CVS could lose 10% of its Medicare Advantage members in 2025

CVS Health executives are bracing to lose up to 10% of Aetna's Medicare Advantage members next year, Bloomberg reported May 14. 

At an investor conference on May 14, CVS CFO Tom Cowhey said it's "entirely possible" the company loses a portion of its members in the coming year as it prioritizes profitability, according to Bloomberg. 

"That's OK because we need to get this business back on track," Mr. Cowhey said.

Executives at CVS Health have said they will prioritize "margins over membership" in Medicare Advantage in the coming year. The company has reported rising medical costs in its Medicare Advantage business, and is facing a tougher reimbursement environment from CMS. 

Aetna will exit counties where it believes it can't be profitable in 2025, Brian Kane, executive vice president of CVS Health and president of Aetna, told investors on a previous call. 

Aetna, CVS Health's insurance unit, had 4.2 million Medicare Advantage members as of March 31. The company has added 818,000 new MA members since the first quarter of 2023, and led the industry in growth in 2024. 

According to The Wall Street Journal, Aetna offered more supplemental benefits than its competitors in 2024, one contributing factor to its growth. Now the company will likely cut back on some of these extras.

Mr. Cowhey told investors Aetna may reduce supplemental benefits such as fitness memberships, over-the-counter allowances and transportation assistance for its 2025 offerings, according to Bloomberg. 

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