With Post-Acute Care Investments, Elevance Health Believes It’s Staying Ahead Of Curve

Elevance Health Inc. (NYSE: ELV) leaders believe that investing early in its at-home care platform will give it a comfortable runway as rumors of a recession swirl around the U.S. economy.

By purchasing myNEXUS, a convener that manages home-based care for payers, Elevance has been able to diversify its business profile and feels like it has become a more resilient business.

Elevance believes the same about Carelon – its provider services wing.


“Carelon obviously adds additional opportunities to impact the affordability of our health plan business and allows us to take on more risk,” Elevance CEO Gail Boudreaux said during the company’s earnings call Wednesday. “Between [AIM Specialty Health] and myNEXUS, we’ve got a long runway there. Again, these investments are all about driving affordability. “

Carelon saw operating revenue grow by 26% in the third quarter, proving to company leaders that being a multi-dimensional company is valuable in today’s market.

“Carelon [is] delivering significant value to our commercial and government health plans,” Elevance CFO John Gallina said. “And consistent with our strategy, we continue to increase the breadth and depth of services Carelon is providing.”


Over the last three months, Elevance has started to implement and rapidly expand the myNEXUS post-acute care management product, which is now serving Medicare Advantage (MA) members in 15 markets.

Boudreaux said there are plans to add more markets in the coming months.

As MA plans become more popular, Elevance plans to reap the benefits.

“We expect strong earnings growth in Medicare Advantage driven by membership growth in excess of the broader market,” Gallina said.

There are three main factors why Elevance sees a growth opportunity for MA plans, Gallina said.

The first one being that 73% of Elevance’s MA members are in four-star or higher-rated plans for the 2023 payment year. That’s an increase of 15% year over year.

“No. 2 [being that] the continued recovery and risk adjustment as utilization has returned to more normalized levels,” Gallina said. “And number three, a relatively strong funding environment for the overall industry in 2023.”

myNEXUS is Elevance’s fully delegated post-acute benefit manager and one of the company’s key emerging assets within the Carelon health care services platform.

Elevance would not disclose how much post-acute business myNEXUS currently handles just yet.

However, the goal is for it to cover all of the insurer’s MA business from a post-acute care perspective eventually, Peter Haytaian, executive vice president of Elevance Health and president of Carelon, said.

“We started on this journey in July and we’ve seen really good success,” Haytaian said. “We also had another integration in September and will complete all the Medicare Advantage markets in early 2023. You can assume more broadly that, as it relates to post-acute care management for the Medicare business, we will be covering the management of all that population.”

Elevance profits were up 7.2% in quarter three to $1.6 billion compared to $1.5 billion a year ago.

Revenues were up 11.5% year-over-year, checking in at $39.9 billion.

Companies featured in this article:

, ,