Every few months a health insurance news story breaks that’s so big it is likely to require reporters unfamiliar with the beat to get up to speed quickly on how insurance works. A recent case in point came in February when a former medical director for Aetna admitted in a pre-trial deposition that he never looked at a patient’s medical record when approving or denying care. Continue reading
For decades, those who pay for health care have urged providers to move patients out of hospitals into lower cost settings such as home care and doctors’ offices.
That trend is accelerating today as seen in recent mergers involving insurers, pharmacies and providers. Continue reading
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
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
It’s no secret that health care prices nationwide vary widely from one market to the next, and even within individual markets. A panel on hospital mergers during AHCJ’s Health Journalism 2016 conference in Cleveland will examine the many factors driving these variations in hospital prices. We’ll also discuss how consumers can shop more effectively for the lowest-priced care.
The session, “Merger mania of health providers and the rise of dominant and potential monopolies,” will be 4:40-6 p.m. on Saturday, April 9. Continue reading