1Q26 MCOs Round Up - MLR Trends Lower; MA & Medicaid Membership Continued to Dec

Research evidence excerpt

1Q26 MCOs Round Up - MLR Trends Lower; MA & Medicaid Membership Continued to Dec

Health Care | Healthcare Facilities & Managed Care

May 12, 2026

Elizabeth Anderson Ayush Vyas Amir Farahani, CFA Joanna Zhou

212-446-5632 646-551-8512 646-551-8518 212-446-5659

elizabeth.anderson@evercoreisi.com Ayush.Vyas@evercoreISI.com Amir.Farahani@evercoreisi.com joanna.zhou@evercoreisi.com

1Q26 MCOs Round Up - MLR Trends Lower; MA & Medicaid Membership

Continued to Decline; Commercial Remained Mixed

What Were the Key Highlights Post 1Q Earnings for CVS, CI, CNC, ELV, HUM, MOH, and UNH?

• FY26 EPS guidance came in meaningfully better for the group in 1Q26, with most payers

raising outlooks, reflecting improved visibility into utilization trends and better alignment

between pricing and medical cost trend. ELV, UNH, CVS, CI, and CNC all raised guidance,

while HUM and MOH maintained.

• MLRs improved broadly in 1Q26, with most payers seeing year-over-year MLR contraction

as prior pressures eased (though flu/weather/seasonality contributed modestly to the

beats). In MA, utilization remained elevated but largely in line with expectations. In Medicaid,

margins were more stable year-over-year, with incremental progress on rate alignment,

though a mismatch between acuity and reimbursement persists in several states.

• Medical Claims Reserves showed more constructive dynamics in 1Q26, supported by

stable runoff, generally higher payment velocity, and favorable prior period development

across much of the group:

o Runoff ratios were stable to modestly improving, with several payers running above

historical medians, suggesting solid reserve utilization and/or favorable

development.

o Payment velocity was mixed but skewed positive, indicating generally faster claims

payment.