健康保险公司金融脉搏第11卷

IN THIS ISSUE11Q4 2022 statutory12Individual MLR13Q1 2023 Large14M&A Corner and results by marketRebate trendspubliccompanies’financialperformanceQ1 2023 marketcapitalization © Oliver WymanHEALTH INSURERS FINANCIALS BY MARKETWe summarize the profitability trends of carriers with 2022 reported statutory financial information. We alsosummarize enrollment and loss ratio trends in theIndividual,Group, Medicare, and Medicaid markets. Overall, pre-tax margins increased from 0.6% in 2021 to 2.3% in 2022, driven by slightly decreased loss ratios. This 2.3% margin isreasonably close to the pre-COVID average from 2017 to 2019 of 2.7%.ALL MARKETSCommercial, Medicare, Medicaid, andOtherProfit marginPre-tax margins in 2022 increased for all type ofcompanies following decreased margins in 2021. Publiccompanies increased by 0.5% over full-year 2021. ForNon-Public Blues, margins increased by 0.4%. For otherhealth carriers, the reported 2022 margin increased by1.1%andmoved back into positive territory at 0.7%.PubliccompaniesNon-PublicBluesOther healthcarriersAll healthcarriersAll markets pre-tax profit margin2017 to 2022/Public vs. Blues vs. Other-1012345620172018201920202021Pre-tax profit margin (as % of premium)201720182019202020212022 vs. 2021Public companies3.8%3.8%3.6%4.7%3.6%0.5%Non-Public Blues3.3%3.8%1.9%3.4%0.2%0.4%Other health carriers0.3%0.5%0.5%2.9%-0.4%1.1%All health carriers2.8%3.0%2.4%3.9%1.7%0.6% 2202220224.1%0.6%0.7%2.3% © Oliver WymanGROUP MARKETPremiums PMPMGroup premiums PMPM increased in 2022, with averagemarket premiums reaching $516 PMPM, an increase of5.6% from 2021. The increase is the lowest for other healthcarriers (+5.1%) and highest for Non-Public Blues (+6.0%).PubliccompaniesNon-PublicBluesEnrollment2Enrollment in the comprehensive fully insuredgroup market declined at an accelerated rate in 2022,decreasing by 4.0% compared to 2021.Total enrollment (in millions)20172018201931.630.730.1PubliccompaniesNon-PublicBluesLoss ratioThe 2022 reported loss ratio of 86.2% is a decrease of2.1% relative to 2021. The decrease is driven by Non-Public Blues (-2.6%), while the overall loss ratio for publiccompanies and other health carriers decreased at a rateof -1.5%.PubliccompaniesNon-PublicBluesPublic companiesNon-Public BluesOther health carriersAll health carriers Other healthcarriersAll healthcarriers2020202120222022vs.202129.128.227.1-4.0%Other healthcarriersAll healthcarriersOther healthcarriersAll healthcarriers20172018201981.8%82.1%84.0%81.7%81.9%84.2%87.8%86.8%88.2%83.3%83.3%85.2% Public vs. Blue vs. Other420440460480500520540560201720182019Premium PMPM ($)Commercial group enrollmentPublic vs. Blue vs. Other0510152025303520172018201920182019Covered Lives (in Millions)Commercial group loss ratioPublic vs. Blue vs. Other8082848688909220172018201920182019Loss Ratio (%)2020202182.4%84.3%82.7%88.8%85.4%90.6%83.3%88.3% 2022 vs. 2021 © Oliver WymanINDIVIDUAL MARKETPremiums PMPM3Individual premiums PMPM decreased in 2022 withreported average individual market premiums of$525 PMPM, a decrease of 0.6% from 2021.Non-Public Blues and public companies experiencedincreases of 3.5% and 6.8%, respectively. Other healthcarriers decreased by 9.9% due to significant growthin plan membership for lower priced products offeredfrom a limited number of market competitors.PubliccompaniesNon-PublicBluesOther healthcarriersEnrollment2Overall enrollment increased an average of 11.1% in2022 relative to 2021. Other health companies hadthe largest enrollment increase of 34.3%, while publiccompanies decreased by 1.7% and Non-Public Bluesincreased by 3.6%.Total enrollment (in millions)201720182019202013.812.612.112.5PubliccompaniesNon-PublicBluesOther healthcarriersLoss ratioReported loss ratios in 2022 decreased to 86.4%, a1.1% decrease from 2021. The decrease is largest amongpublic companies at 2.5%, followed by Non-Public Bluesand other health carriers at 1.3% and 0.2%, respectively.PubliccompaniesNon-PublicBluesOther healthcarriers2017Public companies79.2%Non-Public Blues79.9%Other health carriers92.6%All health carriers82.5% All healthcarriers202120222022vs.202113.414.8+11.1%All healthcarriersAll healthcarriers201871.1%70.5%80.1%73.3% 201976.8%78.7%83.2%79.4% Public vs. Blue vs. Other350400450500550600650201720182019Premium PMPM ($)Comprehensive individual enrollmentPublic vs. Blue vs. Other0246810121416201720182019Covered Lives (in Millions)Comprehensive individual loss ratioPublic vs. Blue vs. Other707580859095201720182019Loss Ratio (%)2020202172.7%83.2%73.2%86.8%79.7%92.9%74.8%87.5% 202020202022 vs. 2021-2.5%-1.3%-0.2%-1.1% © Oliver WymanMEDICARE ADVANTAGEEnrollment2Enrollment growth in the Medicare Advantage (MA)market continued in 2022 with the overall trendof gradual increases driven by population demographicsand the continued popularity of MA plans. Recentlyoverall growth has decelerated and been spread moreevenly amongst provider types.Total enrollment (in millions)2017201820192020202115.015.716.718.320.220