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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.
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
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