Payer Issues

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

Hillcrest HealthCare System, BCBS reach multiyear contract

Tulsa, Okla.-based Hillcrest HealthCare System and Blue Cross and Blue Shield of Oklahoma negotiated a multiyear agreement allowing BCBSOK members to access Hillcrest facilities and providers at in-network prices, The Claremore Daily Progress reports. By Morgan Haefner - 3/14/18
Former BCBS of Minnesota CEO failed to disclose $20k consulting payments to board

Recently departed Blue Cross and Blue Shield of Minnesota CEO Michael Guyette didn't make the BCBSM board of directors aware of roughly $20,000 he earned in consulting income during his tenure with the payer, the Star Tribune reports. By Morgan Haefner - 3/14/18
AHIP CEO Marilyn Tavenner to retire after 3 years with trade group

Marilyn Tavenner will retire as CEO of America's Health Insurance Plans, the biggest trade group for health insurers, June 1. By Morgan Haefner - 3/14/18
Shareholders approve CVS Health's $69B acquisition of Aetna

CVS Health and Aetna shareholders have overwhelmingly approved the drug store chain's proposed acquisition of the insurer, according to CNBC. By Ayla Ellison - 3/13/18

UnitedHealth, Cigna, Humana, others see stocks fall on report of insurers gaming Medicare

UnitedHealth Group, Cigna, Humana and other health insurance stocks dipped March 12 following a Wall Street Journal report stating the insurers boosted Medicare payments by gaming the Medicare Advantage plan rating system, Insider Louisville reports. By Morgan Haefner - 3/13/18
UnitedHealth taps former GlaxoSmithKline CEO to lead Optum: 4 things to know

UnitedHealth Group selected Sir Andrew Witty, former CEO of GlaxoSmithKline, as CEO of Optum, effective July 1. By Morgan Haefner - 3/13/18
Some Anthem patients afraid to use ED under new policy: 6 things to know

Ohio residents with Anthem insurance told The Plain Dealer they fear Anthem's discretionary emergency department policy will negatively affect them. By Morgan Haefner - 3/12/18
13 payer-provider contract disputes, resolutions in 2018 so far

Becker's Hospital Review reported these 13 contract resolutions and dissolutions between payers and providers since Jan. 1, beginning with the most recent. By Morgan Haefner - 3/12/18

How health insurers game Medicare Advantage ratings to boost bonus payments

Humana, UnitedHealth, Aetna, Anthem and other insurance companies that provide Medicare Advantage plans use a tactic known as "crosswalking" to collect additional revenue from the federal government, according to an analysis of federal data by The Wall Street Journal. By Ayla Ellison - 3/12/18
Cigna's stock price tumbles on news of deal with Express Scripts

Cigna's stock price dropped March 8 after the company announced a $67 billion deal to acquire pharmacy benefits manager Express Scripts. By Ayla Ellison - 3/9/18
8 quotes from Alex Azar's speech on the transition to value-based care

HHS Secretary Alex Azar discussed the nation's transition to a value-based care system in a speech to America's Health Insurance Plans in Washington, D.C., March 8. By Julie Spitzer - 3/8/18
2 senators call on HHS Secretary Alex Azar to probe Anthem's ED rules

Two Democratic senators penned a letter to HHS Secretary Alex Azar and Labor Secretary Alexander Acosta requesting they review whether Anthem's emergency department policy violates law. By Morgan Haefner - 3/8/18
Cigna to buy Express Scripts for $67B: 5 things to know

Cigna signed a definitive agreement to acquire Express Scripts for $67 billion in cash and stock, including assumption of $15 billion in Express Scripts debt. By Morgan Haefner - 3/8/18
UnitedHealth takes aim at costly ED visits with new policy: 5 things to know

UnitedHealth Group's insurance arm, UnitedHealthcare, changed its emergency department reimbursement policy for commercial and Medicare Advantage plans. By Morgan Haefner - 3/7/18
Piedmont, BCBS negotiations stall ahead of March 31 deadline

Atlanta-based Piedmont Healthcare still lacks a new contract with Anthem Blue Cross Blue Shield of Georgia, the Newnan Times-Herald reports. By Morgan Haefner - 3/7/18
Aetna gives $200k toward protest against gun violence

Aetna will support March For Our Lives, a rally against gun violence and mass shootings, with a $200,000 donation, the insurer's CEO Mark Bertolini wrote in a LinkedIn post. By Morgan Haefner - 3/7/18
Blue Shield of California requires network hospitals participate in HIEs

Later this year, Blue Shield of California will mandate network providers participate in Manifest MedEx, the state's nonprofit health information network. By Julie Spitzer - 3/7/18

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