Payer: Page 49
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Centene closes $2.2B acquisition of Magellan Health
The deal is designed to broaden Centene's ability to provide "whole person" care, as the pandemic has highlighted the need to increase access to behavioral health services.
By Samantha Liss • Jan. 5, 2022 -
Molina closes $60M acquisition of Cigna's Medicaid contracts in Texas
Molina is known for being acquisitive, but has been on a recent tear as it looks to capitalize on growth in the Medicaid program.
By Rebecca Pifer • Jan. 5, 2022 -
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 -
UnitedHealthcare permanently shelves controversial ER coverage changes following confusion
Following concerns from hospitals regarding an apparent change to its ER coverage policy, the payer clarified no changes were made — or will be made — to how it approves or denies its members' emergency claims.
By Rebecca Pifer • Jan. 4, 2022 -
For the first time in 25 years, Centene looks for new CEO
Soon, the payer will begin searching for Michael Neidorff's successor, kicking off an executive search for the first time since he was installed in 1996.
By Samantha Liss • Dec. 22, 2021 -
Alex Wong via Getty Images
Insurers returned $2B to consumers for 2020 under ACA
The rebates, tied to lower medical loss ratios, were triggered as utilization rates dropped at the start of the COVID-19 pandemic.
By Susan Kelly • Dec. 21, 2021 -
Permission granted by Biogen
After intense pushback, Biogen to cut price of Alzheimer's drug
Effective Jan. 1, the average list price for Aduhelm will drop about 50% to just over $28,000 a year. It's a move the company hopes will appease insurers and lower out-of-pocket costs for patients.
By Jacob Bell • Dec. 20, 2021 -
E+ via Getty Images
Flurry of doctor group buyouts helps fuel 'extraordinary' surge in health M&A
Companies across the healthcare spectrum are pursuing deals to strengthen operations after two years of pandemic-driven challenges, a new PwC report found.
By Susan Kelly • Dec. 14, 2021 -
Humana, Centene sue slate of drugmakers, alleging anticompetitive practices to protect HIV drug monopoly
Both payers have filed suit against Gilead, Teva, Janssen and Bristol Myers Squibb, alleging the drugmakers conspired to protect the market dominance of lucrative HIV medications despite the existence of generic alternatives.
By Rebecca Pifer • Updated Dec. 15, 2021 -
Samantha Liss/Healthcare Dive
Neidorff to retire as Centene, activist investor group agree to board shakeup
The longtime CEO is now set to be replaced by the end of next year, and a new policy mandates a board retirement age of 75.
By Samantha Liss • Dec. 14, 2021 -
Samantha Liss/Healthcare Dive
Centene rethinking its international business as it looks to divest non-core assets
As the payer continues its quest to improve profit margin, it's now re-examining its international business, two hospital operators in the U.K. and Spain.
By Samantha Liss • Dec. 13, 2021 -
Employers report highest annual increase in per-employee health costs in over a decade
The findings raise questions of whether employers are experiencing a temporary correction to the cost trend or if they're staring down the barrel of a new period of higher cost growth.
By Rebecca Pifer • Dec. 13, 2021 -
New CVS primary care locations to include physicians for first time
CVS wants to broaden its care delivery strategy, including "physician-led primary care centers with integrated virtual and home assets," CVS EVP and president of pharmacy services Alan Lotvin said.
By Rebecca Pifer • Dec. 10, 2021 -
Megan Quinn/Healthcare Dive
Senate passes legislation to avoid Medicare cuts in year-end sprint
The bill, which delays 2% cuts to Medicare rates through March and a separate round of 4% cuts to 2023, now heads to President Joe Biden's desk for his signature.
By Rebecca Pifer • Updated Dec. 10, 2021 -
Medicare Advantage quality bonus program hasn't improved quality, study finds
The new findings published in Health Affairs suggest the quality bonus program doesn't move the needle on quality despite a significant federal investment — hinting the American people may not be getting enough bang for their buck.
By Rebecca Pifer • Dec. 8, 2021 -
Julia Rendleman via Getty Images
Bright Health nabs $750M capital infusion with help from new investor (and competitor) Cigna
Cigna is investing $550 million in an apparent rival, attracted by its clinical network and opportunities to drive value there as more insurers look to snap up doctor's groups.
By Rebecca Pifer • Dec. 8, 2021 -
WhiteHouse.gov
Insurers now required to pay for at-home COVID-19 tests
Nearly 150 million insured Americans will benefit from the move, helping to lower their costs for the over-the-counter tests that can retail for around $25 for one kit.
By Samantha Liss • Dec. 2, 2021 -
Justin Sullivan via Getty Images
CVS, Microsoft ink alliance to develop digital health, personalized products
CVS is banking that Microsoft's computing capabilities can help it weave together its virtual and physical assets to capture a greater slice of patients' healthcare journeys — and the corresponding revenue.
By Rebecca Pifer • Dec. 2, 2021 -
UnitedHealthcare to appeal after jury awards TeamHealth $60M in damages
The payer is arguing the Las Vegas jury didn't get to hear several key pieces of evidence in its ongoing legal fight with private equity-backed TeamHealth.
By Rebecca Pifer • Updated Dec. 8, 2021 -
UPMC more than quadruples net income to $1.2B amid returning care and investment gains
Though patients returning to medical care delayed earlier in the pandemic helped its provider division, UPMC's health plan margin shrank due to higher medical claims in the period.
By Rebecca Pifer • Nov. 29, 2021 -
Humana, Allina Health expand value-based care partnership in Minnesota
The insurer also announced it extended another value-based care partnership for Medicare Advantage members with Hutchinson Clinic, a physician group in central Kansas.
By Susan Kelly • Nov. 24, 2021 -
Streeter Lecka via Getty Images
Anesthesiologists say Blue Cross NC 'abusing' surprise billing ban to drive down rates
Doctors are raising the alarm against what they perceive as Blue Cross NC's "take it or leave it" ultimatums to in-network clinicians, using the consumer protection legislation as a bargaining chip to negotiate more favorable rates.
By Rebecca Pifer • Nov. 23, 2021 -
Surprise Billing
Ground ambulances, excluded from surprise billing ban, to get scrutiny from federal committee
Recommendations from the new federal advisory committee will help inform policy changes to improve how charges and fees for ground ambulance services are disclosed to consumers, CMS said.
By Hailey Mensik • Nov. 22, 2021 -
Alex Wong via Getty Images
Biden admin proposes wide-reaching drug data collection in fourth surprise billing rule
Payers and employers will need to give HHS an annual overview of the top 50 drugs across different areas, including the most frequently dispensed drugs and the most expensive prescription drugs.
By Rebecca Pifer • Nov. 18, 2021 -
Insurtechs notched feverishly high MLRs in Q3. But it's not necessarily a mark of poor cost management
Despite strong year-over-year revenue growth, the finances of Bright, Clover and Oscar were walloped by coronavirus and risk adjustment headwinds.
By Rebecca Pifer • Nov. 17, 2021 -
Surprise Billing
Congress, alongside provider and consumer groups, continues spat over surprise billing ban rules
While payers and providers must start complying with the No Surprises Act by Jan. 1, the fight over rules implementing the ban is heating up as provider groups object to what they think is a favoring of insurers.
By Hailey Mensik • Nov. 17, 2021
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