Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Health Insurance Mergers

Cigna to Acquire Express Scripts for $67B to Expand Consumer Value

March 8, 2018 - Cigna is purchasing pharmacy benefit manager (PBM) Express Scripts Holding Company for $67 billion to improve consumer value, enhance care coordination models, and create long-term financial opportunities. Cigna stated in a press release that the purchase provides several strategic advantages including the ability to improve distribution channels for members using online and retail purchasing....

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Humana Becomes Latest Payer to End AHIP Membership

by Thomas Beaton

Humana is the latest commercial payer to end its membership in AHIP, the nation’s largest health insurance trade organization. “Humana has not actively participated in AHIP since early 2017,” a Humana spokesperson told

CVS Health to Buy Aetna for $69B, Altering Payer Landscape

by Jennifer Bresnick

CVS Health is continuing its quest to become a major force in the growing world of consumer-centric healthcare by announcing that it will buy Aetna for $69 billion.  "This combination brings together the expertise of two great companies...

AMA: Payers Operate in Extremely High Concentrated Markets

by Thomas Beaton

Payers have significant control of their respective healthcare markets as 69 percent of payers offering HMO, PPO, POS, and public health exchanges operate in very high concentrated markets, AMA found in a study of national insurance markets....

Anthem Terminates Cigna Merger, but Refuses to Pay Out $1.8B

by Jesse Migneault

After a court ruling in Delaware, Anthem has notified Cigna that their proposed $54 billion merger is off, but that doesn’t mean the two insurance companies are amicably parting ways. Anthem has stated that it will not pay Cigna a $1.85...

Anthem Pursues Cigna Merger Up to the Supreme Court

by Jesse Migneault

Just seven days after a court upheld the initial ruling which blocked Anthem’s acquisition of Cigna, the nation’s second largest insurer is not giving up.   Anthem has confirmed that it is filing a writ of certiorari with...

Court Upholds Antitrust Ruling Against Anthem-Cigna Merger

by Jesse Migneault

On Friday, a federal DC district appeals court upheld a February 2017 decision which blocked the acquisition of Cigna by health insurance giant Anthem.  Antitrust concerns led 11 states and the District of Columbia to join the US Justice...

Top 5 Largest Health Insurance Payers in the United States

by Jesse Migneault

The Affordable Care Act has been a divisive policy for the public and politicians, but since 2010 it has been a financial boon for the top five giants of the health insurance payer industry.  The expanding customer base created by the ACA,...

Anthem Appeals Cigna Merger with Cost, Quality Arguments

by Thomas Beaton

Anthem has opened an appeal in the U.S District Court citing opportunities for increased consumer savings and quality of care weeks after the DOJ blocked its planned merger with Cigna. Anthem argued that the DoJ’s ruling neglected a possible...

Market Monopoly Cause of Court Blocking Cigna-Anthem Merger

by Thomas Beaton

The full opinion of United States District Court for the District of Columbia blocking Anthem’s acquisition of Cigna became publicly available earlier this week and provides details into the court’s decision. In the memorandum opinion,...

After Terminated Merger, Cigna Demands $13B from Anthem

by Thomas Beaton

UPDATE: Anthem has secured a restraining order against Cigna preventing the final dissolusion of the merger.  The temporary order will be reviewed during a Delaware Chancery Court hearing on April 10. After a court ruling ended the...

Humana to Leave ACA Health Insurance Exchanges by 2018

by Thomas Beaton

Humana will halt sales of individual health insurance plans through the Affordable Care Act’s exchanges by 2018, which will leave more than 150,000 Humana customers without a carrier.   Amid ongoing political uncertainty, Humana said...

Aetna, Humana Terminate Merger Deal After Court Defeat

by Thomas Beaton

Aetna and Humana have scrapped their merger plans after the Department of Justice blocked the deal due to antitrust concerns.  Aetna will pay Humana a $1 billion termination fee, included as part of the original agreement. The DOJ lawsuit,...

Federal Judge Strikes Down Cigna-Anthem Health Insurance Merger

by Jacqueline Belliveau

A federal judge in Washington DC recently blocked a potential $48 billion health insurance merger between Cigna and Anthem, according to a Department of Justice (DoJ) press release. The two payers started the merger process back in the summer...

Payers with Larger Market Share Have More Negotiating Power

by Thomas Beaton

Payers that dominate the local market are able to negotiate lower physician office visit prices than their smaller peers, found investigators from Harvard Medical School. Health insurance companies with 15 percent or more of the market share...

Shareholder Class Action Lawsuit Filed Against Aetna

by Vera Gruessner

A shareholder class action lawsuit has been filed against the national health insurance company Aetna Inc., according to a press release from the law firm of Kessler Topaz Meltzer & Check, LLP. The announcement came earlier this...

Why a Court Stopped the Aetna-Humana Health Insurance Merger

by Vera Gruessner

On January 23, Judge John D. Bates of the Federal District Court for the District of Columbia ruled that the Aetna-Humana health insurance merger would lead to antitrust problems and was not allowed to continue. The Coalition to Protect Patient...

Federal Court Blocks Aetna-Humana Health Insurance Merger

by Vera Gruessner

Today, a federal judge ruled that the health insurance merger between the healthcare payers Aetna and Humana should be blocked on the grounds that it would create antitrust issues, according to The New York Times. The health insurance...

How Blue Cross Health Plans Affect Anthem-Cigna Merger Lawsuit

by Vera Gruessner

The Anthem-Cigna merger lawsuit has brought significant evidence to light ever since the case began on November 21, 2016. The Department of Justice has been able to illuminate that the health insurance merger would create major market concentration...

How 4 Healthcare Payers Fare in 2016’s Health Insurance Market

by Vera Gruessner

The health insurance market has gone through significant changes in 2016. A number of payers have pulled back from the health insurance exchanges such as UnitedHealth and Humana. The Department of Justice has also filed lawsuits against the mergers...


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