Every year, ahead of the Medicare Advantage open enrollment period, the Centers for Medicare and Medicaid Services (CMS) publish Medicare Part C and Part D Star Ratings to give Medicare beneficiaries a metric by which to assess plans. Last week, CMS released the 2023 Star Ratings for qualifying MA plans.
Medicare Advantage plans are...
The insurer has a strong presence in Arizona, insuring about 400,000 Medicaid and 47,000 MA lives, and also competes under the Ambetter brand on the Health Insurance Marketplace.
According to reporting from the Phoenix Business Journal, Centene's notice to terminate its Medicaid contract with Tenet Healthcare's Abrazo Health...Arizona News
The lawsuit filed August 5 features an Arizona plaintiff and alleges the insurer has used a "churn-based strategy" that leveraged its role as a Medicaid insurer to boost enrollment in its Marketplace plans, which were allegedly in violation of network adequacy regulations, supplied beneficiaries with inaccurate provider directories, and...National News
This week in Medicare Advantage news, the home-based care industry is gearing up to assert itself amid concerns that home care services are being inadequately compensated. A new bill modeled on existing Texas law tries to limit the harms caused by prior authorization in Medicare Advantage plans. Also, Centene is concerned about its star...
Arizona's Medicare Advantage market continues to grow in Arizona with 48% penetration. UnitedHealthcare dominates enrollment in the state with its AARP branded offerings including the only 5-star plans in Arizona. Humana and Centene were the only two insurers to knock UnitedHealthcare off its No. 1 spot in a handful of Arizona...
There were a couple of legal challenges announced this week for hospitals and health systems on the concern of paying. Hospitals accused of overcharging for procedures is a common theme in two cases while Louisiana accused UnitedHealth Group of inflating drug prices to its Medicaid program via Optum Rx by billions.
The Colorado State...
On Tuesday, Centene Corporation announced its financial results for the first quarter of 2022, which ended on March 31. The company showed strong growth out of the COVID-19 pandemic and expects to maintain momentum throughout the year, but faces investigation for its participation in state Medicaid programs, including the California...National News
The longtime leader of Centene, Neidorff died Thursday, April 7, 2022 surrounded by family and friends, he was 79 years old. London, former vice chairman of Centene was appointed CEO on March 22, 2022.
Neidorff joined Centene, now the largest Medicaid managed care company in America, as CEO in 1996 and led the company from a $40...Arizona News
Centene has received federal and state regulator approval for its acquisition of Phoenix-based Magellan, which will bring 5.5 million new members in government-sponsored plans to the deal while operating independently under Centene's corporate umbrella as the insurer extends its market reach in specialty healthcare and pharmacy...National News
The activist investor, Politan Capital Management, made an agreement with Centene, the country's largest Medicaid insurer, that included a retirement plan for CEO Michael Neidorff. It comes following the insurer's settlement of fraud allegations with Kansas for $27.6M that came on a string of settlements with Mississippi, Illinois,...National News
Centene will retain a minority stake in USMM, a family of companies providing home healthcare. Politan Capital Management is led by activist investor Quentin Koffey; the hedge fund is reportedly seeking to replace several members of Centene's Board of Directors.
With revenues totaling $32.4 billion, Centene counts 26 million...
It's just a couple bucks, nonetheless MA plans in 2022 are advertising an average monthly premium of $19, far more than the average MA premium in Arizona at $11.64. But, it all adds up, last year 26.9 million were enrolled in MA nationally; Arizona's MA market enrollment stands at about 636,000, as of Sept. 1, 2021.
National MA...
Spending per beneficiary is growing faster in Medicare Advantage (MA) and private plans than traditional Medicare and Part D prescription drug plans, according to the MedPAC analysis.
Modern Healthcare reports that the spending disparity has experts concerned, considering that Medicare Advantage enrollment is surging, currently...
The special enrollment period for individual health care plans offered through the Affordable Care Act has been a boon for major health insurers participating in the Marketplace. But many insurers are concerned that extending the SEP could cause unintended issues for insurers and enrollees alike. Also, the Brookings Institute says that...
This week Humana signed a definitive agreement to acquire One Homecare Solutions (“onehome”) from WayPoint Capital Partners (a private equity affiliate of a family investment office). This acquisition will continue Humana’s strategy to create a value-based home health offering. One Homecare Solution's offers a variety of home-based...Arizona News
As the Affordable Care Act’s Special Enrollment Period (SEP) rolls along, the Biden Administration is continuing its mission to expand ACA plan access and affordability.
Last week, CMS announced a number of 2022 ACA Marketplace Plan changes, according to its press release, “to protect and build on the Affordable Care Act,...National News
Centene reported underwhelming Q1 numbers and Molina picks up Cigna's Medicaid share of the Texas market. Also, questions about what happened with the Berkshire Hathaway-Amazon insurance venture, Haven? And how will social determinants of health impact commercial health insurance?
Centene
Insurance giant Centene's first quarter profits...Top of The Day
This week, a study shows Medicaid enrollment trends during the COVID-19 pandemic, a neighboring state removes Planned Parenthood as a Medicaid provider and a Medicaid managed care insurer is accused of overcharging the state of Ohio.
A new study published by Kaiser Family Foundation looked at Medicaid spending and enrollment during...News
As a light emerges at the other end of the pandemic and the stock market surges, insurers and other healthcare companies are looking to a bright future and engaging in a frenzy of capitalistic activity.
According to Home Health Care News, Optum—a part of UnitedHealth—this week reportedly purchased Landmark Health, an in-home...Arizona News
During a time when millions are losing employer-sponsored health insurance, shoppers in Arizona and across the nation may have more plans to choose during the 2020 Open Enrollment Period (OEP) on the Federal Health Insurance Marketplace that begins November 1 and continues through December 15.
This week Cigna and Centene announced...
