Cigna Beats The Street; Will Exit Exchanges
The Cigna Group beat The Street on both earnings and revenue in Q1 2026, posting $1.65 billion in profit. That’s up from $1.3 billion in Q1 2025. Revenues in the quarter were $68.5 billion, up from $65.5 billion haul in Q1 2025. Cigna’s medical loss ratio (MLR) decreased from 82.2% to 79.8%. Cigna is predominantly commercial.
But Cigna will exit the individual market for the 2027 plan year given troubles with membership and risk. And the company is likely to sell its company EviCore, which specializes in prior authorization services. Its Express Script PBM revenue was down given the transition to net pricing.
Additional articles: https://www.fiercehealthcare.com/payers/cigna-posts-165b-profit-q1-earnings-beat and https://www.modernhealthcare.com/insurance/mh-cigna-aca-exchanges-2027/ and https://www.healthcaredive.com/news/cigna-exit-aca-exchanges-despite-q1-2026-profit-growth-ci/818873/ and https://www.beckerspayer.com/financial/cigna-to-exit-aca-individual-business-posts-1-65b-q1-profit/
(Some articles may require a subscription.)
#healthplans #margins #cigna
https://www.modernhealthcare.com/insurance/mh-cigna-earnings-outlook-evernorth-health
340B RFI Comments
The Health Resources and Service Administration solicited input on its next try at a 340B reform pilot and gained many comments. Hospitals and other providers urged the agency to not move forward, arguing it would endanger safety net providers and recipients. Brand drug makers say the system is abused and discounts are not passed on to those in need. Hospitals are arguing for a clearinghouse to distribute discounts and audit.
(Some articles may require a subscription.)
#340b #drugpricing #branddrugmakers #hospitals
https://www.modernhealthcare.com/politics-regulation/mh-hrsa-340b-rebate-pilot-hospitals-drugmaker
Centene Will Be In BRIDGE
Centene will participate in the GLP-1 BRIDGE program for Medicare Part D. BRIDGE is a lead-in to the “Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth” (BALANCE) Model. BALANCE was just delayed due to too little participation from plans. BRIDGE was extended through 2027. The Centers for Medicare and Medicaid Services (CMS) will negotiate most-favored-nation (MFN) discounts and cover any cost about $50 per month. The program also would include lifestyle-focused initiatives.
#drugpricing #balance #bridge #partd
— Marc S. Ryan
