In an effort to further build out its Carelon service subsidiary, Elevance Health is buying Kroger Specialty Pharmacy. This will add to its growing PBM offerings.
Additional articles: https://www.fiercehealthcare.com/payers/elevance-health-acquire-kroger-specialty-pharmacy and https://www.modernhealthcare.com/finance/elevance-health-carelonrx-kroger-specialty-pharmacy
(Some articles may require a subscription.)
#kroger #elevancehealth
Some services have been restored by Change Healthcare and more are readying. Change says that claim preparation software for providers will soon come back online. Electronic payments have come back online. United says it has made more than $2 billion in advanced payments from its program.
United as an insurer, Highmark, and the Blue Cross and Blue Shield Association have developed advanced payment programs for providers, but many other insurers are moving slowly on the idea. Other insurers are contracting with Change competitors to help providers file claims. They also are extending claim deadlines. Provider groups say aid is not enough. The Centers for Medicare and Medicaid Services is also asking states to submit state plan amendments so they can advance Medicaid payments.
Additional articles here: https://www.modernhealthcare.com/cybersecurity/change-update-unitedhealth-systems-progress and https://www.modernhealthcare.com/insurance/change-outage-prior-authorization-pay and https://www.modernhealthcare.com/government/change-update-cms-medicaid-reimbursements and https://www.healthcaredive.com/news/change-healthcare-cyberattack-medicaid-flexibilities-american-hospital-association-survey/710561/
(Some articles may require a subscription.)
#changehealthcare #cyberattacks
Good article from Fierce Healthcare and analysis from Kaiser Family Foundation on healthcare spending in Medicare households. Medicare households spend more on healthcare than other households. Health spending burden was twice as high.
Analysis by KFF: https://www.kff.org/medicare/issue-brief/medicare-households-spend-more-on-health-care-than-other-households/
#coverage #costs #medicare #medicareadvantage
While insurtechs overall have struggled, at least three – Alignment Healthcare, Devoted Health, and Clover Health – appear to be doing well. Clover Health had an adjusted EBITDA loss of $19.1 million in the fourth quarter and a full-year loss of $44.7 million last year. This is significantly better than in 2022. Its medical loss ratio (MLR) is projected to be just 81.2% for 2024. It expects adjusted EBITDA profit up to $20 million. Since it began, it, too, amassed a sizeable membership.
#clover #insurtechs
While insurtechs overall have struggled, at least three – Alignment Healthcare, Devoted Health, and Clover Health – appear to be doing well. Clover Health had an adjusted EBITDA loss of $19.1 million in the fourth quarter and a full-year loss of $44.7 million last year. This is significantly better than in 2022. Its medical loss ratio (MLR) is projected to be just 81.2% for 2024. It expects adjusted EBITDA profit up to $20 million. Since it began, it, too, amassed a sizeable membership.
#clover #insurtechs
At an unprecedented meeting, UnitedHealth Group CEO Andrew Witty heard from both Health and Human Services (HHS) Secretary Xavier Becerra and providers at a government sponsored meeting. The plea was for United to take responsibility for the Change Healthcare cyber attack and give additional financial support to providers.
In addition, HHS detailed more about what a $1.3 billion fund for cyber security would be used for. About 2,000 hospitals will receive incentive funds to adopt new cyber security practices. Another $153 million would go for various government initiatives.
Additional article: https://www.fiercehealthcare.com/providers/becerra-stakeholders-its-time-take-accountability-cybersecurity
#changehealthcare #unitedhealthcare #cyberattacks
The President announced his FFY 2025 budget even as all bills for the current FFY 2024 year have not been approved (including Health and Human Services spending). Biden did sign into law the bill that funds some agencies for the current fiscal year, including a partial retreat on a major Medicare doc cut. Because of the split in Congress, most of his proposals are dead on arrival but serve as campaign differentiators against his GOP opponent, former President Donald Trump.
In the FFY 2025 budget, Biden funds the commitments he made at the State of the Union and more:
Additional articles: https://www.modernhealthcare.com/politics-policy/biden-budget-cybersecurity-insurance-subsidies and https://insidehealthpolicy.com/health-insider/admin-releases-budget-addresses-fallout-over-change-healthcare-attack and https://www.fiercehealthcare.com/providers/congress-reaches-spending-deal-doc-pay-bump-delayed-dsh-cuts-and-more
(Some articles require a subscription.)
#budget2025 #healthcare #healthcarereform
President Joe Biden gave a fiery campaign speech at the State of the Union Thursday. He touched on policy changes he wants to see across government and society. In the healthcare world, he asked for significant additions to what he thinks is his successful record:
Additional articles: https://www.fiercehealthcare.com/payers/biden-call-drug-negotiation-expansions-stronger-reproductive-care-access-sotu and https://insidehealthpolicy.com/daily-news/biden-advocates-expansion-drug-price-controls-aca-state-union and https://www.modernhealthcare.com/politics-policy/joe-biden-state-union-sotu-2024
(Some articles may require a subscription.)
#biden #sotu #healthcare #healthcarereform #aca #obamacare #exchanges #drugpricing #ira #coveragegap #insulin
The Kaiser Family Foundation reports that almost 18 million initially lost coverage during Medicaid redeterminations. Some regained eligibility later. Most lost coverage on procedural grounds. Enrollment has dropped by about 10M so far in Medicaid nationwide.
#medicaid #redetermintations
Walgreens says that its road to financial recovery will be long – not a 12-month plan. It is undertaking a strategic review of its business. It plans to cut $1 billion in expenses this year.
Additional article: https://www.modernhealthcare.com/providers/walgreens-tim-wentworth-villagemd-shields-health-ownership
(Some articles may require a subscription.)
#walgreens
