Health Plan Weekly

Centene Corp. on March 22 named Sarah London as its next CEO, effective immediately. London, who currently serves as the firm’s vice chairman, will fill the role held by Michael Neidorff for decades, though she has been part of a group of top executives who have handled day-to-day management of Centene since Neidorff took medical leave in late February.

In her previous management role, London was responsible for a “portfolio of companies independent of Centene’s health plans, designing differentiated platform capabilities, and delivering industry-leading products and services to third-party customers,” per a March 22 press release. Before coming to Centene, she worked for UnitedHealth Group’s venture capital arm, Optum Ventures, and its data analytics division.

For the country’s major health insurers, an increasing amount of revenue and growth comes from business lines that serve government programs. Industry experts tell AIS Health that they don’t envision this changing anytime soon, but they do see ongoing business risks that will keep insurers on their toes.

“The aging of the U.S. population has had a positive impact on the senior products segment and has led to consistent growth in the segment’s revenues and earnings for health insurers, a trend that is expected to continue in 2022 and beyond,” noted a recent report from the insurance-focused credit rating firm A.M. Best. Medicare Advantage premiums reached $292.9 billion in 2020 — about 13.8% higher than 2019 and more than double that of 2012.

Sutter Health, the nonprofit hospital system that dominates the Northern California market, recently won a class action lawsuit brought by individuals and small-group plan sponsors who accused the hospital system of anticompetitive practices, including price gouging. Experts tell AIS Health that the trial shows the difficulty of limiting hospitals’ price-setting power when they consolidate, and that robust antitrust enforcement — the kind that ended a proposed hospital system merger in Rhode Island — is critical to keep prices down.

In the lawsuit, according to a website maintained by the plaintiffs’ council, “plaintiffs claim that Sutter forced upon health plans certain pricing and contractual terms, and those practices and terms violated state and federal antitrust and unfair competition laws. Plaintiffs claim this caused the health plans to pay more than they otherwise would for Sutter’s hospital services, and that this resulted in higher insurance premiums for class members whether or not they used Sutter hospitals.”