Struggling CVS Health appoints health insurance executive to lead Aetna

The news: CVS Health appointed longtime health insurance executive Steve Nelson president of its embattled insurance business, Aetna.

  • Nelson previously served as CEO of health insurer UnitedHealthcare from 2017 to 2019.
  • In the time since, he’s been CEO at Duly Health and Care and value-based primary care company ChenMed.

Zooming out: The appointment comes as part of CVS’ mixed Q3 2024 earnings.

  • Total revenues increased to $95.4 billion for the quarter, up more than 6% year-over-year.
  • On the other hand, Aetna reported an operating loss of $1.2 billion, compared with a profit of $1.1 billion the same time last year.

The insurer continues to deal with persistent cost pressures in the Medicare Advantage (MA) market as MA enrollees receive more medical care than it anticipated.

  • Aetna reported a medical benefit ratio of just over 95% in Q3, up from nearly 86% the same time last year.
  • A medical benefit ratio measures how much a health plan spends on patient care—a lower medical benefit ratio means the health plan pays fewer claims for care received.

Why it matters: CVS’ Q3 earnings mark its first under new CEO David Joyner, who replaced outgoing CEO Karen Lynch just last month.