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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.
Profits
Payors rake in in record profits—when the economy is healthy and when it’s in a recession, during normal times and during this global pandemic. Payors are the only group benefitting from the healthcare system without interruption.
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
Connecticut AG pushes back on health plan premium hikes – again
Summer in New England is quite nice – our Northeastern friends often enjoy somewhat cooler temps than the rest of the country. Unless you’re an insurance plan, in Connecticut. Then you’re (appropriately)… Read More
Will new federal rules bring health insurers’ shady negotiation tactics to light?
It’s finally here – after wrangling substantially more time to prepare than hospitals had, insurers are now required to post their negotiated prices publicly on their websites. According to Fierce Healthcare, the… Read More
Just how profitable have health insurers been in the last few years?
If you’ve been reading Un-covered for a while, you’re probably well aware that health insurers have been extremely profitable in the last few years. Even so, new information continues to demonstrate just… Read More
‘No-fault’? Yeah, right. Centene’s foibles are starting to add up
It’s been a while since we’ve done a good ‘ole update in our series, Managed Care Mischief. But not to worry — we’re back and headed to New Mexico, where Centene, known… Read More
Can you guess which health insurer has a history of tax breaks?
Benjamin Franklin once said, “Nothing is certain except death and taxes.” Well, apparently, not true for Blue Cross Blue Shield (BCBS). According to a new report from STAT News, many BCBS plans… Read More
American Hospital Association begs feds to enforce the law
According to a recent article in Fierce Healthcare, in late May the American Hospital Association (AHA) published a letter to the Department of Justice (DOJ) pleading for an investigation “into commercial payers… 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
It’s time for another contract dispute round-up
Are insurer contract disputes ‘business as usual’? A recent Becker’s Payer Issues article rounds up eight recent disputes between health plans and hospitals — from Maine to Mississippi, Colorado to Georgia, and… Read More
Another slam dunk for UnitedHealthcare
An unfortunate reality in this country is that many Americans struggle to access and pay for healthcare. The reasons are varied, and different stakeholders cast blame differently: Hospital prices. Decreased Medicaid reimbursement.… Read More
Patients over profit: How rural maternity units are barely hanging on
Losing a maternity unit is not just bad for the health of OB-GYN patients, but for the health of the hospital. Can rural hospitals safely deliver babies when reimbursements keep dropping?
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
Pretty pandemic pennies for BCBSNC
The pandemic’s been kind to BlueCross BlueShield of North Carolina (BCBCNS), according to 2021 financial reports. Revenue? Up. Profits? Up. Executive bonuses? Well, up, of course, to the tune of an extra… Read More
For BCBSNC, COVID costs are up – but so are profits
If anyone in healthcare could say they actually benefited from COVID-19, it was health insurance companies. Don’t get us wrong – there were bills for health plans to pay. According to a… 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
Seeing beyond the peak of UnitedHealthcare’s revenues
No mountain is too high when it comes to revenue expectations for UnitedHealthcare. 2020 was good, 2021 was better, and in 2022, we can’t even see the peak yet. Per a recent… 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
More Medicaid trouble in Ohio
Today, we’re talking about “clawbacks.” And yes, they are as scary and painful as they sound. Before we explain what’s going down in the Buckeye State, here’s a refresher on PBMs. These… Read More
The big get bigger, but at whose expense?
It seems like the rollercoaster that never drops. As if you couldn’t guess, yes, we’re talking third-quarter earnings for two of the biggest insurers. Anthem and UnitedHealthcare saw a dramatic increase in… Read More
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