Bob Herman
Modern Healthcare
Chicago, IL, United States
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Past articles by Bob:
UnitedHealth Group's earnings soar as ACA retreat ramps up
Third-quarter profit shot up at UnitedHealth Group, just as the health insurance and services conglomerate is set to drastically reduce its presence in the Affordable Care Act's individual marketplaces. → Read More
Minnesota Blues' decision to alter ACA plans mirrors stampede to narrow networks
Blue Cross and Blue Shield of Minnesota is cutting back its participation in the state's Affordable Care Act exchange after losing nearly $300 million in the individual market in 2015. Narrow networks have become the primary cost-control tool for insurers now. → Read More
Health systems with insurance operations stumble in 2015
Not-for-profit, vertically integrated hospital systems continued to churn out surpluses in 2015, but the margins were a lot tighter than the year before. → Read More
Vast majority of Obamacare enrollees still receiving subsidies
Nearly 12.7 million Americans selected or re-enrolled in health coverage on the Affordable Care Act's state and federal marketplaces, and most people qualified for financial assistance to help pay down the costs of coverage. → Read More
Humana CEO to bank $40 million if Aetna deal closes
Humana Inc. CEO Bruce Broussard is primed for a huge payday: If the federal government approves Humana's $37 billion sale to Aetna Inc., Mr. Broussard will receive $40.2 million. The “golden parachute” compensation package includes a $6 million severance payout, while most of the remaining money will come from cashing out stock, according to a regulatory disclosure released Wednesday. The U.S.… → Read More
More insurers embracing telehealth
Blue Cross and Blue Shield of Alabama resisted paying for most telehealth services for years after their introduction. The insurer, which holds a near-monopoly of the state's commercial market, had cost concerns about the still-evolving technology that electronically connects patients with... → Read More
Medicare to cut payments to employer-sponsored Advantage plans
A new federal proposal would slash overpayments made to Medicare Advantage plans sponsored by employers and unions years after an advisory board recommended the policy. → Read More
Telemedicine being embraced by more insurers
More private insurers are paying for telehealth services, but Medicare still has restrictive rules for telehealth payment. Insurance, provider and technology groups are stepping up lobbying efforts to pass legislation that will force Medicare to provide greater financial support for the service. → Read More
Insurers, drugmakers seek to build value-based contracts
The deafening public outcry over drug pricing has forced health insurers and pharmaceutical companies to devise ways of expanding access to potentially life-saving drugs without breaking the bank. → Read More
The health insurance industry's identity crisis
As lawmakers and policy groups debated the mechanics of what would become the Affordable Care Act, health insurers saw the writing on the wall. The public viewed as intolerable insurance strategies that denied coverage to people with pre-existing conditions or charged higher premiums to sick members. More people needed access to care, and that meant the system had to expand coverage and rewrite… → Read More
Anthem's individual ACA plans hammer 4th-quarter profit
Health insurer Anthem Inc. reported much lower profit in the final quarter of 2015, mostly because it had to pay out a lot more in claims for its individual market members. Anthem, like other insurers, grappled with a tougher-than-expected second year in the Affordable Care Act's exchanges. People who signed up for coverage turned out to be sicker than originally thought. But the… → Read More
Leader of big health insurer lobby discusses its future
Marilyn Tavenner was hired last year to take over leadership of America's Health Insurance Plans, the industry's leading advocacy group.ts members were struggling to get their bearings in the fledgling insurance marketplaces erected through the Affordable Care Act while Medicare Advantage and... → Read More
Medicaid expansion, exchanges push healthcare spending past Social Security
In 2015, the U.S. federal government spent more on healthcare than on Social Security for the first time. The Affordable Care Act's expansion of Medicaid and the growing availability of subsidies for exchange plans are driving much of the higher spending, the Congressional Budget Office said Monday. → Read More
UnitedHealth's federal health insurance exchange losses reach $720 million
UnitedHealth Group Inc.'s first foray with the health insurance exchanges turned out to be worse than expected as it lost $720 million on its individual-market health plans in 2015, the company said Tuesday, nearly $300 million above estimates made a few months ago. The massive deficit on Affordable Care Act plans consequently ate away at UnitedHealth's fourth-quarter profit, which dropped 19%… → Read More
Big health insurer defections signal AHIP's fading clout
Aetna Inc.'s departure from AHIP months after UnitedHealth Group Inc. bolted is further evidence that the large national insurers are increasingly happy to fight their own battles on Capitol Hill. Managing members of a trade group is often like herding cats. Worse, actually. All kinds of cats — tabbies to lions. And the strain of corralling consensus is starting to fracture America's Health… → Read More
Big insurance companies leaving AHIP as its clout fades
Aetna's departure from AHIP months after UnitedHealth Group bolted is further evidence that the large national insurers are increasingly happy to fight their own battles on Capitol Hill, such as shepherding their pending mega-mergers and negotiating changes to the ACA marketplaces. → Read More
AHIP takes second big blow with Aetna leaving
Another top-five health insurer is ditching the industry lobbying group, which is struggling with revenue problems as a new CEO attempts to right the ship.Aetna Inc., which in the process of buying competitor Humana Inc., is not renewing its membership in America's Health Insurance Plans for 2016,... → Read More
Aetna leaving insurance industry lobbying group AHIP
Another top-five health insurance company is ditching the industry lobbying group as a new CEO attempts to right the ship. → Read More
Medicaid plan gives Chicago public hospital a big boost
As more Americans gain Medicaid coverage, investing in a health plan is a potential lifeline for urban safety net systems. In Chicago, the Cook County Health and Hospitals System and its patients have both seen their health improve with CountyCare, the system's Medicaid managed-care plan. → Read More
CMS suspends enrollment of Ascension-owned senior-care program
The CMS halted all enrollment in a program that cares for poor seniors at Alexian Brothers Community Services in St. Louis. The agency found Alexian failed to provide necessary services and avoided enrolling sick, more expensive patients. → Read More