by Third Horizon | May 2, 2025 | Payers, Tea Leaves
Aetna, part of CVS Health, will exit the individual markets in 2026, just five years after re-entering the Affordable Care Act (ACA) exchanges. Despite a return to the individual market in 2022, Aetna faced disappointing sign-ups and continued losses. CVS Health...
by Jessica Casebolt | Jul 17, 2024 | Payers, Tea Leaves
UnitedHealth Group revealed in its second-quarter earnings report that costs stemming from a significant cyberattack on its Change Healthcare unit are expected to range between $2.3 billion to $2.45 billion this year. This projection surpasses earlier estimates by...
by Jessica Casebolt | Jul 17, 2024 | Payers, Tea Leaves
The Federal Trade Commission (FTC) is poised to sue the three largest pharmacy benefit managers (PBMs) in the United States — CVS’ Caremark, Cigna’s Express Scripts, and UnitedHealth’s Optum Rx — over their pricing negotiations with pharmaceutical...
by Jessica Casebolt | Jul 17, 2024 | Payers, Tea Leaves
A federal judge in Texas recently blocked a Biden administration policy designed to prevent Medicare insurers from paying commissions to agents and brokers who enroll people in certain plans. This decision is significant as it undermines efforts by the administration...
by Jessica Casebolt | Jul 17, 2024 | Payers, Tea Leaves
The U.S. Federal Trade Commission (FTC) has highlighted concerns over the consolidation of pharmacies and health insurance companies, which has empowered a small number of pharmacy benefit managers (PBMs) to wield significant influence over prescription drug...
by Jessica Casebolt | Jul 16, 2024 | Payers, Tea Leaves
A new analysis from KFF digs into insurers’ financial performance across multiple markets and found the highest gross margins in the Medicare Advantage (MA) space. At the end of 2023, gross margins per enrollee in MA were $1,982 on average compared to $1,048 in...
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