Leading consulting firms and a growing list of niche advisers are competing aggressively to help major insurers use big data to identify high-risk patients and manage their costs.
Enduring influence is the central theme for many of the names atop this year's list, Modern Healthcare's 15th annual ranking. Coming in at No. 2 and No. 3 this year are CEOs of two of the nation's largest healthcare systems. The nation's payers are also well represented at the top.
Industry and regulatory fixes to the ACA marketplaces appear inevitable as impatience and insurer losses escalate.
Aetna and Anthem's multibillion-dollar health insurance mergers may be decided by the end of the year, after all. The federal judge overseeing the U.S. Justice Department's challenges to the deals has sent one case to another judge.
The Department of Justice is pushing for February trial dates for its looming challenges to Aetna and Anthem's massive health insurance merger deals, and the companies' self-imposed deadlines shouldn't speed up the process.
While several health insurers are cutting back on plans sold on public health insurance exchanges next year, Cigna Corp. hopes to rev up its exchange participation.
Less than a week after finding out the U.S. Justice Department would seek to block its acquisition of Cigna Corp., Anthem said Wednesday that its second-quarter profit fell more than 9% year over year and it lowered its earnings projections for the rest of the year.
Anthem threw punches back at the U.S. Department of Justice's attempt to block the insurer's acquisition of Cigna Corp. The response signals Anthem will indeed litigate the case to the end even though many analysts and policy experts say the company is unlikely to win
A superficial reading of the latest headlines about the health insurance industry suggests it is facing serious problems, but the steady drumbeat of bad news for insurers is showing up everywhere except in the finances of the major carriers.
Even if the feds bury Anthem's acquisition of Cigna and Aetna's Humana deal, the big five health insurers are likely to forge new transactions to scale up and improve their position at the bargaining table with consolidating hospitals and systems.
The government argues both transactions would “substantially lessen competition in numerous markets around the country.” The result, antitrust regulators said, would lead to “higher prices and reduced benefits” for consumers. Both companies plan to challenge the DOJ in court.
Attempts by the CMS to limit the use of special enrollment periods to obtain exchange coverage do not go far enough to ensure that the circumstances won't be abused by those seeking to game the system, according to health plan critics.