MAAT INDEX

CLAIM #18480 · CVS Health Corp (CVS) · 2024Q4 earnings call · Feb 12, 2025 · due Dec 31, 2025

During the quarter, we made additional progress on rate updates, and with over 40% of our book having re-priced in early January 2025, we have line of sight to a mid-4% [indiscernible] rate increase.

Tom Cowhey · CFO

PENDING
graded after results covering Dec 31, 2025 are reported

In context

and third quarter dates of service. In our Medicare book, continued elevated trend levels were attributable to the same categories we discussed last quarter, including inpatient, outpatient, supplemental benefits, and pharmacy. Relative to our downside scenario discussed on the third quarter call, we did see some moderation of inpatient trends while supplemental benefit costs remained stubbornly high. We are cautiously optimistic that our benefit design changes in 2025 will help alleviate some of this supplemental benefit pressure. In our Medicaid business, acuity remained consistent with the latter part of the third quarter as redeterminations have largely concluded across our state footprint. We continue to work closely with our state partners to align rates with the changes in acuity. During the quarter, we made additional progress on rate updates, and with over 40% of our book having re-priced in early January 2025, we have line of sight to a mid-4% [indiscernible] rate increase. Our overall rate advocacy efforts are currently on track. In our group commercial risk book, fourth quarter trends remained elevated and, similar to others in the industry, we experienced some pressure on our stop loss business, which represents less than 3% of our 2024 premiums. We continue to take a cautious outlook on medical cost trends in this book and, combined with lower membership, we expect lower contributions from this business in 2025. Finally in our individual exchange book of business, we saw continued acceleration of medical cost trends driven by the specialist, inpatient and ambulatory categories. As we discussed on prior calls, we made meaningful price adjustments in our offerings for this product in 2025 which will lead to a significant rationalization of our membership w

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SEC filings for CVS · Claim quote is verbatim from the 2024Q4 earnings call.