Insurers Brace For Expected Medicare Advantage Losses Next Year
CVS Health and Humana are making moves ahead of anticipated drops in Medicare Advantage memberships in 2025. Meanwhile, low Medicare Advantage pay further stresses rural hospitals.
Modern Healthcare:
Aetna, Humana Expect Medicare Advantage Membership Losses In 2025
Industry heavyweights CVS Health Aetna and Humana foresee Medicare Advantage membership losses next year. Anticipated changes to health plan offerings and benefit design to achieve long-term business profitability could mean losing a significant portion of their Medicare Advantage membership, executives told investors at the Bank of America Securities Healthcare Conference on Tuesday. (Tepper and Berryman, 5/14)
Stat:
CVS Is Willing To Dump 10% Of Its Medicare Advantage Members
CVS Health is preparing to make significant changes to its 2025 Medicare Advantage plans, which could potentially drive away 10% of its membership, the company’s chief financial officer said at an investment banking conference Tuesday. (Herman, 5/14)
Modern Healthcare:
Rural Hospitals Facing Low Medicare Advantage Pay Risk Closing
To explain how the accelerating penetration of Medicare Advantage is harming rural hospitals in ways that will likely require action by Congress and regulators to fix, Nemaha Valley Community Hospital CEO Kiley Floyd pointed to patients in her northeastern Kansas community who previously were covered by traditional Medicare. One diabetic man who was not competent to mind his own finances used to have his care covered by regular Medicare and his veteran's benefits, Kiley said — until a Medicare Advantage marketer called and he said the magic word: "Yes." (McAuliff, 5/14)
Modern Healthcare:
Talkspace Enters Medicare Space With Services In 11 States
Behavioral health provider Talkspace rolled out services Tuesday to 13 million Medicare members across 11 states and will expand to 33 million members nationwide by the end of the year. Talkspace services are available to those with traditional Medicare in California, Florida, New York, Ohio, New Jersey, Virginia, Missouri, Maryland, South Carolina, New Mexico and Idaho. The company plans to offer services to Medicare Advantage members later on, as well. (DeSilva, 5/14)
In other industry news —
Reuters:
Getinge Limits Sale Of Heart Devices In The US After FDA Warning
Sweden's Getinge (GETIb.ST), opens new tab will limit sales of some of its heart products in the U.S., the medical equipment maker said late on Tuesday, after recent advice from the U.S. Food and Drug Administration (FDA) to move away from its devices. "We have decided to immediately pause promotional activities of the Cardiohelp System and Cardiosave Intra-Aortic Balloon Pump in the U.S. until outstanding actions related to quality improvements have been addressed and approved," said CEO Mattias Perjos in a statement. (5/15)
Modern Healthcare:
Humana’s Jim Rechtin To Succeed CEO Bruce Broussard On July 1
Jim Rechtin will take the helm as Humana's next CEO on July 1. Rechtin will succeed CEO Bruce Broussard, who has led the company for more than a decade. Rechtin joined Humana’s leadership team in January as president and chief operating officer with plans to move into the additional role of CEO during the second half of the year. (Berryman, 5/14)
Reuters:
Activist Jana Partners Built Position In QuidelOrtho In First Quarter, Sources Say
Activist investor Jana Partners built a new stake in U.S. diagnostics company QuidelOrtho (QDEL.O) during the first quarter, sources familiar with the hedge fund's position told Reuters. It is unclear whether the hedge fund will seek changes at the company, which makes the popular QuickVue COVID-19 test for home use, and it could not be determined how large Jana's stake is. (Herbst-Bayliss, 5/14)
Modern Healthcare:
What Healthcare REITs Mean For Providers, Patients
Steward Health Care's Chapter 11 bankruptcy filing is the latest example of the significant role real estate investment trusts play in healthcare. REITs have served as a financial solution for providers and health systems, allowing them to broaden their networks without as hefty a capital investment. (DeSilva, 5/14)
Also —
KFF Health News:
Why One New York Health System Stopped Suing Its Patients
Jolynn Mungenast spends her days looking for ways to help people pay their hospital bills. Working out of a warehouse-like building in a scruffy corner of this former industrial town, Mungenast gently walks patients through health insurance options, financial aid, and payment plans. Most want to pay, said Mungenast, a financial counselor at Rochester Regional Health. Very often, they simply can’t. (Levey, 5/15)
