Humana to leave most ACA exchanges after losing $1B: 5 notes

The payer marketplace endures another blow as Humana reported it will leave almost half of the Affordable Care Act’s exchanges in 2017, according to The Hill.

Advertisement

Here are five notes:

1. The payer said during an earnings report it will participate in “no more” than 11 state marketplaces.

2. Humana suffered $1 billion losses on ACA exchanges last year.

3. In April, UnitedHealth reported it was exiting many ACA exchanges, which raised questions about the ACA’s sustainability.

4. The ACA has come under scrutiny after many of its original 23 co-ops closed to offset steep financial losses. In July, regulators in Oregon, Ohio, Connecticut and Illinois said the co-ops would shut down, leaving only seven contenders left to navigate the payer marketplace.

5. Humana’s move to pull out of many exchanges follows news of Justice Department antitrust officials filing a suit against the pending Anthem/Cigna and Aetna/Humana mergers.

More articles on coding & billing:
GOP chairman rejects Trump’s Medicare negotiating drug prices proposal: 4 notes
There were winning & losing payers in the 1st year of ACA: 6 things to know
US insurers pay nearly $8k more for TKR than other developed countries: 5 findings

Advertisement

Next Up in ASC Coding, Billing & Collections

  • ASCs have taken center stage of many hospital and health systems’ growth and development strategies in recent years as they…

  • Germantown, Md.-based Capital Surgical Solutions plans to open a new ASC in Portland, Ore., in the fourth quarter of 2026,…

Advertisement

Comments are closed.