Payer Roundup—Anthem, Cigna head to court to settle failed merger fallout

Gavel court room lawsuit judge
Anthem and Cigna are in Delaware court to settle the remains of their failed merger, plus more insurance headlines. (Pixabay)

Anthem, Cigna head to court to settle failed merger fallout

Anthem and Cigna’s planned merger—which would have created the largest payer in the country by membership—was spiked due to antitrust concerns, and now a Delaware judge will be tasked with wading through what remains of the dispute.

Anthem argues that Cigna owes it $20 billion, as it slowed the merger process with the goal of sabotaging the deal. Cigna, meanwhile, counters that Anthem owes it $15 billion because the deal failed.

Ana Gupte, an analyst at Leerink, said a settlement is more likely to end with Anthem paying Cigna less than the fee to end the merger, which was about $1.8 billion. Even that is useful from Cigna’s perspective, she said, as it needs to pay down debt it incurred in purchasing Express Scripts.

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

The trial is set to last 10 days and executives at both insurers are likely to testify. (Bloomberg)

Wyoming takes step toward Medicaid work requirements

The Wyoming House narrowly passed a bill that would establish work requirements in the state’s Medicaid program.

The bill seemed poised for failure and did not pass on a standing vote. However, a roll call vote shortly thereafter passed, 30-28. The bill will require two more votes before it can be sent to Gov. Mark Gordon, a Republican.

Proponents of the bill said the work requirements are a way to help able-bodied adults re-enter the workforce.

“Some have said this is less a work requirement than it is work encouragement,” Rep. Dan Laursen said. “Taxpayers will thank us, and so will those on these programs, who benefit from the structure of this bill.” (Casper Star Tribune)

More than half of Medicare beneficiaries in Minnesota on MA: report

Minnesota is the state with the largest share of Medicare beneficiaries enrolled in private plans, according to analysis from Axios.

The publication found that 57.3% of beneficiaries are enrolled Medicare Advantage plans. In six additional states, more than 40% of the Medicare population is in an MA plan: California, Pennsylvania, Florida, Hawaii, Oregon and Rhode Island.

Beneficiaries in less populous states, such as Alaska, Vermont and Wyoming, were also less likely to be enrolled in an MA plan. (Axios)

UnitedHealth, Anthem, Permanente Medical Group on improving trust between payers, providers

Payers and providers can boost their trust in each other by breaking down traditional expectations and tackling problematic practices head-on as a team.

Clinical representatives from UnitedHealth Group, Anthem and the Permanente Medical Group penned a joint editorial in the Journal of the American Medical Association that they hope serves as a call to action for improving the relationship between payers and providers.

Both have had a negative view and distrust in one another, the authors said, and breaking through those preconceived notions is key to finding success in mutual interests like value-based care.

“Relationships should change from being based on contracts to relationships built on a shared covenant to patients and to system improvement,” they said. (Editorial)

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