medpac

Change Pharmacy Network Back On 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 Federal Appeals Court Deals Drug Makers A Blow On 340B A federal appellate court said that a state law could be reconciled with the federal 340B drug discount program. Drug makers are fighting to rein in the discounts they give to various pharmacies and hospitals.  While I find Big Pharma’s constant lawsuits defending their unreasonable pricing system

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

UnitedHealth Group CEO Hears From Becerra And Providers 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 Link to Article New Study Says Provider Email Claims Largely Require No Patient Cost-Sharing A new study says that less than 20% require a patient to pay out-of-pocket for so-called “email messaging” claims. Those that did paid a median of $25 per claim. Good summary of the