Dive Brief:
- Cigna netted a profit of $1.2 billion in the first quarter, on par with the first quarter of last year, while increasing revenue to $41 billion despite continued COVID-19 headwinds in the health insurance market.
- The Connecticut-based insurer beat Wall Street expectations in the quarter, and increased its forecast for the full year, signaling optimism for the remainder of 2021 despite the ongoing uncertainty.
- Cigna's Evernorth health services unit, which includes pharmacy benefit manager Express Scripts, helped propel the first quarter beat after netting a 13% increase in revenue year over year.
Dive Insight:
The first quarter was one of the worst of the pandemic in the U.S., as hospitalizations, cases and deaths all peaked at some point in the period. Those metrics improved dramatically as the quarter went on and as vaccinations climbed, according to data maintained by the Centers for Disease Control and Prevention.
Industry observers have been closely watching how quickly patients return for care as COVID-19 cases and hospitalizations hopefully continue to decelerate. Heading into the first quarter, there was a level of uncertainty on how quickly that care might ramp up — and what effect that will have on insurers, which have benefited financially from a dampening of patient volumes as patients avoided or lost access to healthcare facilities during the pandemic.
Cigna's utilization is back to pre-pandemic levels, Cigna executives said on a call with investors Friday morning on the first-quarter results.
CEO David Cordani said preventative screenings such as mammograms, colonoscopies, childhood immunizations, and cervical cancer screenings were at pre-pandemic levels, calling the return "tremendous." Cordani said national data seems to show a more dampened rate for those screenings, but that Cigna's data seems to be at a more elevated rate.
That characterization seems to jibe with the insurer's medical cost ratio, a measure of how much it spent on patient care compared to the premiums brought in. Cigna's medical cost ratio for the first quarter was 81.8%, an increase from 78.3% during the first quarter last year. It's also notably higher than 78.9% from the first quarter of 2019, a year of more normalized utilization patterns.
Compared to its peers, Cigna's medical cost ratio was slightly higher than UnitedHealth's 80.9% for the first quarter and lower than Anthem's of 85.6%.
Molina and Centene, which focus more exclusively on government plans than commercial plans, both reported medical cost ratios of 86.8%.
For the outlook on the full year of 2021, Cigna now expects to generate revenue of at least $166 billion, an increase of $1 billion from prior projections, and income from operations to reach at least $7 billion, an increase of $50 million from prior forecasts.