how the firm’s in-house PBM IngenioRx is carving out a niche in the marketplace.

“We are, as you know, trying to be a different PBM,” Peter Haytaian, Elevance’s president of Diversified Business and IngenioRx, said in response to an analyst’s question about the PBM’s progress selling its services to self-insured employers that already contract with Elevance.

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Amid Headwinds, CVS Beats Street’s 3Q Earnings Estimate

CVS Health Corp., the parent company of insurance firm Aetna, reported solid results in the third quarter, beating Wall Street earnings projections. However, the company also acknowledged headwinds including declining Medicare Advantage Star Ratings, the loss of Centene Corp.'s PBM business, a major legal settlement over opioid overprescribing, and losses posted by newly acquired divisions.

The insurer reported $2.09 in adjusted earnings per share (EPS), beating the Wall Street consensus projection of $2.00. Executives project an end-of-year adjusted EPS of $8.55 to $8.65, slightly up from a previous projection of $8.40 to $8.60. Total revenues across the firm increased by 10% year over year to $81.2 billion.

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