In 2023, Aetna, like many other payers, laid off employees. The insurer also snagged a big contract in North Carolina, and had another multibillion dollar contract blocked in New York City.
Here are the 10 most read stories about CVS Health's insurance subsidiary Becker's reported in 2023:
- CVS Health laid off 591 Aetna employees in 2023. The company announced a round of layoffs in August, and cut an additional 70 positions in October. When Woonsocket, R.I.-based CVS Health acquired Aetna in 2018, it struck an agreement with state insurance regulators to keep employment at Aetna and its subsidiaries at 5,300 for at least four years after the closure of the deal. The agreement expired in 2022.
- Aetna and OptumHealth Care Solutions are facing a class-action lawsuit alleging the two companies conspired to use "dummy code" to make administrative fees appear to be billable medical charges.The class action, approved by a judge in September, could cover 87,000 health plan members.
- Beginning in 2025, Aetna will take over North Carolina's state employee health plan, a contract BCBS North Carolina held for over 40 years. The state cited cost savings and more price transparency as reasons why it awarded Aetna the $17.5 billion contract covering more than 740,000 people.
- In December, Kraft Heinz voluntarily dismissed a lawsuit against Aetna alleging the payer breached its fiduciary duties and used its role as third-party claims administrator for Kraft's employee health plan "to enrich itself" to the food manufacturer's detriment. The claims will move to arbitration.
- In August, a New York State Supreme Court judge permanently blocked New York City's plan to switch 250,000 retired city employees from traditional Medicare to an Aetna Medicare Advantage plan. The deal was one of Aetna's largest contract awards in history, CVS Health CEO Karen Lynch said, worth $15 billion over five years.
- Brian Kane, Humana's former CFO, took over as president of Aetna in September.
- Aetna is a "little bit behind" its peers in value-based care, but it can get ahead by leveraging the rest of the CVS Health business, Aetna President Brian Kane said. At CVS Health's 2023 investor conference in December, Mr. Kane said the company is "under-penetrated" in value-based relationships in Medicare Advantage but plans to change this over time.
- Aetna is leveraging CVS Health stores to reach Medicaid beneficiaries who may need to renew their coverage, Kelly Munson, former president of Aetna Medicaid, told Becker's in March.
- Aetna received $632,070 in overpayments for Medicare Advantage claims from 2015 to 2016, an audit from HHS' Office of Inspector General, published in October, found. The OIG used the audit sample to estimate the insurer received at least $25.5 million in overpayments during the time period.
- Building and maintaining successful value-based care arrangements is difficult and will require innovative thinking from leaders across the healthcare spectrum, Aetna's Southeast region president, Rich Weiss, told Becker's in October.