瑞信美股医疗保健行业管理式医疗预期业绩适中焦点转移到20192018101522页

DISCLOSUREAPPENDIXATTHEBACKOFTHISREPORTCONTAINSIMPORTANTDISCLOSURES,ANALYSTCERTIFICATIONS,LEGALENTITYDISCLOSUREANDTHESTATUSOFNON-USANALYSTS.USDisclosure:CreditSuissedoesandseekstodobusinesswithcompaniescoveredinitsresearchreports.Asaresult,investorsshouldbeawarethattheFirmmayhaveaconflictofinterestthatcouldaffecttheobjectivityofthisreport.Investorsshouldconsiderthisreportasonlyasinglefactorinmakingtheirinvestmentdecision.15October2018Americas/UnitedStatesEquityResearchManagedC[e-mail]@[e-mail],[e-mail]manceAsFocusShiftsto2019;3Q18EarningsPreview■WeExpectAnotherSolidQuarterforMCO.UNHwillbethefirstMCOtoreportthirdquarterearnings,settingthetoneforthegroup.ManagedCarecompaniesbenefittedfromfavorablemedicalcosttrendsin1H18,andbasedonintra-quartercompanycommentaryandourrecenthospitalsurveys,webelievecosttrendsinQ3haveremainedsteady.Asaresult,weexpectanothersolidquarterformanagedcarecompanies.■TheMagnitudeofBeatsisLikelytoBeModest.ThemagnitudeofearningsbeatsforMCOsistraditionallyhighestin1Qbuttapersoffastheyearprogresses.Webelievethistrendisdrivenbyseasonalityinsomeofthekeybusinesslinesandmorebenefitfromprioryeardevelopmentin1Hthanin2H,etc.Additionally,sometimesMCOslimitupsidebyreinvestingtheir2Houtperformancebyacceleratinginvestmentspendingand/orincreasingreserveaccruals,etc.Importantly,currentinvestorexpectationsreflectthistrend.Forexample,ourQ3investorsentimentsurveysuggestsaround55%ofinstitutionalinvestorsexpectMCOstobeatexpectations,whichcompareswith65%expectingabeatheadingintoQ2.■PutsandTakesforIndividualMCOs.Withrespecttoindividualcompanies,webelievetheimplied2H18outlookforbothANTMandCIareconservative,andseebothcompaniesaslikelytopostresultsaheadofcurrentconsensusexpectations.ForHUM,our3Q18EPSestimateis$0.11aheadofconsensusaswebelievethecurrentconsensusof$4.28doesnotaccuratelyreflectthe3QEPSoutlookprovidedonthecompany’s2QEPScall.Further,weexpecttheresultsatUNHtobemodestlyaheadofconsensus.However,werecognizethatthecompany’sMLRcouldcomeinslightlyhigherthancurrentconsensus.Finally,weseein-lineEPSresultsatCNCandAET,albeitconsensusforCNC’srevenuesdoesnotseemtoaccuratelyreflectthepremiumtaxandhealthinsurerfeerevenue(passthroughpayments)expectedin3Q18.■2019Commentary.NoneoftheMCOsinourcoverageareexpectedtoissueformal2019guidancewithQ3results.However,withtheindustryfacingmoretailwindsthanheadwindsin2019,weexpectmostMCOstostrikeapositivetonewithrespecttoearningsgrowthexpectationsnextyear.Webelievecurrent2019consensusEPSexpectationsforANTMandUNHarelowastheimpliedcoreEPSgrowthisbelowtheirrespectivelong-termEPSgrowthoutlook.The2019expectationsforstand-aloneCIlooksreasonable.However,withtheESRXdeal,wesee$1.25ofEPSaccretionin2019.ForHUM,thekeyishowthecompanybalancesMAenrollmentandmargin,whichinturnwilldriveEPSwithina$16.75-$17.75range.15October2018ManagedCare2TableofContentsExecutiveSummary3UtilizationandMLRTrendExpectationsfor3Q18...................................................4Company-by-CompanyExpectationsfor3Q18Earnings5Aetna........................................................................................................................5Anthem.....................................................................................................................5Cigna........................................................................................................................5Centene....................................................................................................................6Humana....................................................................................................................7UnitedHealthGroup.................................................................................................7PricePerformance&Valuation8IndustryOperatingStatistics11CommercialEnrollment..........................................................................................11CommercialFully-Insured(“Risk-based”)Enrollment11CommercialSelf-Insured(“Non-Risk/ASObased”)Enrollment12ManagedMedicaidEnrollment...............................................................................13MedicareAdvantageEnrollment............................................................................14PDPEnrollmentTrends.........................................................................................15MLR/UtilizationTrends...........................................................................................16ConsolidatedMLRTrends16CommercialMLRTrends16InvestmentIncomeTrends.....................................................................................18AdjustedPre-TaxMarginTrends...........................................................................1815October2018ManagedCare3ExecutiveSummaryUNHwillbethefirstMCOtoreport3Q18earnings,settingthet