Finances: Page 8
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CMS recalculates Medicare Advantage stars for UnitedHealth, Centene
After both insurers challenged the agency in court, the CMS improved scores for 12 UnitedHealth contracts and seven Centene contracts.
By Rebecca Pifer • Dec. 4, 2024 -
Illustration: Xavier Lalanne-Tauzia for Industry Dive
Ascension reduces operating loss, grows volumes in Q1
The provider is rebounding from a sweeping cyberattack this spring that took its electronic health record offline for weeks and led to significant losses.
By Susanna Vogel • Dec. 3, 2024 -
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Sanofi joins J&J, Eli Lilly in proposing 340B rebate model
Sanofi plans to phase in its own rebate model for 25 drugs — including anti-inflammatory injectable Dupixent, one of the top 10 drugs in global sales — early next year. It’s unclear how regulators will react.
By Rebecca Pifer • Updated Nov. 27, 2024 -
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MPT installs new leadership at Prospect hospitals as system continues to miss rent payments
Prospect has attempted to sell hospitals to generate liquidity, but has been unable to offload several of its properties.
By Susanna Vogel • Updated Nov. 25, 2024 -
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CareMax, dragged by Steward, files for bankruptcy
CareMax was the exclusive Medicare managed service organization to Stewardship Health. Steward’s bankruptcy posed an “existential threat” that CareMax said it couldn't overcome.
By Susanna Vogel • Updated Nov. 20, 2024 -
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Offering health insurance is becoming less lucrative
In the third quarter, the seven major publicly traded insurers’ medical loss ratios increased an average of 3.3 percentage points year over year — a major jump in medical costs.
By Rebecca Pifer • Nov. 18, 2024 -
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High labor expenses still challenging providers: report
Medical groups' median investment in each employed physician surpassed $300,000 for the first time ever in the third quarter, according to Kaufman Hall.
By Emily Olsen • Nov. 13, 2024 -
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Pharmacy costs, high utilization drive Kaiser to $608M operating loss in Q3
Kaiser said it would institute cost-cutting measures in response to the lackluster financial results, but didn’t detail specifics.
By Susanna Vogel • Nov. 12, 2024 -
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Cigna confirms it is not pursuing Humana acquisition
The flat-out denial comes after Cigna CEO David Cordani tried to discourage persistent speculation of a Humana merger earlier this fall.
By Rebecca Pifer • Nov. 11, 2024 -
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Private equity dealmaking in healthcare services falls again in Q3: PitchBook
Still, PitchBook analysts said the PE market is poised for a turnaround.
By Emily Olsen • Nov. 8, 2024 -
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MedPAC backs tying physician pay to inflation, but ducks specifics
During a meeting Thursday, commissioners debated different solutions to lackluster physician pay with one theme in common: linking doctors’ annual payment update to the Medicare Economic Index.
By Rebecca Pifer • Nov. 8, 2024 -
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CVS appoints new Aetna head following mixed third-quarter results
This year has been defined by an unsuccessful fight against elevated medical costs for CVS. The third quarter was no different.
By Rebecca Pifer • Nov. 6, 2024 -
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MACPAC calls for greater transparency amid steep rise in Medicaid directed payments
Dramatic growth in an opaque Medicaid funding mechanism is exacerbating concerns about the program’s fiscal integrity — while spurring financial gains for the hospital industry.
By Rebecca Pifer • Nov. 5, 2024 -
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Physicians, hospitals decry 2025 Medicare payment rates
Physicians will see their Medicare reimbursement fall 2.9% next year if Congress doesn’t stop the cuts. Meanwhile, reimbursement for hospital outpatient departments is rising 2.9%.
By Rebecca Pifer • Nov. 4, 2024 -
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Cigna CEO tamps down on Humana deal speculation
Despite reports this fall that the two payers had reopened merger talks, Cigna plans to use excess cash to buy back its shares, David Cordani told investors.
By Rebecca Pifer • Oct. 31, 2024 -
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Humana boosts 2024 earnings guidance thanks to Medicare Advantage member retention
The insurer said it doesn’t expect earnings growth next year due to significant investments it plans to make to boost MA stars.
By Rebecca Pifer • Oct. 30, 2024 -
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Rising healthcare costs could trickle down to workers: employer survey
Employers said higher drug costs pose the biggest threat to healthcare affordability, according to the National Alliance of Healthcare Purchaser Coalitions report.
By Rebecca Pifer • Oct. 30, 2024 -
Illustration: Xavier Lalanne-Tauzia for Industry Dive
Demand for services boosts Tenet’s third-quarter revenue to $5.1B
Despite beating estimates for revenue, the health system lowered the upper end of its full year revenue outlook. Analysts said the revision was due in part to the sale of some hospitals.
By Susanna Vogel • Oct. 29, 2024 -
Courtesy of HCA Healthcare
HCA logs $50M hurricane hit in Q3, expects greater loss in Q4
The for-profit giant affirmed its full-year revenue guidance, but executives said the ongoing impact of the storms would likely cause the operator to come in “on the lower half” of its range.
By Susanna Vogel • Oct. 29, 2024 -
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Centene beats investor expectations despite Medicaid headwinds
Like other payers, Centene flagged a mismatch between patient acuity and payment rates in Medicaid. But the insurer said a diversified portfolio helped it navigate challenges in the third quarter.
By Emily Olsen • Oct. 26, 2024 -
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AMA sues MultiPlan, insurers, alleging ‘cartel’ to fix physician prices
MultiPlan, which denies the allegations, has been sued dozens of times over concerns the company is conspiring with health insurers to underpay doctors for out-of-network care.
By Rebecca Pifer • Oct. 25, 2024 -
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State Medicaid directors concerned about program’s stability: KFF
The presidential election, loss of higher federal funding, inflationary pressures and other challenges are leaving state regulators uncertain about Medicaid’s “new normal.”
By Rebecca Pifer • Oct. 24, 2024 -
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Molina ‘beating the odds’ in Medicaid
Conservative planning and continued business growth helped Molina keep an ongoing mismatch between payment rates and member acuity from dinging its bottom line in the third quarter.
By Rebecca Pifer • Oct. 24, 2024 -
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Insurer lobby blames government policies for 2025 Medicare Advantage market makeup
The Better Medicare Alliance is warning of disruptions to care for America’s seniors, though MA premiums and major benefits are essentially unchanged next year.
By Rebecca Pifer • Oct. 23, 2024 -
Samantha Liss/Healthcare Dive
Centene sues HHS over Medicare Advantage star ratings fall
Centene is emulating other insurers unhappy with how regulators handled quality ratings for 2025. The flurry of complaints is “symptomatic of what appear to be systemic issues” with CMS calculations, Centene said.
By Rebecca Pifer • Oct. 23, 2024
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