Tenet, UnitedHealth ink agreement, Optima Health gets top CMS rating & more — 11 payer highlights
The following health insurers made headlines this week. They are listed below, beginning with the most recent.
1. Humana, FullWell enter value-based agreement in Colorado
Louisville, Ky.-based Humana and Centennial, Colo.-based FullWell — an organization offering population health management resources — inked a value-based agreement financially rewarding physicians for quality care.
2. The Ohio State University Wexner Medical Center joins Anthem BCBS network
Columbus-based The Ohio State University Wexner Medical Center will provide in-network care to all Indianapolis-based Anthem Blue Cross and Blue Shield Medicare Advantage members in Ohio.
3. BCBS of Massachusetts to receive $40M in risk adjustment payments
Boston-based Blue Cross Blue Shield of Massachusetts will get an additional $40 million from competing insurers under the ACA's risk adjustment program for 2015.
4. Maine co-op's risk corridor lawsuit gets green light
A federal judge ruled Dec. 2 nonprofit health plan Community Health Options can proceed with its lawsuit against the federal government over payments it claims it is owed under the ACA's risk corridors program.
5. Aetna lawyer: DOJ's antitrust arguments in Humana case address 'a pretend world'
The U.S. Department of Justice began its antitrust challenge to Aetna's proposed $37 billion takeover of Humana Dec. 5, arguing the deal would limit competition between the insurers' Medicare Advantage and ACA public exchange plans.
6. Judge declines federal request to freeze payer's risk corridor lawsuit
A U.S. Court of Federal Claims judge declined the Justice Department's request to stay Portland, Ore.-based Moda Health Plan's lawsuit that seeks more than $208 million in risk corridor payments under the ACA.
7. Cigna introduces plan selection service One Guide
Bloomfield, Conn.-based Cigna launched a service to help policyholders reduce their health expenses through reward programs as well as choose benefits and a team of physicians.
8. Tenet, Centene reach 3-year agreement
Tenet Healthcare in Dallas and Centene reached a three-year agreement to continue providing Centene policyholders access to Tenet facilities at reduced, in-network rates.
9. BCBS, Texas Health Resources reach impasse in contract negotiations
Blue Cross Blue Shield of Texas will drop Arlington-based Texas Health Resources from its network Jan. 1, unless the two organizations reach a new contract by the end of the year.
10. UnitedHealthcare, Tenet reach in-network access agreement
Dallas-based Tenet Healthcare and UnitedHealthcare reached a four-year agreement, which provides UnitedHealthcare members with in-network access to Tenet's facilities throughout the country.
11. Optima Health receives top CMS rating in Va. for marketplace health plans
Optima Health, a Virginia Beach, Va.-based payer with 450,000 members, received a 4-star quality rating from CMS for its OptimaFit individual and family health plans. The rating is the highest score achieved by a health plan in the state of Virginia on the CMS 5-Star Quality Rating System.
More articles on payer issues:
How ACA repeal could affect mental healthcare
UnitedHealthcare eyes up to 11% rate hike for small group plans in Arizona
Humana, FullWell enter value-based agreement in Colorado
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