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N.C. State Health Plan Report Lacks Critical Context

Dale Folwell, North Carolina’s Treasurer, recently commissioned and endorsed the findings of a one-sided, short-sighted report. Its title, ‘North Carolina Hospital Systems Enjoyed Record Profits During Pandemic,’ smells of click-bait. It’s curious… Read More

‘No-fault’? Yeah, right. Centene’s foibles are starting to add up

It’s been a while since we’ve done a good ‘ole update in our series, Managed Care Mischief. But not to worry — we’re back and headed to New Mexico, where Centene, known… Read More

Can you guess which health insurer has a history of tax breaks?

Benjamin Franklin once said, “Nothing is certain except death and taxes.” Well, apparently, not true for Blue Cross Blue Shield (BCBS). According to a new report from STAT News, many BCBS plans… Read More

Prices are up. But insurance premiums? Way up.

It’s no secret that consumer prices are high. (Hello, gasoline.) But whether it’s housing, utilities, or food, costs across the board are continuing to rise. In fact, at 8.6%, inflation is the… Read More

American Hospital Association begs feds to enforce the law

According to a recent article in Fierce Healthcare, in late May the American Hospital Association (AHA) published a letter to the Department of Justice (DOJ) pleading for an investigation “into commercial payers… Read More

For Anthem, a rose by any other name . . .

Drumroll, please. Because later this month, Anthem will become … wait for it: ‘Elevance Health.’ This is the health insurance company’s second rebrand in a decade, and you’re not alone in wondering… Read More

That ‘no-name’ drug in your cabinet? It may not be saving you as much as you think.

Let’s face it: the only reason we buy generic goods is to save money. (And when it comes to healthcare, there’s a lot that inevitably needs to be saved.) This is especially… Read More

Is anyone getting the mental health coverage they pay for?

How much more evidence do we need? You don’t have to go far to find examples of health insurance companies denying coverage or making it exceedingly difficult to access in-network care. Maybe… Read More

It’s time for another contract dispute round-up

Are insurer contract disputes ‘business as usual’? A recent Becker’s Payer Issues article rounds up eight recent disputes between health plans and hospitals — from Maine to Mississippi, Colorado to Georgia, and… Read More

Medicaid expansion: just a bandage for wounds inflicted by NC health insurers

We’ve been sounding the alarm for quite some time now: Rural hospitals struggled before COVID-19. They barely held on during the pandemic. And if private health plans continue to slash reimbursements, rural… Read More

Another slam dunk for UnitedHealthcare

An unfortunate reality in this country is that many Americans struggle to access and pay for healthcare. The reasons are varied, and different stakeholders cast blame differently: Hospital  prices. Decreased Medicaid reimbursement.… Read More

UnitedHealthcare’s ‘evil empire’ strikes back against a new lawsuit

Break out the popcorn for this one.   According to a recent article in HealthLeaders, UnitedHealthcare has found itself in yet another legal battle. United is no stranger to being sued and at… Read More

The truth behind hospital costs: rural areas bear the brunt

Health insurers must face the facts — and admit their role in increased rural hospital closures.

A ‘game of chicken’ in North Carolina? Doesn’t look like fun to us

A recent article in WUNC North Carolina Public Radio calls a contract dispute between WakeMed and UnitedHealthcare ‘a game of chicken.’ But is this a fair fight?

The latest victim of health insurance roadblocks? HIV prevention.

A recent Axios article highlights the hoops patients have to jump through to access PrEP, the essential HIV prevention medication, in spite of federal rules

Patients over profit: How rural maternity units are barely hanging on

Losing a maternity unit is not just bad for the health of OB-GYN patients, but for the health of the hospital. Can rural hospitals safely deliver babies when reimbursements keep dropping?

Reading between the lines in the latest hospital/health plan split

The separation of a Maine hospital from one of the nation’s biggest health insurers speaks to an overarching pattern: the unending blame game of health insurers.

The good times may be coming to an end for UnitedHealth Group

Yet another lawsuit for this Big Insurer over its subsidiaries’ sketchy Medicaid behavior, this time in laid-back Louisiana

Health plans put the squeeze on Medicare Advantage

For health insurers, the Medicare Advantage (MA) cup is definitely not half empty. In fact, the cups runneth over as insurance companies seem to squeeze as much as they can from the… Read More

Pretty pandemic pennies for BCBSNC

The pandemic’s been kind to BlueCross BlueShield of North Carolina (BCBCNS), according to 2021 financial reports. Revenue? Up. Profits? Up. Executive bonuses? Well, up, of course, to the tune of an extra… Read More

Certain telehealth coverage is ending for NC Medicaid patients – are private insurance plans next?

The increased use of telehealth is one of the few good things to come from the pandemic. Telehealth has enabled thousands of patients across the country to access their doctor from the… Read More

A slap on the wrist for Blue Cross Blue Shield of Georgia, Inc.

Imagine the scandal of your local hospital getting charged $5 million for failing to treat patients in emergencies or your supermarket being fined $5 million for failing to report a salmonella outbreak… Read More

Partnerships mean survival for small hospitals

There’s a narrative going around – one that’s repeated mostly by big health insurers and the politicians in their pockets. The story is small hospitals are being swallowed up by big hospitals. And… Read More

Why does UnitedHealthcare seem to have such trouble covering mental healthcare?

On the heels of a traumatic, COVID-ridden three years, overdoses have spiked, and substance abuse disorders are rising. And despite being federally required to cover mental healthcare at the same level as… Read More

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