Stock Performance

Elevance Health, Inc. reported increased premium revenues in the first quarter of 2023 and strong results from its fast-growing PBM and services division, Carelon. While Wall Street analysts were mostly positive about the results, some expressed concerns that the firm’s medical loss ratio (MLR) and operating expenses were too high.

Elevance took in $41.9 billion during the first quarter of 2023, an increase of 10.6% year over year. Income rose 16.6% year-over-year to $2.8 billion, yielding adjusted earnings per share (EPS) of $9.46, which beat the Wall Street consensus of $9.23. Elevance’s MLR was 85.8%, which was in line with projections from the firm and the Street consensus. Days claims payable (DCP) was 46 days as of March 31, “a decrease of 1.5 days from December 31, 2022 and a decrease of 0.9 days compared to March 31, 2022,” per a press release announcing the results.

Although UnitedHealth Group’s executives touted “strong and well-balanced” growth in the first quarter of 2023, the company’s stock dropped following its April 14 earnings report. Equities analysts suggested that a decline in the days claims payable (DCP) metric led to the sell-off, as well as concerns about Medicare Advantage-related business risks — but their views differ about how concerned investors should be.

SVB Securities analyst Whit Mayo, for example, suggested in an April 17 research note that the risks to UnitedHealth’s valuation are overblown.

The company’s first-quarter results “brought forth continued themes of consistency, strong MA and self-funded growth, along with noticeable top-line strength within Optum Health,” Mayo wrote. “Noise around trend, lower DCP, 2024 MA risk balanced against the recent run-up, and a historically high relative valuation premium presumably pushed shares lower on Friday,” he suggested, but added that “1Q results generally and historically present few new details to reshape investors’ views on the full-year earnings curve for the sector.”

During a recent panel discussion featuring equities analysts who cover the health care sector, analysts expressed skepticism that the rapid rate of mergers and acquisitions occurring in the industry will slow down in the near future — and they suggested that may not be such a bad thing.

“Can I just say no?” George Hill, a managing director at Deutsche Bank, said when asked whether tougher antitrust enforcement is having an impact on health care consolidation. Hill was one of four equities analysts who discussed market trends shaping the health care system during the USC-Brookings Schaeffer Initiative for Health Policy’s 27th “Wall Street Comes to Washington” roundtable.

Here’s how major health insurers’ stock performed in March 2023. UnitedHealth Group had the highest closing stock price among major commercial insurers as of March 31, 2023, at $472.59. Humana Inc. had the highest closing stock price among major Medicare insurers at $485.46.

In recent letters sent to seven major publicly traded health insurers, two U.S. senators take aim at the industry’s fierce lobbying campaign against proposed Medicare Advantage rate adjustments — saying insurers are responding to the proposal by threatening to cut benefits for seniors despite spending billions on executive compensation and stock buybacks.

Corporate finance experts say there are valid criticisms to be made about both rising CEO pay and buybacks, but they argue that larger, systemic issues are driving such behavior across all types of industries.

Struggling health insurer Bright Health Group Inc. raised eyebrows with its recent announcement that CEO George Mikan III and other top executives earned more than $3.7 million in performance bonuses — despite posting a net loss of more than $600 million last year. The troubled startup insurer is under supervision by at least two state regulators, and one persistent critic of the firm’s executives tells AIS Health, a division of MMIT, that the bonuses are “outrageous.”

Bright’s 2022 Form 10-K, an annual filing all publicly traded companies are required to submit to the Securities and Exchange Commission (SEC), revealed that Mikan received $1.69 million, with other notable officers of the company receiving between $190,115 and $765,000 in bonuses. Each of the executives who were awarded a bonus received the full amount they could have received based on performance incentives. Bright added in the filing that Mikan’s total compensation was $9,993,169, while the median compensation for a Bright employee was $71,500, meaning Mikan earned 140 times the average Bright employee.

Here’s how major health insurers’ stock performed in February 2023. UnitedHealth Group had the highest closing stock price among major commercial insurers as of February 28, 2023, at $475.94. Humana Inc. had the highest closing stock price among major Medicare insurers at $495.02.

Government-funded health plans have become highly profitable for the country’s largest insurers as Medicaid rolls have swelled and as more and more seniors choose Medicare Advantage plans. Yet analysts say changes are coming that may partially even the playing field between smaller health plans and industry heavyweights, which command the bulk of government business.
A new report from the insurance-focused credit rating firm A.M. Best — titled “US Health Insurers Prepare for Shift Driven by End of Government Mandates” — stated that health plans overall “have reported good top-line growth over the last two years, with premium revenues up 8.2% in 2021 and 10.9% through the third quarter of 2022.”

Here’s how major health insurers’ stock performed in January 2023. Elevance Health had the highest closing stock price among major commercial insurers as of January 31, 2023, at $499.99. Humana Inc. had the highest closing stock price among major Medicare insurers at $511.70.

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.”