“Do you have the guts to break through where others don’t or won’t?” These are the words of UnitedHealthcare’s CEO on their mission to improve healthcare delivery in the United States. As this blog continuously chronicles, the system is fraught with deficiencies and opportunities for substantive improvement. Medical care has become too expensive. Delivery is… [Read More]
Walmart-Humana and the Future of Healthcare
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
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]
Aetna – Reshaping Healthcare
I just attended the Aetna National Broker Advisory Council Meeting. This is a very inspiring meeting to me, one in which I learn of the ways Aetna is helping to tackle the biggest issue in healthcare today: COST! While the CVS-Aetna merger is awaiting approval, it’s nice to hear that Aetna is moving forward with their… [Read More]
Take Politics Out of Healthcare
Three additional states have joined California in an investigation of the third largest insurer in the United States – Aetna – alleging their medical director denied a $20,000-per-dose infusion, admitting in a deposition that he never looked at [the] patient’s medical records. The media and public have cried out that the insurer has put profits over patient… [Read More]
Can You Believe What Happened to Me at the Pharmacy?
This is going to be a rant blog. I happen to know that a lot of people from Aetna (which is my insurer) read this. But, it really doesn’t matter whether it’s Aetna or another medical insurer – they all have the same issues. Thankfully I am reasonably healthy. As with most people, my most frequent encounter with the… [Read More]
CVS-Aetna – a Few Weeks Later
So the CVS-Aetna deal has been seasoning a bit and I really haven’t heard of any major roadblocks to approval. And early integration planning is starting. Not that integration teams are that much of an indication as they didn’t portend a good result for the Aetna-Humana or Anthem-CIGNA mergers. It would seem that horizontal integration is… [Read More]
Will the Urge to Merge Help Healthcare?
The announcement this week that CVS would be acquiring Aetna is the latest effort to remake U.S. healthcare. Costs are still spiraling upwards at an unsustainable rate and try as we can, inertia makes efficiency and cost reduction battles difficult to win. “Bigger” hasn’t done much to reduce costs. The health insurance market is down to… [Read More]
Cost-Control Over Risk: More Employers Embrace Self-Insurance
More and more employers are embracing self-insurance; according to the U.S. Department of Health & Human Services, more than 80% of companies with 500 or more employees have self-insured plans. That’s astounding in the context of historic statistics which showed that only the largest employers used this funding mechanism. And since new products from traditional… [Read More]
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]
