Health Plan Weekly
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MCO Stock Performance, March 2024
Here’s how major health insurers’ stock performed in March 2024. Elevance Health, Inc. had the highest closing stock price among major commercial insurers as of March 28, 2024, at $518.24. Humana Inc. had the highest closing stock price among major Medicare insurers at $346.72.
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Market Concentration Pushes up ACA Plan Premiums, Analysis Shows
High gross premiums in the Affordable Care Act marketplaces are related to limited choices of health plans and high levels of hospital concentration, a recent Urban Institute report shows.
The study analyzed insurer and premium participation data from more than 503 rating areas on HealthCare.gov and state-based marketplaces from 2019 to 2024. In 2024, the average national benchmark premium — the second-lowest-cost silver premium — is $473. State average benchmark premiums range from $335 in New Hampshire to $886 in Alaska. Average annual premium growth between 2019 and 2024 was modest, averaging 0.2% per year.
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News Briefs: Judge OKs Clover Settlement With Shareholders
Clover Health Investments Corp. said on April 4 that a federal district court preliminarily approved its settlement agreement to resolve multiple shareholder-filed lawsuits against the Medicare Advantage startup. Clover had faced several class-action lawsuits that accused it of concealing material information from investors — including an active Dept. of Justice investigation — when it went public in 2021. That litigation stemmed from a highly critical report from an activist short-selling firm. In April 2023, Clover agreed to pay $22 million to pay one of the consolidated shareholder lawsuits against it. The more recent settlement agreement — which was first disclosed last June and received preliminary court approval on March 5 — would resolve the remaining shareholder-led civil cases filed against Clover in Delaware, New York, and Tennessee courts. While this settlement does not involve any monetary payment, it will require Clover to “implement a suite of corporate governance enhancements.”
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Bright Health Gave CEO $2M Bonus Despite Owing Insurers Millions
Although NeueHealth Inc. — formerly known as Bright Health Group Inc. — still owes a substantial sum of money to health insurers and is struggling to stay afloat, its CEO received a $1.95 million cash bonus last year, according to a new regulatory filing.
“It really is just a mockery of good governance and fairness at this point,” remarks Ari Gottlieb, principal of A2 Strategies and a prominent critic of Bright and other startup "insurtech" firms.
NeueHealth did not respond to AIS Health’s questions about the basis for the bonus earned by G. Mike Mikan, who has served as the firm’s president and CEO since April 2020.
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Ground Ambulance Surprise Billing Committee Will Back Rate Setting, Medicare On-Site Coverage
A panel of experts will recommend in a formal report to Congress that ground ambulance-related balance bills should be settled using a rate-setting benchmark rather than arbitration, according to one member of the panel; in addition, the report will recommend that Medicare should begin to cover care that is delivered by ambulance personnel but does not result in a hospital transport. The report is under review by CMS, and is expected to kick off another battle on Capitol Hill over surprise billing policy.
Balance or surprise billing generally occurs when a person unwittingly receives care from an out-of-network provider and is then billed by that provider for whatever balance remains after insurance reimbursement. According to a member of the panel, the report will recommend that balance bills for ground ambulance care should be banned in virtually all circumstances, including emergency transports to a hospital, interfacility transports and care delivered by EMTs in the field that does not result in a transport to a hospital.
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