CVS Health is expecting Aetna's Medicare Advantage star ratings to hurt its 2024 outlook, and the payer is investing in more value-based care.
Here are seven updates about Aetna and parent company CVS Health Becker's has reported since May 8.
- CVS Health is expecting Aetna's operating income to decrease by up to $1 billion next year because the number of its Medicare Advantage members in four-star plans has dropped significantly since last year. The company said 21 percent of its Medicare Advantage members were enrolled in four-star plans for 2023 ratings, compared to 87 percent for 2022 star ratings.
- Aetna Better Health of Virginia provided $7.3 million in value-based care incentive payments to 22 federally qualified health centers in the state in an effort to increase screenings for diabetes as well as breast, cervical and colon cancer.
- Lawmakers are seeking more information about claims denials from the largest Medicare Advantage insurers, including Aetna. The Senate Permanent Subcommittee on Investigations sent letters to CVS Health, Humana and UnitedHealth Group seeking internal documents detailing how the companies decide to approve or deny claims, including how the payers use artificial intelligence in the process.
- Grocery chain Albertsons named Tom Moriarty as executive vice president and general counsel, effective June 5. Most recently, he served as executive vice president, chief policy and external affairs officer, and general counsel at CVS Health.
- Aetna, UnitedHealthcare and two other insurance companies will pay a combined $4.6 million to New York state to settle allegations the companies charged unapproved rates for student insurance.
- Baton Rouge (La.) General has reached an agreement on a new contract with Cigna but remains out of network with Aetna. The system's hospitals have been out of network with Aetna since November, and its physician clinics went out of network in mid-April. About 5,000 patients have been affected by the split.
- Bryan Baier, former executive director of government programs at Aetna, was named president of Healthy Blue Kansas.