UnitedHealth beats the Street with $6B in Q3 profit
Fierce Healthcare
OCTOBER 15, 2024
UnitedHealth Group kicked off another round of earnings calls for major health insurance companies Tuesday morning, when it
Health Insurance Companies Related Topics 
STAT+: The Covid-19 test maker that pivoted to being a health insurance company
STAT
DECEMBER 12, 2022
But that business is now firmly in the past, and the company has switched to an even more regulated industry: health insurance. Curative rose to prominence during the throes of the pandemic, as people and governments across the country used its Covid-19 tests. Last year, Curative had a cloud hanging over its head.
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A Win for Indiana Patients: “Share the Savings” Legislation Now Law
PhRMA
MAY 8, 2023
This new law will ensure that Indiana patients aren’t paying more for their medicines than their health insurance company or the middlemen known as pharmacy benefit managers (PBMs). This week, Governor Holcomb signed into law Senate Bill 8 recently passed by the Indiana legislature.
STAT+: Behind CVS CEO’s ouster, a question: Do a pharmacy and a health insurer make sense together?
STAT
OCTOBER 21, 2024
Does it make sense for a chain of drug stores to own a major health insurance company? That has been the existential question for CVS Health for six years, since its $70 billion acquisition of the massive insurer Aetna. The biggest pharmacy chain in the U.S.
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STAT+: Frustrated with Change Healthcare breach, senators propose removing limits on HIPAA fines
STAT
OCTOBER 23, 2024
Having worked as a medical director for several large health insurance companies and having suffered through the Change fiasco herself as a rehab doctor with a private practice in Kansas City, she figured that if her data had been exposed in that February breach, she would have been notified by now.
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Maia Oncology picks up $4.25M to build out virtual primary care clinic for cancer patients
Fierce Healthcare
DECEMBER 4, 2023
million in seed funding to hone its go-to-market strategy, hire more talent and launch its first pilot in partnership with a cancer center and health insurance company. . | Maia Oncology raised $4.25
STAT+: Medicare Advantage market expected to grow in 2025, despite big changes from insurers
STAT
OCTOBER 4, 2024
Health insurance companies will still offer older adults a lot of plan choices with low, or completely free, premiums. Next year’s Medicare Advantage market will be two things at once: remarkably stable broadly, but rife with changes under the surface.
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STAT+: CVS could break itself up. Why, and what does that mean for you?
STAT
OCTOBER 2, 2024
It worked maybe a little too well for CVS, as the surge in new customers backfired when the medical costs for those sporty seniors spiraled well beyond the company’s expectations. Now, after the Woonsocket, R.I.-based
STAT+: How UnitedHealth harnesses its physician empire to squeeze profits out of patients
STAT
JULY 25, 2024
UnitedHealth Group started out as a small, Minnesota health insurance company and has since morphed into a modern-day Standard Oil, exerting unmatched dominance over health care in the United States.
STAT+: New Medicare Advantage star ratings give extra bonuses to multiple insurers
STAT
JULY 3, 2024
More than two dozen Medicare Advantage insurers received higher quality marks for 2024, based on a STAT review of new data released July 2 by the federal government.
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The stability of $0 premiums in Medicare Advantage
STAT
OCTOBER 2, 2023
Arbitration, the land where nobody is happy After Congress officially outlawed most types of surprise medical bills last year, there’s been endless, litigious debate as to how health insurance companies and providers should settle their differences while patients are held harmless.
STAT+: Medicare Advantage plan’s quality ratings were incorrectly calculated by government, judge rules
STAT
JUNE 4, 2024
The federal government inappropriately lowered the 2024 Medicare Advantage star ratings of SCAN Health Plan, which led to the health insurance company in California losing hundreds of millions of dollars in bonuses from the government, a judge ruled Monday.
Why Congress should prioritize fixing the 340B program
PhRMA
MARCH 2, 2023
These include things like making sure patients aren’t paying more for their medicines than their health insurance company or requiring first-dollar coverage, so insurance companies cover the cost of certain lifesaving medicines from day one of the plan year.
STAT+: CVS Health sees Medicare Advantage patients seek more care, eating into profits
STAT
JANUARY 8, 2024
Medicare Advantage members continue to go to the doctor and get health care procedures a lot more than predicted, CVS Health executives said at the J.P. Morgan Healthcare Conference on Monday.
STAT+: Biden administration to recalculate Medicare Advantage quality ratings and bonuses
STAT
JUNE 14, 2024
The federal government is rescoring the quality ratings of this year’s Medicare Advantage plans, which could lead to an additional $1 billion of taxpayer money flowing into the coffers of health insurance companies.
STAT+: Pharmalittle: We’re reading about an Italian acquisition, Medicare Advantage market growth, and more
STAT
OCTOBER 4, 2024
Italian pharma company Recordati said it will buy from Sanofi the global rights to an approved drug to treat cold agglutinin disease , a rare autoimmune disorder, for $825 million, Reuters reports. The Medicare Advantage market is expected to grow in 2025, despite big changes from insurers , STAT reports.
A letter from the executive editor: STAT’s investigation into a UnitedHealth algorithm
STAT
NOVEMBER 14, 2023
We reveal that the nation’s largest health insurance company pursued a strategy to pressure its medical staff to cut off payments for seriously ill patients in lockstep with a computer algorithm’s calculations, denying rehabilitation care for older and disabled Americans as profits soared.
Justice Department sues Cigna for allegedly exaggerating conditions of Medicare Advantage members
STAT
OCTOBER 17, 2022
The Department of Justice filed a new lawsuit against Cigna Monday, alleging the health insurance company overcharged the federal government by purposefully inflating how sick its Medicare Advantage members were. Read the rest…
Have you had difficulty getting access to medications for opioid addiction?
STAT
MARCH 21, 2023
People and organizations that sometimes make it difficult to access medication can include doctors, methadone clinics, health insurance companies, recovery groups, law enforcement agencies, jails, prisons, drug courts, and labor unions. Read the rest…
STAT+: Elevance buys IU Health’s insurance company
STAT
SEPTEMBER 10, 2024
Financial terms of the deal weren’t disclosed, and IU Health declined to answer questions from STAT. Earlier this year, Baystate Health in Massachusetts sold its health insurance company , Health New England, to Point32Health, the insurer formerly known as Harvard Pilgrim Health Care.
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STAT+: UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care
STAT
NOVEMBER 14, 2023
The nation’s largest health insurance company pressured its medical staff to cut off payments for seriously ill patients in lockstep with a computer algorithm’s calculations, denying rehabilitation care for older and disabled Americans as profits soared, a STAT investigation has found.
STAT+: Which hospital systems will join Kaiser’s Risant next?
STAT
JUNE 3, 2024
Geisinger’s 10 hospitals and 1,700 employed physicians are now officially part of the group, known as Risant Health. Kaiser, which is both a health insurance company and a network of providers, said it wants to add at least five to six more health systems by 2028.
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STAT+: Oscar Health’s CEO on post-hype health insurance and finally turning a profit
STAT
JANUARY 13, 2023
Oscar Health has excelled at one thing in particular since its inception a decade ago: burning cash. The health insurance company did not plan to be profitable immediately. It was staking its future on the new Affordable Care Act marketplaces and had to grow quickly to compete with larger insurance carriers.
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STAT+: Heated lawsuit between AdventHealth, MultiPlan attracts hospital lobbyists
STAT
JANUARY 10, 2024
A lawsuit between a large hospital system and a dominant vendor that works for health insurance companies is getting a lot more heated — with one party calling the other an “economic parasite.”
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Judge invalidates parts of the ACA that mandate health coverage of many preventive services and drugs
STAT
SEPTEMBER 7, 2022
A federal judge in Texas has ruled that parts of the Affordable Care Act mandating health insurance companies cover many preventive services and drugs for free are unconstitutional.
STAT+: U.S. Anesthesia Partners, Welsh Carson face class action over monopoly allegations
STAT
NOVEMBER 22, 2023
The lawsuit builds on the Federal Trade Commission’s complaint filed in September, which argued USAP and Welsh Carson illegally bought up anesthesia practices across Texas as a way to concentrate market power, gain negotiating leverage over health insurance companies, and raise prices.
STAT+: More hospital and outpatient visits expected to persist through fall and winter
STAT
OCTOBER 2, 2023
Health care providers and health insurance companies are closing the books on their third quarters, and one major question continues to hang over them: How much care is everyone actually getting, now that Covid-19 isn’t scaring so many away from doctors and hospitals?
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STAT+: Biden administration ignores calls to bolster hospital price transparency
STAT
JULY 10, 2024
Since 2021, hospitals have been required to post the prices they have negotiated with all health insurance companies, as well as their cash prices. Those two groups have excoriated hospitals’ high prices and profits and lobbied aggressively to ensure hospitals are held accountable for publishing pricing information.
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STAT+: ‘Everybody has blood on their hands’: A decade-long battle over Medicare Advantage audits is coming to a head
STAT
JANUARY 30, 2023
The federal government and health insurance companies have been clashing for more than a decade over how Medicare Advantage plans should be audited and how the well-documented overpayments to those plans should be clawed back.
STAT+: Bright Health looks to get out of health insurance entirely
STAT
APRIL 28, 2023
Bright Health Group started as a health insurance company. Bright is looking to sell off the Medicare Advantage plans it manages in California, the company said Friday. But it will no longer be one.
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STAT+: Biden administration goes easy on Medicare Advantage insurers after intense industry lobbying
STAT
MARCH 31, 2023
WASHINGTON — The Biden administration backed off some of its plans to rein in billions of dollars from wasteful spending in Medicare Advantage next year, after intense lobbying from health insurance companies.
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Michigan, Vermont Blues plans finalize merger after securing key regulatory approval
Fierce Healthcare
OCTOBER 12, 2023
The partnership will allow the Green Mountain State insurer to gain access to better technology and other innovations without losing its appeal as a local health insurance company, according to plan officials.
STAT+: What to know about this year’s Medicare open enrollment period
STAT
OCTOBER 15, 2023
7, allowing eligible older adults and people with disabilities to sign up for traditional Medicare coverage or Medicare Advantage, the alternative option that is run by health insurance companies. Medicare’s annual enrollment period kicked off Sunday and runs through Dec.
Opinion: True peer-to-peer conversations will improve prior authorization
STAT
APRIL 26, 2024
Patients are waiting, but I’d be unwise to put off the caller: a physician calling from a health insurance company. This peer-to-peer call is part of the prior authorization process; my “peer” needs information to determine whether the company will cover a procedure I requested for one of my patients.
STAT+: Devoted Health’s losses in Medicare Advantage persist
STAT
FEBRUARY 5, 2024
Health insurance companies take a while to reach profitability because they need to enroll a lot of people, which then allows them to spread medical costs across a bigger pool. And Devoted isn’t sharing many details about its progress, either.
STAT+: Blue Cross Blue Shield plans in California evaded $170 million in taxes, whistleblower says
STAT
JULY 17, 2023
Two dominant Blue Cross Blue Shield companies in California intentionally underreported premiums of certain health plans so they could avoid paying Affordable Care Act taxes, according to new federal whistleblower complaints.
STAT+: Fiery MedPAC meeting highlights massive overpayments in Medicare Advantage
STAT
JANUARY 12, 2024
The Medicare Payment Advisory Commission, a group that advises Congress on Medicare policy, gathered to discuss its pending March report on the state of Medicare Advantage, the alternative to traditional Medicare that is run by health insurance companies.
STAT+: Government looks to tinker with new caps on Medicare Advantage broker payments
STAT
NOVEMBER 6, 2023
The federal government is proposing to rein in health insurance companies that entice brokers with lavish bonuses to sell their Medicare Advantage plans by placing a firmer cap on broker compensation.
Opinion: Even with lawsuits and copay caps, will insulin ever be affordable?
STAT
JANUARY 20, 2023
It’s a complex tangle of drug manufacturers who’ve been resisting generics , health insurance companies trying to keep up impressive profits , plus the wholesalers who distribute medicines to pharmacies and the pharmacies that provide them to patients.
STAT+: Health insurance stocks tumble after UnitedHealth says Medicare enrollees are getting more care
STAT
JUNE 14, 2023
UnitedHealth is one of the country’s largest health insurance companies, and also owns a major chain of ambulatory surgery centers. A vast majority of the care has come from Medicare enrollees who are getting hip and knee replacements and heart procedures in outpatient clinics, he said.
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STAT+: Option Care takes over Amedisys in ‘perplexing’ $3.6 billion home care deal
STAT
MAY 4, 2023
Option Care Health is buying Amedisys in an all-stock merger valued at $3.6 billion, creating a national company that specializes in almost all types of home care that can be provided from cradle to grave.
STAT+: Buyer’s remorse: How a Medicare Advantage business is strangling one of its first funders
STAT
MARCH 13, 2023
Health insurance companies hire NaviHealth to mine medical data and predict the post-acute care a patient will need. A STAT investigation found Medicare Advantage insurers are routinely using that unregulated technology to deny care, unbeknownst to patients and regardless of whether they need the treatment.
STAT+: New lawsuit highlights another wrinkle for settling disputes over surprise medical bills
STAT
OCTOBER 2, 2023
After Congress officially outlawed surprise medical bills last year, there’s been endless, litigious debate as to how health insurance companies and providers should settle their differences over how much to pay for out-of-network medical bills.
STAT+: AdventHealth sues MultiPlan, alleging a ‘cartel’ that underpays out-of-network medical claims
STAT
AUGUST 10, 2023
AdventHealth, a large religious-affiliated hospital system, has sued MultiPlan, alleging the company has worked with health insurers to create a “cartel” that systematically underpays hospitals and doctors for care that is delivered out of an insurance company’s network.
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