Payer

Cigna health services arm Evernorth acquires telehealth vendor MDLive

The deal, which is expected to close in the second quarter of this year, will mean MDLive's telemedicine offerings will be available to Evernorth's third-party clients, along with Cigna's medical customers and clients in the U.S.

By Rebecca Pifer • Feb. 26, 2021

ACLA urges Biden to fund uninsured COVID-19 testing, close coverage loopholes

The plea from the trade group for Quest and LabCorp is the latest in a row between labs and insurers over paying for the diagnostics and comes as a $2 billion federal testing fund runs dry.

By Nick Paul Taylor • Feb. 24, 2021

Explore the Trendline➔

Trendline

The Healthcare Dive Outlook on 2021

The next steps for the explosion of telehealth, the Biden administration's efforts to roll back Trump-era policies and the road back to a new normal way of doing business for payers and providers are Healthcare Dive’s big trends for 2021.

By Healthcare Dive staff

Biden asks SCOTUS to drop Medicaid work requirement arguments

The high court has already canceled some oral arguments defending Trump-era policies, including a suit defending Mexico border wall funding and another forcing migrants to wait in Mexico while their asylum claims are processed.

By Rebecca Pifer • Feb. 23, 2021

Oscar Health eyes $6.7B valuation with upcoming IPO

Even though the startup added members to plans and expanded to several states last year, it faces flagging financial performance that could tamp down investor enthusiasm.

By Rebecca Pifer • Feb. 22, 2021

Sponsored by IQVIA

Managing risks through enhanced analytics

Read 6 ways to leverage different data sources to mitigate risks associated with COVID-19.

By Tracy Milanette, Sr. Director, U.S. Healthcare Services Information Assets & Offerings & Julianne Migely, Director, US Provider & Payer Solutions • Feb. 22, 2021

Obama admin alum Chiquita Brooks-LaSure picked to head CMS

Brooks-LaSure will have a lot on her plate. Biden during his campaign ran on expanding the role of the Affordable Care Act and perhaps attempting to build in a public option or lowered Medicare age eligibility.

By Shannon Muchmore • UPDATED: Feb. 19, 2021 at 11:14 a.m.

Anthem-backed digital startup Sharecare goes public in $3.9B blank check deal

The startup, launched by WebMD founder Jeff Arnold and medical TV personality Mehmet Oz, will merge with special purpose acquisition company Falcon Capital Acquisition and is the latest in the digital health SPAC craze.

By Rebecca Pifer • Feb. 17, 2021

Payer profits nosedived in Q4 on increased COVID-19 expenses

Still, major insurers ended 2020 in the black, buoyed by the pullback in utilization during earlier quarters.

Biden admin begins plan to rescind Medicaid work mandates in win for providers

The policies threatened to lower hospitals' Medicaid revenues as enrollees lost coverage, raising uncompensated care costs. But lawsuits and the pandemic have kept states from implementing the controversial Trump-era requirements.

By Samantha Liss • Feb. 16, 2021

CVS to jump back into individual ACA markets in 2022

The health giant has yet to disclose specific geographies or the cost of the plans, with newly installed CEO Karen Lynch telling investors Tuesday to expect more details in the second quarter.

By Rebecca Pifer • Feb. 16, 2021

Molina expects utilization to remain depressed in 2021

Looking ahead, executives seemed cautiously optimistic for this year but noted headwinds from the COVID-19 pandemic will persist. Bright spots for the payer include the recently announced ACA special enrollment period.

By Samantha Liss • Feb. 11, 2021

As COVID-19 becomes a business, vaccine makers confront thorny pricing questions

Yearly vaccinations could be required after the pandemic ebbs. Will drugmakers change how they approach pricing their shots?

By Jonathan Gardner • Feb. 10, 2021

Medicare DME competitive bidding in doubt after failed round

Cowen analysts said a recent report found steep rate hikes, leading them to conclude the program is no longer such a big threat to companies like Baxter, ResMed and Philips.

By Nick Paul Taylor • Feb. 10, 2021

Centene to ax 3,000 jobs as run of profitable quarters ends

After months of benefiting from deferred care like many other insurers, Centene reported a loss in the fourth quarter in part due to higher COVID-19 testing and treatment costs.

By Samantha Liss • Feb. 09, 2021

Oklahoma selects 4 private payers to manage Medicaid for $2B, faces legal suit

The state maintains the switch will improve costs while maintaining access, but the move to cede Medicaid control to for-profit entities is highly controversial.

By Rebecca Pifer • Feb. 09, 2021

Fitch: Biden's healthcare plans could boost nonprofit hospitals

The ratings agency cited administration plans to bolster the Affordable Care Act, which could reverse the increased number of uninsured people, as among the factors driving brighter prospects.

By Ron Shinkman • Feb. 04, 2021

Cigna's COVID-19 costs outweighed deferred care savings for first time in Q4

CEO David Cordani told investors he expects 2021 to be a "year of transition" as coronavirus vaccine rollouts will "continue to tax an already overburdened healthcare system."

By Shannon Muchmore • Feb. 04, 2021

UnitedHealth CEO Dave Wichmann steps down, replaced by Optum head Andrew Witty

Wichmann's retirement ends his relatively short tenure at the diversified healthcare giant, and results in a leadership shakeup with Witty immediately taking the reins.

By Rebecca Pifer • Feb. 04, 2021

Medicare buy-in for older adults could cut health costs, increase coverage value: Urban Institute

A Medicare buy-in is not a specific prong of President Joe Biden's health policy agenda, but there are currently two proposals in Congress designed to build upon the ACA.

By Rebecca Pifer • Feb. 03, 2021

Humana posts Q4 loss after uptick in COVID-19 care, tests

The payer's executives said depressed utilization last year created unique challenges for 2021, particularly in the Medicare book of business.

By Samantha Liss • Feb. 03, 2021

Anthem to acquire largest Medicare Advantage plan in Puerto Rico

The deal also nets the insurer the second-largest Medicaid plan there and a network of specialized clinics.

By Samantha Liss • Feb. 02, 2021

Payers welcome reopening of ACA marketplaces

Healthcare.gov will be open for a special enrollment period from Feb. 15 through May 15, though advocates say robust outreach and marketing efforts need to be coupled with the move.

By Samantha Liss • Jan. 28, 2021

FDA approves first-of-its-kind lupus drug

Lupkynis, the first oral drug approved for lupus nephritis, comes with a high list price. Its developer, Aurinia Pharmaceuticals, expects average net revenue of roughly $65,000 per patient per year.

By Jacob Bell • Jan. 27, 2021

Anthem cuts 2021 outlook, as Q4 profits fall 40% on care resurgence

This year "presents its own unique set of business challenges," CFO John Gallina told investors. "While much has changed, it is clear we are still in the depths of a pandemic."

By Rebecca Pifer • Jan. 27, 2021

Biden to create new enrollment period for ACA exchanges

While most state-based exchanges created special enrollment periods earlier in the COVID-19 pandemic, CMS under former President Donald Trump resisted calls to do so as his administration fought the landmark law in the courts.

By Shannon Muchmore • Jan. 26, 2021