Health Plan Weekly

Health insurers have competed against each other to buy up home-care providers over the past several years. The most recent transaction involves UnitedHealth Group, which revealed a $3.26 billion bid to buy home care provider Amedisys at the end of May. UnitedHealth acquired LHC, another home care provider, in a 2022 deal worth $6 billion. CVS Health Corp. and Humana Inc. have also closed their own blockbuster home care transactions in recent years. 

Monique Reese, Highmark Health's senior vice president for home and community care, has a unique perspective on the flurry of transactions that promise to transform home care. Before coming to Highmark in 2018, she led Sutter Health's home care division between 2015 and 2018, and she oversaw UnityPoint Health's home care division between 2010 and 2015. 

UnitedHealthcare will remove out-of-pocket costs and deductibles for remote urgent-care visits, effectively making them free for 5 million members in fully insured employer plans. 

The goal is to remove financial barriers that prevent members from getting necessary acute care while deterring them from costlier settings like the emergency room, Donna O’Shea, M.D., chief medical officer of population health for UnitedHealthcare, tells AIS Health, a division of MMIT.  

UnitedHealthcare’s effort to steer patients away from the ER is not new — but its $0 copay telehealth visits  represent more of a consumer-friendly strategy than it has previously employed. In 2021, the insurer walked back a proposed policy that generated considerable outrage: It would have led to denials of some ER claims that were deemed non-emergencies after the fact.  

Curative Inc., the Texas startup that launched as a COVID-19 testing provider and pivoted to selling commercial health insurance last year, bought bankrupt Illinois-based life insurance firm American Country Insurance Company (ACIC) earlier this month for an undisclosed sum. The transaction will allow Curative to sell health plans in Illinois, but health care insiders doubt that the firm’s signature offering — large-group commercial health plans with no deductibles — can viably be delivered by a small startup. 

Curative said on June 15 that it acquired ACIC, which entered bankruptcy in 2020 and has been in receivership in the states where it operates ever since. Terms of the deal were not disclosed. Per a Curative press release, the ACIC deal will allow the firm to operate “licenses to sell large-group health insurance in select additional states.” Michael Abrams, principal of Numerof & Associates, tells AIS Health, a division of MMIT, that one of those states will be Illinois, as ACIC held both life insurance and health insurance licenses in that state. 

The percentage of LGBTQ+ adults with health care coverage increased from 76% in 2013 to 91% in 2019, due to the Affordable Care Act and the 2015 Supreme Court ruling on same-sex marriage equality, according to a new Health Affairs study.

An analysis of Health Reform Monitoring Survey data showed that, historically, LGBTQ+ adults were less likely to access health care coverage. Yet the disparities between LGBTQ+ and non-LGBTQ+ adults began to decline in 2014 when the main coverage provisions of ACA went into effect. By 2019, coverage rates for LGBTQ+ people (91.2%) were comparable to those of non-LGBTQ+ adults (90.6%).