Oscar Health insurance exchange expansion planned: Mark Bertolini

Oscar Health plans to extend its geographic reach and launch new products next year to counter shrinking membership, CEO Mark Bertolini said Tuesday. Enrollment fell 6.4% to 970,543 during the second quarter, largely driven by declines in its health insurance exchange and Medicare Advantage businesses, although enrollment in Cigna+Oscar small business plans grew 48.7% to … Read more

Nautic Partners to take Tabula Rasa private in $570M deal

Nautic Partners has agreed to acquire Tabula Rasa HealthCare in a take-private deal, the pharmacy benefit manager announced in a news release Monday.  The private equity firm plans to merge Tabula Rasa with ExactCare Pharmacy, a Nautic Partners portfolio company that provides medication management and pharmacy services. The all-cash deal values Tabula Rasa at $570 … Read more

UnitedHealth’s OptumRx CEO Patrick Conway appointed

UnitedHealth Group has named Dr. Patrick Conway CEO of its OptumRx pharmacy benefit manager effective immediately, the executive posted on LinkedIn Thursday. Conway succeeds Heather Cianfrocco, who will serve as president of UnitedHealth’s Optum healthcare services arm, a position John Prince vacated in June. “Pharmacy services have a major impact on people across the healthcare … Read more

Kaiser Permanente posts $2B net income in Q2

Kaiser Permanente delivered another strong quarter in 2023, in contrast to last year’s multibillion-dollar losses. On Friday, the Oakland, California-based nonprofit organization reported net income of $2.08 billion in the second quarter, compared with a $1.3 billion loss in the year-ago period. Revenue was up 7.2% to $25.17 billion. Quarterly expenses rose 4.5% to $24.42 … Read more

Alignment reports Q2 loss, plans to boost benefits

The Medicare Advantage industry at large may be cutting benefits and increasing premiums to account for higher-than-anticipated medical expenses, but Alignment Healthcare CEO John Kao said the company plans to take the opposite tack. The insurance company plans to capitalize on rival carriers cutting supplemental benefits and capture market share by enhancing benefits in 2024 despite reporting … Read more

Amwell earnings show $93M net loss in Q2 2023

Amwell saw its net losses balloon in the second quarter driven largely by the company’s dwindling market capitalization, the telehealth provider reported Wednesday. The Boston-based company, also known as American Well Company, recorded a $93 million net loss, or 33 cents per share, a 34.8% increase from the year-ago period. Revenue declined 3.3% to $62.4 million … Read more

CMS to boost Medicare pay for inpatient, long-term care hospitals

Inpatient hospitals will see a larger Medicare payment hike next fiscal year than first proposed, the Centers for Medicare and Medicaid Services announced Tuesday. Acute care hospitals complying with quality reporting rules and electronic health record guidelines will get a 3.1% net increase in Medicare reimbursements in fiscal 2024 under the hospital inpatient prospective payment … Read more

Tenet Healthcare Q2 profits led by recovering patient volumes

Tenet Healthcare Corp. is the latest for-profit system benefiting from recovering patient volumes in the first half of 2023.  Dallas-based Tenet said Monday same-hospital admissions in the second quarter grew by about 3% compared with a year ago, including a 5% growth in non-COVID-19 patients, while ambulatory surgical cases grew 6.6%. The company reported second-quarter … Read more

Centene CEO Sarah London: Medicare Advantage star ratings may drop

Centene’s standing in the Medicare Advantage market may further deteriorate as the company anticipates losing its sole four-star quality rating, CEO Sarah London told investors Friday. The insurer reported the greatest drop in star ratings among Medicare Advantage carriers last year after the Centers for Medicare and Medicaid resumed stringent reviews it had paused during … Read more