Insurance Company Subsidiaries... Dozens of Companies Hidden within United, Cigna, CVS, Blue Cross
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- Опубліковано 27 вер 2024
- Insurance Company Subsidiaries... Dozens of Companies Hidden within United, Cigna, CVS, Blue Cross.
The four major health insurance carriers--United Health Group, The Cigna Group, CVS Health and Elevance Health (the largest Blue Cross company)--have complex, hidden subsidiary companies.
United Health Group has United Health Insurance, UMR, Optum, OptumRx, Emisar, Optum Specialty Pharmacy, Change Healthcare, Interqual, The Advisory Board Company, Kelsey-Seybold, WellMed, Atrius and dozens more.
The Cigna Group has Cigna Healthcare, Allegiance, Evernorth, Express Scripts, Ascent Health Services, Accredo, eviCore, MDLive, VillageMD and Summit Health and many more.
CVS Health has Aetna, Meritain, CVS Caremark, CVS Specialty Pharmacy, CVS Retail Pharmacies, Cordavis and many more.
Elevance Health has Anthem, Wellpoint, Carelon, AIM Specialty Health, Millenium Physician Group and many more.
All of these insurance subsidiaries 1) give the false impression of choice and competition in the health insurance market and 2) are the result of growth by acquisition financed by cheap debt, NOT growth by superior customer value (i.e. better, faster, cheaper).
Sources:
insights.greyb...
www.managedhea...
www.evernorth....
www.cigna.com/...
www.elevancehe...
www.fierceheal...
www.summitheal...
www.cordavis.com/
www.askallegia...
www.atriusheal...
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God bless you. You should be nominated for Presidential Medal of freedom. Love it.
You are kind. Thank you for watching.
Awesome. Thank you. Up and down arrows! 4 companies only! The last five minutes of part 2 is amazing!
Thank you for watching and for your feedback.
I listened to Part 1 of the podcast and quickly realized this collage of information was too much for this little old lady to comprehend in one sitting! I will save part 2 for tomorrow! So, how are you spending your retirement years: traveling to Paris, chearing on your grandchildren in their athletic and academic achievements. No, I spend my days trying to figure out the US health care system so I can attempt to get halfway decent care!!
Question... With the medical loss ratio, wouldn't the insurance company make more money when costs go up?
Good question. Not on Medicare Advantage and ACA plans. Premium from the Government is based on Risk Adjustment.
@@ahealthcarez I understand that for Medicare advantage but wouldn't ACA plans pay based on network contracts?
I didn't think the government dictated how much was paid under the ACA. Hence the medical loss ratio.
Doesn't EviCore make MORE money if healthcare costs go up? Meaning, if more therapies required prior auth, don't they benefit? And if so, shouldn't the arrow next to them point up?
Good we question. The performance guarantees on their contracts likely have cost-containment metrics. Healthcare costs down via decreased inappropriate care is their value prop. Therefore, fees likely mirror.
Dr. Bricker, thank you for the warning that this video was going to be complicated! However, you did a remarkable job explaining everything with the flow chart diagram and up and down arrows. This took a lot of time and thought to pull this off.
Thank you for watching and for your feedback.
Insurers do not control the incidence and prevalence of disease.
These companies implement best practice in organizational design by separating conflicting profit incentives and distinct value models. Ultimately, it balances out to reflect the complexity of the environment and the challenge in managing healthcare costs while guiding effective treatment.
Thank you for watching and sharing your thoughts.
Where does “coupon” vendors like GoodRx fall in under these scaffolds?
GoodRx is essentially a marketing firm for the PBMs… they run cash-pay prescriptions through a variety of PBMs that are hidden in the back end.
Banger video as always! Could you explain more about what Advisory Board Company is? Your explanation of its purpose seemed like it would lose UHG money?
We'd better let Chinese companies run US healthcare. Then you'll get 10 times higher quality product at 10 times lower price.