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Express Scripts says likely to lose top client Anthem

April 24, 2017  /  Insurers

Pharmacy benefit manager Express Scripts Holding Co said Anthem Inc, its biggest customer and one that has sued the company over claims of being overcharged, was unlikely to renew its contract after it ends in 2019.

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HHS, States Move To Help Insurers Defray Costs Of Sickest Patients

April 24, 2017  /  Insurers

The Trump administration and some states are taking steps to help insurers cover the cost of their sickest patients, a move that industry analysts say is critical to keeping premiums affordable for plans sold on the law’s online marketplaces in 2018.

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Insurer Financial Performance in the Early Years of the Affordable Care Act

April 23, 2017  /  Insurers

Although insurers have generally remained profitable overall since implementation of the Affordable Care Act, many companies participating in the individual market – where most of the major market reforms took place in 2014 – experienced substantial losses in this market in the early years of reform.

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Commercial Health Insurance Financial Results provide insight into ACA Program Stability

March 31, 2017  /  Insurers

Risk corridor shortfall seen as a significant driver of underwriting losses.

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Aetna Gives Up On Merger, Will Pay Humana $1B Breakup Fee

February 16, 2017  /  Insurers

Rather than seek an appeal, Aetna said it will now have to pay Humana $1 billion “as a result of the termination of the merger agreement.” Aetna will also end an agreement to sell certain Medicare Advantage plans to a smaller insurer, Molina Healthcare,  and will pay undisclosed termination fees associated with that deal.

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Blocked insurer mergers: What the decisions mean and what lies ahead

February 16, 2017  /  Insurers

With both the Aetna-Humana and Anthem-Cigna deals struck down by the federal courts, the implications for both the health insurance industry and antitrust enforcement are just as powerful.

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Demand For Popular Short-Term Insurance Plans Could Surge If Health Law Is Relaxed

February 3, 2017  /  Insurers

Short-term health plans have been around for decades and after the health law passed, some people gravitated toward them because they were willing to trade comprehensive coverage for a cheaper sticker price — even if it meant paying a tax penalty for not having the comprehensive coverage required in the law.

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Humana, Aetna, Cigna Invest in Value-Based Care Payment Models

January 7, 2017  /  Insurers

National health insurers are continuing to advance value-based care payment models such as accountable care organizations.

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MACRA Pushes Payers to Adopt Value-Based Care Payment Models

December 25, 2016  /  Insurers

With providers focused on meeting MACRA regulations, commercial payers are investing in value-based care payment models that align with the quality payment program.

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UnitedHealthcare Pioneers National ACO Product; NexusACO Expands Access to Quality Care and Lowers Costs

December 13, 2016  /  Insurers

New plan design is built around UnitedHealthcare’s relationships with accountable care organizations (ACOs) and Tier 1 physicians.

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