Which insurer was most profitable in Q2? The answer won't surprise you

Another quarter is on the books for major national insurers, and the most profitable company through the first six months of this year isn't likely to be a surprise.

UnitedHealth Group continues to be a financial juggernaut through two quarters, leading the charge in revenues and profit for the first half of 2022. The healthcare giant brought in $160.5 billion in revenue across Q1 and Q2 this year, as well as $10.1 billion in profit.

Its next-closest competitor, CVS Health, earned $5.2 billion in profit for H1, according to company earnings reports. It's a closer second on revenue, however, with $157.5 billion for the first six months of this year.

In the second quarter specifically, UnitedHealth is again the most profitable, earning $5.1 billion. However, CVS just edges it out for revenue, bringing $80.6 billion to UHG's $80.3 billion. CVS earned $2.95 billion in profit for Q2, the second highest among the six national payers we tracked.

UnitedHealth Group and CVS Health are by far the most vertically integrated companies among the six major national payers, with each encompassing a sprawling enterprise with a slew of diverse businesses under its umbrella. At UnitedHealth, for instance, Optum has repeatedly posted double-digit growth, and executives said they believe the business arm has plenty of "untapped potential" still to find.

In particular, Optum's provider services arm Optum Health is a major growth engine within the company, and UnitedHealth has made multiple acquisitions this year alone to bring additional docs into the fold.

Aetna has also grown steadily since it joined CVS Health in late 2018, but the company also brings in significant cash from its retail pharmacies and pharmacy benefit manager, Caremark. But CVS is taking a cue from its rival and looking to bulk out its healthcare services, including the potential for a primary care acquisition sometime this year.

As Optum continues to grow, competitors are starting to take lessons from UnitedHealth Group's success.

Cigna beats out Elevance Health, formerly Anthem, to be the third-highest revenue earner in both Q2 and H1 2022, but falls short of its rival on profitability. Much of Cigna's revenue growth over the past several quarters is attributable to Evernorth, the sister company to its health plan that includes a major national PBM, Express Scripts, telehealth services, data analytics and more.

Elevance Health, too, rebranded earlier this year as it looks to grow beyond simply being a health plan and instead a "lifetime trusted partner" in its members' health.

Cigna reported $45.4 billion in revenue for the second quarter and $89.5 billion in the first half of the year. Anthem brought in $38.6 billion in revenue for Q2 and $76.7 billion in H1 revenue.

Elevance Health, meanwhile, earned $1.7 billion in profit for Q2 and $3.5 billion in profit through the first six months of 2022. Cigna earned $1.6 billion in the second quarter and $2.7 billion in the first half of the year.

Five of the six major insurers did post profits in the second quarter, with only Centene reporting a $172 million loss. The government insurer is profitable for the first half of the year, however, earning $677 million through the first two quarters of the year.

Centene is in the middle of the pack on revenue both in the second quarter and in the first half of the year, according to its earnings reports. The company brought in $39.5 billion in revenue for Q2 and $73.1 billion in revenue through the first six months of 2022.

Humana beats out Centene in profitability but lands in sixth place for revenues, according to its earnings report. The insurer reported $23.7 billion in revenue for the quarter and $696 million in profit. For the first half of the year, it brought in $47.6 billion in revenue and $1.6 billion in profit.

Echoing other competitors in the market, alongside its earnings Humana announced a plan to consolidate its operations into an insurance services arm as well as a healthcare services arm, CenterWell. Humana has made multiple acquisitions of late to bulk up CenterWell, most notably its buy of Kindred at Home which made it the largest provider of home health services in the United States.