Health insurers' profits topped $35B last year. Medicare Advantage is the common thread

Big-name health insurers raked in $8.2 billion in profit for the fourth quarter of 2019 and $35.7 billion over the course of the year.

The common theme in their financial success? Growth in Medicare Advantage (MA). Of the seven biggest national insurers, all but one saw notable growth in their MA enrollment by the end of 2019.

Many were projecting even bigger expansion to come in 2020.

UnitedHealth Group was once again the most profitable company on the list, netting $3.5 billion in profit for the quarter and $13.8 billion in profit across 2019. By comparison, the second-place finisher, CVS, earned $1.7 billion in quarterly profit and $6.6 billion in profit for the year.

CVS edged out UnitedHealth in revenue, however, posting $66.9 billion in fourth-quarter revenue and $256.8 billion in annual revenue. UnitedHealth earned $60.9 billion in revenue for the quarter and $242.2 billion in revenue for the year.

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Here's a full recap of profits and revenues for both the quarter and the year:

CVS also bounced back from profit losses in both the fourth quarter and full-year 2018.

While those two companies led the way by a substantial margin for the industry, Cigna's growth was the most explosive thanks in large part to its ongoing integration with Express Scripts. The insurer's profits nearly doubled within a year, from $2.6 billion in 2018 to $5.1 billion in 2019.

Its revenues also skyrocketed, jumping from $48.1 billion in 2018 to $140.2 billion in 2019.

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Other plans generally held steady, posting less flashy gains in their year-end reports. All saw an increase in their annual profits, and all but Molina Healthcare saw a boost in revenue year over year. Anthem, for example, saw its revenue grow from $92.1 billion in 2018 to $104.2 billion and profits increase from $3.8 billion in 2018 to $4.8 billion last year.

Humana reported $64.9 billion in revenue for 2019, an increase from $56.9 billion the year before, and earned $2.7 billion in profit for the year, up from $1.7 billion the year prior.

Centene Corporation posted similar gains, with profits increasing from $1.4 billion in 2018 to $1.9 billion and revenues growing from $60.1 billion to $74.6 billion.

Molina, which has continued to emerge from a financial quagmire, reported $737 million in profit for 2019 on $16.2 billion in revenue, up from profits of $707 million on revenue of $17.6 billion in 2018.

Medicare Advantage

While a number of health plans saw their MA enrollment increase in 2019, they're truly eyeing 2020 as a big year for expansion.

Here's a side-by-side look at their MA membership as of December:

UnitedHealthcare saw an MA membership boost from 1.9 million to 2.1 million in 2019. However, the insurer is planning for much bigger things in 2020—in its guidance, it estimates adding 700,000 new members in Medicare.

Humana estimates 9.2% growth in its MA membership for 2020, adding between 270,000 and 330,000 people to its plans. It reported nearly 5.3 million MA members at the end of 2019.

Cigna views the market as a critical opportunity for expansion, and although its membership in Medicare trails UnitedHealthcare, Humana, Aetna and Anthem by a wide margin, the insurer grew its footprint significantly for the 2020 plan year. That growth is set to continue.

Centene's 2020 guidance is on tap for next week, as it was delayed for about a month following the closure of its WellCare Health Plans acquisition. That deal primes Centene to also be a strong presence in the MA market.

Charts contributed by Data Editor Eli Richman.