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Private Payers News

AHA Urges D.C Appeals Court to “Uphold Cigna-Anthem Ruling”

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The American Hospital Association (AHA) released a public document urging the U.S Court of Appeals in Washington D.C, to affirm the block on the Cigna-Anthem merger. In an amicus barae, the AHA outlined various antitrust violations and inhibitions...

CBO Score Confirms Industry’s American Health Care Act Concerns

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After the Congressional Budget Office released their cost estimate on the American Health Care Act (AHCA) several healthcare industry leadership groups reaffirmed their concerns about the bill, which may leave approximately  14 million Americans...

Aetna, Cigna Join 300 Organizations in CAQH CORE Phase III

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A new press release confirmed that Aetna and Cigna are now certified under CAQH CORE Phase III Operating Rules. Their certification will provide the entire CAQH CORE collaboration interoperable access to two of the largest payers in the US. Under...

Market Monopoly Cause of Court Blocking Cigna-Anthem Merger

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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

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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

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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

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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

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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...

Shareholder Class Action Lawsuit Filed Against Aetna

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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...

Top 4 Ways Payers Could Improve Patient Health Outcomes

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Health insurance companies have been putting more focus on preventive care, a reduction in unnecessary medical testing, and better patient health outcomes by transitioning to value-based care reimbursement. National payers have utilized a number...

Anthem Cut ER Costs by 3% with Value-Based Care Reimbursement

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  In recent years, the national health payer Anthem has been advancing value-based care reimbursement by collaborating with primary care providers and operating the Enhanced Personal Health Care program, according to a report released...

Vermont Blue Cross Plan Reaches Highest Member Satisfaction

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Blue Cross and Blue Shield of Vermont (BCBSVT) announced in a company press release this month that the payer has achieved the highest scores for member satisfaction and efficiency rankings for the fourth continuous year. This particular Blue...

Why a Court Stopped the Aetna-Humana Health Insurance Merger

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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

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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...

UnitedHealthcare Adopts Bundled Payment Model for Surgeries

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The national health insurance company UnitedHealthcare has followed the lead of the Centers for Medicare & Medicaid Services (CMS) and implemented a bundled payment model specifically for hip, spine and knee surgeries much like...

Aetna, Humana, Harvard Pilgrim Target Patient Health Outcomes

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Commercial health insurance companies have pursued a number of different approaches to improve patient health outcomes and reduce wasteful medical spending. The payers Aetna, Humana, and Harvard Pilgrim conducted some key collaborations to achieve...

Humana Advances Population Health Management, Value-Based Care

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The health insurer Humana has been progressing with population health management and value-based care by partnering with the population health company FullWell in December 2016, according to a company press release. The partnership creates a...

Cigna Partners with Scripps Health in Pay-for-Performance Model

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The national health insurer Cigna announced in a company press release yesterday that it will be partnering with the nonprofit healthcare delivery system Scripps Health through a pay-for-performance contract to provide employers in the San Diego...

Cigna’s Key Principles for Healthcare Quality Measures

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Cigna is one national health insurance company that has moved forward with creating successful healthcare quality measures for their provider networks. The company uses national standards along with physician feedback when creating its own healthcare...

Key Steps for Payers to Improve Population Health Management

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In recent years, population health management has become a larger factor in the success of a health insurance company. With more payers transitioning to value-based care reimbursement platforms, the quality of care and patient outcomes have grown...

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