Summary
At the end of earnings season, we spent some time reflecting on the major themes from the companies we cover:
Payers say they have their arms wrapped around trend. After a series of surprises to the upside this year across Medicare Advantage (MA), Medicaid, and ACA marketplaces, management teams are talking about trend as “in the model” rather than an ongoing shock.
While most companies are focused on retrenching, Privia and Alignment are getting the green light for growth. A small set of “good-problems-to-have” names (Privia, Alignment) are fielding questions about how fast they can grow while most other companies are walking investors through how they will retreat to move forward or weather structural and policy challenges.
Personalization and AI are still the buzz words. Hims and Hers and Oscar Health have interesting takes on the personalization theme whereas UnitedHealth Group seems really well positioned on the AI front. We’re a little more skeptical of other AI claims, however, for instance not understanding Omada’s claim of 3% gross margin improvement thanks to AI.
We wrote a lot about these calls between our company research notes and HTN community posts, so we used an AI assistant to create a deck based on our insights which you can download here:
What we covered:
00:00 Introduction to Q3 Earnings
00:31 Medicare Advantage payers mostly targeting stability
02:14 Clover and Humana think about growth
10:29 Medicaid Challenges and Trends
17:13 Uncertainty in the ACA marketplace
22:41 Provider and Hospital Dynamics
31:48 Ambulatory Surgery Centers (ASCs)
34:36 Pharmacy Benefit Managers (PBMs)
35:31 The math of Cigna's impact from PBM changes
38:26 Retail Pharmacies' Unexpected Growth
40:35 Consumer-Driven Healthcare and HIMSS
52:36 Oscar's Personalized Health Plans
58:58 AI in Healthcare: Tangible Implementations
01:08:24 Looking forward