Health Plan Weekly
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Insurers, Retailers Rethink Clinics After ‘Exuberant’ Spending Spree
Some insurers and retailers are backing away from their investments in provider verticals, especially retail health brands. Cigna's stake in VillageMD, a joint venture with Walgreens Boots Alliance Inc., has lost money, and VillageMD will soon close many locations instead of pursuing aggressive growth. Walmart Inc. also said it will close its health care venture.
In recent years, diversified insurers have seen clinics in which they own a stake as a place where they can control cost of care and, ideally, improve member satisfaction by reducing the friction required to access basic care services — in addition to growing revenue in a segment that isn’t capped by medical loss ratio (MLR) rules. But that premise hasn’t always amounted to much more than a compelling story in practice.
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Telehealth Policies May Get Extended, but Conference Speakers Call for More Research
Although telehealth policies that were put in place in March 2020 following the onset of the COVID-19 pandemic are set to expire at the end of the year, congressional leaders are taking steps to extend the policies for an additional two years. Even if the legislation passes, more research needs to be done to assess the benefits and downsides of treating people virtually from a payer, provider and patient perspective, according to speakers at a May 1 panel organized by the National Institute for Health Care Management (NIHCM) Foundation.
The House Ways and Means Committee on May 8 unanimously advanced legislation that would preserve Medicare beneficiaries’ access to telehealth through 2026. Reps. David Schweikert (R-Ariz.) and Mike Thompson (D-Calif.) are sponsors of bill H.R. 8261, which is known as the Preserving Telehealth, Hospital, and Ambulance Access Act.
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HSA-Eligible Plans Have Mixed Impact on Health Care Use, No Impact on Spending
People with health savings account-eligible high-deductible health plans (HDHPs) use less outpatient services and fill fewer prescription medications than people with PPOs, but HSA plan enrollment appears to have no impact on total health care spending, according to a recent study published by the Employee Benefit Research Institute (EBRI).
As of 2022, 57.9% of employees were enrolled in an HSA-eligible health plan, while 32.3% of them were in an HDHP that was not associated with an HSA.
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MCO Stock Performance, April 2024
Here’s how major health insurers’ stock performed in April 2024. Elevance Health, Inc. had the highest closing stock price among major commercial insurers as of April 30, 2024, at $528.58. Humana Inc. had the highest closing stock price among major Medicare insurers at $302.09. -
News Briefs: Judge Allows RICO Suit Against Centene to Proceed
A federal judge on May 2 ruled that the majority of claims against Centene Corp. can move forward in a lawsuit that accuses the insurer of defrauding customers via its marketing of Affordable Care Act exchange plans. The suit, filed in August 2022, accuses Centene and two of its subsidiaries of misleading consumers by publishing provider directories that are not up to date and that misrepresent the benefits that members will receive when they purchase an Ambetter insurance plan. Those primarily low-income consumers then have trouble finding providers who will take their insurance, according to a press release from the law firm representing the plaintiffs. The suit claims that this alleged scheme violates the Racketeer Influenced and Corrupt Organizations Act (RICO) and numerous state laws, and attorneys for the plaintiffs are seeking to certify the lawsuit as a class action.