Here is what you’ll find in this week’s newsletter!

1. Important links 🔗 - the best articles we found this week about the Medicare Market along with links to Jared’s recent LinkedIn posts.

2. Deep Dive 📚 - Q1 2025 Medicare Carrier Financials Side-By-Side 🏥 

3. Sponsor Snapshot 🚀 - brought to you by MMI+

4. Compliance Chatter 📢 - Several new regulations to review!

It’s only a 5 minute read, but it will make you 10x smarter.

DEEP DIVE 📚

Q1 2025 Medicare Carrier Financials Side-By-Side 🏥 

In this week’s deep dive, we are looking at publicly traded Medicare carrier Q1 2025 financials side-by-side.

The insurance carriers included in this analysis are all trying to capture a piece of the growing Medicare market (along with other insurance markets), and do so profitably. Here they are:

• UnitedHealth Group ( $UNH ( ▼ 5.61% ) )

• Elevance Health ( $ELV ( ▼ 1.66% ) )

• Centene Corp. ( $CNC ( ▼ 1.13% ) )

• Humana ( $HUM ( ▼ 2.16% ) )

• Molina ( $MOH ( ▼ 1.04% ) )

• CVS ( $CVS ( ▼ 1.84% ) )

• Cigna ( $CI ( ▼ 1.89% ) )

Aside from Centene and Molina, these carriers have both health insurance operations and healthcare services operations (providers, PBMs, pharmacies, etc.).

Here is the split of Q1 2025 revenues between these two segments for each carrier:

Before comparing results I did want to mention a few newsworthy items from Q1:

• UnitedHealth Group cut full-year EPS guidance by over 10% (read more here)

• Elevance pulled back marketing non D-SNP products (read more here)

• Cigna closed the sale for their Medicare insurance business to HCSC (read more here)

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Income Statement & Membership Side-By-Side

To compare and contrast the Q1 2025 results for each carrier, the Income Statement is split between “Insurance Operations” and “Healthcare Service Operations”. The consolidated statement is also displayed.

One Note: Healthcare Service Operations is different for each carrier, but generally includes providers, pharmacies, PBMs, and technology.

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YoY % Change

Here is the % change in key metrics from Q1 2024 to Q1 2025.

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Current Valuation Metrics

Here are current valuation metrics for these carriers:

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Notable Observations

Membership

• UNH and ELV both increase Medicare Advantage membership significantly YoY (they were the “winners” of AEP enrollment growth)

• Humana and CVS Medicare Advantage membership declined YoY driven by Plan Termination, Service Area Reductions, and benefit reductions

• Humana increased Medicare Supplement 30% YoY!

• The impact of Cigna’s sale of their Medicare products is flowing through their membership numbers (100% reduction in MA and MS).

• Centene grew their PDP membership 22% while paying no commissions

• Centene and Molina both grew their Commercial membership

Insurance Operations

• Combined, these carriers increased revenues (up 11%), lowered MLRs (down 0.2%), increased operating profits (up 29%), and improved profit margins by 0.7%

• Notably, Humana and CVS (the two carriers the reduced MA membership the most) saw the biggest improvement in MLR

• United (up 19%), Centene (up 39%), Humana (up 75%) and CVS (up 291%) saw increased profitability in their insurance segments.

Healthcare Services Operations

• CVS saw a decline in profitability (down 13%)

• All other Companies with Healthcare Service operations increased profitability.

Consolidated Results

• Combined revenue up 11%

  • Elevance and Centene saw the largest increase of 15%

• Combined operating profit up 18%

• Combined profit margin up 0.3%

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Final Thoughts

Most carriers had a solid Q1.

Insurance ops were strong across the board—higher revenue, better margins, more profit. United and Elevance led the way in MA growth.

Humana and CVS lost members but actually saw insurance profit jump (thanks to tighter benefits and footprint).

Healthcare services were more mixed—CVS stumbled, others improved.

Overall: steady results, but lots to watch heading into the second half of the year.

If you’re ready, here are some ways we can help you:

• Newsletter Sponsorship opportunities: Promote your product or services to leaders in the Medicare space. Let’s discuss. (link)

• Market Research: Reports that help you wrap your arms around the Senior focused insurance markets. (link)

• Consulting: We can help you develop new insurance products for the Medicare market, appraise your books of business, and keep you compliant. Let’s discuss. (link)