Elevance Beats The Street For Q2
Elevance Health beat The Street on both profit and revenue in Q2 2024. The insurer posted $2.3 billion in profit and $43.9 billion in revenue. It signaled it is seeing 5% enrollment declines in Medicaid due to redetermination. That should end later this year. Utilization could increase due to increased acuity in Medicaid. Carelon, its service entity, increased its financial position dramatically. With its win in a lawsuit on Star ratings, Elevance expects 56% of its Medicare Advantage (MA) members to be in 4 Star or greater plans. A huge boost to its MA program.
Additional articles: https://www.fiercehealthcare.com/payers/elevance-health-beats-street-q2-it-posts-23b-profit and https://www.healthcaredive.com/news/elevance-second-quarter-2024-medicaid-medicare-advantage/721551/ and https://www.beckerspayer.com/payer/medicaid-utilization-rising-elevance-health-warns.html and https://www.beckerspayer.com/payer/elevance-health-posts-2-3b-profit-in-q2.html
(Some articles may require a subscription.)
#elevancehealth #medicaid #medicareadvantage
https://www.modernhealthcare.com/insurance/elevance-health-profits-medicaid-medical-costs
Humana Invests In AI-Driven Medicare Advantage Plan Choice Firm
Humana has acquired a minority stake in Healthpilot, which offers consumers artificial intelligence-driven guidance in selecting Medicare Advantage (MA) plan options. This move is likely related to rising concerns about third party marketing organizations’ (TPMO) unseemly behavior in enrolling seniors and the disabled. Over time, many large MA plans will begin distancing themselves from external enrollment entities in favor of their own technology and closely-held assets. CVS Health and Aetna have acquired an agent organization.
(Article may require a subscription.)
#medicareadvantage #marketing
https://www.modernhealthcare.com/digital-health/humana-ai-data-healthpilot-investment
Commercial Healthcare Costs Expected To Increase 8% Next Year
PricewaterhouseCoopers (PwC) says commercial healthcare costs are expected to increase 8% next year due to expensive medications like GLP-1s, behavioral health, and inflationary trends.
(Article may require a subscription.)
#healthplans #healthinsurance #commercial
https://www.modernhealthcare.com/finance/healthcare-costs-2025-pwc
Project 2025 Healthcare Proposals
Former President Donald Trump has distanced himself from The Heritage Foundation’s Project 2025. But the proposal does include a number of traditional Republican positions and proposals. Among the healthcare proposals are a default option in Medicare Advantage (MA) when someone becomes eligible for Medicare, site-neutral payments, and value-based care (VPC) physician payments. The document also calls for lifting the significant regulatory burden on MA.
(Article may require a subscription.)
#election2024 #trump #healthcare
Medicare Advantage Becomes Part Of Political Fray
As Democrats accuse Trump of being in favor of reducing Medicare funding, the former president has accused the Biden administration of gutting Medicare Advantage (MA) with its recent payment reductions and regulatory changes.
(Article may require a subscription.)
#election2024 #trump #biden #healthcare
Johnson & Johnson Reports IRA Will Not Impact Long-Term Sales Growth
Johnson & Johnson reports that, despite the passage of Medicare drug price negotiations, its long-term sales growth projections are not impacted. So the sky will not fall.
(Article may require a subscription.)
#drugpricing #ira #branddrugmakers
Kaiser Health News Bill Of The Month Shows Patients Are In The Middle
Kaiser Health News’ Bill of the Month article focuses on a patient who struggled for months to get a huge bill paid due to inaction between a hospital and health plan. Her treatment is unreasonable and a provider should not be allowed to bill a patient while still working with health plans. The health plan appeared to be acting reasonably in demanding details, while the provider jumped to billing the patient when a claim was denied.
#surprisebilling #healthcare #claimsdenials
https://kffhealthnews.org/news/article/hearing-implant-preapproved-met-deductible-bill-of-the-month/
Almost Half Of All Americans Struggle To Afford Access To Healthcare
The Healthcare Affordability Index finds that nearly half of Americans struggle with healthcare affordability. The index has fallen six points since 2022, a record low of 55 percent since the index was launched back in 2021.
#healthinsurance #affordability #coverage
https://www.newsweek.com/us-healthcare-unaffordable-americans-1925972
— Marc S. Ryan
