Anthem's announced $54.2 billion takeover of Cigna Corp. last week is the latest and largest sign of health insurers' lust for scale. But at the heart of the merger momentum is their desire to expand their government business, particularly in the lucrative Medicare Advantage market.
One large health system in North Carolina is ready to launch a Medicare Advantage plan, and two others are mulling the pros and cons of entering the insurance business.
One large health system in North Carolina is ready to launch a Medicare Advantage plan, while two others are mulling the pros and cons of becoming a payer. The state is a microcosm of health system discussions across the nation.
Healthcare fraud is a seemingly overwhelming problem. Large healthcare companies perpetrate systematic schemes, while corrupt practitioners and common criminals steal funds through hoaxes involving phony clinics, phantom patients and billing for services and medical equipment never provided.
The CMS has fined New West Health Services, a Medicare Advantage plan, for the second time this year after the Helena, Mont.-based not-for-profit failed to correct previously cited Medicare violations.
An insurer's transformation: Humana's evolution into Medicare powerhouse offers strong lure to Aetna
An acquisition by Aetna would bring an end to the half-century of radical company makeovers by Humana and create an insurance giant in the fast-growing market for government-subsidized health plans.
Insurer Humana is no stranger to transformation since its founding in 1961. But the company's proposed deal to be acquired by rival Aetna is more likely driven by powerful market forces rather than by the need for another makeover.
Aetna's proposed $37 billion offer for Humana is about building strength and scale in the government insurance business, but some investors are nervous about whether the parties can deliver on expectations.
Aetna has signed a nearly $35 billion deal to buy rival Humana, which would dramatically expand its Medicare Advantage business.
Paul Kusserow, president and CEO of Amedisys, discusses the company's management shake-up, its expansion strategy and its moves toward risk contracting.
The federal government has expanded its investigation into DaVita HealthCare Partners' Medicare Advantage risk-adjustment practices, DaVita revealed in a Securities and Exchange Commission filing Wednesday.
UnitedHealth Group saw an upsurge in its government business as it topped Modern Healthcare's list of the largest publicly traded health insurance companies in 2014. Nearly all of insurers on the list enjoyed an increase in total revenue in 2014 compared with the previous year.