A slow motion train wreck is underway on the ACA insurance exchanges, but it is a crash that can be avoided if insurers, providers and regulators take decisive action.
WellCare executives are getting “formal M&A training” this month and will eventually scour the marketplace for promising Medicaid and Medicare Advantage plans. The insurer has been storing surplus cash and now has $1.25 billion of “dry powder” to spend on transactions.
As the CMS seeks to simplify the application process for exchange plans and Medicaid, payers want to make it harder for individuals to sign up after open enrollment ends. Meanwhile, advocates and providers want to reduce barriers and have the CMS learn more about who is signing up, including their...
HHS says that 12.7 million people signed up for 2016 coverage through the insurance exchanges, well within previously stated expectations. Now the Obama administration must ensure that the risk pool evens out so that premiums will stabilize and insurers will remain interested in selling the plans.
A new report shows that major health insurers are moving away from the Affordable Care Act's reformed insurance market to the days of favoring healthier customers. That could bolster Democratic presidential candidate Bernie Sanders' argument to abolish private insurance.
Aetna has joined other major health insurers in sounding a warning about the ACA's public insurance exchanges. The nation's third-largest insurer said Monday that it has been struggling with customers who sign up for coverage outside the ACA's annual enrollment window and then use a lot of care.
Most insurers have embraced the ACA, and it has helped many of them financially through the tacit encouragement of products such as high-deductible plans. But many still puzzle over how to pivot beyond what was long the core of their business: employer-based plans and holding down medical claims.
America's Health Insurance Plans, the primary lobbyist for the health insurance industry, is funding a “seven-figure” ad campaign that targets Medicare Advantage and aims to put pressure on the Obama administration to stabilize funding for the private version of Medicare.
Health systems and other provider organizations represent a majority of the new participants in the Medicare Advantage program, according to a new Avalere Health study. The paper serves as another talking point for a certain large insurer under the government's antitrust lens right now.
Former CMS chief Marilyn Tavenner discusses her move to head up America's Health Insurance Plans and the challenges faced by the group's members, which have struggled in the fledgling insurance marketplaces created under the ACA.
Last year ended as frenzied as it began for healthcare dealmakers. Globally, merger and acquisition activity reached record volume in 2015, and the value of global healthcare deals increased 66% last year to $723.7 billion, according to Dealogic.
The CMS has banned Cigna from offering new Medicare Advantage plans after finding issues with the way the insurer handled appeals, grievances and its drug formulary. Investors don't believe the sanctions would affect the insurer's pending deal with Anthem.