By: Bruce Japsen
Forbes
The parent of Blue Cross and Blue Shield of Florida will buy Puerto Rico’s Triple-S Management in a deal valued at $900 million, the companies said Tuesday.
The Chattanoogan.com
C. Mark Warren
Blue Cross-Blue Shield is acting like a for-profit bully”
Their offices on Cameron Hill sit almost empty.
But their bank account is full of cash.
By law, Blue Cross Blue Shield (BCBS) is a non-profit company mandated to maintain $1billion in reserves to pay potential claims in the case of a pandemic.
Not only has BCBS weathered the pandemic, BCBS has profited during the pandemic.
BCBS has over $3 billion in reserves. That is $2 billion more than required by law.
The Provider Plaintiffs have filed motions for Partial Summary Judgment Regarding the Defendants Single Entity Defense (Doc. 2784) in MDL No. 2406 in Re: Blue Cross Blue Shield Antitrust Litigation.
By: Camillia Lanham
As of July 16, Central Coast residents insured by Anthem Blue Cross lost in-network coverage at French Hospital Medical Center in San Luis Obispo, Arroyo Grande Community Hospital, and Marian Medical Regional Center in Santa Maria, which are part of the nonprofit Dignity Health system.
“Dignity Health and Anthem Blue Cross have been negotiating new contracts in good faith for six months,” Dignity Health Medical Foundation President/CEO Dr. Robert Quinn said in a statement emailed in response to questions from New Times. “We remain in active discussions and hope to reach a responsible new agreement soon that will protect patients’ access to the care they need.”
Law360 (July 28, 2021, 7:56 PM EDT) — Health care providers accusing Blue Cross Blue Shield organizations of thwarting competition by carving up the national market into service areas and refusing to compete against each other are asking an Alabama federal court to revisit the insurers’ argument that it is a single entity.
In a motion for summary judgment filed Tuesday, health care providers argued BCBS is multiple entities working to manipulate the market. If granted, the judgment would wipe out one of BCBS’ defenses and add leverage to their providers’ arguments accusing it and the array of affiliated insurers of conspiring to divide the market among themselves and not compete with one another through a series of trademark licensing agreements and other arrangements.
“Potential competitors never act as a single entity when they agree to insulate themselves from competition by allocating territory or restricting output,” the providers said. “The Blues, who resisted being called a single entity until this case was filed, are no exception.”
The provider plaintiffs, who are still pursuing their track of the multidistrict litigation after Blue Cross Blue Shield subscribers settled their own claims last year for a $2.67 billion class payout, are trying to secure at least $15 billion after trebling for antitrust damages in the Alabama market alone.
By: Colette Ngo
KSBY 6
In California, Dignity Health and Anthem Blue Cross have terminated their network agreement. This removes Dignity hospitals and medical clinics across California from Anthem’s network.
For the past six months, Dignity Health and Anthem Blue Cross have been in contract negotiations.
Despite their efforts, most of Dignity Health’s California agreements with Anthem were terminated on July 16,
Anthem Blue Cross members received a letter in the mail notifying them that Dignity Health doctors and hospitals will no longer be in their plan’s network.
By: Nick Moran
Beckers Hospital Review
After Dignity Health issued a contract termination notice in January, the health system and Anthem have ended their relationship as of July 16.
Anthem claimed in a statement the relationship primarily fizzled out because the insurer refused to agree to rate increases that would continue to make San Francisco-based Dignity more expensive than other systems. The insurer said Dignity is nearly 30 percent more expensive than other California health systems.
An Anthem spokesperson told Becker’s that it is still negotiating with Dignity, but has made members aware of alternatives in the interim.
“Anthem Blue Cross (Anthem) is currently in active negotiations with Dignity Health (Dignity) and working to reach a fair agreement that would keep Dignity in our provider network,” Anthem said in a statement to Becker’s. “Maintaining stability in our network of local doctors and hospitals is extremely important to us. As we negotiate with providers, we try to strike a balance between protecting affordability and providing a broad network of providers to create choices, which can take time.”
A Dignity spokesperson also confirmed negotiations are ongoing, but cited inflation costs as a point of contention. They pointed to the company’s website dedicated to the negotiation process for more information.
El Camino Health severs ties with country’s second largest health insurer
by Kevin Forestieri / Mountain View Voice
El Camino Health terminated its contract with Anthem Blue Cross last month over price disputes, suddenly putting the hospital out of network for those covered by the country’s second-largest health insurer.
But it’s not the first time and it’s unlikely to be the last, as many Bay Area hospitals are finding it tough to live with Anthem’s price-cutting tactics.
Rising health care costs are at the heart of these clashes, which are happening with surprising regularity. El Camino and Stanford Health Care have both temporarily dropped Anthem at least three times over the last decade, along with MarinHealth last year and Sutter Health in 2019.
The story is almost always the same: The hospitals accuse Anthem of penny pinching and paying less for services than other insurers, while Anthem describes health care costs in Northern California as unreasonably high and partly to blame for the country’s high cost for health care.
These disputes rarely happen between local hospitals and other health insurers.
Law360 (July 9, 2021, 9:59 AM EDT) — President Joe Biden on Friday issued an expansive executive order aimed at boosting competition across the U.S. economy and lowering prices for consumers and increasing pay for workers.
With an eye toward halting consolidation that Biden said has led to higher prices and lost jobs, the president ordered merger enforcers to challenge deals that not only are likely to raise prices for consumers but also may harm labor, agricultural and health care markets and hinder new business formation.
The order requires 72 initiatives by more than a dozen federal agencies and also specifically targets barriers to competition that Biden said has led to higher prices for food, prescription drugs, hearing aids, internet service, airfares, consumer products, rent, financial transactions and telecommunications services, The order also aims to boost wages in a variety of industries and make it easier for small business to compete.
“Once implemented, these initiatives will result in concrete improvements to people’s lives” by addressing a lack of competition that costs the median American household $5,000 per year, the Oval Office said in its statement announcing the order.
The U.S. economy suffers from a lack of competition. President Biden wants to change that.
By: David Leonhardt
July 9, 2021
New York Times
The U.S. economy has been less dynamic in the 21st century, by many measures, than it was in the late 20th century.Get The Morning by email Make sense of the day’s news and ideas with this daily newsletter. Sign up.
Fewer new businesses are starting. Existing businesses have slowed the pace at which they hire new workers (as the chart here shows). Workers are less likely to switch jobs or move to a new city. Companies are investing in new buildings and equipment at a lower rate. And small businesses make up a shrinking share of the economy.
Together, these trends suggest that the economy suffers from a lack of fair competition, many economists believe. Large corporations are often able to increase profits not by providing better products than their rivals but instead by being so big that they exercise power over workers and consumers. The government also plays a role, through policies that protect existing companies at the expense of start-ups and new entrants into an industry.
