Industry Control

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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