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CMS Finalizes 2027 Medicare Advantage Rate Hike as Elevance Gains and Targets Shift

The decision gives insurers clearer 2027 planning visibility despite ongoing Medicaid and Medicare margin strain at Elevance.

Overview

  • CMS, which finalized the 2027 Medicare Advantage and Part D payment rule Tuesday, set a 2.48% average increase for plan rates.
  • Officials said tweaks to risk adjustment, the formula that scores patient health, add about 2.5% and lift total new funding above $13 billion, shaping 2027 premiums and benefits.
  • Regulators delayed some planned risk‑model changes after warnings that a fast rollout was prompting insurers to drop fixed‑payment contracts with providers and leading to network exits.
  • Elevance shares rose intraday after the rule, with Bank of America raising its price target to $405 with a Neutral view and Evercore ISI reinstating at Inline with a $345 target.
  • Elevance still faces a 2026 earnings trough, with management guiding to at least $25.50 in adjusted EPS and projecting Medicaid operating margins near negative 1.75%, which keeps near‑term results under pressure.