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A closer look at Optum, United’s fastest growing business

We talk a lot about Optum in terms of its place in the UnitedHealth Group family tree, and how it fuels its parent company United’s growth. But a recent piece in Fierce… Read More

The feds take a closer look at mental healthcare coverage

To set the stage, let’s look at how things were before the pandemic. A recent report by the Government Accountability Office (GAO) paints a picture of a behavioral health system that was… Read More

A surprise bill from United (that we could have seen coming)

Insurers like to lay the blame for surprise medical bills on providers. Sometimes, they’re even brazen enough to blame their own members, claiming that they have failed to scrutinize their insurance coverage… 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

What happens when insurers take the doctor out of the equation?

In a recent article, Modern Healthcare shared some of the repercussions of a growing trend: health insurance companies taking patients’ pharmaceutical care from doctors. It’s clear that insurers can reap massive financial… Read More

There’s big money in those PBMs

The stats on the expansion of IngenioRx, Anthem’s pharmacy benefit manager (PBM), are hot off the presses—and the numbers are big. To help put them in context, here’s a quick primer on… 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

Evernorth’s high-rise portfolio gains another story

On April 20, Healthcare Dive updated a story we’ve been following about the acquisition of telehealth company MDLive by Evernorth, the recently re-branded primary health services umbrella group of Cigna. The Dive story… 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

United’s power play

As UnitedHealthcare continues to make bold moves—acquiring here, consolidating there—it’s managing to become the biggest health insurance entity in the known universe. As we’ve reported on several times, its health services subsidiary,… 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

Death by 1,000 prior authorizations

Providers hoping to treat their patients with radiation therapy may want to add some extra hours to their billing departments’ budgets. (And while they’re at it, they might consider prescribing them some… Read More

The battle of the blacklisted anesthesiologists

The New York Times recently devoted more than 1,000 words to the legal dispute between UnitedHealthcare and the private-equity-backed, physician-owned practice U.S. Anesthesia Partners (USAP). It’s an illuminating read—here are the highlights.… Read More

Humana’s operations expand—and so does its rap sheet

In the past few weeks, we’ve seen a glimpse of what Humana might look like as it grows in size and becomes a bigger employer. And, to be honest, we’re a little… Read More

Mississippi to Centene: I want my millions back too!

When the Mississippi Department of Medicaid contracted with Centene Corp. subsidiary Magnolia Health to manage care for the nearly half a million lower-income adults and children in its Medicaid system (MississippiCAN), state… Read More

United’s pending purchase of Change Healthcare goes under the DOJ’s microscope

You may have read our earlier coverage of UnitedHealthcare subsidiary Optum’s intended purchase of Change Healthcare, the enormous administrative network that processes claims and medication requests for physicians and pharmacies. Recently, the… Read More

“Information wants to be free”

So, here’s a clever way to bolster an insurance company’s annual profit report: Charge physicians to access claims payment data. Sound crazy? Well, that’s what UnitedHealthcare was doing, until recently, through its… Read More

Antitrustworthy: Michigan Blues customers see red

There seem to be a lot of antitrust issues with health insurers at the moment. Today’s tale involves a suit against Michigan Blues (the umbrella name for Blue Cross/Blue Shield and Blue… Read More

Humana finds a new name, runs familiar playbook

The health insurance behemoth Humana is about to embark on a rebranding initiative that will unite its primary care, pharmacy, and in-home care services under the name CenterWell. Its first two rebranded… Read More

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