The Top Public Medicare Advantage Payers and Brokers

The Medicare Advantage market has seen significant growth and transformation, with several key players dominating the space. This detailed analysis covers the top Medicare Advantage payers and brokers, focusing on their business units/segments, points of differentiation, and key trends impacting their operations and strategies.

Elevance Health Inc. (Ticker: ELV)

Business Units/Segments: Elevance Health operates in four segments: Commercial & Specialty Business; Government Business; CarelonRx; and Other [3][15].
Points of Differentiation: Known for its comprehensive health plans and services, Elevance Health focuses on whole health, integrating physical, mental, and social health services. Its CarelonRx segment provides innovative pharmacy solutions [3][15].
Key Trends: Elevance Health is expanding its digital and telehealth offerings, aiming to become a lifetime, trusted health partner. The company is also focusing on value-based care models to improve patient outcomes and reduce costs [10][18].
4Q23 Elevance Earnings Recap

eHealth, Inc. (Ticker: EHTH)

Business Units/Segments: eHealth operates through two segments: Medicare; and Individual, Family and Small Business[4].
Points of Differentiation: eHealth differentiates itself with a strong online marketplace that offers a wide range of health insurance plans. Its platform provides consumer engagement, education, and enrollment solutions[4].
Key Trends: The company is leveraging technology to enhance customer experience and streamline the insurance buying process. eHealth is also expanding its offerings in the Medicare Advantage space to capture the growing senior market[4].
4Q23 eHealth Earnings Recap

Humana (Ticker: HUM)

Business Units/Segments: Humana’s business is focused on its Medicare Advantage, Medicaid, and Primary Care businesses[2].
Points of Differentiation: Humana stands out for its strong focus on Medicare Advantage and its integrated care delivery model. The company is also known for its wellness and health management programs[2].
Key Trends: Humana is investing in value-based care arrangements and digital health technologies. The company is also expanding its home health services to meet the needs of aging populations[2][7].
4Q23 Humana Earnings Recap

UnitedHealth Group (Ticker: UNH)

Business Units/Segments: UnitedHealth Group operates through UnitedHealthcare, which offers health care coverage and benefits services, and Optum, which provides information and technology-enabled health services[6].
Points of Differentiation: UnitedHealth Group is distinguished by its comprehensive health care services, extensive network, and innovative health technology solutions through Optum[6].
Key Trends: The company is focusing on expanding its telehealth services, enhancing patient care through data analytics and technology, and pursuing growth in Medicare Advantage and Medicaid markets[6].
4Q23 UHC Earnings Recap

CVS Health (Ticker: CVS)

Business Units/Segments: CVS Health operates through its Health Care Benefits segment (Aetna), Retail/LTC, and Pharmacy Services segments[6].
Points of Differentiation: CVS Health integrates its health services with its extensive retail and pharmacy network, offering accessible care and wellness solutions. Aetna’s focus on personalized health care plans is a key differentiator[6].
Key Trends: CVS Health is expanding its health services offerings, including health hubs and digital health tools. The company is also focusing on addressing social determinants of health to improve outcomes[6].
4Q23 CVS Earnings Recap

Centene Corporation (Ticker: CNC)

Business Units/Segments: Centene’s operations focus on managed care with a significant presence in the Medicare Advantage and Medicaid markets[6].
Points of Differentiation: Centene is known for its focus on underserved and vulnerable populations, offering tailored health solutions. The company’s extensive network and localized approach to health care are key strengths[6].
Key Trends: Centene is investing in technology to improve health outcomes and patient experiences. The company is also expanding its Medicare Advantage offerings and focusing on holistic health services[6].
4Q23 Centene Earnings Recap

Cigna (Ticker: CI)

Business Units/Segments: Cigna operates through its Cigna Healthcare segment, which offers medical, dental, disability, life, and accident insurance and related products and services[6].
Points of Differentiation: Cigna’s global footprint and comprehensive range of health services set it apart. The company focuses on personalized and preventive care[6].
Key Trends: Cigna is enhancing its digital health platforms and expanding its value-based care models. The company is also exploring strategic partnerships to broaden its services[6].
4Q23 Cigna Earnings Recap

These companies are at the forefront of the Medicare Advantage market, driving innovation and adapting to changing healthcare needs and regulatory landscapes. Their focus on technology, value-based care, and expanding services to meet the needs of diverse populations are key trends shaping the future of Medicare Advantage.

| Ticker | Market Cap | 2023 Revenue |
|--------|------------------|---------------------|
| ELV | $117,058,000,000 | $170,200,000,000 |
| EHTH | $187,207,743 | $452,900,000 |
| HUM | $42,267,264,939 | $106,374,000,000 |
| UNH | $456,543,133,725 | $371,600,000,000 |
| SLQT | $327,849,145 | $1,159,350,000 |
| GOCO | $301,115,276 | $527,350,000 |
| CVS | $93,590,855,586 | $357,776,000,000 |
| CNC | $41,949,297,410 | $141,270,000,000 |
| CI | $98,322,298,844 | $195,300,000,000 |

Figures as of 2/29/24

Sources:
[1] https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2023-enrollment-update-and-key-trends/
[2] https://humana.gcs-web.com/static-files/810f7c6f-7169-4ad9-b94e-cbd21b2b391e
[3] https://www.stock-analysis-on.net/NYSE/Company/Elevance-Health-Inc/Ratios/Reportable-Segments
[4] https://finance.yahoo.com/quote/EHTH/profile/
[5] https://csimarket.com/stocks/segments.php?code=ELV
[6] https://www.beckerspayer.com/payer/big-payers-ranked-by-2023-revenue.html
[7] https://humana.gcs-web.com/static-files/89aed37d-3970-4101-a2e7-0af9e5fa6fb2
[8] https://www.wsj.com/market-data/quotes/ELV
[9] https://www.reuters.com/markets/companies/EHTH.A/
[10] https://s202.q4cdn.com/665319960/files/doc_financials/2023/q1/1Q2023ELVEarningsRelease-Final.pdf
[11] https://healthpayerintelligence.com/news/top-5-largest-health-insurance-payers-in-the-united-states
[12] https://www.benefitspro.com/2023/11/09/cms-new-rule-would-cap-commissions-for-medicare-advantage-brokers-agents/?slreturn=20240021211226
[13] https://www.elevancehealth.com/newsroom/elv-quarterly-earnings-q4-2022
[14] https://www.marketwatch.com/investing/stock/ehth/company-profile
[15] https://finance.yahoo.com/quote/ELV/profile/
[16] https://www.linkedin.com/pulse/medicare-advantage-market-size-2023-forecasting-flksf
[17] https://www.multiplan.us/multiplan-reports-fourth-quarter-and-full-year-2023-results/
[18] https://dcf.fm/blogs/blog/elv-business-model-canvas
[19] https://www.elevancehealth.com/newsroom/elv-quarterly-earnings-q2-2022
[20] https://www.chartis.com/insights/shifting-market-medicare-advantage-shows-continued-growth
[21] https://ritterim.com/blog/2024-maximum-broker-commissions-for-medicare-advantage-medicare-part-d/
[22] https://www.quantumonline.com/search.cfm?sopt=symbol&tickersymbol=ELV
[23] https://sg.finance.yahoo.com/quote/ELV/profile/
[24] https://www.valuepenguin.com/largest-health-insurance-companies
[25] https://www.spglobal.com/marketintelligence/en/news-insights/latest-news-headlines/us-managed-care-stocks-dip-as-medicare-advantage-weighs-on-q3-2023-earnings-78340157

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