January 18, 2024

Disappointing Medicare Advantage Enrollment Numbers

Huge disappointment for some during the Medicare Advantage enrollment season. My quick math says that overall MA numbers increased a strong 8.7% from January 2023 to January 2024.  That is up from a year ago, which was a little over 6%. But a number of plans did not fare well during the recent enrollment campaign.  Aetna shined.  While United and Humana grew, it was a much lower rates than before.  Centene took a big hit. I will have my usual annual blog looking at all the data on Monday. Stay tuned.

Additional article here: https://www.healthcaredive.com/news/humana-earnings-outlook-cut-high-medical-costs/704865/

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#medicareadvantage #healthplans #enrollment

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Government Shutdown Averted Until Early March

Over objections of the right flank in the House, Congress passed a new continuing resolution (CR) to keep government open until early March.  New House Speaker Mike Johnson, R-LA, previously said he would not pass a new temporary CR but relented.  Some cuts to healthcare programs were avoided for now.  But the prospects of passing major healthcare bills and reversing certain cuts are worse due to a further delay in a final budget solution.

Additional articles here:




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#governmentshutdown #crs

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Sanders May Subpoena Two Brand Drug Maker CEOs

Sen. Bernie Sanders, I-VT, chair of the Senate Committee on Health, Education, Labor and Pensions (HELP), says he will hold a vote to issue subpoenas to the chiefs of Johnson & Johnson and Merck regarding drug pricing.  The two have refused to accept voluntary invitations. Good for Sanders. These Drug Maker CEOs should appear to defend their outrageous prices.

#drugpricing #branddrugmakers #sanders

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Mental Health and Drug Prices Top Healthcare Concerns Of Employers

This Fierce Healthcare article discusses results of a survey of employers that assembled top concerns of employers on healthcare.  At the top of the list are mental healthcare and pharmacy costs.  Go to the article for a link to download an executive summary.  A good read.

#employers #healthcare #coverage

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Humana And Other Health Insurer Stocks Slide On Medical Expense Rise

Last week United reported troubling news on medical expenses. Now Humana has done so, leading health insurers’ stocks to get hit today. Medicare Advantage-dominant Humana saw its medical loss ratio (MLR) for the quarter exceed 90%. It also had a tough open enrollment season. While Humana is a strong overall company and a success story, it had poor enrollment in 2022, rebounded in 2023, and now saw poor results for 2024. Its Star record is better. We should expect more negative medical expense news as other insurers report on earnings calls.

Additional articles here:



(Some articles may require a subscription.)

#medicareadvantage #healthplans #mlr

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2023 M and A In Hospital World Included Many Distressed Hospitals

Nearly a third of announced hospital and health system mergers and acquisitions last year involved a financially distressed partner. The report goes into great facts about the partial rebound in M and A here. Mergers and acquisitions could see issues in 2024 as the Biden administration ups its anti-trust scrutiny.

(Article may require a subscription.)

#manda #mergers #acquisitions #antitrust

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Texas Extends Medicaid For Moms

Good news out of Texas, which does not look kindly on Medicaid expansion efforts.  The Centers for Medicare and Medicaid Services (VMS) approved a waiver to allow post-partum mothers to stay on the program for one year after childbirth.

#medicaid #tx #coverage

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— Marc S. Ryan

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