Humana (HUM) opened up around 11% on Tuesday following Monday’s after-hours announcement of the final 2027 Medicare Advantage payment rates.
Humana Inc., HUM
The final rate of 2.48% is a major step up from the 0.09% proposed rate in January, which caught the industry off guard and sent insurer stocks lower at the time.
The CMS announcement means private health insurers will collect more than $13 billion in additional Medicare Advantage payments from the government in 2027.
UnitedHealth (UNH) and CVS Health (CVS), parent of Aetna, both gained more than 6% in premarket Tuesday. Elevance Health (ELV) climbed around 5%. Hospital and managed care names also caught a bid, with Molina Healthcare (MOH) up 7% and Centene (CNC) rising 4%.
The jump in these stocks came after months of lobbying from insurers and their trade groups, who argued the January proposal did not reflect rising medical costs. The Better Medicare Alliance had called the near-zero initial proposal a functional “cut,” pointing to medical cost trends running at 7% to 9% annually.
CMS made several technical updates alongside the headline rate. Starting in 2027, the agency will exclude diagnosis data from unlinked chart review records when calculating risk scores, with a carve-out for beneficiaries switching between Medicare Advantage organizations.
The agency said this change will have a bigger impact on plans that rely heavily on those chart reviews to document patient diagnoses and collect higher payments. CMS also updated the Part D risk adjustment model to account for changes under the Inflation Reduction Act.
Medicare Advantage covers around 35 million beneficiaries and has grown steadily to surpass enrollment in traditional government-run Medicare. The final rate governs how more than half a trillion dollars flows through private health plans each year, making it one of the most closely watched data points in the health insurance sector.
The rate includes factors such as underlying cost growth, 2026 Star Ratings for quality bonus payments, and risk adjustment methodology updates. CMS confirmed it will continue using the 2024 Medicare Advantage risk adjustment model for 2027.
Bipartisan pressure to rein in Medicare Advantage spending had added uncertainty to the process. Both parties have raised questions about insurer coding practices that can lead to higher payments for patients with more recorded diagnoses. The Biden-era CMS had already started tightening those payments, and the January proposal under the Trump administration signaled that scrutiny would continue.
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