Health Plan Weekly

Price transparency has reemerged as a hot topic after President Donald Trump signed an executive order directing increased enforcement of rules requiring hospitals and health plans to post their negotiated rates. Employers can use this wealth of data from insurers and health systems to design the best benefit plans for their employees — if they use the data correctly — noted the panelists of a March 18 webinar sponsored by Catalyst for Payment Reform, an independent, nonprofit organization. 

Before the Transparency in Coverage (TiC) rule went into effect in 2022, employers did not have much pricing data to work with, said Shay Forbes, head of employer solutions with Turquoise Health. “Generally, it’s been nearly impossible for employers to get data” before the transparency rules took effect, he noted during the webinar. 

A major reorganization and workforce reduction is on its way to HHS, Politico reported. This move would come after the agency already fired thousands of probationary workers in February, creating a chaotic situation in which some workers were rehired. The new cuts could hit the Agency for Healthcare Research and Quality, the Office of the National Coordinator for Health Information Technology, the Administration for Children and Families and the Health Resources and Services Administration, according to anonymous sources within the agency.  

Health Care Service Corp. has completed its acquisition of The Cigna Group’s Medicare business. The $3.7 billion sale was announced in January 2024 as Cigna sought to exit the Medicare Advantage market amid increasing pressures. Cigna will continue to provide pharmacy benefit management and other services for Medicare members through its Evernorth health services arm. 

In a move that Wall Street analysts expect will eventually catapult him into the role of CEO, The Cigna Group Chief Financial Officer (CFO) Brian Evanko is being promoted to president and chief operating officer (COO).  

“We view this as essentially anointing Evanko as the next CEO,” Bernstein Research’s Lance Wilkes advised investors. Wilkes, who worked at Cigna before joining Bernstein, pointed out that David Cordani was named president and COO in 2008 before ascending to the role of CEO in 2009. 

“We have expected that Cigna would move toward succession planning and see this as a possible driver in further diversification, with the potential acquisition of an MA [Medicare Advantage] or Medicaid MCO to expand their membership base and diversify their holdings,” Wilkes wrote.  

Centene Corp. and The Cigna Group both reiterated their adjusted earnings per share (EPS) guidance for the year during Barclays 27th Annual Global Healthcare Conference on March 12. While both companies remain optimistic about their 2025 guidance, they face different pressures related to stop-loss insurance, Medicaid and more.  

“We’re only two months into the year, but we continue to feel good about the earnings power of the enterprise this year and also continue to feel good about our ability to unlock the embedded earnings power that we laid out at our December Investor Day over the next few years,” said Centene CEO Sarah London while affirming the company’s EPS guidance of greater than $7.25. 

In the first Affordable Care Act regulation issued since President Donald Trump started his second term, CMS on March 10 unveiled a set of proposals that experts say would add new coverage hurdles for consumers — and may concern health insurers that want their business.  

“It’s not like the Trump administration is looking to hide the ball,” says Zachary Baron, director of the Center for Health Policy and the Law at Georgetown University’s O’Neill Institute. “They’re pretty clear here that they do see this as going to increase burden on consumers and decrease enrollment.”