Essentia Health has reached an agreement with UnitedHealthcare (UHC) to remain an in-network provider for UHC’s Medicare Advantage insurance plan in 2025. Earlier this year, Essentia announced plans to discontinue its status as an in-network provider for UHC and Humana Inc. (NYSE: HUM) Medicare Advantage insurance plans due to reported issues with denials of payment […]
Category: Medicare Advantage
The U.S. Department of Justice (DOJ) and four state attorneys general filed a lawsuit to block UnitedHealth Group’s (NYSE: UNH) acquisition of Amedisys (Nasdaq: AMED) this week. The DOJ’s complaint is thorough, with some compelling arguments, and some less so. Home health veterans have been predicting consolidation of the fragmented industry for a long time. […]
The Cigna Group (NYSE: CI) said on Monday that it is officially not pursuing a combination with Humana Inc. (NYSE: HUM). That means that CenterWell Home Health, one of the largest home health entities in the country, will not be changing hands. Together, Cigna and Humana would have become one of the largest health care […]
Medicare Advantage (MA) star ratings have become a hot topic for Humana Inc. (NYSE: HUM). On Oct. 18, the company filed a lawsuit against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) over its drop in star ratings. The number of Humana MA plans rated […]
Medicare Advantage (MA) companies receive higher risk-adjusted payments from the Centers for Medicare & Medicaid Services (CMS) for sicker enrollees. This helps ensure that plans receive sufficient payments to cover increased care costs and that enrollees have access to plans. However, a new report states that taxpayers are footing the bill for billions of dollars […]
UnitedHealth Group (NYSE: UNH) and Amedisys (Nasdaq: AMED) leaders are reportedly expected to meet with officials from the Department of Justice over the next week to discuss their pending deal. The companies will likely make a final case for why the deal should go through, while the DOJ considers whether to officially file a lawsuit […]
The Federation of American Hospitals (FAH) released a statement Thursday regarding recent investigations into Medicare Advantage (MA) plans. Those investigations included concerns around claim denials, as well as discrepancies between MA plan practices when compared to traditional Medicare. It is yet another example of health care providers and advocates pushing back. It also shows that […]
As home-based care demand continues to increase, several leaders are thinking about the unique growth trajectories at their companies. At Impact Healthcare, growth has been achieved by not overextending. In recent years, the company has seen 35% year-over-year growth, except for in 2020. “When I think about our growth trajectory, it’s making sure that we […]
Humana Inc. (NYSE: HUM) and Cigna Group (NYSE: CI) have reportedly resumed conversations around a merger. The two companies discussed the possibility of a merger in 2023, but ultimately paused those conversations a few weeks later. Bloomberg first reported resumed merger discussions between the two companies on Friday. The news comes at a time when […]
The Senate Homeland Security Permanent Subcommittee on Investigations (PSI) released a report on Thursday revealing that the nation’s three largest Medicare Advantage (MA) insurers have significantly increased the rate at which they denied seniors’ post-acute care from 2020 to 2023. This includes denying access to nursing homes, inpatient rehabilitation facilities and long-term acute care hospitals. […]
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