What Happens When Health Insurers Report Less Often? Rethinking Short-Termism in a Long-Term Industry

What happens when health insurers report less often?

When President Trump revived his call for U.S. companies to move from quarterly to biannual earnings reporting, the headlines practically wrote themselves. Wall Street worried that fewer updates would make the markets less transparent. Others cheered at the thought of freeing executives from the tyranny of the ninety-day countdown. 

But in healthcare, and especially among publicly traded insurers like UnitedHealth Group, Humana, CVS Health, and Elevance (Anthem), the implications are more nuanced. Managed care organizations (MCOs) sit at the intersection of profit, policy, and population health. How often they report their results shapes not only investor confidence, but also how the public evaluates whether these companies are delivering on their missions of access, equity, and value.

Wall Street vs. Main Street: Two Audiences, Two Clocks

For Wall Street, quarterly earnings are the heartbeat of market confidence. Investors use these disclosures to price risk, adjust models, and gauge management credibility. In this sense, a move to twice-yearly reporting could increase volatility because fewer data points and longer gaps between disclosures mean surprises could be sharper and more destabilizing.

But Main Street runs on a different clock. For patients, providers, and policymakers, quarterly expectations can distort incentives. When success is measured in ninety-day increments, it becomes harder for insurers to justify slow-building investments, such as those in social determinants of health (SDOH), health-equity programs, or behavioral-health infrastructure. These are areas where ROI often unfolds over years, not quarters.

If MCOs no longer face the drumbeat of every-three-month reporting, they might finally have breathing room to pursue projects that don’t show up in next quarter’s EPS but matter immensely for long-term value creation. They could focus on projects surrounding maternal health outcomes, care management models for high-cost populations, or partnerships with community-based organizations that reduce disparities before they widen.

Why this debate matters more for payers than most sectors

Health insurers don’t just follow the market’s clock. They keep time with three: 

1. Actuarial Clock: Claims lags, seasonality, reserve development, and risk-adjustment dynamics that unfold over 12–24+ months.

2. Regulatory Clock: Rate filings, Star Ratings, redeterminations, quality measures, audits, and medical loss ratio (MLR) guardrails.

3. Capital Markets Clock: EPS beats/misses every 90 days.

The proposed shift alters only the third clock. Actuaries won’t price risk differently because of an SEC filing cadence. They’ll keep doing what they’ve always done and track emerging experiences weekly or monthly and adjust reserves and forecasts. But the external narrative, and the pressure on management attention, could change. That’s where this gets interesting.

The conventional case: Fewer reports, more long-termism

Proponents argue that semiannual reporting lowers compliance burden and reduces the myopic focus on next quarter’s EPS. In theory, that breathing room could help payers commit to multi-year investments in:

• Social determinants of health (SDOH) and health equity programs that need time to show utilization and outcome shifts.

• Behavioral health access and care models with long maturation cycles.

• Value-based contracting where shared savings materialize after 12–24 months.

• Data and automation (e.g., care management analytics, AI triage) whose financial impact scales gradually.

On paper, that sounds like a win for Main Street with better outcomes, steadier long-run MLR, less churn-and-burn on quarter-to-quarter medical cost noise. On Wall Street, it could foster lower guidance drama and a more thesis-driven view of payer moats.

The contrarian view: Reporting frequency ≠ investment horizon

Here’s the pushback: Frequency alone rarely changes behavior. When the U.K. dropped mandatory quarterly reporting in 2014, research from the CFA Institute found no measurable uptick in long-term investment. What did change was the accuracy of analyst forecasts and the depth of coverage among public companies. As Forbes columnist Shivaram Rajgopal later observed, disclosure practices adapted, but corporate time horizons largely stayed the same.

In other words, changing the calendar didn’t automatically make companies think more long-term.

To translate that for payers, changing the reporting calendar doesn’t automatically build long-term discipline. If the goal is to accelerate SDOH or equity ROI, governance and incentives matter more than the SEC’s calendar. Boards that tie executive pay to multi-year quality and cost outcomes (e.g., readmissions, maternal health disparities, preventive visit completion, diabetic control) will do more for long-termism than any filing rule.

Wall Street vs. Main Street: What really changes?

For Wall Street

• Information gaps widen. With fewer official checkpoints, more weight shifts to informal signals (industry conferences, investor days, monthly utilization commentary), which can produce bigger surprises twice a year. That implies higher idiosyncratic volatility around prints.

• Comparability challenges. If some peers continue quarterly updates (even voluntarily) while others go semiannual, cross-section analysis of MLR trends, enrollment mix, and service-line performance gets harder.

• Cost of capital risk. Reduced frequency may modestly increase uncertainty premiums in models for sectors where capital allocation pivots quickly. This is arguably less true for payers than for hyper-cyclical industries, but still relevant.

For Main Street

• Accountability risk. Public payers steward large flows of taxpayer-funded premium (Medicare/Medicaid). Fewer formal updates could dampen public scrutiny of benefit design changes, prior authorization policies, and network adequacy unless regulators and companies bolster interim transparency.

• Policy signaling. Quarterly disclosures often double as policy “thermometers” (e.g., Medicaid redetermination impact, Star Rating shifts). With longer intervals, policy analysts may have less frequent visibility into knock-on effects for beneficiaries and providers.

Guidance for payer leaders (Main Street first, then Wall Street)

The shift doesn’t have to be passive. Health-plan leaders can shape what long-termism actually looks like.

1) Define the long game numerically.

Pick 3-5 multi-year, population-level targets (e.g., maternal morbidity reduction, cardiometabolic control, serious MH access) and translate them into actuarial value. Publish baselines, goals, and the return channel (reduced acute utilization, improved retention, higher quality bonuses).

2) Tie pay to the plan.

If executive comp continues to be dominated by annual EPS, changing the SEC calendar won’t matter. Increase the weight of 3-5-year health outcomes and quality metrics in long-term incentive plans.

3) Pre-commit to interim transparency.

Announce now that, regardless of SEC frequency, you’ll deliver quarterly operating dashboards on quality/equity and brief utilization color. Control the narrative before markets worry about a disclosure vacuum.

4) Educate the Street on variance.

Use your next investor day to teach the anatomy of MLR variance, covering topics like seasonality, program mix, lagged claims development, and policy effects. Give analysts a better toolkit to interpret semiannual results without overreacting.

5) Protect mission-critical experiments.

Adopt a stage-gate model for SDOH/equity pilots with small, pre-declared budgets and milestone reviews. If pilots work, scale. If not, sunset visibly. That builds credibility that “soft benefits” are managed with hard discipline.

Guidance for investors and analysts

Investors, too, can evolve.

1) Ask for the model, not just the metric.

When payers discuss SDOH or equity, request the causal pathway (i.e. which levers move utilization, what the lag structure is, how retention mediates ROI, and where confidence intervals sit).

2) Reweight your signal sources.

With fewer formal filings, prioritize:

• Regulatory data (Stars, risk adjustment updates, Medicaid rate actions),

• Utilization trackers and claims proxies from providers/pharmacy channels,

• CFO/actuary teach-ins and quarterly dashboards (if companies commit).

3) Underwrite transparency as an advantage.

Reward issuers that voluntarily sustain quarterly operating updates and publish equity metrics with the same rigor as EPS. Penalize opacity with higher rates.

4) Prepare for fatter tails.

If semiannual becomes the norm, expect larger two-times-a-year moves. Options strategies, risk budgets, and position sizing should reflect the higher “surprise amplitude.”

The harder question: Should payers be public at all?

It’s impossible to talk about how often insurers report without first asking who they’re reporting to, and what those owners are really optimizing for. Behind every quarterly update is a deeper tension between purpose and performance, between what serves the market and what serves the mission. 

The U.S. public model (for-profit, listed)

• Strengths: They have the scale to invest in tech and analytics, while access to capital markets allows them to grow rapidly. Additionally, public disclosure rules often keep organizations accountable by creating a steady rhythm of communication with their stakeholders, and the constant scrutiny from investors can, at its best, sharpen both decision-making and operational discipline.

• Weaknesses: Quarterly EPS pressure can crowd out investments with diffuse, delayed benefits. Narrative management (a.k.a. the art of pleasing the market) can sometimes take precedence over genuine performance improvement. When that happens, a single disappointing quarter can overshadow years of careful progress and shift focus from the organization’s mission to its image.

The nonprofit model (think Germany’s “sickness funds”)

Germany’s statutory insurers are nonprofit and operate under tight rules, risk adjustment, and social objectives. They still must earn a margin (surplus) for solvency and reinvestment, but their success is measured in public value, not profit margin. Oversight exists, though it comes through regulators, rather than being equity-market driven.

• Strengths: Without the constant pressure of quarterly earnings targets, leaders can take a longer view, investing in programs that strengthen population health over time. Mission and management move in tandem, allowing for steady reinvestment in prevention, equity, and social well-being. Freed from market expectations, these insurers can focus on creating sustainable value rather than chasing short-term gains.

• Weaknesses: Capital builds more slowly, which can limit how quickly these organizations invest in new technology or large-scale innovation. With fewer market signals to guide them, inefficiencies may persist longer, and progress often depends on regulatory approval rather than competitive momentum.

What might U.S. payers learn?

1. Separate “profit” from “purpose” in compensation. Public or nonprofit, tie leadership rewards to multi-year outcome goals (disparity closure, avoidable ED rates, maternal morbidity) alongside financial stewardship.

2. Treat prevention like core infrastructure. Establish ring-fenced budgets and milestone-based stage gates for SDOH/equity programs. Additionally, publish criteria for scaling or sunsetting, just like capital projects.

3. Make regulatory transparency legible to the public. Borrow from nonprofit norms, and publish plain-English impact scorecards the way you publish financials.

Ultimately, whether a payer behaves like a civic utility or a quarterly-optimized financial product depends less on ownership structure than on incentives and oversight. 

Closing thought: It’s not the calendar. It’s the covenant.

Shifting from quarterly to semiannual reports won’t magically turn payers into long-term stewards overnight. But it offers a moment to reset the covenant between insurers and their stakeholders:

• Tell us what outcomes you’re chasing.

• Show us the math behind them.

• Report progress consistently, even when you don’t have to.

If payers use this debate to raise population health outcomes alongside earnings in their public stories, and if investors respond to that openness with trust and affordable capital, both Wall Street and Main Street can come out ahead. If payers use the debate to elevate population health outcomes alongside EPS in their public storytelling (and if investors underwrite that transparency with cheaper capital) both Wall Street and Main Street can win.

Sources worth reading

• For those interested in the broader debate, Reuters and the Financial Times have both covered recent SEC discussions around reducing corporate reporting frequency and what that could mean for investor transparency. 

• CBS and NPR have offered accessible explainers that unpack how these policy changes might affect public companies and everyday investors. 

• AP News provides a clear summary of how policymakers are weighing market accountability against regulatory burden.

• For a deeper analytical view, the CFA Institute’s work on the U.K. experience remains a useful reference point on how reporting cadence influences investor behavior.