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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

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

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

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

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.

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

Another coverage “error” for BlueCross BlueShield

Health insurance is a tricky business. In most lines of work, you can’t just say one thing and then do another. But as it turns out, if you’re a big enough insurance… Read More

UnitedHealth Group wants to talk healthcare “realities.” We’re game.

If healthcare were real estate, UnitedHealth Group owns the whole block. They just don’t want you to know that. According to a March 17th article in the Minnesota newspaper The Star Tribune,… Read More

When we break out the Monopoly board, health insurers come to mind

Big Health Insurer continues to speed around the Monopoly board – passing GO, speeding past Park Place, and disengaging the brakes towards their intended win. We covered the continued rise of concentrated… Read More

Insurers claim hospitals are in it for the money – is it projection, or deflection?

Health insurance companies would like you to believe that hospitals – despite being filled with folks dedicated to saving lives – are not on the side of patients. They’d like you to believe that… 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

What’s the strategy behind Cigna’s investment plays?

Welcome to the Players Club…of insurers, that is, and the alliances and partnerships are only getting more complex. Per a recent article in Axios, Cigna has invested $750 million into Bright Health,… 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

Are pharmacy benefit managers a prudent service – or a profit scheme?

Pharmacy business managers (PBMs) control the cost of prescriptions for patients. This might sound like a good thing – theoretically, by monitoring prescription costs, PBMs are supposed to increase access to necessary… Read More

Did insurers get a “thumb on the scale” in the No Surprises Act?

Surprise bills, be gone! Spooky season may be over, but the holiday season is here, and we still hope there’s some magic left in the air to rid patients of surprise bills… Read More

Optum strikes its biggest hospital deal yet – but is it for the greater good?

We’ve said it before: Optum is getting bigger. A subsidiary of UnitedHealthcare, Optum has inked its largest health system deal yet, Healthcare Dive reports. After another successful quarter (if you’re a shareholder,… Read More

Do health insurance monopolies cause poor health?

Big Appliance. Big Oil. Big Dairy. Big Pharma. Annnnnd Big Health Insurer. Not that we needed more evidence to prove the big business of health insurance, but a recent article in Modern… Read More

Breaking news for the DHHS…but not for us

Finally, at (very) long last, the Department of Health and Human Services (DHHS) is putting the many pieces of Medicare fraud together. An exclusive report in the Wall Street Journal explains that… 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

Here’s what we know about the latest reconciliation bill drama

Change is a-coming, as it normally does during a new legislative year. This year, Congress is mid-debate on Biden’s bipartisan infrastructure bill and Democrats’ $3.5 trillion reconciliation bill, which includes Medicare reform.… Read More

Who is responsible for preparing states for healthcare “storms”?

Storm preparation is a major priority for many cities across the nation, and rightly so. But where’s the preparation for healthcare “storms,” like COVID-19? Mississippi has what’s believed to be the weakest… Read More

Insurers keep going into overtime…and overtime…and overtime

When a football game goes into overtime, it’s exciting, competitive, and generally applauded. But when enforcement of health insurer transparency goes into overtime, it’s frustrating, exhausting, and costly. Per a recent Fierce… Read More

The DOJ is AHA’s newest pen pal. Their mutual concern? United.

You can always count on the American Hospital Association (AHA) to address red flags from insurers, namely, UnitedHealthcare. Thumbs. Up. AHA’s latest effort involves a letter addressed to the Department of Justice… Read More

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