After several years of elevated utilization that has not been fully offset by rate increases yet, covered MCO shares have risen about 35% on average since our last managed care industry report in September 2025, in anticipation of rising profits in at-risk medical insurance plans.
Elevance continues to use its scale-related advantages for the benefit of clients, and we remain intrigued by its ongoing efforts to align incentives with caregivers, including the deployment of high performance provider networks.
Bears
The insurance and PBM industries will likely remain targets of regulators aiming to reduce the healthcare cost burden on society, which is its key ESG risk, in our opinion.
Elevance Health remains one of the leading health insurers in the US, providing medical benefits to 45 million medical members at the end of 2025. The company offers employer, individual, and government-sponsored coverage plans. Elevance differs from its peers in its unique position as the largest single provider of Blue Cross Blue Shield branded coverage, operating as the licensee for the Blue Cross Blue Shield Association in 14 states. Through acquisitions, such as the Amerigroup deal in 2012 and MMM in 2021, Elevance's reach expands beyond those states in government-sponsored programs, such as Medicaid and Medicare Advantage plans, too. It is also an emerging player in pharmacy benefit management and other healthcare services.