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You get a bill, you pay it. Right? Not these two top health insurers…

A pair of insurers have yet to pay their bills, and we aren’t talking chump change. Provider representatives say the insurers are billions of dollars behind on payments owed to hospitals and… 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

Is this mic on? We’ve been looking for some clarity on record-breaking profits for insurers

We interrupt our regular programming to take you back to Connecticut, where insurance scrutiny remains high. Which, if we’re being honest, is our regular programming. Just last week, we covered the Connecticut… Read More

(Some) states push back on rate increases—finally!

It’s that time of year. No, not just for pumpkin spice lattes, but for health insurers to petition state Departments of Insurance for the next year’s rate increases. Everybody, brace yourselves. Each… Read More

Two trips to space, or roughly $11B. That’s how much insurers profited in Q2 this year

Drum roll, please. It’s earning season once again and, sure enough, five of America’s largest health insurers cleaned up in Q2. We’re not just talking “cleaned up”—we’re talking bleached, waxed, and wiped… 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.

Up, up, and away: Anthem’s expectations for membership growth soar

Despite an already impressive growth in membership, Anthem is adding more to its expected year-end goals, reports a July 21 article in Healthcare Dive. Wondering how? Us, too!

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.

Humana’s latest purchase morphs into a sale

We’re feeling a bit buffeted by multiple aftershocks here. Humana’s chess pieces just keep sliding around the board. First, the insurer snapped up full ownership of Kindred at Home, the biggest home… Read More

Payor? Provider? Insurance industry lobbyist gets less clear

When Kentucky Fried Chicken changed its name to KFC there was little doubt in anyone’s mind that they were still serving up classic deep-fried poultry. But according to the company, the rebranding… 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

While its front end dips, the rest of CVS’ business soars

CVS Health’s vertical healthcare model is proving lucrative—and to us, is starting to look dauntingly powerful. As you may know, the company owns an international string of pharmacies, a pharmacy-benefit manager and—the… Read More

A new diagnosis: Munchausen syndrome by payor?

We’ve heard of Munchausen syndrome by proxy, but Anthem’s latest billing snafu has us wondering if a new diagnosis is in order — Munchausen syndrome by payor. A report by the Office… Read More

Where telehealth goes from here

We’ve shared before how we’re anxiously waiting to see how telehealth will be treated in upcoming contract hospital-insurer negotiations. Now, Congress is debating how to expand access to telehealth as the pandemic’s… Read More

Cigna is sitting pretty, not sitting still

It looks like Cigna Corp. has found the health insurance industry’s sweetest of sweet spots. Two of the most lucrative places to be right now, if you’re Big Insurance, are the pharmacy… Read More

Are the Michigan Blues really ready to settle?

We’ve got an update on the antitrust suit against Blue Cross Blue Shield of Michigan—and it’s got a fun twist at the end. We’ve already covered part one of this story, about how… Read More

Oops, Humana did it again

Is it just us, or do health insurers seem to be, um, taking advantage of Medicare Advantage (MA)? This year alone, we’ve seen stories about Cigna and Anthem hitting stop signs on their… Read More

It was a very good year (if you’re a health insurance exec)

In reviewing Health Care Service Corp. (HCSC)’s executive compensation for 2020, Modern Healthcare threw out some pretty big numbers. Its CEOs (there were two, during different parts of 2020) reaped a combined… Read More

United is on the gain: Profits, members, and scrutiny

Spring is in the air, which means that it’s time for Q1 reports. As Insider Intelligence’s eMarketer article details, UnitedHealthcare shows soaring numbers, both in membership, which grew by more than 1… 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

Who’s running the Medicare Advantage show?

Becker’s Hospital Review recently ran down the top for-profit insurers with the largest national share of Medicare Advantage members, based on a report by the Chartis Group, a healthcare management consulting firm.… Read More

Megabucks for managed care

A massive arrangement has been reached between Ohio and six insurance companies hired to coordinate Medicaid managed insurance for more than 3 million low-income and/or disabled state citizens. It’s set to go… Read More

The 2021 financial prognosis for hospitals: Critical condition

If you look at the ledgers of the country’s largest health insurance companies, you could be forgiven for assuming that the COVID-19 pandemic has actually been a boon to the healthcare industry… Read More

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