CVS Health and Centene Report Q3 Financial News
CVS Health, hit by a literal financial meltdown, reported relatively good recovery news for Q3 2025. Its troubled Aetna insurance business and pharmacy benefit management Caremark are recovering. Because of this, CVS Health is forecasting double-digit earnings growth in 2026.
CVS Health had $103 billion in revenue for Q3. Revenue was up 7.8% year over year. The company recorded a Q3 net loss of $3.99 billion, compared with net income of $71 million, or 7 cents per share, in the same period for 2024. The decline was due to a $5.7 billion goodwill impairment charge from the healthcare delivery unit. Aetna had $36 billion in revenue in the third quarter, up 9% year over year. The medical cost ratio dropped from 95.2% to 92.8%.
Centene raised its yearly profit guidance despite ongoing struggles with health insurance Exchange spending and huge cuts to the federal health programs that are the foundation of its business. Centene posted a $6.6 billion loss in Q3 after incurring a one-time impairment charge related to ongoing market headwinds. The goodwill impairment charge was $6.7 billion and tied in part to the changes in the One Big Beautiful Bill Act. But Centene is making good progress on its turnaround. The company’s medical loss ratio was 92.7% in the third quarter, up from 89.2% at the same time last year but down sequentially.
Revenues were $49.7 billion in the quarter, which also beat Wall Street forecasts. By comparison, Centene reported $42 billion in revenue and $713 million in profit in the prior year quarter. Through the first nine months of 2026, the company posted $145.1 billion in revenue and $5.6 billion in losses. It brought in $122.3 billion in revenue and $3 billion in profit through the first three quarters of 2024.
Centene also emphasized its commitment to the Exchange line of business, saying even a smaller population after a subsidy expiration will still make coverage more affordable for many.
In other news, UnitedHealth Group is projecting its Medicare Advantage (MA) enrollment will decrease by 1 million people in 2026. That is up from a 600,000-member decrease it projected in July.
Additional articles: https://www.fiercehealthcare.com/payers/centene-posts-66b-loss-writedown-cost-pressures-continue and https://www.modernhealthcare.com/insurance/mh-centene-marketplace-congress-medicare-medicaid/ and https://www.healthcaredive.com/news/centene-value-writedown-q3-2025-medicaid-centene/804074/ and https://www.beckerspayer.com/financial/centene-ceo-prescription-drug-plans-steering-medicare-revenue/ and https://www.beckerspayer.com/financial/cvs-health-reports-4b-q3-loss-but-raises-earnings-outlook/ and https://www.beckerspayer.com/financial/centene-posts-6-6b-loss-but-steep-revenue-increase-for-q3/ and https://www.modernhealthcare.com/insurance/mh-cvs-health-earnings-oak-street-health/ and https://www.beckerspayer.com/payer/medicare-advantage/unitedhealth-projects-1-million-member-drop-in-medicare-advantage-enrollment/
(Some articles may require a subscription.)
#healthplans #centene #cvshealth #margins
FDA To Promote Biosimilar Approval
The Food and Drug Administration will streamline biosimilar drug introduction via a new draft guidance. It proposes major updates to simplify studies and reduce unnecessary clinical testing. The agency also plans to loosen interchangeability standards with brand-name biologics. The FDA notes that biologic medicines make up just 5% of prescriptions but are 51% of drug spending. Europe has approved more than twice as many biosimilars as the U.S.
Additional articles: https://www.hhs.gov/press-room/fda-accelerates-biosimilar-development-and-lowers-drug-costs.html and https://www.hhs.gov/press-room/fact-sheet-bringing-lower-cost-biosimilar-drugs-to-american-patients.html
#drugpricing #biosimilars
https://www.fiercepharma.com/pharma/fda-aims-streamline-access-biosimilars-us
Dems Blast CMS Over Provider Inaccuracies
Top Democratic lawmakers blasted the Centers for Medicare and Medicaid Services (CMS) over flaws in the Medicare Advantage (MA) provider network lists an agency contractor assembled. House Ways and Means Committee Ranking Member Richard Neal, D-MA, and House Energy and Commerce Committee Ranking Member Frank Pallone, D-NJ, demanded CMS rectify “inaccurate, incomplete and contradictory information” on provider networks the agency placed on the Medicare Plan Finder.
(Some articles may require a subscription.)
#medicareadvantage #providers #networks #cms
https://www.modernhealthcare.com/politics-regulation/mh-medicare-plan-finder-fix-democrats-cms
States Reducing Drug Costs In Medicaid
States are using a number of initiatives to reduce Medicaid drug costs. States including Minnesota, Nevada and Virginia, enacted laws this year to use one PBM for their Medicaid managed care programs. Other states have adopted comparable models or are considering similar approaches.
In other news, a good article on whether the new Express Scripts model seeking to eliminate rebates will create meaningful change in the marketplace.
Additional articles: https://www.modernhealthcare.com/politics-regulation/mh-pbm-pressured-states-shift-medicaid-pharmacy-models/
(Some articles may require a subscription.)
#drugpricing #pbms #medicaid
https://www.modernhealthcare.com/insurance/mh-express-scripts-commercial-rebate-phase-out-pbms
Trump Administration Tone Deaf On Subsidy Expiration
Trump administration officials appear to be tone deaf on the looming expiration of the enhanced premium subsidies in the Exchange. In addition, they also appear to have no plan despite declarations to the contrary.
President Trump urged today that the two parties look at an alternative to ObamaCare, arguing that they could come up with a “much better” option. “We have to fix health care, because ObamaCare is a disaster. … When you see the increases in ObamaCare, it never worked. It never will work, and we can do something with the Democrats much better than ObamaCare. … Less money and better health care. And I think that’s something that could come out of this with the Democrats. We work with the Democrats.” No mention of compromising on subsidies now that open enrollment is set to open in a few days.
In addition, Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz declared his opposition to an extension. “I think we all agree that COVID has passed, so therefore COVID-era subsidies should also pass,” Oz said. Oz attempted to justify the expiration by pointing to CMS calculations that the average American who purchases an ACA plan will pay $50 a month in 2026 even if the enhanced tax credits expire, an increase of only $13 from this year.
“So, there can be a lot of hair pulling and scratching, mudslinging. But the fundamental reality for most Americans is that although it is an increase in spend, that’s not the big issue,” Oz said. “The big issue is the fundamental flaws within the ACA.”
But healthcare policy group KFF notes CMS is fudging a bit with the statistics. The $50 figure is misleading because CMS is touting the lowest-cost bronze plan, not the “benchmark” silver plan that most people buy, which is used to determine tax credit amounts.
Additional article: https://thehill.com/policy/healthcare/5580142-affordable-care-act-premiums-increase-dr-oz/
#exchanges #healthcare #coverage
https://thehill.com/homenews/administration/5578479-trump-democrats-obamacare-alternative/?tbref=hp
— Marc S. Ryan
