Subscribe to Un-covered Essentials
Insurer policies limit coverage and disrupt patient care, while producing record profits for corporate shareholders. Stay informed with the Un-covered newsletter.
Industry Control
Payors are taking control across the full continuum, advancing their business interests without providing real value to patients or their communities.
TennCare’s convenient self-congratulations
To get a job done right, it’s often better to take care of it yourself. But that’s not necessarily the case for many states when it comes to health insurance coverage for… Read More
A deep dive into the risks of the UnitedHealth and Change Healthcare merger
What if there was an opportunity to make the biggest health insurance conglomerate in the United States even more powerful by equipping them with boatloads of sensitive health data? Imagine no more.… 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
Is it just us, or are claim denials on the rise?
Over the past year, hospitals across the nation have experienced a rise in denied medical claims from insurance companies. According to a recent article in Modern Healthcare, approximately 67% of healthcare leaders… Read More
Humana goes on a primary care spending spree
It’s been a while since we’ve talked about Humana. But this one is big. According to a September 2022 article in Fierce Healthcare, Humana is pumping $500 million into primary care clinics,… Read More
Break out your umbrella — we’ve got a payer forecast ahead.
Showers are forthcoming. Maybe even thunderstorms, by the look of it. According to a recent article in Becker’s Payer Issues, UnitedHealth Group (UHG) reported third-quarter revenue growth in the double digits across… Read More
More people are covered by health insurance – but health insurance covers less
Here’s the good news: The number of Americans with health insurance is hitting historic highs. And the bad news: The health insurance itself is inadequate. According to recent findings from the Commonwealth… Read More
Can the feds finally make mental health parity a reality? Here’s hoping…
The future of mental health coverage parity remains uncertain, according to a recent article from Axios. But it’s not for lack of trying. For the upcoming legislative session in February, the Senate… Read More
California governor shoots down bill to protect patient access
It’s an unfortunate ending for California patients – a utilization management bill successfully passed the state Assembly and Senate, just to be vetoed by Governor Gavin Newsom. Sponsored by California Assembly member Dr.… Read More
A picture’s worth a thousand words. For health insurers, it’s worth millions.
You know that $100+ premium you pay each month to ensure you have health insurance? Or maybe it’s more like $500+? For the really unlucky, it could even be $1,000+! Turns out,… Read More
With big premium bumps, Northeastern consumers may be facing a frigid financial future
We’re not saying we told you so, but we are saying we saw this coming. Health insurance premiums are up nearly 14%, and consumers across the States are already facing inflated insurance… Read More
Hospital outlooks? ‘Deteriorating.’ Payor predictions? ‘Attractive returns.’
Bad news for nonprofit hospitals (and just after things were maybe looking up!). Ratings agency Fitch Ratings published a new outlook for the nonprofit hospital sector, and it’s anything but encouraging. In… 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
Hospitals may catch a break in insurer negotiations (but we’re not holding our breath)
Dare we say we have . . . good news? Could it be that payers are finally acknowledging how expensive it is to operate a hospital? According to a recent article in… Read More
Insurance contract disputes: when the odds are not in patients’ favor
They say all’s fair in love and war. Well, not when it comes to health insurance contract disputes. At least, such is the case for one local community in California. Adventist Health… Read More
Health insurers don’t want to cover your care—their chronic denials prove it
In 2020, amid a global pandemic, health insurers on the Affordable Care Act marketplaces denied close to one-fifth of all in-network claims, according to a Healthcare Dive article citing Kaiser Family Foundation… Read More
Optum takes its joint ventures to the next (vertical) level
Is there any type of business that health insurance giant UnitedHealth Group won’t try to stick a flag in? Per a July 11 article in Modern Healthcare, UnitedHealth’s massive physician group, Optum,… Read More
Aetna sees the light (finally)
Has a health insurer actually seen the harm their restrictive policies cause for patients? According to a recent article in Fierce Healthcare, Aetna is coming to terms with the fact that last… Read More
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