Aetna CEO’s $131 Million Parachute Biggest Among Health Targets

http://www.bloomberg.com/news/articles/2015-06-17/aetna-ceo-s-131-million-parachute-biggest-among-health-targets

 

Aetna Inc. CEO Mark Bertolini has the most to gain among top executives at the three U.S. health insurers seen as targets in a potential wave of industry consolidation. Bertolini could receive $131.3 million should he lose his job in a takeover, according to data compiled by Bloomberg. Cigna Corp. Chief Executive Officer David Cordani would get $58.7 million, while Humana Inc. CEO Bruce Broussard’s so-called golden parachute is valued at $26.1 million.

The five biggest publicly traded insurers are all eyeing potential combinations after a two-year lull in big managed-care deals. Anthem Inc. has explored a takeover of Cigna and Humana, and Aetna and Cigna have considered buying Humana, Bloomberg has reported. The Wall Street Journal has said UnitedHealth Group Inc. might be interested in Aetna or Cigna.

We “expect this merger frenzy will culminate in a ‘Big Three’ that is a more efficient industry landscape,” Ana Gupte, an analyst at Leerink Partners, said Tuesday. Humana is likely to be acquired by Aetna or Anthem for $200 to $225 a share, she wrote.

The change-in-control payouts are meant to keep investor interests in mind.

“These protections provide a certain level of comfort for executives to put aside their personal issues and think, ‘What’s in the best interest of shareholders?’” said Yonat Assayag, a partner at ClearBridge Compensation Group, an executive pay consulting firm. “The amounts may seem large, but the cost compared to the value that’s created for shareholders is usually a very small percentage.”

Hospital CEO pay rises faster than overall health care spending

https://www.bostonglobe.com/business/2016/08/16/pay-packages-rise-for-many-hospital-ceos/Sytc3sUiubyr21tPhVxp3K/story.html

BOSTON, MA - 6/24/2016: Brigham and Women's Healthcare President Elizabeth Nabel speaks at a news conference at One Brigham Circle on Friday, June 24, 2016. Hospital officials said they were reducing patient capacity and bringing in hundreds of temporary nurses in anticipation of a strike by nurses on Monday. (Timothy Tai for The Boston Globe)

Pay increases for many top Massachusetts hospital executives outpaced the growth of state health spending in 2014, according to new filings with the Internal Revenue Service.

Leading the pack was Elizabeth G. Nabel, president of Brigham and Women’s Hospital in Boston, who drew total compensation of $5.4 million that year, up 119 percent from her $2.5 million pay package in 2013. Most of the increase was attributed to a jump in deferred compensation in 2014, the year she vested in a retirement plan managed by Brigham and Women’s corporate parent, Partners HealthCare.

Cut Healthcare Spending or Face the Public Option

http://www.healthleadersmedia.com/finance/cut-healthcare-spending-or-face-public-option?spMailingID=9394331&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=981810720&spReportId=OTgxODEwNzIwS0#

“If we don’t get a handle on spending at some point, we will have a government-financed system,” predicts the head of the Pacific Business Group on Health.”

HIPAA is 20 years old. What has it meant for healthcare?

HIPAA is 20 years old. What has it meant for healthcare?

birthday cake

On Aug. 21, 1996 — 20 years ago Sunday — President Bill Clinton signed the Health Insurance Portability and Accountability Act (HIPAA) into law.

Back when bipartisanship still occasionally happened in Washington, this law, championed by then-Sens. Edward M. Kennedy (D-Massachusetts) and Nancy Kassebaum (R-Kansas) has come become to be defined by the privacy and security regulations that it enabled. Those took effect in 2002 and 2003, respectively, after the Bush administration modified rules that the Clinton administration rushed to finish before Clinton left office in January 2001.

But, as the formal name implies, HIPAA initially was known for giving people the right to “portability” of health insurance when they change jobs by limiting the ability for insurers to exclude coverage of pre-existing conditions. The complex law also led to standards for healthcare administrative transactions and a national system of provider identity codes.

HIPAA did call for a national patient identifier as well, but in 1998, Congress voted to deny the Department of Health and Human Services funding to implement a patient ID. The program still has never been funded, and the private sector has since taken it upon itself to address the issue.

So what has HIPAA accomplished in 20 years? Where has it fallen short?

Healthcare Hypocrite of the Week: Aetna’s Mark Bertolini

http://medcitynews.com/2016/08/hypocrite-aetna-mark-bertolini/?utm_source=hs_email&utm_medium=email&utm_content=33097793&_hsenc=p2ANqtz-8tHuz1OyW0jad1rYHbmCrWm51PA21pdsKB9af25xlqpvHnWr2o1T0b7LutMzmXzy521UtBFmUcZw75t8pNJcQYSG5Uvw&_hsmi=33097793

Mark Bertolini

Mark Bertolini, CEO of Aetna

It’s only Thursday, but it’s probably safe to announce that the winner of Healthcare Hypocrite of the Week is Aetna Chairman and CEO Mark Bertolini. And it’s not because Elizabeth Holmes and Martin Shkreli have managed to stay out of the news for a while.

Despite calling the Affordable Care Act business a “good investment” as recently as April, Bertolini has decided to pull Aetna out of most of the public health insurance exchanges. Initially, he cited the ACA risk pools as being unsustainable — in other words, too many old people with chronic illnesses and not enough young and spry customers to mitigate the risk. But as it turns out his actions may have been prompted by a desire to get even when the insurer didn’t get its way on a business deal.

On Monday, Aetna announced that it was pulling out of public individual insurance exchanges in all but four states. For the 2017 plan year, the Hartford, Connecticut-based insurer will only participate in the exchanges in 252 counties in Delaware, Iowa, Nebraska and Virginia. The reason? The company said it lost $200 million on individual plans in the second quarter and $430 million since the Obamacare insurance mandate took effect in 2014.

One-third of states have little to no competition on the Obamacare exchange markets

http://www.healthcarefinancenews.com/news/one-third-states-have-little-no-competition-obamacare-exchange-markets

Alaska, Alabama, Kansas, North Carolina, Oklahoma, South Carolina and Wyoming, will have only one carrier per region.

As major insurers UnitedHealth, Humana and Aetna — along with smaller insurers like the Scott & White Health Plan in Texas — plan to leave theObamacare insurance markets, the exodus will leave some states without much competition on the exchanges.

A new study by Avalere predicts one-third of the country will have no exchange plan competition in 2017. Seven states: Alaska, Alabama, Kansas, North Carolina, Oklahoma, South Carolina and Wyoming, will have only one carrier per rating region in every region in the state, the Avalere study said.

States divide up their exchange market region into rating areas. Consumers may only purchase plans offered within the rating region in which they reside.

Nearly 55 percent of exchange market rating regions have two or fewer carriers, the Avalere study said.

How Clinton and Trump view Medicare and retiree health plans

http://www.cbsnews.com/news/how-clinton-and-trump-view-medicare-and-retiree-health-plans/?utm_campaign=CHL%3A+Daily+Edition&utm_source=hs_email&utm_medium=email&utm_content=33162087&_hsenc=p2ANqtz-9oAIbaDQtxb4QcswlBvNhptpEnOvAuPzdM3wZ5GPdm93T9u09D7SfE0LClB9DcepAVRVolZJmQkwZXYhWNWpR3jUrmqg&_hsmi=33162087

 

Aetna’s withdrawal from Obamacare exchanges isn’t the start of a death spiral

http://www.latimes.com/opinion/editorials/la-ed-aetna-obamacare-20160817-snap-story.html?utm_campaign=CHL%3A+Daily+Edition&utm_source=hs_email&utm_medium=email&utm_content=33162087&_hsenc=p2ANqtz-8NvJGaCD6NRfk633U9oruy0gAARfnzhUmgR73MXbgH6Kn-xnwzqWVetaFD6yxn73Itj2RU7GT3GpmmZQmhcpzETdNU6Q&_hsmi=33162087

Aetna, Inc. headquarters

Giant insurer Aetna announced this week that it was withdrawing from the Obamacare exchanges in 11 of the 15 states it had been doing business, becoming the third major insurance company to scale back its offerings dramatically in the face of heavy losses. The news led to a chorus of “I told you so’s” from critics of the 2010 healthcare law, who have long predicted that it would collapse under its own weight. But they are confusing the growing pains of a new market with the death rattle of a failing one.

It’s important to bear in mind what Obamacare, formally known as the Patient Protection and Affordable Care Act, set out to do. Over the long term, it sought to improve the quality of healthcare and rein in costs — an ambitious effort that may not yield significant results for years, if ever. In the short term, its goal was to extend insurance coverage to millions of uninsured Americans. To do so, it barred insurers from denying coverage or charging higher rates to those with preexisting conditions, required all adults to obtain coverage and offered subsidies to help poorer households pay their insurance premiums.

These changes reinvented the market for individual policies, which serves those not covered by large employer plans or government-run health programs. No longer could insurers minimize their risk by denying coverage to or gouging those with preexisting conditions. The new subsidies also attracted many previously uninsured people who had no track record to guide insurers on their needs and costs.

The result was a hotly competitive market with winners and, yes, losers. The insurance companies that have done well include those with experience serving low-income communities, as well as those in states such as California that have worked hard to bring young and healthy customers into the market. But Aetna and UnitedHealth, which announced in April that it would withdraw from almost all the Obamacare exchanges it had entered, had previously focused on serving large employers, a much less risky and volatile market.

When It’s Time To Split Up The Family

When It’s Time To Split Up The Family

Businessman hand drawing an umbrella above a family concept for protection, security, finance and insurance

All five members of the Wadstein family have Covered California’s most comprehensive — and expensive — level of health insurance, even though the two youngest children are the only ones who need that kind of plan.

Zachariah, 8, and Zoey, 2, have a serious metabolic disorder, but the El Cajon family was told it couldn’t purchase a benefit-rich plan for them and a separate, cheaper policy for the other three, said their mom, Christine Wadstein.

That’s about to change. This month, Covered California began making it easier for families like the Wadsteins to choose different health plans for different members of the family.

Sutter Health to employers: Waive rights to sue or pay the price

http://www.healthcaredive.com/news/sutter-health-to-employers-waive-rights-to-sue-or-pay-the-price/424614/