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Insurers

All articles tagged with #insurers

healthcare3 months ago

Medicare Advantage 2026 Ratings: Winners, Losers, and Industry Insights

The 2026 Medicare Advantage star ratings remained stable overall, with some insurers like Elevance and Centene improving, while others like Humana and Aetna saw declines. Clover Health experienced a significant drop below 4 stars, potentially impacting its earnings. The ratings influence insurer revenues and strategies, with some plans adjusting their offerings to maintain or improve their scores amid regulatory and market pressures.

via Healthcare Dive|
#2026#healthcare#healthcare-quality
health6 months ago

Insurers' Stance on Kids' Vaccine Coverage Without Government Recommendations

Major insurers are uncertain about whether they will continue to cover childhood vaccines if the CDC's Advisory Committee on Immunization Practices (ACIP) stops recommending certain vaccines, following a recent review of the vaccination schedule and changes in committee membership led by Robert F. Kennedy Jr. Only Blue Shield of California confirmed it would maintain coverage, while others are monitoring the situation. The review and political shifts have raised concerns about the future of vaccine coverage and public health policy.

via WIRED|
#acip#child-immunizations#health
insurance-market1 year ago

"Harvard Study Reveals Troubling Truth About Florida's Insurance Market"

A recent study led by researchers at Harvard University, Columbia University, and the Federal Reserve Board warns that smaller, lower-quality insurers are replacing major private home insurers that have left Florida, leading to a crisis in the state's home insurance sector. These new insurers are found to be less financially stable and may not meet the minimum requirements set by government guidelines. The exodus of bigger private companies from high-risk areas in Florida has led to a reliance on approximately 50 small insurers, all rated by a single company, Demotech Inc., whose ratings differ significantly from those of other rating agencies. The situation has been exacerbated by factors such as excessive litigation, widespread fraud, and the increased risk of severe weather events due to climate change.

via Newsweek|
#financial-stability#florida#insurance
health-insurance1 year ago

"Uncovering Hidden Fees: How Insurance Companies Profit at Patients' Expense"

A little-known data firm called MultiPlan helps health insurers maximize profits by negotiating lower payments for out-of-network claims, leaving patients responsible for the remaining balance. This practice has resulted in patients receiving unexpected bills amounting to tens of thousands of dollars, despite having insurance coverage. MultiPlan and insurers typically receive a percentage of the "savings" on each claim, creating a financial incentive to recommend lower payments. Confidential pricing and fee data, as well as insurance statements, have shed light on the extent of these hidden fees and the impact on patients.

via The New York Times|
#health-insurance#hidden-fees#insurers
insurance2 years ago

"California's Wildfires: Can Insurance Commissioner Ricardo Lara Attract Insurers with a New Plan?"

California's Insurance Commissioner, Ricardo Lara, is facing the challenge of luring insurers back to the state after major companies like Allstate, Star Farm, and Farmers Insurance limited or stopped coverage due to the growing risk of wildfires. Lara's plan involves requiring insurers to write policies in fire-prone areas in exchange for faster decisions on rate requests. However, insurers may demand rate increases of up to 40% to accommodate the higher risk. The situation reflects a business model unprepared for environmental disasters, leaving homeowners in a difficult position.

via KTLA Los Angeles|
#california#climate-change#insurance
healthcare2 years ago

Insurer Restrictions Cause Delays for US Diabetes Patients Seeking Ozempic

Some patients with type 2 diabetes in the US are facing difficulties in getting reimbursed for drugs like Ozempic as insurers tighten coverage restrictions to discourage doctors from prescribing the medication for weight loss. This trend has led to a decline in US prescriptions, causing delays and disruptions for diabetes patients. Insurers are implementing prior authorization requirements, forcing patients to try other drugs before being allowed to access newer medications. The high cost of these medications and the paperwork burden on physicians are additional challenges. Patients and doctors are preparing for potential changes in coverage terms in January.

via Yahoo News|
#diabetes#glp-1-drugs#healthcare
healthcare2 years ago

Insurers' Tightened Coverage of Ozempic Causes Delays for US Diabetes Patients

Some patients with type 2 diabetes in the US are facing difficulties in getting reimbursed for drugs like Ozempic as insurers tighten coverage restrictions to discourage doctors from prescribing the medication for weight loss. This trend has led to a recent decline in US prescriptions, causing delays and disruptions for diabetes patients. Insurers are implementing prior authorization requirements, forcing patients to try other drugs before being allowed to access newer medications. The average number of weekly Ozempic prescriptions has dropped by over 6% since the third quarter of this year. Patients and doctors are preparing for changes in coverage terms in January, which may further impact access to these medications.

via Reuters|
#diabetes#glp-1-drugs#healthcare
healthcare2 years ago

"Key Changes in This Year's Affordable Care Act Enrollment: A Must-Know Guide"

Open enrollment for Affordable Care Act (ACA) insurance plans is underway, with a sign-up period that extends until January 15. Last year's enrollment reached a record high of 15.7 million, and this year's enrollment is expected to exceed that. Factors driving up enrollment include the ongoing disenrollment of beneficiaries from Medicaid, new sign-up mechanisms, and increased engagement from insurers. This year, applicants will have more time to submit income verification documents, and those already enrolled will be automatically reenrolled with some changes to ensure they are eligible for cost-sharing reduction plans. More insurance providers are entering the market, offering a wider range of options, but the abundance of choices may be overwhelming for some. The ACA's Navigator program is available to assist consumers in navigating the enrollment process.

via Yahoo News|
#aca-marketplace#affordable-care-act#healthcare
business2 years ago

Warren Buffett's Berkshire Hathaway: Record Cash Pile Amidst Investment Losses

Berkshire Hathaway, the conglomerate owned by Warren Buffett, reported a loss of $12.8 billion in the third quarter due to a decline in the paper value of its investments. However, the company's insurers performed well, contributing $2.4 billion to its operating profit. Berkshire's operating earnings, which exclude the value of its investments, increased by nearly 41% to $10.8 billion. The company's insurance unit benefited from low losses related to major catastrophes and improved profits at Geico. Berkshire's railroad and utility units saw a decline in profits, while the company repurchased $1.1 billion of its own stock. Buffett continues to hold a significant amount of cash and has not made any major investments or acquisitions this year.

via ABC News|
#berkshire-hathaway#business#insurers
finance2 years ago

Insurers' Private Credit Investments Pose Systemic Risk, Warns JC Flowers

JC Flowers, a private equity firm, has issued a warning about insurers' increasing investments in private credit, stating that it poses a systemic risk. The firm highlights concerns about the lack of transparency and potential illiquidity of these investments, which could lead to significant losses in the event of a market downturn. JC Flowers urges insurers to exercise caution and ensure proper risk management in their investment strategies.

via Financial Times|
#finance#insurers#jc-flowers
healthcare2 years ago

Insurers Exploit Generic Drugs, Charging Exorbitant Prices

Insurers are charging exorbitant prices for generic drugs, which are supposed to be affordable alternatives to brand-name medications. This practice has led to increased healthcare costs for patients, as they are forced to pay thousands of dollars for drugs that should be inexpensive. The high prices are attributed to a complex system of rebates and discounts negotiated between insurers and drug manufacturers, resulting in a lack of transparency and affordability in the generic drug market.

via The Wall Street Journal|
#generic-drugs#healthcare#healthcare-costs