Elevance Health, Inc. (formerly known as Anthem) reported strong first quarter 2024 profits of $2.2 billion, a 12.9% increase from the prior year quarter, beating both analysts’ and Elevance’s internal expectations. First quarter revenues also increased to $42.6 billion compared to $42.2 billion in the prior year quarter. Elevance also reported that BlueCard membership grew …
UnitedHealth Group (“United”) reported strong revenues of $99.8 billion for the first quarter of 2024, growing nearly $8 billion from the prior year quarter. United’s strong revenues beat analysts’ expectations and caused its stock price to soar by more than 5%. UnitedHealthcare’s revenues were $75.4 billion in the first quarter, an increase of nearly …
In an article entitled “Hospitals’ Medicare Advantage problem hits an inflection point,” Becker’s Healthcare reports on hospitals’ increasing problems with collecting payments from Medicare Advantage plans, to the extent that many hospitals are planning or considering terminating their Medicare Advantage contracts. Chip Kahn, President and CEO of the Federation of American Hospitals, was quoted in …
In a front-page investigative report headlined “Patients Hit with Big Bills While Insurers Reap Fees,” the New York Times shows how health insurers use MultiPlan to reduce payments to medical providers, which increases the fees employers pay the insurers and MultiPlan, but which frequently results in higher medical bills for patients. Here’s how it works: …
On March 19, 2024, New York-based Mount Sinai Health System and UnitedHealthcare announced that they had resolved their disputes and reached agreement on a four-year contract for Mount Sinai’s hospitals and physicians to be in-network with the health insurer. In a statement, Mount Sinai CEO Brendan Carr stated: We are pleased to have reached an …
Health care providers nationwide have been impacted with substantial disruptions to the health care services they provide following a February 2024 data breach by Change Healthcare (https://www.changehealthcare.com/), a technology-based subsidiary of United HealthCare. Change serves as an intermediary between health insurance companies, providers and patients, and claims on its website to be “a trusted partner …
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The Federation of American Hospitals (“FAH”) proposal that CMS add a quality measure to its Medicare Advantage star rating system that would require these plans to report their level 1 prior authorization denial rates has been recommended for approval by an expert panel. The “Level 1 Upheld Denial Rate” proposal is intended to add transparency …
Beating analysts’ expectations, the Cigna Group reported strong profits of $1 billion and revenues of $51.1 billion for the fourth quarter of 2023. Fourth quarter revenues were up 12% from $45.8 billion in the prior year quarter. Growth was particularly strong at Cigna Healthcare. Cigna also reported full year 2023 profits of $5.2 billion and …
Elevance Health, Inc. (formerly known as Anthem) reported strong fourth quarter 2023 profits of $856 million and strong fourth quarter revenues of $2.6 billion in revenue, beating analysts’ expectations. Its revenues were up nearly 7% from the prior year quarter. As a result of these strong earnings, Elevance raised its quarterly dividend by 10.1% to …
The Centers for Medicare & Medicaid Services has finalized its Interoperability and Prior Authorization Rule, which applies, inter alia, to Medicare Advantage plans. Beginning in 2026, Medicare Advantage and other plans subject to the Final Rule will be required to respond to prior authorization requests within 72 hours for expedited (urgent) requests and seven calendar …
CMS FINALIZES INTEROPERABILITY AND PRIOR AUTHORIZATION RULE Read More »