Lilly rolling out direct-to-employer obesity drug coverage
The Indianapolis-based drugmaker said the coverage would be administered by third-party administrators to provide employers “transparent, flexible cost-sharing options” for their workers.
Health Insurance
-
Most Americans blame insurance profits and denials alongside the killer in UHC CEO death, poll finds
In the survey from NORC at the University of Chicago, about 8 in 10 U.S. adults said the person who committed the killing has “a great deal” or “a moderate amount” of responsibility.
Read More -
Insurance-tech firm Remodel Health raises $100M in growth funding
The firm, which helps employers transition workers to individual health insurance plans, has more than doubled its workforce in the last year and hopes to go on an acquisition spree.
Read More -
Tensions boil between ER docs, insurers as no-surprises law rolls out
The federal No Surprises Act—which took effect Jan. 1 and protects patients from receiving surprise medical bills resulting from unexpected, out-of-network coverage—is already creating huge waves.
Read More -
Arcane world of pharmacy benefit managers slowly unraveling
A series of federal and state actions are putting the $400 billion PBM industry under a spotlight.
Read More
Articles
Health insurance sticker shock begins as shutdown battle over subsidies rages
Lawmakers face greater pressure to act as Americans who buy insurance through the Affordable Care Act are seeing, or about to see, the consequences of enhanced subsidies expiring at the end of the year.
Doctors, advocates brace for potentially ‘tragic’ premium increases
Five Indiana marketplace insurers—Anthem, UnitedHealthcare, CareSource, Cigna and Coordinated Care Corp.—will hike premiums an average of 31.4% effective Jan. 1 under plans recently approved by the Indiana Department of Insurance.
Small Columbus health insurer tries to take on the giants
SIHO Insurance Services is tackling the gargantuan challenge of growth in the employer-based benefits market in Indianapolis and across the state.
‘Narrow’ health plans gain wider acceptance
Direct-to-employer health insurance plans, in which an employer contracts directly with a health care network for coverage, restrict provider choice but are generally less expensive for employers and employees.
Pricing legislation shows health reform complexities
Indiana lawmakers discovered this legislative session that performing major financial surgery on multibillion-dollar nonprofit hospital systems is a motley and entangled task.
Trump administration nixes plan to cover anti-obesity drugs through Medicare
President Trump’s predecessor, Joe Biden, proposed a rule in late November after Trump won re-election that would have extended coverage of drugs like Zepbound and Wegovy.
Elevance Health faces mix of hurdles
For Elevance Health and other big insurers, 2024 devolved into something of an annus horribilis over the year’s final weeks. And 2025 holds more challenges but also an opportunity for a rebound.
UPDATE: Elevance Health shares tick up on better-than-expected earnings
The company also reported higher medical expenses, mainly from its Medicaid business.
Gov. Mike Braun signs executive orders addressing health care costs, transparency
The orders largely direct state agencies to audit current programs and coverage as a means to find health care savings.
Insurer-provider contract impasses leave many patients without care
Indiana physicians are keeping an eye on the trend of large insurers dropping medical practices from their networks, which they call a classic case of David versus Goliath.
Federal ruling against Healthy Indiana Plan potentially jeopardizes program
Former Gov. Mitch Daniels first introduced the consumer-driven, cost-sharing approach in 2007 when the state expanded Medicaid to moderate-income workers. Gov. Mike Pence developed the program even further.
Health care providers dig out from ransomware attack
A Feb. 21 cyberattack against a Nashville, Tennessee-based medical-billing clearinghouse sent shock waves across Indiana’s health care system.
ACA enrollment grows as Indiana unwinds Medicaid coverage
Nearly 300,000 Hoosiers secured health insurance coverage through the Affordable Care Act Marketplace during the open enrollment period for 2024, part of the record 21.3 million consumers nationally utilizing the program for the upcoming year.
Insurers clamping down on doctors who prescribe Ozempic for weight loss
Indianapolis-based Elevance Health, which operates Anthem plans, said that in most cases, it won’t cover Ozempic unless a patient is diagnosed with diabetes and has tried another medication to manage it, but physicians can still prescribe it.
Elevance Health buys Louisiana insurer, pushing operations into 15th state
The two companies said the combination builds on a seven-year collaboration in Louisiana through joint ownership of Healthy Blue, which serves Medicaid and Medicare Dual Eligible members.
Three bills in Indiana Senate take aim at health-care costs, practices
The proposals aim to lower prescription drug costs, promote competition among physicians and end the practice that allows for inaccurate medical billing in certain circumstances.
Beth Keyser: Working together to make health care more affordable
The longtime industry standard of negotiating hospital reimbursement as a discount on the hospital’s billed charges is being replaced with fixed rates based on what Medicare would pay for a given service.
Hackers hit health companies, insurers with increasing regularity
Of all the industries in the country, health care might be the juiciest for cyberhackers. And around central Indiana, institutions large and small are paying the price.
Anthem sues former executive over trade secrets
Indianapolis-based health insurer Anthem Inc. is suing a former executive, claiming he stole trade secrets, went to work for a direct competitor, and breached a contract involving restricted stock agreements.