Payer Issues

Aetna CEO: 'Warren Buffett said healthcare was a tapeworm on US economy — It's true'

In February, Berkshire Hathaway CEO Warren Buffett called healthcare spending in the U.S. a "tapeworm on the economic system," and Aetna CEO Mark Bertolini agrees, according to CNBC. By Alia Paavola - 3/26/18

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64 surgeons across 7 health systems join BCBS bundled payment pilot

Blue Cross Blue Shield of Michigan will collaborate with 64 surgeons across seven Michigan health systems on a new bundled payment initiative. By Morgan Haefner - 3/23/18
Georgia governor will 'take whatever steps necessary' to quell Piedmont, BCBS dispute

Georgia Republican Gov. Nathan Deal urged the CEOs of Atlanta-based Piedmont Healthcare and Blue Cross Blue Shield of Georgia to reach a new contract before a fast-approaching deadline, the Athens Banner-Herald reports. By Morgan Haefner - 3/22/18

UnitedHealth puts Envision's ED billing policies in its crosshairs: 5 things to know

UnitedHealthcare, the health insurance arm of UnitedHealth Group, created a website targeting Envision Healthcare's emergency department billing policies amid an ongoing payment dispute. By Morgan Haefner - 3/22/18
Meet the 1st UnitedHealthcare Professor of Healthcare Management

UnitedHealthcare, the insurance arm of UnitedHealth Group, endowed $2.5 million to the University of Michigan School of Public Health in Lansing to establish the UnitedHealthcare Professor of Healthcare Management. By Morgan Haefner - 3/21/18
South Carolina health system hits contract snare with Cigna

Spartanburg (S.C.) Regional Healthcare System may go out of network with Cigna April 1 if the parties don't ink a new agreement. By Morgan Haefner - 3/20/18
Cigna CEO: Express Scripts deal about 'capabilities, reach, quality, affordability'

Cigna CEO David Cordani said the insurer's proposed $67 billion takeover of pharmacy benefit manager Express Scripts is more of an expansion of Cigna's portfolio than a routine acquisition, according to CNBC. By Morgan Haefner - 3/20/18

Medicare to cover genomic testing for advanced cancer patients

Medicare-eligible patients with advanced cancers will have access to genomic tests under a national coverage determination CMS finalized March 16. By Jessica Kim Cohen - 3/19/18
Viewpoint: Hospitals don't want an all-payer system

An all-payer system, or a system requiring all hospitals to charge the same prices to each payer, would force hospitals to compete over pricing, Boston University health policy professor Austin Frakt, PhD, told BU Today. By Morgan Haefner - 3/19/18
Fitch: UnitedHealth's Optum a 'favorable' differentiator from other insurers

Fitch Ratings affirmed UnitedHealth Group's "AA-" insurer financial strength ratings due to the payer's strong financial performance, strong capitalization and leverage profile. By Morgan Haefner - 3/19/18
Health Partners Plans appoints EVP of Medicare & operations: 3 points

Health Partners Plans selected Barry Volin to serve as executive vice president of Medicare and operations. By Anuja Vaidya - 3/19/18

92% of physicians say prior authorization negatively impacts patient outcomes: 5 things to know

About 92 percent of physicians report prior authorization has a negative effect on patient clinical outcomes, according to a new survey from the American Medical Association. By Alia Paavola - 3/19/18
ACA insurers saw financial success in 2017 amid repeal efforts: 8 things to know

Many insurers on the ACA's exchanges benefited financially from individual plans last year, even with various Republican efforts to dismantle the health law, according to an analysis from Politico. By Kelly Gooch - 3/19/18
Partners, Care New England deal could raise insurance premiums in Rhode Island, study says

Boston-based Partners HealthCare and Providence, R.I.-based Care New England's proposed merger could raise health insurance premiums in Rhode Island, according to a new study commissioned by Rhode Island and obtained by WPRI. By Alia Paavola - 3/19/18
New Jersey lawmaker requests hearing on proposed Cigna-Express Scripts, CVS-Aetna deals

A New Jersey lawmaker asked the chairman of the House Committee on Energy and Commerce to hold hearings on Cigna's potential takeover of Express Scripts and CVS Health's bid for Aetna. By Morgan Haefner - 3/19/18
Arkansas congressman calls on Sessions to probe CVS Health-Aetna deal

Rep. Rick Crawford, R-Ark., penned a letter to Attorney General Jeff Sessions and the Federal Trade Commission head urging a thorough review of CVS Health's proposed $69 billion takeover of Aetna, WPRI reports. By Morgan Haefner - 3/16/18
Centene's next move? Stake in a national PBM

Centene Corp. invested an undisclosed sum and partnered with RxAdvance, a national pharmacy benefit manager for health plans, ACOs, Medicaid programs and employer groups. By Morgan Haefner - 3/15/18
Humana's board changed performance goals so execs could cash in stock awards

Humana's board of directors adjusted its membership growth goal when it became clear the target wouldn't be met, allowing top executives to cash in stock awards based on performance, WDRB reports, citing a recent proxy statement. By Morgan Haefner - 3/15/18
UnitedHealth ditches bid for Envision's ambulatory services arm: 3 things to know

UnitedHealth Group tossed its attempt to acquire Envision Healthcare Corp.'s ambulatory services unit, a source familiar with the matter told Bloomberg. By Morgan Haefner - 3/15/18
BCBS forms BCBS Institute to partner with Lyft, give members rides to Walgreens, CVS pharmacies

Blue Cross and Blue Shield expanded its partnership with Lyft to give plan enrollees rides to their neighborhood Walgreens and CVS pharmacies, as part of a new company known as the Blue Cross Blue Shield Institute. By Julie Spitzer - 3/15/18

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