Some payers and hospitals fail to reach eleventh-hour deal on Dec. 31
Plus: RIP Bright Health Group
Good morning, happy Friday, and Happy New Year. Welcome to the first 2024 edition of the Friday Pulse Check.
In the news:
Jan. 1 sees splits between payers and hospitals
It is that time of year again when we see which payers did and didn’t manage to reach an eleventh-hour deal with the hospitals to ensure that their patients can continue to access high-quality care. Here are three highlights:
UnitedHealthcare and Greenville, South Carolina-based Prisma Health fail to reach a deal
UnitedHealthcare and Little Rock, Arkansas-based Baptist Health fail to reach a deal
Cigna and Raleigh, North Carolina-based WakeMed reach deal to keep hospital in-network
LIVE payer stock prices:
UnitedHealth Group - UNH 0.00%↑
Cigna - CI 0.00%↑
RIP Bright Health Group
It seems like only yesterday that Ron and I were discussing Bright Health Group on the FLATLINING Podcast. If you need a refresher: Bright Health Group was a private equity-backed insurance company that was trying to break into the Medicare Advantage and marketplace areas but woefully failed to do so. They were unable to build a profitable customer base and it appeared to be doomed early on. Bright Health Group managed to close or sell a number of its plans at the end of 2022, but its last remaining plan, a Medicare Advantage product in California, was only sold to Molina on January 1. Molina paid $425 million for the Bright Health Group product. Read more in Business Wire and Becker’s Payer Issues.
LIVE Molina stock price - MOH 0.00%↑
Listen to episode 25 of the FLATLINING Podcast: The Decline and Fall of Bright Health Group
Cigna may have found a buyer for its Medicare Advantage business
Remember towards the end of last year when the Wall Street Journal reported that Cigna and Humana were in talks to merge? That deal fell apart after about a week but not before both Cigna’s and Humana’s stock prices fell. Cigna ended up buying back a significant portion of its stock (over $10 billion worth).
Apparently, Health Care Service Corp, also known as HCSC, has agreed to buy Cigna’s Medicare Advantage business for between $3 and $4 billion. Elevance (formerly Anthem) was also looking at buying the business. HCSC operates BlueCross BlueShield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. Read more in the Wall Street Journal. 🔒
Ron and I first discussed why Cigna would want to sell its Medicare Advantage business and what it means for providers and patients on the FLATLINING Podcast in November.
Listen to episode 70 of the FLATLINING Podcast: Cigna may sell its Medicare Advantage Business
Other articles of interest:
CVS to end reimbursement for Humira and instead recommend biosimilars - Reuters
LIVE CVS stock price - CVS 0.00%↑
LIVE AbbVie stock price - ABBV 0.00%↑
Ozempic and Wegovy may reduce inflammation - New Scientist
LIVE Novo Nordisk stock price - NVO 0.00%↑
CDC: New JN.1 COVID-19 variant is now 30% of cases - FOX News
Opinion: These pro-consumer health bills are ready for the Senate - RealClear Health
Florida surgeon general continues to spread discredited theory about mRNA vaccines - The Hill
California Watch: Blue Shield of California will lay off 140 employees by the end of January - Becker’s Payer Issues
You have may have noticed over the past few weeks that we have not had new episodes of the FLATLINING Podcast. That is in part because we have been on our usual winter break and we have been sharing our best episodes of 2023. If you’ve missed any of them, check them out below:otolaryngologist
We will have a new episode out next week at the usual time on Wednesday morning. Thanks for continuing to listen and for sharing with your friends and colleagues.
I hope this first week of 2024 has been good to you and that it continues to stay good for the whole year.
Have a good weekend,
Matthew