Payer

Insurance covers some of the costs for GLP-1 drugs for weight loss for around 1 in 4 Americans, according to data from Leverage and the Robert Wood Johnson Foundation.

The country's largest payers reported year-over-year increases in medical cost ratios, with the exception of Elevance Health, which decreased 0.1%.

In 2024, 32.8 million people are enrolled in Medicare Advantage, or 54% of the eligible Medicare population.

The consumerization of healthcare is accelerating, and the nation's largest health insurer is keeping pace.

Both CVS Health and Humana contend with rising inpatient costs in Medicare Advantage, but each points to different causes for the increases. 

Medicaid redeterminations began in April 2023, and all major payers have released their second quarter 2024 earnings, revealing which have recorded the largest enrollment losses in the Medicaid market since redeterminations began.

L.A. Care Health Plan has removed 24% of its prior authorization requirements. 

At least 16 states provide coverage of GLP-1 drugs for weight loss to state employees, according to data from Leverage and the Robert Wood Johnson Foundation. 

Medicare Advantage costs could rise in the second half of 2024, CVS Health CFO Tom Cowhey told investors. 

Payers are preparing an aggressive defense of their pharmaceutical benefit managers from scrutiny on Capitol Hill.