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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

All aboard the insurer investment train to end-stage renal disease

We’re hearing a bit more than crickets from Cigna. According to a Modern Healthcare article, Cigna and Blue Shield of California participated in a $83.5M funding round for Cricket Health, a software… Read More

UnitedHealthcare is hitting pre-pandemic profit records…yippee.

It’s common knowledge at this point – insurers made a killing last year due to the pandemic. Limited care led to fewer medical claims, which led to more dollars in insurers’ pockets.… Read More

The “insurer” will see you now

UnitedHealthcare’s profits seem to correlate with how much control they have over the industry, and according to a July 16 article in Axios, it’s more than we previously thought.

The double-team PBM scheme from Anthem and Humana

What happens when two top insurers team up together to take over the PBM world? A July 26 article in Insider Intelligence has us wondering.

Is BCBS stealthily stifling competition?

Remember when we covered the $2.67 billion class action suit against several Blue Cross Blue Shield (BCBS) plans in Michigan and the claims accusing them of price-fixing to squelch competition? We noted… Read More

Humana’s latest home care acquisition

Health insurer Humana is on an acquisition roll, bringing yet another home health care provider into its fold. They just snarfed up One Homecare Solutions, which goes by Onehome, for an undisclosed… Read More

Humana invades the home health business

In April, we covered Humana branding its health services arm to bring together its primary care, pharmacy, and in-home care services under the name CenterWell. While we pontificated on Humana’s dramatic growth, it… Read More

Is a year’s worth of pent-up medical care about to hit?

As the COVID-19 pandemic upended our lives over the past year, many people delayed aspects of their medical care and postponed elective procedures. But now that the country is starting to open… Read More

Forget telehealth. We’ve got an app for that.

Cigna’s latest offering for its 14 million members is a behavioral health coaching, therapy, and psychiatry services app called Ginger. This new product is reflective of a steadily increasing demand for behavioral… Read More

Is Anthem heading for an Epic fail?

Anthem (big health insurance company) is going to team up with Epic (large data analytics and health tech company) to leverage Epic’s massive medical records database for its internal purposes. Through this… Read More

There’s big money in those PBMs

The stats on the expansion of IngenioRx, Anthem’s pharmacy benefit manager (PBM), are hot off the presses—and the numbers are big. To help put them in context, here’s a quick primer on… Read More

Artificial intelligence in healthcare: Does it lower costs for patients or lower the costs of patients?

Healthcare Dive recently broke the news that med-tech startup K Health is partnering with two major players—health insurer Anthem and investment management giant Blackstone Growth—to launch a joint venture called Hydrogen Health.… Read More

Evernorth’s high-rise portfolio gains another story

On April 20, Healthcare Dive updated a story we’ve been following about the acquisition of telehealth company MDLive by Evernorth, the recently re-branded primary health services umbrella group of Cigna. The Dive story… Read More

United’s power play

As UnitedHealthcare continues to make bold moves—acquiring here, consolidating there—it’s managing to become the biggest health insurance entity in the known universe. As we’ve reported on several times, its health services subsidiary,… Read More

Humana finds a new name, runs familiar playbook

The health insurance behemoth Humana is about to embark on a rebranding initiative that will unite its primary care, pharmacy, and in-home care services under the name CenterWell. Its first two rebranded… Read More

Super-sized Cigna

The telehealth company MDLive, one of the biggest telehealth platforms in the country, will be acquired by Evernorth, Cigna’s recently rebranded health services unit. The deal is expected to close in Q2… Read More

In every way, Optum is getting bigger. And bigger, and bigger

We’ve said it before: One man’s pandemic is another man’s windfall. Especially when that “man” is UnitedHealth Group, which appears to be taking the profits it’s piled up during the COVID-19 pandemic… Read More

The slide toward regional health insurance monopolies picks up speed

With its 2020 “Competition in Health Insurance” study, the American Medical Association (AMA) set out to identify markets where the M&A of health insurance companies could cause competitive harm to consumers and… Read More

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