健康保险金融脉搏——2024年夏季版

2© Oliver Wyman2We present the Summer 2024 edition of our Health Insurer Financial Pulse! This edition of Pulse includes thereported annual statutory financial experiencefor health insurers through 2023,Medical Loss Ratio (MLR)Rebate trends, highlights fromPublic Companies’ Q1 2024 financial statements, and a summary of recenthealth plan Merger and Acquisition (M&A)activity and valuation trends. Our aim is to keep you abreast of keymarket trends and dynamics that impact health insurer financial results and profitability. We hope you enjoy thenewsletter and find it informative. Please look for our next edition in early Fall of2024.Full-year 2023 statutory results bymarketPre-tax margins decreased 0.6% in 2023 to 1.7% across all lines of business with decreased loss ratios in individualcomprehensive coverage, flat loss ratios in the group market, and increased loss ratios in Medicare and Medicaidcompared to 2022.2022 MLR Rebate trends in the individualmarketHigher premium and slightly lower incurred claims in 2022 resulted in a lower current year MLR at 88.1%, areduction from 91.1% in 2021. MLR Rebates paid in 2023 for the 2022 reporting year of $332 million, are thelowest since those paid in 2018 for the 2017 reportingyear.Q1 2024 large public companies’ financialperformanceWe reviewed large public companies’ profitability for their insured business and noted that reported profitmargins for Q1 2024 were 2% lower than Q1 2023 on average, driven by UnitedHealthcare’s recognized $7.1billion loss on the sale of its Brazil business. Most companies saw utilization in line withexpectations.M&A activity of health plans in Q1 2024 and marketcapitalizationM&A activity generally has been slow over the past year or so, with the only notable acquisition being HCSCpurchasing Cigna’s Medicare Advantage block. Four of the seven tracked public healthcare companies reportedgains in market capitalization in Q12024.IN THIS ISSUE101Full-year 2023 statutory results bymarket122022 Individual MLR rebatetrends13Q1 2024 Large public companies’ financialperformance14M&A corner and Q1 2024 marketcapitalization 201820192020202120222023Public companies3.8%3.6%4.9%3.6%4.1%3.2%Non-public Blues3.8%1.9%3.4%0.2%0.5%0.5%Other health carriers0.7%0.6%2.9%-0.4%0.8%-0.3%All health carriers3.0%2.4%4.0%1.7%2.3%1.7%© Oliver Wyman3HEALTH INSURERS FINANCIALS BY MARKETProfitmarginMargins in 2023 decreased for Public and Other healthcarriers. Public companies decreased by 0.9% relativeto 2022. For non-public Blues, margins remained flatat 0.5%. For Other health carriers the reported margindeclined from (0.8%) in 2022 to (-0.3%) in2023.All markets pre-tax profitmarginPublic vs. Blues vs. OtherPre-tax profit margin (as % of premium)-10123456201820192020202120222023We summarize the profitability trends of carriers with 2018-2023 annual reported statutory financialinformation. We also summarize enrollment and loss ratio trends in the Individual, Group, Medicare, andMedicaid markets. Overall, pre-tax margins decreased in 2023 to 1.7%, with decreased loss ratios in individualcomprehensive coverage, flat loss ratios in the group market, and increased loss ratios in Medicare andMedicaid compared to 2022.ALL MARKETSCommercial, Medicare, Medicaid, and OtherPublic companiesNon-public BluesOther health carriersAll health carriers Public companiesNon-public BluesOther health carriersAll health carriers© Oliver WymanGROUP MARKETEnrollment2Enrollment in the comprehensive fully insured groupmarket continued to decline in 2023, decreasing by3.5% compared to2022.20182019 2020 2021 2022 2023All health carriers30.730.129.1LossratioThe 2023 reported loss ratio of 86.3% was flat relativeto 2022. It was driven downward by a decrease forPublic companies (-1.7%) and upward by increasesfor non-public Blues (0.4%) and Other healthcarriers(0.3%).PremiumsPMPMGroup premiums Per Member Per Month (PMPM)increased in 2023, with average market premiumsreaching $546 PMPM, an increase of 5.9% from 2022.The increase is the lowest for Other health carriers(+5.0%) and highest for Public companies (+8.5%).20182019 2020 2021 2022 2023All health carriers446459 20202021202282.4%84.3%82.8%82.7%88.8%86.2%85.4%90.6%89.2%83.3%88.3%86.3%Commercial group premiumsPMPMPublic vs. Blue vs. Other42044046048050054052056058060020182019202020212022Premium PMPM ($)Commercial groupenrollmentPublic vs. Blue vs. Other5010152025303520182019202020212022Covered lives (in millions)Commercial group lossratioPublic vs. Blue vs. Other8084828688909220182019202020212022Loss ratio (%)Public companiesNon-public BluesOther health carriersAll health carriers 2018201982.1%84.0%81.9%84.2%86.8%88.2%83.3%85.2%28.227.126.2473488515545 2018Public companies70.7%Non-public Blues70.5%Other health carriers80.1%All health carriers73.3%© Oliver WymanINDIVIDUAL MARKETEnrollment2Overall enrollment increased an average of 13.8%in 2023 relative to 2022. Other health carriers had alarge enrollment decrease of 22.9% due to companyexits in 2