Payer: Page 2
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Courtesy of UnitedHealth Group
Deep DiveUnitedHealth, Amedisys merger appears set to close post-DOJ settlement
The settlement is weaker than at least one antitrust expert expected based on the severity of the DOJ’s concerns. But it means the $3.3 billion merger is very likely to close.
By Rebecca Pifer • Aug. 8, 2025 -
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Democrat senators probe UnitedHealth over nursing home care denials
Sens. Ron Wyden and Elizabeth Warren are seeking more information from the beleaguered healthcare behemoth after The Guardian found it was incentivizing nursing homes to reduce hospital transfers.
By Rebecca Pifer • Aug. 8, 2025 -
Explore the Trendline➔
Yujin Kim/Healthcare Dive
TrendlinePayer/provider relationships
As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.
By Healthcare Dive staff -
Courtesy of UnitedHealth Group
UnitedHealth and Amedisys reach settlement with DOJ over $3.3B merger
The settlement filed with the Maryland district court on Thursday requires UnitedHealth and Amedisys to divest 164 home health and hospice sites to placate the DOJ’s concerns that the merger is anticompetitive.
By Rebecca Pifer • Updated Aug. 7, 2025 -
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ACA plans want to hike premiums by median of 18% next year: KFF
The KFF’s projection is steeper than an older analysis that relied on less complete data. It’s the largest increase that ACA insurers have asked for in more than five years as payers brace for membership turmoil.
By Rebecca Pifer • Aug. 7, 2025 -
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The great Medicare Advantage contraction appears set to continue
Insurers plan to keep sacrificing MA growth for profitability next year, after second quarter results for Humana and CVS showed the success of the strategy.
By Rebecca Pifer • Aug. 6, 2025 -
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More urban hospitals dually classifying as rural under Medicare: study
Dually classifying allows urban facilities to benefit from rural health programs, even as many rural facilities struggle financially and are at high risk of closure, researchers wrote.
By Emily Olsen • Aug. 6, 2025 -
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More than half of patients report health insurance denied drugs for chronic or rare diseases: poll
The survey also found high rates of alternative funding programs, controversial arrangements in which employers outsource access to pricey specialty drugs to third parties.
By Rebecca Pifer • Aug. 5, 2025 -
Samantha Liss/Healthcare Dive
Incoming UnitedHealth CFO steps down from Centene’s board
A clause in Wayne DeVeydt’s new contract prevents him from participating in activities that compete with UnitedHealth. That’s standard for senior executives.
By Rebecca Pifer • Aug. 5, 2025 -
Courtesy of UnitedHealth Group
UnitedHealth replaces CFO in another leadership shakeup
Wayne DeVeydt, a healthcare veteran who most recently worked at Bain Capital, will take up the finance chief job on Sept. 2 as the healthcare behemoth faces an array of operational challenges.
By Emily Olsen • Aug. 1, 2025 -
Julia Rendleman via Getty Images
Cigna beats investor expectations on Evernorth growth
Cigna’s health insurance business is performing within expectations, even as the insurer faces persistently heightened medical costs, executives said.
By Emily Olsen • Aug. 1, 2025 -
Foremniakowski via Getty Images
CMS finalizes inpatient payment rate increase for 2026
Medicare finalized inpatient pay rates that are slightly higher than those proposed in April. Hospital groups were pleased with the increases, but said they were still inadequate.
By Sydney Halleman • Aug. 1, 2025 -
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CVS hikes adjusted earnings guidance as Aetna performance improves
The company raised its outlook as many insurers are struggling with elevated medical costs in the second quarter.
By Emily Olsen • July 31, 2025 -
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PBM markets lack competition, new paper finds
The American Medical Association’s research, which found that local PBM markets are highly concentrated, is more fuel for critics of the powerful drug middlemen.
By Rebecca Pifer • July 31, 2025 -
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Medicare Part D premiums likely to increase next year
The average monthly bid submitted by insurers for 2026 prescription drug plans increased 33% from last year, according to data released by the CMS.
By Emily Olsen • July 30, 2025 -
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Judge halts Arkansas law forcing PBMs to sell pharmacies
U.S. District Judge Brian Miller agreed with pharmacy benefit managers that the state’s law may violate the Constitution in granting their request for a preliminary injunction.
By Rebecca Pifer • July 30, 2025 -
Permission granted by Elevance Health
Elevance names former Cencora CEO to board
Steve Collis’ three decades of experience at a major drug distributor could prove helpful for Elevance as it continues to build out its pharmacy services.
By Rebecca Pifer • July 30, 2025 -
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Humana hikes 2025 guidance on medical cost control, pharmacy growth
The health insurer’s results are a bright spot in what’s otherwise been a gloomy quarter for the sector. Humana says it has a handle on snowballing medical costs after taking a conservative stance heading into the year.
By Rebecca Pifer • July 30, 2025 -
Courtesy of UnitedHealth Group
UnitedHealth expects lower profits in 2025 amid medical cost spike
The beleaguered company plans to focus on business fundamentals, cut Medicare Advantage plans, raise prices and forge a new relationship with regulators as it slogs its way back to favored status with Wall Street.
By Rebecca Pifer • July 29, 2025 -
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OpinionDrug innovation should benefit patients. PBMs are preventing that from happening.
Health plans should directly contract with drug manufacturers to provide medications at transparent and affordable prices, argues Kathy Chang, head of trade relations at Blue Shield of California.
By Kathy Chang • July 29, 2025 -
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Top medical association warns RFK Jr. not to overhaul preventive services task force
The health secretary reportedly wants to fire all 16 members of the task force that advises insurers on what services they have to cover under the Affordable Care Act. The American Medical Association thinks that’s a bad idea.
By Rebecca Pifer • July 28, 2025 -
Samantha Liss/Healthcare Dive
Centene stock hits decade low after insurer reports rare loss on higher medical costs
The St. Louis-based payer slipped into the red during the second quarter for the first time since 2022. Centene executives said they were disappointed and frustrated by the results.
By Rebecca Pifer • July 25, 2025 -
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UnitedHealth confirms it’s under investigation by DOJ
The company said it was complying with criminal and civil investigations from the Justice Department into its Medicare program.
By Sydney Halleman • July 24, 2025 -
Alamy
Molina cuts 2025 earnings outlook again on ACA, Medicaid pressures
The California-based insurer outlined its plans to survive what CEO Joe Zubretsky deemed a “season of great uncertainty” stemming from roiling acuity shifts and looming policy changes.
By Rebecca Pifer • July 24, 2025 -
Rebecca Pifer/Healthcare Dive
A ‘bastardized’ program: GOP lawmakers eye Medicare Advantage reform
In a hearing this week, Republican legislators appeared open to changing the privatized Medicare program — once a GOP darling that’s fallen out of favor amid concerns about prior authorizations, care denials and profiteering.
By Rebecca Pifer • July 23, 2025 -
Scott Olson via Getty Images
Half of large employers plan to shift health plan costs onto employees: Mercer
Employers are looking for ways to manage costs, cover popular weight loss drugs and offer well-being and mental health options.
By Carolyn Crist • July 23, 2025
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