Centene Likely To Lose 2.2 Million Medicaid Members Over 18 Months
The redetermination process will significantly impact the insurer's pandemic-era growth, Modern Healthcare reports. Meanwhile, a federal judge's ruling issued another win to providers against surprise billing regulation, related to the arbitration process.
Modern Healthcare:
Centene Expects To Lose 2.2M Medicaid Members In 2023
Centene expects to lose an estimated 2.2 million Medicaid members during the redetermination process over the next 18 months, which would significantly dial back the insurer's pandemic-era growth. (Devereaux, 2/7)
Modern Healthcare:
Providers Score Another Win In Surprise Billing Litigation
Judge Jeremy D. Kernodle of the U.S. District Court for the Eastern District of Texas tossed portions of the final rule issued by three federal agencies in August related to the independent resolution process that aims to settle payment disputes between out-of-network insurers and providers. The regulation instructs a third-party arbiter to consider both an insurer's median in-network rate, or qualified payment amount, and additional information when determining the correct payment for a surprise bill. (Kacik, 2/7)
Modern Healthcare:
Encompass Health Profits Plummet In Uneven 2022
Encompass Health saw profits plummet nearly 30% last year as it dealt with the rising labor costs and inflation besetting the healthcare sector, the inpatient rehabilitation provider reported Tuesday. Net income for the Birmingham, Alabama-based company reached $365.9 million in 2022, compared with $517.2 million in the prior year. Revenue increased 8.3% to $4.35 billion and operating expenses grew 10.8% to $3.72 billion. Salaries and wages rose 12.5%. (Hudson, 2/7)
Stat:
Verily, Struggling To Turn Profit, Turns To Starbucks Veteran
The newly-minted CEO of the Alphabet health tech spinout Verily is not a doctor or a Ph.D. scientist. He’s never run a top-flight lab or published a seminal paper in health care. His breakthrough executive job, far from the halls of science or medicine, was at Starbucks. But Stephen Gillett, 47, now finds himself in charge of one of the most ambitious (some would say overhyped) efforts to transform American health care with technology. (Ross, 2/8)
Bloomberg:
Carlyle In Talks To Buy Veritas’s Cotiviti For Up To $15 Billion
Private equity firm Carlyle Group Inc. is in talks to buy health-care technology firm Cotiviti Inc. for close to $15 billion, including debt, from Veritas Capital, according to people familiar with the matter. (Lee, Davis and Brown, 2/7)
On protecting medical data —
Stat:
Senators Probe Telehealth Companies Sharing Sensitive Health Data
A bipartisan group of senators fiercely criticized several prominent telehealth startups for failing to protect sensitive health information, citing an investigation by STAT and The Markup which found dozens of telehealth companies sharing patient data with Facebook, Google and other major advertising platforms. (Wilkerson, 2/7)
Houston Chronicle:
Cybersecurity Expert Warns Against Threats To Online Medical Records
David Finn recently received a prestigious award from the Baldrige Foundation for Leadership Excellence in the Cybersecurity sector. The Humble resident has a storied career in the private sector in cybersecurity but isn’t talking about his award. Instead, the veteran tech guru is warning everyone he knows of the dangers lurking with medical records on the internet. “I guess we can ignore it, and pretend it's not happening, but it's happening every day,” he said. (Taylor, 2/7)
In other health care industry news —
The New York Times:
New York City’s Social Services Commissioner Will Resign
New York City’s embattled social services commissioner, who has faced criticism over his handling of the city’s homelessness crisis, said in a television interview on Tuesday that he is resigning. The commissioner, Gary Jenkins, has overseen the city’s response to one of the greatest challenges facing New York City as the homeless population hit a record last year. (Fitzsimmons and Newman, 2/7)
Charlotte Ledger:
Emailing Your Doctor? Not At Novant
For patients, being able to drop a message to your doctor for some quick medical advice is one of the best things about electronic patient portals. But if your doctor is at one of the 15 Novant hospitals or dozens of clinics in the system, you may have to pay for that. (Crouch, 2/8)