Health Plan Business

From Health Plan Week - In its third-quarter 2016 earnings report, Centene Corp. on Oct. 25 outlined how it will integrate Health Net into its operations next year and limit a previously discussed premium deficiency reserve (PDR) of $300 million to fix a series of pre-existing issues for its $6 billion acquisition (HPW 7/13/15, p. 3). A few days later on Oct. 27, Aetna said its third quarter beat Wall Street expectations as Medicaid and Medicare Advantage (MA) enrollment grew by nearly 10% each on a year-over-year basis, with costs in line as well. Read more

From Health Plan Week - Moffitt Cancer Care in Tampa, Fla., and UnitedHealthcare on Oct. 17 said they have launched a three-year pilot program to test a new bundled payment model for early-stage lung cancer. The effort continues the health plan’s move into value-based care and will be a proving ground in the area of lung cancer for both the provider and payer as focused bundles are increasingly seen as a way to circumvent traditional… Read more

Health Plan Business Blog

By Patrick Connole - October 18, 2016
Amid media attention on the concerns of high-deductible health plan (HDHP) members that they pay full freight for their prescriptions while the health plan or employer sponsor (in a self-insured model) receives rebates on these same drugs, consultants in the field explain that the nuances of the...
By Patrick Connole - June 6, 2016
If you were in charge of a U.S. health insurer, what issue would make you lose sleep as you peer ahead to the rest of 2016 and into next year? When a pair of consultants and a noted lawyer were asked that question, they produced a list of challenges for health insurers that amounted to a virtual...
By Patrick Connole - May 31, 2016
When the Missouri insurance regulator came out on May 24 with a preliminary finding declaring its opposition to the pending Aetna Inc. acquisition of Humana Inc., industry watchers and stakeholders immediately took to form and either said (1) this spells doom for the deal’s overall approval, or (2...

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