STAT+: CVS Health sees Medicare Advantage patients seek more care, eating into profits

Medicare Advantage members continue to go to the doctor and get health care procedures a lot more than predicted, CVS Health executives said at the J.P. Morgan Healthcare Conference on Monday.

A persistent theme for health insurance companies throughout 2023 has been their Medicare Advantage members using more care than their actuaries projected, which has been eating into the profits they get from federally funded health care premiums.

CVS, a major seller of Medicare Advantage plans, has not yet closed the books on its 2023 finances. But CVS’ new CFO, Tom Cowhey, disclosed on Monday that costs for its Medicare Advantage members now “might exceed” their already-elevated guidance from November as the company sifts through fourth-quarter data.

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