This report reflects the latest 12 months (LTM) of payer performance through Q1 2025. The findings, based on NAIC Financial Statement Filings, highlight shifting financial trends across national and regional payers and the resulting implications for provider negotiations, product strategy, and capital deployment.
It’s important to note that all health insurers, including provider-sponsored health plans (PSHPs) and regional health plans that are not subject to standard public company disclosures, are required to file quarterly financial statements with NAIC by the first week of June (three months after the end of Q1). Therefore, while these figures may appear slightly delayed, Q1 2025 LTM data offers the most current and comprehensive view of payer performance available at this time.
Here are three takeaways from ECG’s Q1 2025 Health Plan Quarterly Report:
- Regional plans and PSHPs experienced a notable increase in their medical cost ratios, reaching 94.7% and 92.9%, respectively, inferring rising utilization and medical costs.
- Anthem, UnitedHealthcare, and other national affiliates were the only plan categories to report pretax operating margins above 3%. Aggregated Blues plans hovered around breakeven, while all other plan categories operated at a loss.
Cigna saw the most significant financial fluctuations due to the ongoing shift in revenue and strategic focus away from covered lives and toward its healthcare services platform, Evernorth. This trend should continue following the divestiture of its Medicare Advantage business to Health Care Service Corporation, a transaction that was completed on March 19, 2025.
ECG’s Payer Services team is an extension of our health plan clients, and we want to hear from you. Please reach out to share your thoughts, additional insights, or any challenges we can assist with.
