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Wednesday, Feb 8 2023

Full Issue

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.

Centene聽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.聽(Devereaux, 2/7)

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聽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.聽(Kacik, 2/7)

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)

The newly-minted CEO of the Alphabet health tech spinout Verily is not a doctor or a Ph.D. scientist. He鈥檚 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)

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.聽(Lee, Davis and Brown, 2/7)

On protecting medical data 鈥

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)

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鈥檛 talking about his award. Instead, the veteran tech guru is warning everyone he knows of the dangers lurking with medical records on the internet. 鈥淚 guess we can ignore it, and pretend it's not happening, but it's happening every day,鈥 he said. (Taylor, 2/7)

In other health care industry news 鈥

New York City鈥檚 embattled social services commissioner, who has faced criticism over his handling of the city鈥檚 homelessness crisis, said in a television interview on Tuesday that he is resigning. The commissioner, Gary Jenkins, has overseen the city鈥檚 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)

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.聽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)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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