March 13, 2024

Clover Health Readying For Positive Margin

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

Link to Article

Feds Investigating Change Healthcare

The federal government has launched an investigation into UnitedHealth Group and its Change Healthcare subsidiary after a major cyber attack.  While I am always weary of government investigations based on headlines, in this far-reaching incident it is important to understand what happened and whether there was negligence. 

In related news, major for-profit hospitals say they have addressed Change’s impact on them and it will not have a huge effect: https://www.fiercehealthcare.com/providers/change-healthcare-cyberattack-isnt-threatening-major-profit-systems-bottom-lines-execs

Additional article: https://www.modernhealthcare.com/cybersecurity/change-update-hhs-investigation-unitedhealth

(Some articles may require a subscription.)

#changehealthcare #cyberattacks

Link to Article

Jefferson Health Investing $762M In Ambulatory Care Center

Congratulations to Jefferson Health for its major investment in Philadelphia.  Jefferson has both provider and payer assets in a challenging location. It provides vital services in a heavily SD-impacted area.

(Article may require a subscription.)

#healthplans #providers #hospitals

Link to Article

Continuous Eligibility Helps Those Maintain Coverage Post Childbirth

A new study in JAMA Forum says that continuous eligibility in Medicaid meant a large decrease in those who lost coverage post childbirth. More and more states are adopting expanded coverage for certain groups, including pregnant women and children. While some expansions remain controversial (although they shouldn’t be), these expansions appear to have supporters across the political aisle.

#medicaid #coverage

Link to Article

Biden Budget Outlines Medicare Increases

The Biden FFY 2025 budget gives us some figures on expected Medicare spending. About $839 billion in Medicare mandatory outlays are expected. The Medicare tax would increase an additional 1.2 percentage points for income over $400,000. Medicare benefit expenditures would hit $1.1 trillion with all of his proposals. About $534 billion would be spent on Medicare Advantage.

(Article may require a subscription.)

#medicare #medicareadvantage

Link to Article

— Marc S. Ryan

Leave a Reply

Your email address will not be published. Required fields are marked *

Available Now