CMS authors plot twist in Medicare Advantage comeback story The Medicare Advantage revival might come later than insurers such as UnitedHealthcare and Humana hoped.

Even after Congress grilled insurance CEOs last week, they didn't see the Trump administration coming for Medicare Advantage pay.
"It’s clearly not good news, unless you were smart enough to short the stocks,” said Ari Gottlieb, an independent health insurance consultant. via @nonatc.bsky.social

Wow. Rep. Greg Murphy (R-N.C.), who had brain surgery 5 weeks ago, told health insurers he would turn them all to dust, and at this point, he wants a non-profit system. This is a very conservative lawmaker, and a doctor.

Insurance CEO hearings: Bigwigs face Congress Thursday The chief executives of UnitedHealth Group, CVS Health, Elevance Health, Cigna and Ascendiun appear before Congress Thursday.

The CEOs of UnitedHealth, CVS, Elevance, Cigna and Blue Shield of California are testifying at two House committees today. Follow along with live updates from @mcauliff.bsky.social and @nonatc.bsky.social on @modernhealthcare.bsky.social (registration required but no paywall) bit.ly/4pO3apr

Map of the US showing how many counties have insurers

Medicare Advantage can be an option for seniors IF it's offered in the county where you live. We found that even if you have the option this year, next year it could go away.
My deep dive with @nonatc.bsky.social for @modernhealthcare.bsky.social
www.modernhealthcare.com/insurance/mh...

@timbroderick.bsky.social and I mapped where UnitedHealth, Humana, Aetna, Elevance Health and Kaiser deemed worthy of investment in Medicare Advantage — and which counties they were willing to leave behind.

Do the changes surprise you?

www.modernhealthcare.com/insurance/mh...

Cambia proposes another Blue Cross Blue Shield affiliation Cambia Health Solutions plans to affiliate with Arkansas Blue Cross, following a similar proposal with Blue Cross of North Dakota announced in August.

What's behind Cambia's affiliation spree? The company just announced its second proposed Blue Cross partnership in months. Here's an inside look at the company's strategy 👇

www.modernhealthcare.com/insurance/mh...

This exchange open enrollment period is going to be different The open enrollment period for health insurance exchange plans begins Saturday as seismic changes shake up the market.

Big premium hikes aren't the only thing different about this year's open enrollment

www.modernhealthcare.com/insurance/mh...

Molina announces health insurance exchange cutbacks Molina Healthcare's health insurance exchange membership could be 50% smaller next year.

Real-world impacts on the business level.
Molina Healthcare is pulling out of one-fifth of the counties where it sells health insurance exchange plans, @nonatc.bsky.social reports.

"Premiums for Molina Healthcare exchange plans will be 30% higher next year."

Centene CEO London: 'We are really at a moment of revolution' Health insurance companies are responding to consumer demand for a different system by investing in new technology and customer experience. Centene CEO Sarah London said she's in.

Centene CEO London: 'We are really at a moment of revolution'
www.modernhealthcare.com/insurance/ce...

PBMs fight back as state seeks stronger regulation CVS Health and Cigna are angling to undo new state laws limiting vertical integration in healthcare and regulating retail pharmacy contracting.

"The more you see how #PBMs have evolved and the games they play, the more you just get pessimistic that this little piecemeal legislation at the state level is going to do anything to them," USC Schaeffer Senior Scholar Geoffrey Joyce told @nonatc.bsky.social @modernhealthcare.bsky.social.

Medicare Advantage sector’s hopes dashed as Trump keeps up pressure Health insurance stocks soared when President Donald Trump won last year. The Medicare Advantage world is less bullish now.

On Nov. 6, share prices for $UNH, $HUM and $CVS, the Medicare Advantage market share leaders, jumped a collective 10.9%. Seven months later, their value is down 38.1%, largely driven by $UNH's downfall.

www.modernhealthcare.com/politics-pol... w/ @birdy.bsky.social

UnitedHealth woes incite worry about its value-based partners UnitedHealthcare and Optum's struggles with an evolving Medicare Advantage market have investors questioning if valued-based care companies are at risk.

“When you look at the challenges amongst these value-based care players today, it's less patient-driven, right? It's about revenue, it’s all about upcoding, which V28 killed”

www.modernhealthcare.com/insurance/un...

Sarah London named Modern Healthcare's Leading Women Vanguard Sarah London is the first woman to serve as Centene's CEO.

You are not going to want to miss this! www.modernhealthcare.com/events/cente...

States reconsider Medicaid expansion 'trigger laws' as cuts loom Nine Medicaid expansion states have "trigger laws" requiring them to pull out if federal funding diminishes. Congress is weighing huge cuts.

"It’s very important for people to understand what we are trying to do but we can’t do because we don’t have the power to push bills through”

www.modernhealthcare.com/politics-pol...

Health insurers slash thousands of jobs, more cuts ahead For the first time in 15 years, employment across the major health insurance companies fell last year, according to a Modern Healthcare analysis.

“It was such a growth story for many years, and that's tapered a little bit”

www.modernhealthcare.com/insurance/un...

Republicans' Medicaid cuts could cripple Centene, Molina Republicans' proposed Medicaid cuts pose the greatest threat to Centene and Molina, among large insurers.

Execs from Medicaid insurers Centene and Molina have downplayed the financial effect of possible Medicaid policy shifts and the likelihood that Congress will change how the program operates. What gives?
www.modernhealthcare.com/insurance/me...

My lovely colleague Nona Tepper is here!! Please give her a follow for top-tier insurance coverage @nonatc.bsky.social ⭐️