Revenue Cycle and Payer News 3-14-2018

In the News…

Health insurer Cigna to buy Express Scripts for about $52 billion
U.S. health insurer Cigna Corp (@Cigna) struck a $52-billion deal to buy pharmacy benefits manager Express Scripts Holding Co recently, looking for new ways to hold onto their profits as the industry faces greater scrutiny for rising healthcare costs. Cigna’s deal follows close on the heels of a rival $69-billion merger between CVS Health Corp and health insurer Aetna Inc, announced in December.

Congress should closely scrutinize proposed CVS-Aetna merger
The AMA (@AmerMedicalAssn) last week asked Congress to closely scrutinize the massive proposed merger of CVS Health and Aetna because of the potential negative impact it poses to American health care consumers. The AMA submitted a written statement to the House Judiciary Subcommittee on Regulatory Reform, Commercial and Antitrust Law in anticipation of a Feb. 27 hearing entitled “Competition in the Pharmaceutical Supply Chain: The Proposed Merger of CVS Health and Aetna.”

What merger mania means for health care
Health insurer giant Cigna’s proposed purchase of pharmacy benefits manager Express Scripts for $67 billion comes just three months after Cigna rival Aetna agreed to be bought by drugstore chain CVS (CVS) for $69 billion. According to CNN Money the insurance companies have been forced to find alternative ways to adapt and grow in a rapidly changing health care industry after the Justice Department blocked two massive deals involving four of the five biggest health insurers on antitrust grounds a year ago.

UnitedHealthcare Launches Expansion of Direct-to-Consumer Pharmacy Discounts to Millions of Americans
UnitedHealthcare (@UHC), a UnitedHealth Group company, will expand pharmacy discounts to millions of its plan participants when they fill prescriptions through retail pharmacies or home delivery. The new program will apply to over 7 million people enrolled in UnitedHealthcare fully insured commercial group benefit plans, lowering out-of-pocket costs by directly providing consumers with savings from pharmacy manufacturer rebates at the time of purchase.

Anthem, Inc and American Medical Association Pursue Collaboration to Help Create Positive Change to the Health Care System
Health care affordability is one of the biggest challenges facing patients and doctors today. With a shared goal to help patients have improved access to quality, timely and affordable health care, the American Medical Association (AMA) and Anthem, Inc. (@AnthemInc)  recently announced they will seek to identify and collaborate on solutions that drive a high-value experience for patients, physicians, other health care professionals and health plans.

Vote Today – Humana’s Pattie Dale Tye a finalist for ‘Most Admired Woman’
When Humana (@humananews) started Project San Antonio (the precursor to its Bold Goal), the company recognized Pattie Dale Tye, who was serving as president of Humana’s Large Employer Group Business, as an ideal leader. Pattie Dale’s love of community has been evident throughout her 13 years at Humana. She is now being recognized by Today’s Woman magazine as one of their “Most Admired Woman” finalists.

Premiums for ACA health insurance plans could jump 90 percent in three years
Insurance premiums for Affordable Care Act health plans are likely to jump by 35 to 94 percent around the country within the next three years, according to a new report concluding that recent federal decisions will have a profound effect on prices. The nationwide analysis, issued by California’s insurance marketplace, finds wide variations state to state, with a broad swath of the South and parts of the Midwest in danger of what the report calls “catastrophic” average rate increases by 2021.

Health Care Service Corporation Launches $1.5 Billion Commitment to Accelerate Affordable Health Care Solutions
Health Care Service Corporation (@hcsc), the nation’s largest customer-owned health insurer, today announced it has committed $1.5 billion over three years to accelerate its efforts to reduce health care costs for its members. The new endeavor, Affordability CuresSM, builds on the company’s ongoing efforts to control medical and administrative costs for the long-term and was bolstered by benefits due to the more recent Tax Cuts and Jobs Act.

Aetna’s Response to the Parkland Tragedy
Mark Bertolini, Chairman and Chief Executive Officer at Aetna, says, “Today, Aetna is donating $200,000 to support the March For Our Lives rally taking place in Washington, D.C., on March 24. This demonstration is being organized by the brave survivors of the Parkland tragedy who are taking action to ensure that future generations will not be subject to the same fear and violence that have invaded our schools and communities. I want to emphasize that our actions are not an indictment of responsible, legal gun owners. Instead, we are joining others who cannot sit by idly while mass shootings become a part of our everyday life.”

Oscar CEO Mario Schlosser on Data, Narrow Networks, and the Cleveland Clinic
Back in June of 2015, we reported on Oscar’s (@oscarhealth) funding and expansion as a new startup. In our last Revenue Cycle and Payer News post we reported on an update from Oscar CEO Mario Schlosser. On Wednesday, January 24, 2018, Schlosser visited Bloomberg’s Global Headquarters in New York City, where he was interviewed by Bloomberg Television anchor Scarlet Fu as part of the monthly CornellTech@Bloomberg speaker series. The pair discussed the insights that led to the founding of Oscar, the company’s progress since then, and its use of data to create a very different patient experience from most other health insurance companies.

CareSource honored as one of the 2018 Best Places to Work in Indiana
CareSource (@caresource), a nonprofit health plan, was recently named as one of the 2018 Best Places to Work in Indiana by the Indiana Chamber of Commerce and Best Companies Group. This statewide survey and awards program was designed to identify, recognize and honor the best employers in Indiana, benefiting the state’s economy, workforce and businesses.