Medicare Advantage Headwinds Didn't Prevent Payers from Turning a Profit in 2023

Fierce Healthcare | By Paige Minemyer
 
Though a spike in utilization among seniors slammed payers last year, particularly in the fourth quarter, each of the six major national firms turned a profit in 2023.
 
Leading the way, as per the norm, was UnitedHealth Group, which brought in $22.4 billion in profit for the year. Its closest rival, CVS Health, earned $8.3 billion in 2023 profit, according to a Fierce Healthcare review of quarterly earnings reports.
 
Both of these firms represent major players in Medicare Advantage (MA): UnitedHealthcare and Aetna, respectively. And both felt the impacts of the higher-than-expected care use in the back half of the year, with CVS cutting its outlook for 2024 to compensate.
 
Humana, another of the largest MA plans in the country, was the most acutely effected by the utilization increase, given that the bulk of its insurance business is in the Medicare space. While it was profitable for the year, posting $2.5 billion, it reported a $541 million loss in the fourth quarter and set conservative guidance for 2024 amid "greater inherent uncertainty" in MA.

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