CMS Proposes 2027 Medicare Advantage Payment Policy Updates
Written by Emily J. Thompson, Senior Investment Analyst
Source: Benzinga
- Payment Growth Forecast: CMS anticipates a mere 0.09% payment growth for Medicare Advantage in 2027, translating to over $700 million in additional payments, indicating significant pressure on insurers' profitability.
- Market Reaction: Following the update, shares of major health insurers plummeted, with UnitedHealth Group down 13.13%, reflecting market unease regarding future payment policies.
- Risk Adjustment Model Update: CMS proposed updates to the Part C risk adjustment model aimed at enhancing plan competitiveness by reducing administrative burdens and ensuring payment accuracy, highlighting a focus on beneficiary health risks.
- Drug Plan Adjustments: CMS also proposed updates to Part D risk adjustments to reflect changes from the Inflation Reduction Act, aiming to improve predictive accuracy for prescription drug plans, further impacting insurers' operational strategies.
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Analyst Views on UNH
Wall Street analysts forecast UNH stock price to rise over the next 12 months. According to Wall Street analysts, the average 1-year price target for UNH is 397.82 USD with a low forecast of 330.00 USD and a high forecast of 444.00 USD. However, analyst price targets are subjective and often lag stock prices, so investors should focus on the objective reasons behind analyst rating changes, which better reflect the company's fundamentals.
19 Analyst Rating
16 Buy
3 Hold
0 Sell
Strong Buy
Current: 294.020
Low
330.00
Averages
397.82
High
444.00
Current: 294.020
Low
330.00
Averages
397.82
High
444.00
About UNH
UnitedHealth Group Incorporated is a healthcare and well-being company. Its segments include Optum Health, Optum Insight, Optum Rx, and UnitedHealthcare, which includes UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement and UnitedHealthcare Community & State. Optum Health offers comprehensive and patient-centered care, addressing the physical, mental, social, and financial well-being. Optum Health delivers primary, specialty and surgical care; helps patients and providers navigate and address complex, chronic and behavioral health needs. Optum Insight connects the healthcare system with services, analytics and platforms that make clinical, administrative and financial processes simpler and more efficient for all participants in the healthcare system. Optum Rx offers a range of pharmacy care services through retail pharmacies, through home delivery, specialty and community health pharmacies and the provision of in-home and community-based infusion services.
About the author
Emily J. Thompson
Emily J. Thompson, a Chartered Financial Analyst (CFA) with 12 years in investment research, graduated with honors from the Wharton School. Specializing in industrial and technology stocks, she provides in-depth analysis for Intellectia’s earnings and market brief reports.
UnitedHealth Group Shares Plunge 20% After Earnings Miss
- Earnings Disappointment: UnitedHealth Group's Q4 earnings report revealed a slight sales miss, causing shares to plummet nearly 20%, as GAAP earnings fell almost 100% year-over-year to just $0.01 per share, despite non-GAAP earnings meeting analyst expectations.
- Stock Recovery: Following the massive losses, UnitedHealth's stock rebounded by 4% as of 11:55 a.m. ET on Wednesday, indicating some market confidence in the company's future, although this recovery is minimal compared to the previous day's decline.
- Analyst Rating Adjustments: At least seven analysts have lowered their price targets for UnitedHealth, yet all still value the stock above its current price of $294, with nearly all recommending it as a buy, reflecting a belief in its long-term potential.
- Future Profit Expectations: Trading at just 16.7 times forward earnings and with a projected tripling of profits over the next five years, combined with a 3.1% dividend yield, analysts maintain an optimistic outlook on UnitedHealth's future performance.
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UnitedHealth Group Reports Mixed Q4 2025 Results with Earnings Beat
- Earnings Performance: UnitedHealth Group reported adjusted earnings of $2.11 for Q4 2025, significantly down from $6.81 a year ago, yet still surpassing the consensus estimate of $2.10, indicating resilience in profitability.
- Revenue Growth: The company achieved a 12% year-over-year revenue increase to $113.215 billion in Q4, although it fell short of the consensus of $113.817 billion, reflecting challenges faced in a competitive market environment.
- 2026 Outlook: UnitedHealth expects adjusted earnings for 2026 to exceed $17.75 per share, slightly above the consensus of $17.74, while forecasting sales to surpass $439 billion, below the consensus of $454.60 billion, indicating uncertainty in future growth.
- Stock Price Reaction: Following the earnings announcement, UnitedHealth's shares rose by 4% to $293.91, suggesting cautious optimism from the market regarding the company's future performance, despite analysts lowering their price targets.
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