Managed Care Organizations Outlook: Growth, Challenges, and Industry Insights

In 2025, managed care organizations (MCOs)P face a crossroads with political and regulatory landscapes in transition. The Republican-backed "One Big Beautiful Bill Act" in place may reduce the US insured rate as Medicaid loses approximately 10 million members and subsidies on individual exchanges end for 5 million users. This creates challenges for major insurance providers like Centene. Meanwhile, heightened scrutiny on PBMs and Medicare Advantage adds new operational risks, particularly for firms like UnitedHealth and CVS.

The latest analysis on the MCO industry encounters critical challenges and growth drivers. This report unveils how mismatched rates and utilization push medical cost ratios above historical norms, and strategies MCOs can adopt to address profit pressures. 

Explore how these changes impact key sectors in the US healthcare system while identifying actionable strategies to mitigate risks and leverage new investment opportunities.