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Despite millions in settlements, Centene’s doing just fine

In case you’re not up to speed on the drama, managed care organization Centene is no stranger to legal settlements. We call it ‘managed care mischief’ — when a private company is… 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

Centene and the settlement saga

“Centene” and “settlement” are two words that have come up so many times this year, we can’t even count. And it’s not stopping yet. Another million-dollar settlement is on the table for… Read More

Centene and the Managed Care Mischief

Our friends Centene Corporation are back with the next installment of our favorite series: Managed Care Mischief. According to an article in Healthcare Dive, Centene’s settled another set of allegations that it… Read More

Centene is not admitting fault for recent lawsuits…but still paying the price.

Centene might not be one of the Big Five health insurers, but it sure knows how to “follow the leader” when it comes to sneaky business. Oh, and did we forget to… Read More

Mississippi to Centene: I want my millions back too!

When the Mississippi Department of Medicaid contracted with Centene Corp. subsidiary Magnolia Health to manage care for the nearly half a million lower-income adults and children in its Medicaid system (MississippiCAN), state… Read More

Ohio to Centene: I want my millions back!

Well, here we are again. Yet another group is calling in counsel—and calling out insurers—on their shady practices related to pharmacy benefit managers (PBMs). This time, it’s Ohio’s attorney general Dave Yost,… Read More

Centene expands into behavioral health with a $2.2B acquisition, just weeks after dipping further into pharma

On January 4, 2021, Centene announced a definitive agreement to acquire Magellan Health, an insurer with a vast behavioral health network, for $2.2 billion. Centene claims that in light of the pandemic,… Read More

Sugar and spice, not everything’s nice…

It’s the holiday season, a time for peace and goodwill, right? Well, not quite. Because it’s also the season for contract negotiations, err . . . disputes. And it looks like insurers… Read More

Insurance competition keeps weakening

It’s ironic, isn’t it? When hospitals, who are on the verge of closure following a brutal pandemic, decide that partnering with other providers is the only way to keep their doors open,… Read More

Insurers keep winning as the healthcare profit gap widens

That payor-provider gap? It’s becoming an abyss. At this point, it’s clear that the U.S. healthcare system is simply breaking down — with billions of dollars being funneled toward insurance company shareholders,… Read More

We’ve made it another half-year. Guess which health insurer is in the lead (again).

We’ve made it another half-year. Guess which health insurer is in the lead (again). Another earnings season, another unfathomably large profit for our nation’s largest health insurance company (and the rest aren’t… Read More

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

Will insurer investments make behavioral healthcare easier – or harder – to access?

Telebehavioral health has become critical in providing global access to mental and behavioral health services. While telebehavioral health is not new by any means, it’s experienced an explosion of growth since the… Read More

The Three Worst Insurance Trends of 2021

Insurance companies sure found plenty of creative ways to make money in 2021. Some we expected, some were new, and many made it harder for patients to access the healthcare services they… Read More

A royal flush of managed care mischief

Ohio, Mississippi, Arkansas, Illinois – and now, Iowa. By this point, you could probably tell the tale of misused state dollars as well as we can…but here we go again. In 2016,… Read More

Spotted: More growth for Humana?

Word on the street (StreetInsider, to be specific) is that Humana has its eye on a shiny new purchase: Medicaid managed-care organization (MCO), Centene. A recent Fierce Healthcare article gives us the… Read More

Is United the fox guarding OptumRx’s hen house?

Remember how a few months ago we wrote about how pharmacy benefit managers (PBMs) are huge benefactors for profit growth within insurers (ahem, Anthem)? Well, it’s becoming a trend that keeps ascending for… Read More

In-network providers: now you see them, now you don’t

“Come join our health plan—look at this huge list of in-network providers! Scroll through the directory and check out the breadth of our coverage! Just sign here.” Sounds like a good deal,… Read More

Can the new kid on the block make it?

Who is Centene, you may ask? This brazen health insurer shot up seemingly out of nowhere (well, Wisconsin) to become a significant player in the market, with annual revenues (and vertical integration… Read More

Megabucks for managed care

A massive arrangement has been reached between Ohio and six insurance companies hired to coordinate Medicaid managed insurance for more than 3 million low-income and/or disabled state citizens. It’s set to go… Read More

It’s 2021: Do you know where your personal data is?

Earlier this year, UnitedHealth Group’s Optum subsidiary bought itself a present: the data analytics firm Change Healthcare, which is a massive administrative network that processes claims and pharmacy requests for physicians and… Read More

Where do health insurance companies’ billions in profits go? A lot of it rises to the top

The article was based on consulting firm BDO’s recently released Health Insurance Executive Insights Report, which covers compensation for executives and senior managers at health insurance companies, including UnitedHealth Group. According to… Read More

Oklahoma moves state Medicaid business to these 4 for-profit insurers

Oklahoma Governor Kevin Stitt announced the state is moving its Medicaid business to 4 for-profit healthcare companies: Blue Cross Blue Shield of Oklahoma, Humana Healthy Horizons, Oklahoma Complete Health (a subsidiary of… Read More

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