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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.
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
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
North Carolina hospitals save lives—but who’s going to save theirs?
North Carolina is known for many things: gorgeous mountains, delicious barbecue, and college basketball. But in December, North Carolina was recognized for something not-as-exciting: The state came in third on the list… Read More
Did a recent ruling in the Lone Star State embolden BCBSNC’s abuse of the No Surprises Act?
What’s that old phrase? “The road to hell is paved with good intentions”? As it turns out, the No Surprises Act is living proof that, no matter how much the federal government… Read More
Fiery words from Northside Hospital: Anthem decision defies ‘logic and sensitivity’
Ooh, those are fightin’ words! Northside Hospital held nothing back in a recent statement on its efforts to stay in-network with Anthem Blue Cross Blue Shield. The hospital has been battling with… Read More
UnitedHealthcare officially walks back controversial ER policy
What’s that saying? When you find yourself in a hole, quit digging? Looks like UnitedHealthcare (United) finally caught wise that attempting to implement stricter criteria for emergency services was ditch-digging at its finest. In… 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
Our Un-covered hero of the month: Insurance fighter Jackie Fox
If there was a good egg in the Un-covered world, it would be law professor Jackie Fox, who takes on patients’ insurance battles for fun – and wins. Kaiser Health News’ podcast… Read More
UnitedHealthcare’s tactics aren’t so bright in the Sunshine State
It’s time to roll out the insurer red carpet – straight to court! According to an article in the Orlando Sentinel, UnitedHealthcare (United) recently shelled out more than $4.7 million to UF… 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
Centene and the settlement saga
“Centene” and “settlement” are two words that have come up so many times this year, we can’t even count. And it’s not stopping yet. Another million-dollar settlement is on the table for… Read More
More insurers caught underpaying COVID-19 claims – here’s looking at you, Anthem
A few weeks ago, we shared that after providers – namely, pediatricians – complained that the insurer was paying them substantially below market rate to administer COVID-19 vaccines, UnitedHealthcare agreed to reprocess its COVID-19… 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
Humana pats itself on the back in new report
“Home health” has been a buzzword for years, even more so during the pandemic. It’s also been an investment focus for many health insurers – most notably, Humana. But two recent stories… Read More
The (first) jury is in, and UnitedHealthcare takes the hit
The jury has deliberated; the gavel has landed, and an insurance company is forced to face the repercussions of its actions. According to a recent article in Modern Healthcare, Tennessee-based emergency physician company… Read More
Insurers start to feel the contract-cutting heat
In our opinion, hospitals usually bear more than their fair share of blame when insurers make cuts to their health plan networks. To be fair, not every hospital is always in the… 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
Anthem and BlueCross BlueShield: A “whoopsies,” of sorts
In general, making a “whoopsie” is not terribly sinister. We can forgive the occasional mess-up. But for big insurers, when there’s a processing error, it’s a big deal. Case in point: Remember… Read More
UnitedHealthcare reconsiders pandemic underpayments
When it comes to underpaying for COVID-19 care, you almost can’t blame UnitedHealthcare for trying. Well, actually, we can. After providers, largely pediatricians, complained that United was paying them substantially below market… Read More
A royal flush of managed care mischief
Ohio, Mississippi, Arkansas, Illinois – and now, Iowa. By this point, you could probably tell the tale of misused state dollars as well as we can…but here we go again. In 2016,… 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