CAH — Cardinal Health, Inc.

UnitedHealth Group is the largest health insurance company in the US, serving tens of millions of members through UnitedHealthcare. The company also operates Optum, a diversified health services platform spanning pharmacy benefits, care delivery, and health technology.

CVS Health is a vertically integrated healthcare company operating pharmacy benefit management (Caremark), retail pharmacies (9,000+ stores), health insurance (Aetna), and clinic-based care (MinuteClinic, Oak Street Health). The 2018 acquisition of Aetna for $69 billion transformed CVS from a pharmacy chain into a healthcare ecosystem player. CVS manages prescription drug benefits for tens of millions of Americans through Caremark and continues to expand primary care through Oak Street Health, acquired in 2023.

Humana is one of the largest health insurance companies in the United States with a dominant position in Medicare Advantage, the privately managed version of Medicare. Humana serves over 5 million Medicare Advantage members and benefits from the secular trend of Baby Boomers aging into Medicare eligibility. The company is heavily focused on value-based care through its CenterWell (formerly Conviva) primary care clinic network and home health services. Humana's earnings are highly sensitive to Medicare Advantage reimbursement rates set by CMS.

McKesson is one of the three dominant U.S. pharmaceutical distributors alongside AmerisourceBergen (Cencora) and Cardinal Health, distributing branded and generic drugs, medical supplies, and specialty pharmaceuticals to pharmacies, hospitals, and clinics. As a distributor, McKesson's margins are thin but volumes are enormous. The company also operates oncology specialty distribution and has a growing presence in oncology practice management through The US Oncology Network.

Cencora (formerly AmerisourceBergen, rebranded in 2023) is one of the three dominant U.S. pharmaceutical distributors, ranking alongside McKesson and Cardinal Health. The company distributes specialty and traditional pharmaceuticals to community pharmacies, health systems, and physician offices. Cencora has a particularly strong position in specialty drug distribution through its AmerisourceBergen Drug Corporation and World Courier specialty logistics operations. Strategic partnerships with Walgreens Boots Alliance give Cencora significant volume and distribution advantage.