Health Plan Weekly

Months after rumors of a brewing deal with Humana Inc. generated a spate of headlines, The Cigna Group’s chief financial officer is signaling clearly that the company isn’t eager to jump into the mergers and acquisitions game until the conditions are just right.

“We continue to view inorganic activity through the lens of, it needs to be strategically attractive for the company,” CFO Brian Evanko said during a question-and-answer session with analyst Nathan Rich during the Goldman Sachs Global Healthcare Conference on June 11.

Although improving Medicare Advantage margins has been the hottest topic recently in managed care, executives at Elevance Health, Inc. at a recent investor conference made some noteworthy comments about the firm’s commercial and Affordable Care Act exchange businesses — both of which insurers are talking more glowingly about amid government-business headwinds.

Regarding the company’s ACA exchange business, “we certainly aren’t looking for membership over margin,” Morgan Kendrick, president for the insurers commercial and specialty health benefits segment, said during a June 12 question-and-answer session at the Goldman Sachs Global Healthcare Conference.

There are persistent challenges around the collection and transmission of that data between providers and payers. The same is true of the quality of the data itself. It's a key challenge for the health insurance industry as payers try to measure provider quality and transition to value-based contracting.

"I'll just say the accuracy of our directory is bad. It just is," said Mike Kane, senior vice president for provider data operations at UnitedHealthcare. Kane was speaking on a June 12 panel organized by the Council for Affordable Quality Healthcare (CAQH) at the 2024 AHIP Conference in Las Vegas. "About half of every single provider [data profile] that our members call, there's at least one data element in our directory that's wrong."

"It's a horrible, horrible experience," Kane said.

Uninsured rates among Black, Latino, Asian and Native American communities plummeted from 2010 to 2022, as more people gained health care coverage through federal health care programs and employer-sponsored plans, according to reports released by HHS.

The uninsured rate for Black Americans under age 65 dropped from 20.9% to 10.8% between 2010 and 2022, and the rate dropped from 32.7% to 18.0% for Latino Americans during that time. Meanwhile, the uninsured rate went from 16.6% to 6.2% for Asian Americans, Native Hawaiians and Pacific Islanders (AANHPI), and from 32.4% to 19.9% for American Indians and Alaska Natives (AI/AN).