Thirteen days left in the Federal Benefits Open Season.
Healthcare Dive tells us about five payer trends to watch in 2018. The FEHBlog is encouraged by the fact that
Providers and payers have increasingly worked collaboratively. Payer-provider partnerships vary in type, size, location and model. There are 50/50 joint ventures with co-branding, and less intensive partnerships like pay for performance, accountable care organizations, patient-centered medical homes and bundled payments. Oliver Wyman found the partnerships can be broken down depending on providers’ appetite for risk.
They involve national payers like Aetna, Cigna and various Blues and new players in the payer space like Oscar Health and Bright Health.
In this regard, it’s noteworthy that according to a Forbes report, United Healthcare’s Optum unit has launched a $250 million incubator called Optum Ventures “to develop early-stage healthcare companies.” Optum is another leader in the payer – provider collaboration field.
Fierce Healthcare tries to read the tea leaves concerning Humana’s next M&A deal. Leerink Partners analyst Ana Gupte thinks that
Humana is a possible takeout target after the annual enrollment season for Medicare Advantage concludes. Should a transaction occur, Cigna would be the most likely buyer—though it would need to divest its Health Spring Medicare Advantage plans to satisfy antitrust regulators, Gupte wrote in a research note (PDF). Other “dark horse acquirers” of Humana could include either Anthem, Walmart or Walgreens, Gupte wrote. While the two retailers might seem like odd candidates to purchase a health insurer, such a deal makes sense considering CVS Health is said to be in talks to acquire Aetna.
Kaiser Health News offers consumer tips on how to avoid surprise ambulance bills. If you can plan an ambulance trip, e.g., from a hospital to another facility, then you can arrange for an in-network ambulance service. If you can’t plan the trip, it’s a crap shoot because the days of free municipal ambulance service is over.