Cigna Exceeds Expectations for Q2
The Cigna Group reported Q2 earnings that exceeded expectations, driven by growth in its services business. Total revenue in Q2 was $60.5 billion, up 24.6% year over year. It reported $1.5 billion in net income, up 6%.
Cigna is more isolated from Medicare pressures (small line being sold) and Medicaid pressures (no line). Evernorth’s services revenue rose nearly 30% year over year to $49.5 billion. Pharmacy service revenues grew more than 41% to $26.6 billion. In great measure this was due to the migration of Centene from CVS Caremark to ESI.
CEO David Cordani also committed to more aggressive defense of the value of its pharmacy benefit manager, ESI.
In related news, Cigna says its GLP-1 weight-loss program has enrolled two million.
Additional articles: https://www.healthcaredive.com/news/cigna-aggressive-pharmacy-benefit-manager-defense/722638/ and https://www.beckerspayer.com/payer/cigna-posts-1-5b-profit-in-q2-2.html and https://www.fiercehealthcare.com/payers/evernorth-drives-double-digit-revenue-growth-cigna-q2 and https://www.beckerspayer.com/payer/cignas-glp-1-program-enrolls-2-million.html
(Some articles may require a subscription.)
#healthplans #cigna
Alignment Reports Positive Results
Alignment Healthcare reported its second quarter financial results today. The insurtech has outpaced its estimated growth in membership considerably. It has 175,100 members, up 56.1% year over year. At least 5,000 more lives will be added in 2024.
Alignment reported $681.3 million in total revenue, a 47.3% increase year over year. It had a net loss of $24 million. Adjusted gross profit came in at $76.8 million. The adjusted EBITDA was $6 million.
Alignment appears on the road to profitability. It does not seem overly impacted by Medicare Advantage (MA) trends.
#medicareadvantage #alignmenthealthcare
Will Home Care Consolidation Hurt Medicare Advantage?
Interesting article about the consolidation in the home care industry and speculation that it will impact Medicare Advantage (MA) plans’ ability to utilize home care in lieu of more expensive post-acute care. Larger home-care agencies are being selective on what MA plans they will contract. They are driving higher rates. This is a bit of a double whammy for MA plans as they now must honor any physician requests for post-acute care with new prior authorization restrictions.
(Article may require a subscription.)
#homecare #medicareadvantage
https://www.modernhealthcare.com/providers/home-health-deals-medicare-advantage-pay
New York Social Determinant Medicaid Waiver Going Live
A New York Medicaid waiver goes live, with the federal government allowing the state to use Medicaid dollars to overcome social barriers, including rent payments and non-medical. The goal is to improve health outcomes. While some argue spending on non-healthcare items is questionable, the fact is that a majority (perhaps the vast majority) of healthcare costs can be predicted by social not clinical factors.
(Article may require a subscription.)
#sdohs #socialdeterminants #medicaid #ny
https://www.modernhealthcare.com/medicaid/new-york-medicaid-1115-waiver-cms
Biden Administration Has Perfect Record On Medicare Drug Price Negotiation Lawsuits
The Biden administration continued its win against Big Pharma, which is challenging the Medicare drug price negotiation law. A New Jersey federal judge rejected a request for summary judgment in the case, in which Novo Nordisk ( Danish company) challenged the constitutionality of the Inflation Reduction Act (IRA).
In related news, leading drugmakers are arguing to shareholders that the negotiations will not impact long-term sales and finances. Advocacy groups are gathering petition signatures to demand drug makers withdraw their lawsuits against Medicare drug price negotiations.
Additional article: https://insidehealthpolicy.com/daily-news/nj-court-deals-another-blow-drug-industry-rejecting-novo-nordisk-claims-against-ira and https://thehill.com/policy/healthcare/4804400-biden-medicare-drug-price-negotiation/
(Articles may require a subscription.)
#drugpricing #ira #branddrugmakers
Good Briefer on Proposed Part D Premium Stabilization Program for PDPs
The Kaiser Family Foundation (KFF) has a good briefer on the Centers for Medicare and Medicaid Services’ (CMS) proposed PDP premium stabilization program in Medicare Part D. CMS announced the stabilization program this week after data that came in showed a huge rise in premiums in PDPs despite a separate premium stabilization program from the Inflation Reduction Act (IRA). The increases in premiums are tied to the major transfer of risk and costs to health plans from the government and members’ out-of-pocket (OOP) costs after the passage of the IRA. There are doubts that CMS really has the authority to create the program.
#partd #pdp #medicareadvantage
https://www.kff.org/medicare/issue-brief/what-to-know-about-medicare-part-d-premiums/
— Marc S. Ryan
