Revenue Cycle and Payer News 2-21-2018

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Posted By: Roberta Mullin February 21, 2018

In the News…

Meet Oscar, The Health Insurance Startup Trying To Fix America’s Healthcare One City At A Time
Back in June of 2015, we reported on Oscar’s (@oscarhealth) funding and expansion as a new startup. Since that time “over 250,000 members, partnered with doctors in seven major metropolitan areas, and taken a data-centric view to an often byzantine system—all while adjusting to seemingly continuous efforts from Congress to enact reform.” Now, here we are in 2018, three years later and Bezinga has reached out to Mario Schlosser, the current CEO, about the story behind Oscar, and the path he sees for it in the future.

NTT DATA and Oracle Insurance to Offer End-to-End Solution for Government Payers and Health Plans
NTT DATA Services (@NTTDATAServices) a recognized leader in global technology services and a Platinum Cloud Standard member of Oracle PartnerNetwork (OPN), recently announced a new end-to-end solution in collaboration with Oracle Insurance designed to improve operational efficiencies for government payers and health plans. The new payment and benefits solution will manage all aspects of health insurance membership, claims payment and benefits operations. The flexibility and scalability it affords will help to lower administrative costs and streamline processes for both government payers and health plans.

UnitedHealth Group Supporting People Affected by Mass Shooting at Marjory Stoneman Douglas High School
UnitedHealthcare and Optum, the health benefits and services businesses of UnitedHealth Group (@UnitedHealthGrp), are opening Optum’s Emotional-Support Help Line, providing access to specially trained mental health specialists to support people affected by the recent mass shooting at Marjory Stoneman Douglas High School in Parkland.

Cigna Delivers Strong 2017 Results, Expects Continued Revenue and Earnings Growth in 2018
Cigna Corporation (@Cigna) reported strong 2017 results with growth across the Company’s Global Health Care, Global Supplemental Benefits and Group Disability & Life segments.

Humana Reports Fourth Quarter 2017 Financial Results; Provides 2018 Financial Guidance
Humana Inc. (@Humana) recently reported diluted earnings per common share (EPS) for the quarter ended December 31, 2017 (4Q17) versus the quarter ended December 31, 2016 (4Q16) and for the year ended December 31, 2017 (FY17) versus for the year ended December 31, 2016 (FY16) as follows:

Molina Healthcare reports $512-million loss for 2017
The Daily Breeze reports Molina Healthcare (@molinahealth) reported a $512-million loss for 2017, a year when the firm changed its top leadership and underwent a company-wide reorganization.The company attributed its 2017 losses to such factors as the costs of its restructuring and the federal government’s termination of subsidy payments that executives believe are still owed to the firm.

Nasty Flu Season Makes Things Worse for Health-Insurance Stocks
Bloomberg Markets (@markets) reports health-insurance stocks have been taking a beating since Amazon.com, JPMorgan and Berkshire Hathaway announced an alliance to address the health-care needs of their workers late last month. A particularly nasty flu season isn’t helping any.

California launches investigation following stunning admission by Aetna medical director
California’s insurance commissioner has launched an investigation into Aetna after learning a former medical director for the insurer admitted under oath he never looked at patients’ records when deciding whether to approve or deny care.

3 more states investigating Aetna after former medical director’s comments
Becker’s Hospital Review reports Colorado, Washington and Connecticut have joined California in investigating Aetna after one of the health insurer’s former medical directors admitted under oath he never reviewed patients’ medical records when deciding whether to approve or deny claims, according to CNN.

Regulators’ Inquiries Into Aetna Claims Review Practices Not Likely to Derail CVS Merger: Lawyers
The National Law Journal reports that although two states recently announced that they are taking a close look at Aetna Inc.’s practices for denying claims for health care coverage, the scrutiny is unlikely to prevent the insurance giant’s proposed merger with CVS Health from going through, corporate lawyers said.

CareFirst BlueCross BlueShield Among ‘World’s Most Ethical Companies’ For Sixth Consecutive Year
CareFirst BlueCross BlueShield (@CareFirst_News), the mid-Atlantic region’s largest health insurer, has been named by the Ethisphere Institute as one of the “World’s Most Ethical Companies” in 2018. This year’s honor marks the sixth consecutive year CareFirst has been recognized for its commitment to leading ethical business standards and practices.

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.