U.S. Healthcare Facilities & Managed Care: 2025 Individual ACA Risk Adjustment Data Shows Favorable True-Up for CNC, ELV, and OSCR

Research evidence excerpt

U.S. Healthcare Facilities & Managed Care: 2025 Individual ACA Risk Adjustment Data Shows Favorable True-Up for CNC, ELV, and OSCR

Equity Research

U.S. Healthcare Facilities & Managed Care

30 June 2026

2025 Individual ACA Risk

Adjustment Data Shows Favorable

U.S. Healthcare Facilities & Managed CareTrue-Up for CNC, ELV, and OSCR

NEUTRAL

While this update reconciles prior-year risk adjustment, U.S. Healthcare Facilities & Managed

Carefavorable true-ups support conservative 2026 assumptions

and bode well for in-year risk adjustment, in our view - a Andrew+1 212 526Mok,5496CFA

notable positive for CNC, OSCR, and ELV. andrew.mok@barclays.com

BCI, US

Tiffany Yuan2025 CMS Risk Adjustment Release: On Tuesday (6/30), CMS released risk adjustment data

+1 212 526 5568

associated with the ACA premium stabilization program for the 2025 plan year. Results were

tiffany.yuan@barclays.com

broadly favorable, consistent with conservative accruals following last year’s unexpected BCI, US

increase in market morbidity. While this update reconciles prior-year risk adjustment, favorable

Thomas Walshtrue-ups support conservative assumptions embedded in 2026 pricing and guidance. We believe

+1 212 526 5096

this bodes well for in-year 2026 risk adjustment updates and represents a notable positive for thomas.walsh@barclays.com

CNC and OSCR. BCI, US

Sizing EPS Impact by MCO: Based on our subsidiary-level review of the data, public company Mingchuan Song

balance sheet disclosures, and statutory filings, CNC shows one of the largest gross favorable +1 212 526 9787

mingchuan.song@barclays.comtrue-ups worth $751 mn or $1.14 to 2026E EPS with CNC now in a net receivable position (Figure

1). Note, this is a gross benefit; the net benefit will ultimately depend on company-specific