Michael Ha
๐ค SpeakerAppearances Over Time
Podcast Appearances
Great question.
And let me take it at a very high level, and then I'll drill in.
And basically, Medicare, I'll take it at the highest level.
Medicare is health insurance for seniors over the age of 65.
So think of it as health care.
health care is about a $4 trillion to $5 trillion market.
Medicare itself is about a quarter of that, right?
Call it a trillion.
So when you think about...
how important of a role it plays in the overall health care within the U.S.
It's significant.
And your largest players are your UnitedHealth, your Humana, your CVS, the names that you just called out.
And they're all down close to 20%.
So the way to think about it is this is run by the federal government.
And how their pricing works is clearly volume, price, volumes, and membership.
Pricing is determined by the federal government under HHS via a department called CMS.
And every year in January, they provide a proposed rate notice called the advanced rate notice.
And basically, if there's a benchmark rate that every health plan gets for a senior,
that rate should, in theory, every year, go up to track cost trend.