Centene’s Medicare Advantage Quality Scores Missed Their Targets
The scores were worse than executives expected. Modern Healthcare reports that the insurer is hiring a chief quality officer as a result. Separately, Cigna's Express Scripts reportedly won Centene's pharmacy benefit manager contract.
Modern Healthcare:
Centene Says Medicare Advantage Star Scores Worse Than Expected
Centene’s quality scores for its Medicare Advantage plans came in worse than its executives expected, jeopardizing the insurer's revenue in 2024. ... Centene is working to improve its scores by hiring a chief quality officer, centralizing its quality improvement operations and setting up systems to track its metrics in real-time. The insurer also added quality improvement as a compensation metric by which all employees’ performance will be measured this year, London said. The company's new pharmacy benefit provider, Cigna's Express Scripts, will also drive improvement, she said. (Tepper, 10/25)
Modern Healthcare:
Cigna's Express Scripts Wins Centene PBM Contract
Centene will contract with Cigna’s Express Scripts to manage its $40 billion in pharmacy spending in 2024, the companies announced Tuesday. “We’re feeling good about moving forward with the core services and ability to expand the relationship if that makes sense,” Centene CEO Sarah London said during the health insurer's third-quarter earnings call with investors. (Tepper, 10/25)
More on Medicare and Medicaid —
Axios:
Physicians Brace For Medicare Cuts, Will Ask Congress For Help
Radiologists, nuclear medicine specialists and vascular surgeons are bracing to see if they'll take the worst of Medicare physician payment cuts next year. (Dreher, 10/26)
Axios:
States Brace For Medicaid Spending Surge
States could start the new year grappling with a surge in Medicaid spending to accompany supply chain pressures, workforce shortages and the effects of inflation. (Goldman, 10/26)
In other health care industry news —
Modern Healthcare:
Amazon Inks Pharmacy Deal With Blue Cross Plan
Amazon Pharmacy has landed another Blue Cross and Blue Shield customer, Florida Blue announced Tuesday. Florida Blue will rely solely on Amazon Pharmacy to deliver medications to its more than 2 million commercial and self-insured customers next year. (Tepper, 10/25)
The Colorado Sun:
Colorado Losing Another Birth Center As Thornton Location Closes
Colorado is losing another birth center, an alternative for mothers who would rather have their babies in a home-like setting with a midwife than in a hospital labor and delivery ward. (Brown, 10/25)
KHN:
How Private Equity Is Investing In Health Care: A Video Primer
In the past decade, private equity has moved aggressively into health care, gobbling up physician practices and even entire hospitals. But what exactly is private equity? And what does its involvement mean for patients and for the American health care system? KHN explains. (Norman and Tempest, 10/26)
