Skip to Content

Massachusetts governor acts to protect virtual care coverage

In October of 2020, we covered a story about health insurers rolling back coverage for telehealth services, right as demand was skyrocketing due to COVID-19. During the pandemic, virtual visits have been… Read More

Aetna just cut Walgreens from its Medicaid plan in Illinois

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

Centene expands into behavioral health with a $2.2B acquisition, just weeks after dipping further into pharma

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

UnitedHealthcare just cut thousands of emergency room docs from their 2021 network

We rang in 2021 with yet another big move by UnitedHealthcare: its decision to cut Envision Healthcare from its network after the two companies were unable to come to an agreement regarding… Read More

CMS is pushing payors to improve prior authorizations processes

It looks like prior authorizations—or more specifically, the myriad challenges providers face around prior authorizations—are becoming an Un-covered theme. If you’ve been following our feed, you’ll recall that we recently shared our… Read More

United buys itself a $13 billion holiday present

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

Hospital claim denials are on the rise, especially those related to prior authorization issues

According to RevCycle Intelligence, a new survey of 200 hospitals conducted by the American Hospital Association (AHA)—and supplemented by interviews and group discussions with several hundred additional hospital and health system executives—found… Read More

United kicks off 2021 by cutting a critical NYC safety-net health system from its network as COVID-19 cases reach record highs

Here’s a trend we saw in 2020 and will likely continue to see in 2021: UnitedHealthcare forcing providers to choose between accepting dramatic pay cuts or being cut out of United’s network.… Read More

UnitedHealthcare hikes cost for municipal employer by almost 10 percent amid a year of record-breaking pay cuts and job losses

Like most employers, the City of Philadelphia, MS, will be seeing the cost of health insurance for its employers increase next year. What’s unique about this story, however, is how clearly it… Read More

Consumers seeking comprehensive coverage should watch out for this predatory United health plan 

When Sam Bloechl was buying a comprehensive health plan, one he believed would cover him for a life-threatening illness; he did not know he was sick. A subsequent cancer diagnosis led doctors… Read More

Insurers in Massachusetts sued for hawking misleading plans

We recently covered how UnitedHealthcare’s short-term health plan Golden Rule was able to shirk responsibility for covering a man’s cancer treatment. Now, Massachusetts Attorney General Maura Healey is suing three health insurance… Read More

Unanimous Supreme Court decision is a blow to PBMs and the insurers that own them

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

Six health insurance executives to keep an eye on in 2021

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

Survey indicates COVID-19 pandemic adding to insurance cost burdens

A new survey from The Commonwealth Fund (reported on in Healthcare Dive) brings more bad news from the ongoing COVID-19 pandemic. The survey confirms what we already knew—that insurance premiums and deductibles… Read More

CVS and Aetna tighten their grip on market choice with this new plan

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

The five most important things to know about hospital financial losses amid the COVID-19 pandemic

Earlier this month, we covered a Becker’s Hospital Review article about the more than 30 hospitals forced to file for bankruptcy this year and described the factors that could put hospitals in… Read More

This is how much revenue United projects for 2021. Spoiler: it’s a lot

It’s been well documented that insurers have profited from a drop in care utilization during the pandemic, while providers experienced a sharp drop in revenue with many elective procedures being postponed or… Read More

Public opposition to new lab coding policy pushes UnitedHealthcare to hit pause

Back in November, we covered a Health Leaders story about a new lab coding requirement UnitedHealthcare planned to implement in early 2021, smack in the middle of cold and flu season and… Read More

Here’s what members and employers need to get more from the health insurance industry

Health insurance has always been a highly valued employee benefit, and now in the midst of the COVID-19 pandemic, it is even more true. Access to healthcare, including access to health insurance… Read More

UnitedHealthcare squeezes Gaston County’s only hospital during worst pandemic months

Residents of Gaston County with UnitedHealthcare insurance are expected to face higher costs at Gaston County’s only hospital, CaroMont Regional Medical Center. This is due to UnitedHealthcare terminating their CaroMont Health contract.… Read More

Non-profit to for-profit? NJ’s largest insurer seeks corporate restructure

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

Over 30 hospitals have been forced to file for bankruptcy this year

2020: the year COVID-19 flipped the world upside down. COVID-19 continues to have a disproportionately detrimental impact on the healthcare industry, as pre-COVID-19 many hospitals were already struggling. Even before the global… Read More

New research shows just how hard it is for consumers to understand their insurance options

It’s open enrollment season again, which means that employees across the country are assessing the insurance options offered by their employers and trying to understand which plan will offer the most value… Read More

Employers give C+ to health plans overall, and even lower grades to United

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

Un-covered on Twitter

Subscribe to Un-covered Essentials

Insurer policies limit coverage and disrupt patient care, while producing record profits for corporate shareholders. Stay informed with the Un-covered newsletter.