Aetna, Blue Cross Blue Shield of Arizona, Centene, Cigna, and UnitedHealthcare dominate Arizona’s commercial health insurance market, covering hundreds of thousands of residents across individual and employer-based plans, according to new data from AHIP (America’s Health Insurance Plans).
Overall, more than 3.2 million Arizonans...National News
It has been a tough year for insurers in the Medicare Advantage market. After years of threatening to exit the market if profits plateaued, companies like Humana, CVS Health and UnitedHealthcare are planning to recoup losses by cutting benefits and leaving lower-yield markets.
Humana and CVS moved to scale back their Medicare...Arizona News
Banner|Aetna, a joint venture health plan and one of the leaders in innovative, value-based care in Arizona, has announced John Byrnes as Chief Operating Officer. As COO, Byrnes will manage daily operations and lead the company’s strategic efforts to provide quality, accessible, and integrated care.
The joint venture launched in...National News
More insurance companies have posted their first quarter results this week, and the outcomes from Cigna and CVS Health show that Medicare Advantage is not turning out to be the winning ticket to infinite growth that some companies thought it would be.
CVS Health's stock tanked on Wednesday last week after it released its earnings...CMS Rules
Medicare Advantage insurers are struggling to maintain strong projections of growth following the news of very meager reimbursement rate reductions.
The Centers for Medicare and Medicaid Services (CMS) anticipates that the 0.16% reduction in the MA benchmark rate in 2025 will come as an effect of modifications to the diagnostic coding...Arizona News
Pharmacists and pharmacy techs at pharmacy chains including CVS, Walgreens and Rite Aid have expressed their dissatisfaction with workplace environments, corporate expectations and understaffing. Recently, some pharmacy employees have gone so far as to stage walkouts, with walkouts planned for CVS and Walgreens this week in a...Arizona News
Citing an increasingly common complaint of problematic claim denials, Arizona's revered pediatric health system terminated its agreement with Aetna as of August 7, 2023. As the two parties continue to negotiate, all Phoenix Children’s providers, including Phoenix Children’s Hospital, Phoenix Children’s Medical Group, Phoenix...Arizona News
Last Thursday, Arizona Attorney General Kris Mayes announced that the national opioid settlement will net Arizona over $380 million. In total, $18.75 billion is owed to state and local governments from drug manufacturers Allergan and Teva, as well as retail pharmacies CVS, Walgreens and Walmart.
More than $50 billion has been...National News
As the COVID-19 public health emergency winds down, insurers of Medicaid managed care plans are bracing to lose membership.
Centene is expecting it will lose 2.2 million Medicaid members during the redetermination process over the next year. According to Modern Healthcare, the company had 16 million Medicaid members at the end of...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,...Arizona News
VillageMD is expanding its primary care presence in partnership with Walgreens throughout Texas and has announced expansion of its Arizona venture in partnership with the Hatfield Medical Group of Arizona. Amazon has reportedly approached several potential insurance partners to expand its coverage of services.
VillageMD is continuing...National News
A myriad of fiscal and monetary stimulus has come out of Washington in recent months with the government and the Federal Reserve working jointly to provide financial aid and inject liquidity into industries struck by an unprecedented supply and demand shock. The government has provided $175 billion in relief funds to hospitals and other...National News
Last year, Walmart launched its first Walmart Health Center in Dallas, Georgia; offering a slew of healthcare services, such as primary care, dental and vision for a fraction of the out-of-pocket uninsured rate at a doctor's office.
The retail giant had its sights set on becoming "America's Neighborhood Health Destination,"...National News
CVS has revealed RxZERO, calling it a new solution to help employers and health plan sponsors offer diabetes medication at no out-of-pocket cost without increasing premiums or deductibles for all plan members.
The new plan design will be offered through CVS’s pharmacy benefit manager, CVS Caremark.
According to the...Arizona News
Healthcare stocks took quite the beating last week and continue to decline into the third week of April. Even insurance giant United Healthcare cannot escape the downturn as it stays on track for its worst month in a decade. Analysts are already pointing the finger at 'Medicare for All,' claiming the political pressure is not good for...National News
Health insurers are tasked with the job of sending the government detailed cost forecasts for the following year to provide prescription drug benefits to millions of Medicare beneficiaries across the country. A Wall Street Journal investigation uncovered that the same insurers reeled in $9.1 billion thanks to discrepancies between...National News
The ink is barely dry on its $69 billion merger with Aetna and now CVS drops the news on its new Guaranteed Net Cost pricing model designed to simplify the financial arrangements underlying PBM contracts. CVS said it can deliver savings through PBM cost management strategies such as formulary, utilization management and performance...Arizona News
Last week the Department of Justice gave CVS and Aetna approval for their $69 billion merger on the condition that Aetna sells off its Medicare Part D prescription drug business. Insurers cozying up with the pharmaceutical industry is a growing trend, think: OptumRx and UnitedHealth, or the recent Cigna-Express Scripts...National News
Uncertainty surrounds potential mega-healthcare mergers as the CVS-Aetna deal and Cigna's acquisition of Express Scripts are in question. Just last year, the Justice Department thwarted the Cigna-Anthem and Aetna-Humana mergers.
The California Insurance Commissioner is adamant that the CVS-Aetna $69 billion merger proposal be blocked...National News
Currently 8 percent of dialysis in done in-home. CVS wants to change that.
HealthLeaders Media quotes Jack Curran, a senior analyst with IBISWorld.
The dialysis market right now is very concentrated. If any company is going to be able to move into this industry and succeed it is going to have to be a large company with a lot of...
