Suzanne York

Kaiser Family Foundation Health News (“KFF”) has published a news perspective entitled “Denials of Health Insurance Claims are Rising – and Getting Weirder” that shows a sharp increase in denials of health insurance claims. A recent KFF study of Affordable Care Act (“ACA”) plans found that health insurance companies denied an average of 17% of […]

An American Hospital Association post highlighted findings from a Crowe Research report (“the Report”) showing that one in three inpatient claims submitted by providers to commercial insurers was not paid for over three months and that 15% of inpatient and outpatient claims were initially denied.  The AHA post also highlighted the Report’s findings that: claims

Last month after a tragic mass shooting in Dadeville, Alabama, 15 of the gunshot victims were brought by ambulance and private vehicle to Lake Martin Community Hospital in Dadeville for treatment.  Last week, Ivy Creek recognized those first responders with a special lunch.  Without the outstanding work of Lake Martin Community Hospital and the other

In a strongly worded letter sent to UnitedHealth Group’s CEO on May 8, 2023, 175 state and specialty medical associations and physicians’ groups have opposed United’s new policy requiring prior authorization for most GI endoscopic procedures, including colonoscopies, and urged United not to implement the policy as scheduled on June 1, 2023. The letter states

Beating analysts’ expectations, the Cigna Group reported strong profits of $1.3 billion and revenues of $46.5 billion for the first quarter of 2023. Cigna revenues were stronger than analysts expected in all market segments, but were particularly strong in its health insurance business, Cigna Healthcare.  Cigna Healthcare’s first quarter revenues of $12.7 billion were up

CVS Health Corporation reported strong first quarter 2023 profits of $2.1 billion. It also reported strong first quarter revenues of $85.3 billion, up 11% from the prior year quarter. Both CVS’s first quarter profits and revenues beat analysts’ expectations. Revenues were also sharply up at CVS’s health care benefits segment, which includes Aetna.   CVS reported

The health insurers who have reported first quarter 2023 earnings – Elevance Health (Anthem), Humana, UnitedHealth Group, and Centene – have reported strong revenues and profits. These profits have been fueled, in part, by low medical costs, including lower payments to providers than anticipated.  One of the ways that health insurers reduce their healthcare costs

Centene Corporation has reported strong first quarter 2023 profits, with profits of $1.1 billion, up from $849 million from the prior year quarter. Centene also reported strong revenue growth, with revenues of 38.9 billion in the first quarter of 2023, up from $37.2 billion in the prior year quarter. Centene’s membership was also sharply up. 

Humana, Inc. has reported strong first quarter 2023 profits of $1.24 billion, up from $930 million in the prior year quarter, a 33.1% increase. Humana also reported strong revenues of $26.7 billion for the first quarter, an increase of 12% from the first quarter of 2022.  Humana’s first quarter profits equate to $9.38 a share,

Elevance Health, Inc. (formerly known as Anthem) reported strong first quarter 2023 profits with double-digit growth in profits, operating revenue, and adjusted earnings per share.  Elevance reported profits of $2 billion, an increase of 11% over the prior year quarter’s profits. Elevance’s first quarter operating revenues were also sharply up, growing 10.5% over the prior