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CVS Health continued to pay out more than it expected for the medical claims of its Medicare Advantage enrollees in the second quarter, forcing the company to lower its estimates for this year’s profits for the second straight quarter.

Those higher medical costs led CVS chief executive Karen Lynch to remove Brian Kane, the president of Aetna, the subsidiary that operates all health insurance plans. Kane — who used to be the chief financial officer of Humana, another Medicare Advantage giant — was the head of Aetna for less than a year.

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“The financial performance of this business was not meeting my expectations, and I decided to make a change,” Lynch said during Wednesday’s earnings call. Lynch will take over the Aetna business, and Katerina Guerraz, CVS’ chief strategy officer, will be the chief operating officer.

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