Tag Archives: merger

Experts outline framework to address health care consolidations

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Photo: Norman Mosjos via Flickr

The wave of mergers and acquisitions in health care in the age of reform hasn’t stopped – and three top-notch health policy experts in a recent guest post in Forbes explain why we should worry about that.

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Judge cites anti-competitive concerns in blocking Anthem-Cigna merger

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

By AgnosticPreachersKid (Own work) (CC BY-SA 3.0 or GFDL), via Wikimedia Commons

By AgnosticPreachersKid (Own work) (CC BY-SA 3.0 or GFDL), via Wikimedia Commons

U.S. District Judge Amy Berman Jackson has blocked the merger of Anthem and Cigna, the second court ruling this year against megamergers in the health insurance industry.

On Thursday, Anthem said it would appeal the Feb. 8 ruling promptly and request an expedited hearing. Cigna said it would review the decision and evaluate its options. Anthem has a financial incentive to appeal given that under the terms of the merger proposal, Anthem agreed to pay Cigna $1.85 billion if the deal fell apart. Continue reading

Federal judge sides with DOJ, blocking Aetna-Humana merger

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Medicare Advantage 2016 Spotlight: Enrollment Market Update, by Gretchen Jacobson, Giselle Casillas, Anthony Damico, Tricia Neuman and Marsha Gold for the Kaiser Family Foundation, May 11, 2016.

Medicare Advantage 2016 Spotlight: Enrollment Market Update, by Gretchen Jacobson, Giselle Casillas, Anthony Damico, Tricia Neuman and Marsha Gold for the Kaiser Family Foundation, May 11, 2016.

U.S. District Judge John D. Bates on Monday sided with the Department of Justice to block the merger of Aetna and Humana. The ruling is being called a victory for members of Medicare Advantage (MA) plans, since Aetna and Humana — two of the nation’s largest health insurers would, as a combined company, have owned the biggest share of the Medicare Advantage market, The Wall Street Journal reported.

For journalists covering health insurance in their cities and states, there’s a story on how the merger would have affected competition in states where the two companies compete. Continue reading

Aetna has questions to answer regarding offer to buy Humana

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Any health insurance company that seeks to buy another insurer will have some tough questions to answer. So, after Aetna made a formal offer to buy Humana on Thursday and Centene offered to buy Health Net on Wednesday, one of those questions has to be: Will consumers benefit?

As Bruce Japsen noted in Forbes, Aetna and Humana said in a statement:

“The combined entity will help drive better value and higher-quality health care by reducing administrative costs, leveraging best-in-breed practices from the two companies – including Humana’s chronic-care capabilities that measurably improve health outcomes for larger populations – and enabling the company to better compete with more cost effective products.”

Statements like these will form the basis of the companies’ arguments before the federal Department of Justice, which has already said it will scrutinize any mergers or acquisitions involving health insurers. Continue reading

Study: Little evidence that integrating hospital, physician care improves quality or reduces costs

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Photo" PINKÉ via Flickr

Photo: PINKÉ via Flickr

When health system executives tout the benefits of acquiring hospitals or physician groups, they often say the combined entity will benefit consumers and insurers by improving health care quality and reducing costs.

A case in point is a plan from Partners HealthCare in Boston to acquire Harbor Medical Associates, a 70-physician practice south of Boston. The goal of the acquisition is to improve patient care, coordinate care to boost patient outcomes and cut costs, reported The Boston Globe’s Priyanka Dayal McCluskey. Partners is the highest-cost health system in the state, she wrote.

In a post about the proposal in his blog, Not Running a Hospital, Paul Levy wrote that the acquisition would cause Harbor Medical doctors to steer patients to Partners’ hospitals. “So not only would local MD visits become more expensive: Follow-up secondary and tertiary care would also,” Levy wrote.

We know, of course, that acquisitions in health care are about making money, as Dan Goldberg wrote in this tip sheet and Joanne Kenen reiterated earlier this week.

Now, in a new report, researchers for the National Academy of Social Insurance, show there is little evidence that organizing hospital and physician care into integrated delivery networks (IDNs) has promoted quality or reduced costs. “Indeed, there is growing evidence that hospital-physician integration has raised physician costs, hospital prices and per capita medical care spending,” the report said. Continue reading