HUM (US)

The latest draft of the government spending bill, released early this morning, presents an even more manageable policy outcome for pharmacy benefit managers (PBM) [UNH, CVS, CI, CNC, ELV, HUM] than previously expected; it revives…

CMS’s BALANCE Model to facilitate coverage of anti-obesity medications (AOMs) [LLY, NVO] in Medicaid and Medicare Part D (PD) (standalone and Medicare Advantage plans) – released Dec. 23 – while still lacking key details, provides…

Our read of the proposed Contract Year 2027 Policy and Technical Changes regulation for Medicare Advantage (MA) and Part D (fact sheet here), confirms our expectations for a positive regulatory backdrop for 2027 for MA [HUM, ALHC,…

As outlined by the Trump administration, we view yesterday’s obesity drug pricing deal with NVO and LLY as a modest near-term positive (potentially better for LLY), with the $245 / mo. price point for Medicare…

Listening to recent earnings calls held by various Medicare Advantage (MA) insurers and value-based care providers [HUM, ALHC, AGL, UNH, CVS, ELV] leaves us with the following thoughts on the MA regulatory policy environment for…

We think this morning’s court ruling against Humana (HUM) in its Medicare Advantage (MA) Stars litigation is likely the end of the road in its efforts to secure a higher score for its 2026 payment…

While reports over the weekend about CMS’s Friday release of the Medicare Advantage (MA) and Part D Plan (PDP) premium, deductible and other information for the 2026 plan year focused on the 2.6% projected cut…

Medicare Advantage (MA) insurers [HUM, UNH, CVS, CNC, ELV, ALHC] received some positive legal news that for now neutralizes the concern of widespread Medicare audits and potential concomitant recoupments. However, yesterday’s federal district court ruling…

Against the backdrop of positive Q2 earnings, upward full-year guidance, and voiced confidence in the ability to manage the medical cost and utilization trends throughout 2H and into next year, we think the recently refiled…

Today’s CMS release regarding its CY26 Medicare Part D program gives  the impression the agency is focusing on stability in its drug benefit program with the goal to ensure 1) enrollees – especially those in…