Formulary guidance and transparency from P&T to point of care

Radar On Market Access: MA Insurers Report Strong Performance, Predict Enrollment Growth

Posted by Lauren Flynn Kelly on Dec 1, 2020


Select publicly traded insurers reporting third-quarter 2020 earnings this past month predicted big gains in Medicare Advantage enrollment during the current Annual Election Period (AEP), and noted that growth in government products helped offset the impact of commercial losses and COVID-19 costs in the recent quarter, AIS Health reported.

Reporting third-quarter 2020 earnings on Nov. 6, CVS Health Corp. said a 3.5% year-over-year increase in overall revenues was due in part to growth in its Health Care Benefits segment, which includes Aetna. Revenues in that segment rose 8.8% from the prior-year quarter to $18.7 billion, primarily driven by membership increases in Aetna's government products and the favorable impact of the return of the Affordable Care Act health insurer fee for 2020.

Although earnings for the quarter dropped slightly from adjusted earnings per share of $1.84 a year ago to $1.66 (mostly due to COVID-related expenses), CVS raised its full-year adjusted EPS guidance to a range of $7.35 to $7.45.

Aetna President Karen Lynch, who will take over for CVS Health President and CEO Larry Merlo when he retires in February, said the insurer believes it is poised for "above-market growth" in MA in 2021 and beyond.

For the quarter ending Sept. 30, Humana Inc. reported adjusted EPS of $3.08, down from $5.03 in the year-ago quarter as a result of COVID- related expenses, as the company experienced lower-than-usual utilization that was largely offset by higher COVID testing and treatment costs, said Chief Financial Officer Brian Kane. "Accordingly, in the fourth quarter, we expect to record a loss of approximately $2.40 on an adjusted EPS basis, and are tightening our full-year 2020 EPS guidance to a range of $18.50 to $18.75, still within our initial guidance expectations prior to COVID," he stated, as per a transcript of the call from The Motley Fool.

Humana for the year expects its individual MA membership to grow by approximately 375,000 lives, representing year-over-year growth of approximately 10%.

Pointing to continued expansion of its MA business as a growth driver, Cigna Corp. President and CEO David Cordani during a Nov. 5 earnings call said the company is on track to achieve a strategic EPS goal of $20 to $21 next year. Cigna reported adjusted EPS of $4.41 for the third quarter and anticipates full-year consolidated adjusted EPS of $18.30 to $18.60.

Subscribe to the MMIT blog for more pharma, provider, and payer perspectives on key topics that affect the healthcare network.

Subscribe for Weekly Perspectives

Topics: Data & Analytics, Payer