Jared Strock’s Post

$840 Billion. That's the current combined market cap of publicly traded companies focused on the Medicare Market. Who are these 19 companies? 1/ Insurance Carriers UnitedHealth Group (UNH) Centene (CNC) Humana (HUM) CVS Health Corp (CVS) Molina (MOH) Cigna (CI) CNO Financial (CNO) Alignment Healthcare (ALHC) Elevance Health (ELV) Clover Health (CLOV) Combined Market Cap: $838 Billion 2/ Value Based Care Providers NeueHealth (BHG) Cano Health (CANO) Agilon Health (AGL) Combined Market Cap: $2.0 Billion Note: Oak Street (OSH) is now part of CVS and no longer listed, and Bright Health is now NeueHealth 3/ eBrokers eHealth (EHTH) GoHealth (GOCO) SelectQuote (SLQT) Tranzact (part of Willis Towers Watson - WTW) e-TeleQuote (part of Primerica - PRI) Assurance IQ (part of Prudential - PRU) Combined Market Cap: $79 Billion Combined Market Cap excluding WTW, PRI & PRU: $710 Million ____ Over the coming months, these companies will release their Q1 '24 financials. I will post key financial metrics for them shortly after they are released. Don't miss out, give me a follow and subscribe to the newsletter!

$948 Billion. That's the current combined market cap of publicly traded companies focused on the Medicare Market. Who are these 19 companies? 1/ Insurance Carriers UnitedHealth Group (UNH) Centene (CNC) Humana (HUM) CVS Health Corp (CVS) Molina (MOH) Cigna (CI) CNO Financial (CNO) Alignment Healthcare (ALHC) Elevance Health (ELV) Clover Health (CLOV) Combined Market Cap: $877 Billion 2/ Value Based Care Providers Bright Health Group (BHG) Cano Health (CANO) Agilon Health (AGL) Combined Market Cap: $7.5 Billion Note: Oak Street (OSH) is now part of CVS and no longer listed 3/ DTC Distribution eHealth (EHTH) GoHealth (GOCO) SelectQuote (SLQT) Tranzact (part of Willis Towers Watson - WTW) e-TeleQuote (part of Primerica - PRI) Assurance IQ (part of Prudential - PRU) Combined Market Cap: $63 Billion Combined Market Cap excluding WTW, PRI & PRU: $710 Million Are there any companies I'm missing? ____ Over the coming months, these companies will release their Q3 '23 financials. I will post key financial metrics for them shortly after they are released. Don't miss out, give me a follow.

$985 Billion. That's the current combined market cap of publicly traded companies focused on the Medicare Market. Who are these 19 companies? 1/ Insurance Carriers UnitedHealth Group (UNH) Centene (CNC) Humana (HUM) CVS Health Corp (CVS) Molina (MOH) Cigna (CI) CNO Financial (CNO) Alignment Healthcare (ALHC) Elevance Health (ELV) Clover Health (CLOV) Combined Market Cap: $909 Billion 2/ Value Based Care Providers Bright Health Group (BHG) Cano Health (CANO) Agilon Health (AGL) Combined Market Cap: $5.2 Billion Note: Oak Street (OSH) is now part of CVS and no longer listed 3/ eBrokers eHealth (EHTH) GoHealth (GOCO) SelectQuote (SLQT) Tranzact (part of Willis Towers Watson - WTW) e-TeleQuote (part of Primerica - PRI) Assurance IQ (part of Prudential - PRU) Combined Market Cap: $70 Billion Combined Market Cap excluding WTW, PRI & PRU: $750 Million ____ Over the coming months, these companies will release their Q4 '23 financials. I will post key financial metrics for them shortly after they are released. Don't miss out, give me a follow and subscribe to the newsletter!

What does the future of healthcare look like in the US? Let's discuss! As we witness increased transparency in hospital and pharmacy pricing, a trend is reshaping the US healthcare landscape: consolidation and vertical integration. Examples include CVS and Aetna, UnitedHealth Group and Davita, and Cigna and Express Scripts, to name a few. If you're an #employer, you've likely felt this shift with all the provider contract negotiations and letters notifying your employees that their providers are no longer in-network-- a symptom of these larger market influences. Notable models like Kaiser Permanente demonstrate the potential of this integrated "payvider" approach, which combines payer and provider under one roof, leading to enhanced coordination of care and financial efficiencies. Naturally, there are financial incentives for insurance carriers to embrace this model, ranging from circumventing MLR rebates to acquiring one of today's most prized assets—data. Furthermore, the growing trend towards self-funding presents challenges to traditional insurance revenue streams. Self-funded groups still often rely on the expansive networks and negotiated rates provided by large insurance carriers. By acquiring more healthcare facilities—such as hospitals, clinics, and specialist groups—insurance companies can potentially shape care standards and influence market pricing. What does this mean for the future? Will we see a landscape where a handful of large insurance carriers provide our healthcare? How will these shifts impact patient outcomes, accessibility of services, and overall industry competition? There are so many moving pieces, it's hard to keep track, so I'm seeking community insights and perspectives. I invite you to share your take in the comments below! #HealthcareInnovation #HealthcarePolicy #InsuranceIndustry #FutureOfHealthcare #employeebenefits #humanresources #businesstrends #ushealthcare 

CVS Health Corp (CVS)- parent of Aetna - a Medicare focused insurance carrier - reported Q2 2023 recently. Here are 9 key stats and financial metrics: 1/ Total Revenue -Grew from $80.6 billion to $88.9 billion - YoY -up 10% 2/ Total Operating Income (Loss) -Fell from $4.67 billion to $3.23 billion - YoY -down 31% 3/ Healthcare Segment Revenue -Grew from $21.2 billion to $25.1 billion - YoY -up 18.1% 4/ Healthcare Segment Loss Ratio -Increased from 82.7% to 86.2% - YoY 5/ Healthcare Segment Operating Cost Ratio -Decreased from 14.9% to 14.8% of revenue - YoY 6/ Healthcare Segment Operating Income -Decreased from $1.79 billion to $1.16 billion - YoY -down 35% 7/ Medicare Advantage Membership -Grew from 3,216,000 to 3,408,000 - YoY -up 6% 8/ Medicare Supplement Membership -Grew from 1,314,000 to 1,351,000 - YoY -up 2.8% 9/ PDP Membership -Grew from 6,015,000 to 6,094,000 - YoY -up 0.7% ____ If you find this helpful give me a follow. I post Medicare Market insights daily.

AstraZeneca PLC (LSE:AZN) led the fallers on the main index, down 1.3% and echoing falls seen among US peers overnight.  It follows surprise news that federal payment rates to Medicare insurers next year will be lower than analysts predicted, The Centers for Medicare and Medicaid Services said that 2025 payment rates will be in line with a proposal at the start of the year that the insurance industry had argued was too low. Wall Street analysts had forecast the final rates would be some way higher than the proposal, the WSJ reported, as this was often the case in previous years. Last night the biggest fallers on the S&P 500 included health insurance companies and other sector operators, from Humana Inc's (NYSE:HUM) 13% slide to 6% and 7% falls for CVS Health Corp (NYSE:CVS), Centene Corp (NYSE:CNC), UnitedHealth Group Inc (NYSE:UNH, ETR:UNH) and Molina Healthcare Inc (NYSE:MOH).  More at #Proactive #ProactiveInvestors http://ow.ly/X2Ki105ojxj

The better plan for a patient depends on their individual needs and circumstances. Here are some factors to consider: 1. *Network*: If you have a specific doctor or hospital you prefer, choose a plan that includes them in their network. 2. *Cost*: If you want lower out-of-pocket costs, an HMO or POS might be a better option. 3. *Flexibility*: If you want the freedom to see any doctor or specialist without a referral, a PPO might be a better choice. 4. *Healthcare needs*: If you have chronic conditions or need frequent specialist care, a PPO or POS might be more suitable. 5. *Budget*: If you're on a tight budget, an HMO or POS with lower premiums might be a better option. Based on these factors, a patient might prefer: - HMO: Those who prioritize lower costs, have a primary care physician, and don't mind using a specific network. - PPO: Those who value flexibility, want to see specialists without referrals, and are willing to pay higher premiums. - POS: Those who want a balance between cost and flexibility, have a primary care physician, and occasionally see out-of-network providers. Ultimately, the best plan for a patient depends on their unique situation and priorities. It's essential to carefully review plan details and consult with a healthcare professional or insurance expert if needed.

This is not the first occasion on which Cigna and Humana have engaged in such strategic maneuvers. Cigna contributes significant value through its non-Medicare Advantage business and the Express Scripts Pharmacy Benefit Management (PBM) system. While Humana boasts a robust Medicare Advantage portfolio, it falls behind United Healthcare in this specific segment, with its commercial products exhibiting comparatively less strength. The potential regulatory scrutiny surrounding the Express Scripts component could pose a challenge. It's noteworthy that Cigna has been actively exploring avenues to exit the Medicare Advantage market over an extended period. The outcome is a consolidation effort aimed at fortifying each insurance vertical. Unfortunately, for consumers, this translates to one less choice in the market. Additionally, healthcare providers may find themselves investing more time navigating the intricacies of the Humana claims adjudication process and reimbursements. In this intricate landscape, everyone is playing second fiddle to United Healthcare and Optum. #medicareadvantage #unitedhealthcare #cigna #humana

I recently engaged in a discussion on the perception of insurance companies in healthcare. Having worked on both the provider and payer sides, I believe this topic is crucial. During my time on the provider side, there was a common sentiment of negativity towards payers, often referred to as "the dark side." However, after transitioning to the payer side, I discovered a different reality. Payers are not the villains many perceive them to be; decision-makers are former providers striving to make decisions that benefit patients within the healthcare system. It's essential to understand that coverage decisions are evidence-based and denials are reviewed by licensed physicians. While the process may seem cumbersome, it ensures a system of checks and balances. Regarding denied services, treating physicians are always given an opportunity to speak to a physician at the insurance company to ensure patients' needs are being met appropriately. Both, payers and providers, strive to treat patients well. Neither payers nor providers are malintentioned. Both have congruent goals. Payers, often blamed for healthcare system flaws, play a vital role in allocating healthcare dollars. It's crucial to acknowledge their efforts in navigating a complex industry. #Healthcare #Insurance #Payers #Providers #HealthcareSystem #Dialogue #EvidenceBasedCoverage #HealthcareIndustry