Revenue Cycle and Payer News 1-31-2018

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Posted By: Annmarie Budniak January 31, 2018

In the News…

Amazon, Berkshire, JPMorgan to set up a Health Company for Staff
According to Bloomberg News, three corporate giants are teaming up to combat what the billionaire Warren Buffett calls a “hungry tapeworm” feasting on the U.S. economy: health care. Amazon, Buffett’s Berkshire Hathaway and JPMorgan plan to collaborate on a way to offer health-care services to their U.S. employees more transparently and at a lower cost. The three companies plan to set up a new independent company “that is free from profit-making incentives and constraints,” according to a short statement on Tuesday.

Mutual of Omaha Collaborates with Lumeris to Enter Medicare Advantage Market
Mutual of Omaha (@mutualofomaha) announced its entry into the Medicare Advantage market through a strategic alliance with Lumeris (@lumeris), an industry leader in delivering value-based health care solutions. Beginning in 2019, Mutual and Lumeris plan to offer a Medicare Advantage plan with prescription drug coverage in select markets. The multi-year agreement between Mutual and Lumeris will create Medicare Advantage plans across the country to provide high-quality and efficient care for Mutual Medicare Advantage customers.

It’s In The Mail: Aetna Agrees To $17M Payout In HIV Privacy Breach
According to Kaiser Health News, Aetna settled a lawsuit for $17 million Wednesday over a data breach that happened in the summer of 2017. The privacy of as many as 12,000 people insured by Aetna was compromised in a very low-tech way: The fact that they had been taking HIV drugs was revealed through the clear window of the envelope.

UnitedHealth Group Reports 2017 Results Highlighted by Continued Strong and Diversified Growth
Highlights from the report:

  • Revenues Grew 9% Year-Over-Year to $201 Billion
  • Operating Earnings Exceeded $15.2 Billion, Up 18% Year-Over-Year
  • Net Earnings of $10.72 Per Share and Fourth Quarter Net Earnings of $3.65 Per Share included a One-Time, Non-Cash Deferred Tax Benefit of $1.22 and $1.21 Per Share, Respectively
  • Adjusted Net Earnings were $10.07 Per Share for the Full Year, Up 25% Year-Over-Year, and Grew 23% to $2.59 Per Share in the Fourth Quarter
  • Cash Flows from Operations Grew 39% Year-Over-Year to $13.6 Billion

Humana Inc. to Release Fourth Quarter 2017 Results on February 7, 2018
Humana Inc. (@Humana) will release its financial results for the fourth quarter 2017 (4Q17) on Wednesday, February 7, 2018 at 6:30 a.m. eastern time. The company will host a conference call at 9:00 a.m. eastern time that morning to discuss its financial results for the quarter and earnings guidance for 2018.

After Another Merger Monday In Health Care, CVS Is Still The Company To Watch In 2018
Forbes reports that the health care sector rallied yesterday on another “Merger Monday” with the announcement of Sanofi’s (SNY) purchase of Bioverativ (BIVV) for $11.6 billion, and Celgene’s (CELG) $9 billion purchase of 90 percent of Juno Therapeutics (JUNO). But there’s still one transformative merger that will define and reshape the U.S. health care market in 2018: the CVS/AETNA $69 billion deal announced last December.

Cigna Named a “Best Place to Work for LGBTQ Equality” for Sixth Year in a Row
Cigna (@Cigna), a global health service company, received a perfect 100 score on the Human Rights Campaign’s 2018 Corporate Equality Index (CEI) and has been recognized by the HRC Foundation as one of the “Best Places to Work for Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) Equality” for the sixth year in a row.

Health Care Leaders Collaborate to Streamline Prior Authorization and Improve Timely Access to Treatment
According to AHIP, physicians, pharmacists, medical groups, hospitals, and health insurance providers are working together to improve prior authorization processes for patients’ medical treatments, also known as pre-approval. This will help patients have access to safe, timely, and affordable care, while reducing administrative burdens for both health care professionals, hospitals and health insurance providers.

In State News:

Gov. Walker announces proposal for health care in Wisconsin
Governor Scott Walker is taking a new stance on health care, announcing a proposal that would strengthen the Affordable Care Act in Wisconsin. Walker wants to lower rising insurance premiums in the health care market. In a statement, the Governor said, “we need to do what we can at the state level to stabilize our own health care market and make health care more attainable for people across our state.”

Upcoming AHIP Conferences:

National Health Policy Conference
When: March 7 – 8, 2018
Register for this event.
Twitter: @AHIPCoverage

Where will we be in 2018? What health policy issues will be in the spotlight? On what priorities should your organization focus? AHIP’s National Health Policy Conference will deliver expert insights, top-level dialogue, and innovative solutions as we work together to advance a health care system focused on quality and sustainability.

National Conference on the Individual and Small-Group Markets
When: March 8 – 9, 2018
Register for this event.
Twitter: @AHIPCoverage

What will be the key policy and operational issues for those serving the Individual and Small-Group markets? Join us in March as thought leaders from throughout the health care industry share where we are and what’s needed next to succeed in these important markets. You’ll leave with innovative ideas from states, what’s next for small groups, how to best tackle affordability and access, and more. Located immediately following AHIP’s National Health Policy Conference (March 7-8), combine both conferences with one trip.