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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

The AHA flags new UnitedHealthCare policies for federal scrutiny

Two new seemingly unrelated policies being rolled out by UnitedHealthcare—one on labs and the other on specialty drug distribution—have been flagged by the American Hospital Association (AHA) as problematic for the same… Read More

Update on United’s acquisition of Change Healthcare: Shareholders and providers expressing concern

In early January, we shared our point of view on UnitedHealthcare’s planned acquisition of the data company, Change Healthcare. To no one’s surprise (at least not ours), there is some controversy surrounding… Read More

Optum sets its sights on Massachusetts’ largest independent physician group

When we look at the trend toward vertical integration in the insurance industry (i.e., insurance giants gobbling up pharmacy benefits managers, data and analytics companies, specialty pharmacies, digital patient monitoring platforms, provider… Read More

Blues plan switches to a United-owned PBM

Blue Cross Blue Shield of Michigan and Blue Care Network recently announced they are switching from Express Scripts (owned by Cigna) to OptumRx (owned by UnitedHealth Group) with the intention of reducing… Read More

Aetna just cut Walgreens from its Medicaid plan in Illinois

Ever since the CVS/Aetna deal closed in late 2018, we’ve been tracking how the merger of a major insurer with a pharmacy and healthcare services giant will impact the choices individuals with… 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

United buys itself a $13 billion holiday present

Looks like UnitedHealthcare might have been saving up all those profits to buy itself an extravagant New Year’s gift. In early January, United’s subsidiary Optum announced that it will purchase the technology… Read More

Unanimous Supreme Court decision is a blow to PBMs and the insurers that own them

In 2015, Arkansas passed a law prohibiting pharmacy benefits managers (PBMs) from reimbursing pharmacies less than what it cost to acquire a drug. The law was challenged by the PBM lobbying group… Read More

Six health insurance executives to keep an eye on in 2021

The COVID-19 pandemic has forced many industries to pivot. The entertainment industry has taken to Zoom and other virtual formats to continue providing “live” shows. The restaurant industry has shifted to takeout,… Read More

CVS and Aetna tighten their grip on market choice with this new plan

As we eagerly stumble into 2021, let’s take a quick look back to 2019 for a moment: CVS closed on a mega-merger deal with Aetna designed to give Aetna members access to… Read More

Non-profit to for-profit? NJ’s largest insurer seeks corporate restructure

New Jersey’s largest health insurance company, Horizon, says that a corporate restructuring will allow it to better invest in technology, build partnerships, and cut costs of care. Patient advocates say it’s an… Read More

Employers give C+ to health plans overall, and even lower grades to United

In summer 2020, nonprofit watchdog The Leapfrog Group surveyed more than 170 employers on their satisfaction with health plans’ responsiveness, transparency, payment reform, and value. When asked to grade their health plan… Read More

The five most important things to know about Cigna’s newly branded health services unit, Evernorth

Recently, we covered an article by HealthcareDive that discussed Optum’s advantage in vertical integration in the health insurance industry. While there is no question that Optum continues to lead the pack, we… Read More

Colorado’s attorney general takes the unusual step of intervening in a proposed United merger

The 2017 acquisition of DaVita Medical Group by UnitedHealthGroup had impacts across the country, but the strongest opposition to the deal came from the Colorado State Attorney General Phil Weiser, who took… Read More

Optum shows other insurers the path to more gold

With all the vertical integration that’s happened across the insurance industry over the past decade, it’s not surprising that Optum sometimes gets lumped in with Aetna/CVS, Cigna/Express Scripts, and a series of… Read More

Cigna buys 23% of the pharmacy benefit market in landmark deal

In early 2018, it was announced that Cigna, one of the top five health insurance companies, had purchased Express Scripts, the last major independent pharmacy benefit manager, for $52 billion. The merger… Read More

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