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Medicaid and Medicare Claims Managed by Insurers Are Rising. Why Aren’t They Worried About Their Profits?

HEALTH CARE un-covered • 819 implied HN points • 11 Jun 24
🏥 Health Politics Healthcare policy Insurance Practices Medicaid Medicare Profit Margins
  1. Insurers are seeing more claims for Medicaid and Medicare, but they aren't worried about profits. This is surprising to many people looking at the rising costs.
  2. Insurance companies can limit patient care by using tactics like prior authorization, which makes it hard for people to get needed treatment. This helps them keep their profits high.
  3. Medicare Advantage plans allow insurers to charge seniors more out-of-pocket costs. Insurers do this to maximize their profits while still getting a steady payment from the government.

She was the first American woman to win the all-around gold medal in Olympic gymnastics. Now she's buried in medical debt.

HEALTH CARE un-covered • 679 implied HN points • 17 Oct 23
🏥 Health Politics Healthcare access Insurance Market Medical Debt Policy Reform Profit Margins
  1. Mary Lou Retton, a celebrated Olympic gymnast, is struggling with large medical bills and has had to ask for help through crowdfunding. Despite her fame, she's one of millions of Americans facing healthcare debt.
  2. UnitedHealth, a major health insurer, is making huge profits while many people struggle to pay for their medical expenses. The company is focusing on profits instead of lowering costs for its customers.
  3. Many insured Americans are also facing high out-of-pocket costs and can't afford healthcare, even with insurance. This situation reveals serious flaws in the healthcare system that need attention from lawmakers.

Cigna’s Q2 earnings put Wall Street on edge despite huge PBM business revenues

HEALTH CARE un-covered • 599 implied HN points • 08 Aug 23
🏥 Health Politics Insurance Issues Healthcare Costs Profit Margins Corporate Practices Market Trends
  1. Cigna plans to raise health insurance premiums for many customers by about 23% next year, which could leave small businesses and individuals struggling to afford their coverage.
  2. Despite earning more money overall, Cigna's profits fell due to higher medical costs and this disappointed investors, causing their stock price to drop.
  3. Cigna is focusing on its pharmacy benefit manager business, which now accounts for a large share of its revenue, even while prioritizing stock buybacks over customer relief.

UnitedHealth Group's 2022 Earnings are in, PBM Optum outperforms health insurance division

HEALTH CARE un-covered • 199 implied HN points • 13 Jan 23
🏥 Health Politics Healthcare policy Insurance Industry Pharmacy Benefits Profit Margins
  1. UnitedHealth Group's pharmacy benefit manager, Optum, is now making more profits than its health insurance division. This shows a big shift in how these companies are making money.
  2. Over the past decade, Optum has seen huge growth in both revenue and profits, while the health insurance side has not grown as fast. This tells us where the real money is for these companies now.
  3. Many major companies, like Cigna and CVS, are also finding their profits mainly from managing drug supplies instead of just selling health insurance. This shows a trend in the healthcare industry where drug supply roles are becoming more profitable.

Big insurer Cigna took in $44 billion in the first 3 months of 2022. 75% came from its drug business.

HEALTH CARE un-covered • 139 implied HN points • 06 May 22
💰 Finance Health Insurance Corporate Earnings Pharmacy Benefits Profit Margins Market Trends
  1. Cigna's huge revenue of $44 billion in just three months shows they are making a lot of money, mainly from their drug business. This means health insurers can earn a lot just from selling medications.
  2. Cigna's profits rose by 12% compared to last year, and they expect even more profits moving forward. This makes investors happy and boosts the company's stock value.
  3. Many Cigna customers face high deductibles and out-of-pocket costs, making it hard for them to afford care. This highlights a problem in the healthcare system where profits might come at the expense of customers' financial wellbeing.
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