CVS · Earnings call · 2026Q2T · Full report
Medical Cost Trend / Benefit Ratio
CVS HEALTH Corp · 2026-08-05 · Importance 25 · Surprise 32 · In source text
Health Care Benefits reported a second-quarter medical benefit ratio of 87.4%, supported by medical cost management and disciplined pricing. Changes in the individual exchange risk-adjustment position for the 2025 plan year and favorable prior-year development contributed approximately $500 million, or 140 basis points, to the quarter’s MBR. Core performance exceeded expectations, with the strongest favorability concentrated in Medicare, while Medicaid and Commercial performed in line with expectations. CVS expects a full-year 2026 MBR of 89.75%, plus or minus 25 basis points, and expects the first-to-fourth-quarter MBR increase to be slightly above 950 basis points after adjusting for first-quarter prior-year development.
Key facts
- Full year 2026 Health Care Benefits MBR outlook: 89.75%, plus or minus 25 basis points.
- Medical benefit ratio (MBR) in Q2 2026: 87.4%; the cumulative items in the quarter contributed approximately $500 million or 140 basis points to MBR.
- Q2 2026 core outperformance in Health Care Benefits was largely concentrated in Medicare due to strong medical cost management and disciplined pricing.
Impact estimates
| metric | direction | stage | expected | basis |
|---|---|---|---|---|
| margin | unclear | committed | — | Full year 2026 Health Care Benefits MBR outlook: 89.75%, plus or minus 25 basis points. |