Payer


  • A piggy bank rests near a stethoscope.
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    FTC tells states to avoid shielding hospital mergers from antitrust enforcement

    A report released Monday compiles research that shows arrangements, called Certificates of Public Advantage, result in higher prices, lower quality of care and lower wage growth for employees.

    By Aug. 16, 2022
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    Oscar

    Cigna, Oscar to offer small business plans in Philadelphia

    Insurtech Oscar is pushing further into the small employer market through its partnership with Cigna while it holds off on adding more full-service agreements.

    By Aug. 16, 2022
  • Trendline

    Vertical integration and consolidation

    Healthcare companies merging with subsectors of the industry is a growing trend, although certainly not a new one.

    By Healthcare Dive staff
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    Adobe Stock

    Humana inks deal to expand in Medicaid managed care

    The payer acquired Wisconsin-based Inclusa on the heels of its $2.8 billion divestiture of Kindred at Home's hospice and personal care units.

    By Aug. 15, 2022
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    Cardinal Health CFO will replace CEO Mike Kaufmann

    Jason Hollar, who joined Cardinal as CFO in 2020, will lead the healthcare distributor starting in September.

    By Aug. 15, 2022
  • Nancy Pelosi sits at a table to sign the inflation reduction act. She's surrounded by people clapping.
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    Drew Angerer/Getty Images via Getty Images

    House passes bill extending ACA subsidies, allowing Medicare drug price negotiations

    The bill, which passed on party lines in a 220-207 vote, will now head to President Joe Biden’s desk. He is expected to sign it into law this week.

    By Aug. 15, 2022
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    Courtesy of Oscar Health

    Oscar Health pauses full-service tech deals amid implementation woes

    The decision to halt new technology agreements doesn’t change Oscar’s financial expectations for 2022, as the insurtech plans to reallocate resources to focus on achieving profitability in its insurance operations next year.

    By Aug. 12, 2022
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    New York judge dismisses surgeon’s lawsuit challenging surprise billing law

    The lawsuit threatened to again expose millions of patients to surprise out-of-network bills.

    By Aug. 11, 2022
  • A nurse administers a flu vaccine to a patient in Texas.
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    Scan Health Plan makes push into Texas

    The Medicare Advantage insurer will cover seniors in a total of four states, pending regulatory approval.

    By Aug. 10, 2022
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    Karen Ducey via Getty Images

    Profits climb for major insurers as hospital volumes drop in Q2

    All but two of the seven largest insurers saw profits climb in the second quarter as hospital operators continued to struggle with weak volumes and higher labor costs amid record-high inflation.

    By Aug. 9, 2022
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    Kaiser Permanente posts Q2 net loss of $1.3B

    The Oakland, California-based integrated health system attributed the setback in its quarterly results to market investments.

    By Aug. 9, 2022
  • Clover Health's incoming chief executive Andrew Toy
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    Clover Health’s Toy to step up as CEO as insurtech bolsters revenue

    In a call with investors, incoming chief executive Andrew Toy said the path to profitability is “a huge focus” for Clover, and pointed to shrinking its medical loss ratio and controlling operating expense growth as key strategies.

    By Aug. 9, 2022
  • senator Chuck Schumer pauses under an arch in the United States Senate. Both of his hands are raised and giving a 'thumbs up'
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    Drew Angerer/Getty Images via Getty Images

    Senate passes bill extending ACA subsidies, adding Medicare price negotiations

    The Inflation Reduction Act looked dead just weeks ago until Sen. Joe Manchin, D-W.Va., announced late last month that he had successfully negotiated with Democrats to pass it.

    By Aug. 8, 2022
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    Cigna’s Q2 profit climbs to $1.6B as fewer patients seek care

    The payer raised its revenue and operating income targets for the year as a result of the quarterly performance.

    By Aug. 4, 2022
  • A picture of the exterior of a CVS Pharmacy with the logo and name in view.
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    Bruce Bennett via Getty Images

    CVS could look to regional buys as it plans primary care acquisitions

    “We can’t be in ... primary care without M&A. We’ve been very clear about that,” CEO Karen Lynch said during an earnings call Wednesday.

    By Aug. 3, 2022
  • A doctor holding tablets of medicine explains options to a patient in a hospital room.
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    iStock via Getty Images

    Number of uninsured Americans falls to all-time low

    Policy experts are worried, however, that progress on coverage expansion will be threatened when a moratorium on Medicaid disenrollment ends.

    By Aug. 3, 2022
  • A brick wall with a red CVS Pharmacy sign.
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    CVS beats Q2 expectations, Aetna revenue rises nearly 11%

    The company raised its full-year guidance despite a $77 million decrease in adjusted operating income, primarily due to declines in its retail segment.

    By Aug. 3, 2022
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    CMS calls for public input to improve Medicare Advantage

    The agency wants feedback from a variety of voices on how it can strengthen the popular but increasingly controversial program.

    By Aug. 1, 2022
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    Medicare Advantage plans make inflated dialysis payments, study says

    Research published in Health Affairs found large chains in the consolidated dialysis sector have the market power to negotiate higher MA reimbursement.

    By Aug. 1, 2022
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    Molina’s profit rises to $248M on higher Q2 membership

    The insurer’s premium revenue increased 18% in the second quarter compared with the prior-year period as the payer saw membership increase 9%.

    By July 29, 2022
  • Taft Parsons, new chief psychiatric officer for CVS Health
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    CVS names first chief psychiatric officer

    Taft Parsons, who previously worked for Molina Healthcare and Henry Ford Health System, will be tasked with focusing on mental well-being for patients and leading the Aetna Medical Affairs Behavioral Health organization.

    By July 29, 2022
  • President Joe Biden stands at a podium under a painting of Abraham Lincoln
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    Anna Moneymaker/Getty Images via Getty Images

    Senate Dems reach draft deal to extend ACA premiums, lower drug costs

    The bill, part of a more than $300 billion package, extends enhanced ACA premiums and allows Medicare to negotiate select prescription drug prices starting in 2026.

    By July 29, 2022
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    Molina pivots to permanent remote work, plans to cut real estate footprint by two-thirds

    The payer is headquartered in Long Beach, California, and has offices in New York City and assorted properties in other states. It employs 14,000 people.

    By July 28, 2022
  • An elderly woman sits in a doctor's office as a medical worker writes on a clipboard.
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    Adobe Stock

    States mixed on how to improve Medicaid unwinding with PHE end date unknown

    States have a wide variety of opinions on how difficult resuming annual eligibility reviews after the COVID-19 public health emergency ends might be, according to MACPAC.

    By July 28, 2022
  • Centene's headquarters in Clayton, Missouri, a suburb outside of St. Louis.
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    Samantha Liss for Healthcare Dive

    Centene warns star ratings will be ‘disappointing’

    The issues stem from Centene’s WellCare acquisition and plans are already underway to turn the star ratings around, CEO Sarah London said.

    By July 28, 2022
  • A medical professional measures a patient's blood pressure using a sphygmomanometer.
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    Humana's Q2 profit jumps to $696M on lower medical costs

    One reason for the lower inpatient utilization is the shift to outpatient care, which is primarily driven by orthopedic care, Humana CFO Susan Diamond said.

    By July 27, 2022