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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.
Evidence
All the proof that payors are putting wealth over health.
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
Put up your dukes. Insurers are coming out swinging.
Contract negotiations are nothing new – hospitals and insurance companies renegotiate their rates for services regularly. But the trend of the last few years is upped aggression from payors, where networks are… 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
Another way insurance regulation benefits health insurers — not patients
We’ve written many times about how profitable Medicare Advantage plans have been for insurance companies. In part, it seems because they are excellent at taking regulations intended to benefit consumers and managing… 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
Rural hospitals are necessary. So why do they keep closing?
Rural hospitals are literal lifelines for the communities they serve. And yet, they keep closing across the country. A new report from the American Hospital Association (AHA) is sounding the alarm, as… 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
Need medical care? Better prove it.
We all (unfortunately) know that getting your care covered by insurance is anything but simple. And for families with children with autism spectrum disorder, insurers like Trustmark Health Benefits make the process… Read More
Hey North Carolina, where’s the outrage on insurance increases?
Only in the insurance industry can a business secure a $500 million-dollar profit and demand that consumers pay more. According to a September 1 article published in North Carolina News, Blue Cross… Read More
The real reason for North Carolina’s mental health crisis
When health insurers stand in the way of preventive mental healthcare, the results can be dire. Though they are supposed to cover mental healthcare on par with physical healthcare services, the reality… Read More
No kidding: Americans dissatisfied with health insurance plans
Well, well, well . . . if it isn’t the pot calling the kettle black. A new poll revealed that most American consumers are dissatisfied with their health insurance plans. You don’t… 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
How insurance companies police doctors through arcane policies
Insurers never miss a chance to make getting healthcare harder, do they? A new report from Modern Healthcare claims both Horizon Blue Cross Blue Shield of New Jersey and Cigna are planning… 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
Rural or otherwise, running a hospital is no walk in the park
Running a hospital is serious business. Sure, we can talk theoretically all day about payors, providers, and the pandemonium that is healthcare . . . but the reality of the situation is… 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
Another prior authorization delays patient care and ends in tragedy
OK, we admit it. We’re (fairly) snarky when it comes to health insurance companies. But there’s no room for snark when it comes to a recent Medscape article, which follows the journey… Read More
TeamHealth and UnitedHealthcare get in the ring . . . again
Does a Nevada lawsuit with UnitedHealthcare (United) sounds familiar? Well, since TeamHealth filed ten lawsuits against UnitedHealth Group last December, alleging underpayment for TeamHealth physicians – it might! In the first case,… 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