Elevance Health sees an opportunity to grow Medicare Advantage enrollment next year if competitors follow through on plans to cut policies.
Some large insurance companies have said they intend to reduce their Medicare Advantage geographic footprint and slim down supplemental benefits in 2025 in response to unfavorable regulatory updates and an unexpected spike in member utilization.
Related: Humana, Aetna likely to lose Medicare Advantage members
“As we think about [next year] we’re frankly encouraged by the commentary from some of our peers about benefit rationalization and those that are taking a hard look at that market,” Elevance Vice President of Investor Relations Stephen Tanal said during the 45th annual Goldman Sachs Global Healthcare Conference Wednesday.
The company is the fourth-largest Medicare Advantage insurer by membership after UnitedHealth Group's UnitedHealthcare, Humana and CVS Health's Aetna, according to a March report by The Chartis Group consultancy. The for-profit carrier, which manages Blue Cross Blue Shield plans in 14 states, counts 2 million Medicare Advantage enrollees.
Humana and Aetna in May said they anticipate losing Medicare Advantage members next year because of footprint changes and reductions in benefits.
Elevance would be comfortable with above-average Medicare Advantage enrollment increases, Tanal said.
“If everyone is talking about membership losses, those members are going somewhere,” he said.
Not all of Elevance's competitors anticipate enrollment decreases next year: UnitedHealthcare said last month it aims to grow sign-ups at the market rate.
Unlike UnitedHealthcare, Aetna and Humana, Elevance's Medicare Advantage membership decreased during the annual sign-up period for the 2024 plan year. The company last year cut policies in the mainland U.S. and slashed plan benefits in Puerto Rico in response to the Centers for Medicare and Medicaid Services phasing in a new risk-adjustment model, Tanal said. The actions led to a loss of 175,000 members, he said.
The moves ensured the sustainability of the business and will position the company well for next year, Tanal said.
He did not say if Elevance intended to make similar reductions come 2025.
Companies' bids for how they intend to structure their Medicare Advantage contracts in the 2025 plan year were due to CMS earlier this month. Plan changes will be made public at the start of open enrollment, which begins Oct. 15.
Elevance did not comment on how much revenue it anticipated recouping after a federal judge last week ruled that regulators must recalculate the Medicare Advantage star rating for one of its subsidiaries.
