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May 7, 2025
| This week’s payer news for healthcare leaders
Payer profits fell in 2024 as Americans, especially older ones, utilized more medical care. But efforts to resuscitate margins appear to be working for most — at least for now, according to first quarter results.
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UPDATED
According to the complaint, the insurers paid brokers eHealth, GoHealth and SelectQuote hundreds of millions of dollars for enrolling seniors in their MA coverage — regardless of the plans’ suitability for those members’ needs.
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The sales are contingent on the closure of UnitedHealth’s acquisition of Amedisys, which has been held up after the Department of Justice sued to block the deal last year.
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Health systems are battling high turnover, clinician burnout, rising labor costs, and a shrinking pool of skilled professionals. Explore how providers are addressing workforce challenges
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Aetna is once again retreating from the Affordable Care Act market, while its parent company notched a deal with Danish drugmaker Novo Nordisk that should expand access to its in-demand GLP-1 at the expense of Eli Lilly’s.
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White House officials say the budget, which would slash the HHS’ discretionary funding by 26%, is necessary to curb government bloat. Medical groups say it amounts to an attack on biomedical funding and public health.
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Patrick Conway will replace Heather Cianfrocco, who is being promoted to UnitedHealth’s executive vice president of governance, compliance and information security, the company announced Tuesday.
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On Friday, the company’s health services unit Evernorth unveiled new programs in a reliable growth area: helping payers manage GLP-1 utilization. Cigna also posted first quarter results well above analyst forecasts.
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