Late last year the Cigna-Humana merger fell through after the two sides couldn't agree on a price and a hostile antitrust regulatory environment and industry opposition to consolidation ended the deal, but with Humana stock down 32% and Cigna's up 36% the math now works for a possible deal.
In December 2023 the two companies announced...
On Monday, the Centers for Medicare and Medicaid Services (CMS) finalized the Rate Announcement for Medicare Advantage (MA) and Medicare Part D programs for Calendar Year (CY) 2025 which includes a rate increase of 3.7% in addition to finalized Part D rules.
The final rule didn't deviate much from the CMS proposed payment rate issued...
A new study demonstrates that Medicare Advantage members of marginalized identities overwhelmingly report ongoing discrimination in the delivery of health care.
The study, published in the American Journal of Managed Care, was conducted by Humana to test the feasibility of screening for health literacy and perceived discrimination....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...
Last week, Humana published its 10th annual Value-Based Care (VBC) Report for 2023. The report found that Medicare Advantage patients in value-based arrangements were more likely to receive preventive care and were hospitalized less frequently.
The report found that because clinicians are incentivized to provide patients with...
Cigna will no longer pursue a deal to merge with Humana, putting an end to the potential $140 billion health insurance behemoth.
The companies were unable to reach an agreement on price or other terms, the Wall Street Journal reports. WSJ was the first to report last month that the two anticipated reaching a deal by the end of the...
It appears likely that Cigna and Humana, two of the country's largest insurers, are discussing a merger that some report could be finalized by the end of the year.
The first report of the potential deal came from the Wall Street Journal, which reported that the structure and terms of the deal were under wraps, but the deal does...
Humana has filed suit against the Centers for Medicare and Medicaid Services (CMS) for a rule announced earlier this year that would allow the government to recoup overpayments from insurers based on extrapolated audits. Also, Novartis has challenged the Biden administration over the Medicare Drug Price Negotiation rule.
Studies have...
Second quarter, 2023 year-over-year financials were anything but grim for America's top for-profit insurers. Thanks to UnitedHealthcare and Optum, brand giant UnitedHealth Group reported quarterly revenues of $92 billion up 16%. And, as it faces increased MA costs, CVS Health posted revenues of $88.9 billion in the second quarter up...
Get the latest on the national and local Arizona trends in Medicare Advantage - a lucrative and popular product now responsible for privatizing the healthcare needs of half the eligible Medicare beneficiaries in the country. We also included Arizona's PDP market info.
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No Stopping Medicare Advantage
2023...
Humana has revised its outlook, confident that its expected Medicare Advantage enrollment will increase even more than it originally anticipated in 2023. But Centene has reported the opposite, expecting to lose money in Medicare Advantage and from Medicaid redeterminations.
Centene released its first quarter (Q1) corporate reports on...
New research shows 83% of entries in provider directories from America's leading insurers were inaccurate.
Most providers listed in directories from Aetna, Elevance, Cigna, Humana, and UnitedHealth had inaccuracies, but specialty information was much more likely to be accurate. Only 27.9% of physicians had consistently accurate...
This week, some of the insuretech companies that spent the past year struggling are trying to change their fortunes. Oscar Health brings on a seasoned, experienced CEO with a new goal and Bright Health is making some desperate stock moves.
Mark Bertolini, former CEO of Aetna and hedge fund Bridgewater Associates was appointed CEO of...
Health insurance lobbyists and plans have put a ton of work into defending the Medicare Advantage (MA) program from proposed cuts and rule changes by the Centers for Medicare and Medicaid Services (CMS), but this week traditional Medicare gets community support of its own. And one insurer breaks from the pack to support the rule...
Humana is the fifth-largest health insurance company in the nation - the exit follows a strategic and financial review and includes all fully insured, self-funded, and Federal Employee Health Benefit medical plans, as well as associated wellness and rewards programs.
The insurer will continue its focus on Group and Individual...Arizona News
SeniorBridge has a location in Scottsdale that provides home care, care management, private-duty nursing and infusion care for seniors in Arizona.
Humana acquired SeniorBridge in 2012 to expand its scope of elder care services, but as the insurer carries forth a company-wide restructuring to bolster its Medicare Advantage program, it...
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...
As seniors, the Centers for Medicare and Medicaid Services (CMS) and Medicare Advantage (MA) plans gear up for a landmark Medicare Advantage Open Enrollment Period beginning October 15, Medicare Advantage on the whole is in hot water.
Last week, the New York Times published an earthshaking story documenting the extent to which...
The U.S. Department of Justice has lost a case that would have blocked UnitedHealth Group (UHG) from acquiring Change Healthcare, a healthcare technology and data platform, for $13 billion.
Judge Carl Nichols of the U.S. District Court for the District of Columbia issued the opinion on Monday, which ordered Change Healthcare to sell...
Last Thursday, the Kaiser Family Foundation (KFF) published a report demonstrating that Medicare Advantage is poised to represent over half of Medicare beneficiaries as soon as next year. Another report, published simultaneously, showed that over $10 billion has been spent by Medicare on the quality bonus program (QBP) that incentivizes...