Walmart-Humana and the Future of Healthcare

Fast speed dataflow.

Change and consolidation continue to sweep the insurance industry. Healthcare represents almost 20% of the U.S. economy. Costs are increasing and almost no one is happy. These are ingredients for change. The retail sales portion of the economy is also under extreme pressure – with thousands of stores closing and wildly-moving stock prices, this market is as ready for drastic… [Read More]

A Conversation with Dave Cordani, President and CEO of Cigna, About Express Scripts

White Speech Bubble Hanging on the Green Background

I had the opportunity to talk to Dave Cordani, President and CEO of Cigna regarding their planned purchase of Express Scripts. The health insurance carriers get it – they very much need to bring solutions to the market or solutions, which may not be optimal to the carriers, will be imposed upon them. Cigna’s intent is to create… [Read More]

Message Heard – Pharmacy Costs are in the Spotlight

Rx Prescription #2

No doubt the health insurance carriers are getting the message: pharmacy costs are too high, and pricing is not transparent. UnitedHealthcare has announced that they will begin passing rebates directly to retail purchasers at the point of purchase. Pharmacy rebates – which are usually shared between the pharmacy benefits manager (PBM) and the health insurer… [Read More]

Is “Medicaid-for-All” Possible?

is-medicaid-for-all-possible

The ACA exchange rates continue to increase as we witness Nebraska up 35%, Connecticut up almost 25%, and Florida seeing a 19% rise in costs. And now, researchers are showing that these higher costs will change the risk profile on the exchanges. A recent study by the Society of Actuaries reported that average risk scores… [Read More]

Out With the New and in With the Old

Health Insurance Changes

After last year’s collapse of the New York health insurance co-op, Health Republic, the depleted health insurance market for employers with less than 100 employees can expect the return of an old player: Blue Cross Blue Shield. But this old player is changing up tactics a bit. Operating as Empire BCBS in NY, this insurer… [Read More]

Why Is UnitedHealthcare Leaving the Exchanges?

healthcare exchange

UnitedHealthcare’s announcement that it would not participate in the state-based or federal healthcare exchanges wasn’t a big surprise. The cards are stacked against healthcare companies. But first, a little history: The Affordable Care Act erased the actuarial tables on individual health insurance. There were too many unknowns to establish credible pricing. Yet, the national insurers… [Read More]