Healthcare Simplification
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CVS' Aetna Wins Big on 2026 MA Star Ratings: How to Play the Stock?
ZACKS· 2025-10-13 13:41
Core Insights - The Centers for Medicare & Medicaid Services released the 2026 Star Ratings for Medicare Advantage Prescription Drug plans, with CVS Health's Aetna achieving high ratings, indicating strong performance in quality standards [1][6] - Aetna has over 81% of its members in plans rated 4 stars or higher, with more than 63% in a 4.5-star plan for 2026, showcasing its competitive position in the market [1][6] - CVS Health's stock price increased by 1.6% following the announcement, reflecting a year-to-date gain of 73.5%, significantly outperforming its competitors [3][6] Company Performance - Aetna's 2026 Medicare Advantage plans will be available in 43 states, covering nearly 57 million Medicare-eligible beneficiaries, with features like $0 premiums and a maximum annual out-of-pocket cost of $2,100 for prescription drugs [7][8] - The plans include additional benefits such as $0 copays for Tier 1 drugs, dental, vision, and hearing benefits, and a fitness membership, enhancing their attractiveness to potential members [8][9] - Aetna is expanding its Special Needs Plans, targeting chronic conditions and dual eligibility, which will provide additional benefits to eligible members [10] Innovation and Strategy - Aetna has introduced streamlined prior authorization processes for cancer-related treatments, aiming to simplify healthcare access and improve patient outcomes [11] - The Clinical Collaboration program is set to reduce hospital readmission rates and emergency visits, indicating a proactive approach to healthcare management [12] - CVS Health's ongoing digital healthcare investment, amounting to $20 billion, supports Aetna's innovative care options, enhancing its service delivery [12] Valuation and Market Position - CVS currently trades at a forward five-year price/earnings (P/E) ratio of 11.17X, below the industry average, indicating potential undervaluation compared to peers [15] - Despite facing reimbursement pressures and legal challenges, CVS's stock performance and valuation metrics suggest a solid hold for current investors [17] - The company is navigating ongoing challenges in its pharmacy operations, including legal issues related to overcharging Medicare, which could impact future performance [16]