Health care costs

The big picture

UnitedHealth posts most profitable quarter in its history

The coronavirus kept people out of the hospital.

Jul 15, 2020
The coronavirus pandemic hasn't stopped drug price increases

61 of the drugs with price hikes were being used to treat coronavirus.

Jun 29, 2020
The coronavirus is slowing health care spending

Delayed care is beating COVID-19 cases right now.

May 21, 2020
Watch: As Medicare for All debate rages on, costs keep going up

Part 5 of our What Matters 2020 series.

Mar 6, 2020
The health care debate we ought to be having

Health care is eating up more and more of Americans’ paychecks every year.

Dec 22, 2019
Deep Dive: The drug pricing maze

It can be enormously frustrating for patients — and profitable for everyone else.

Nov 17, 2018

All Health care costs stories

Aug 13, 2020 - Health

Unsealed lawsuit alleges Molina overbilled for children's mental health

Molina Healthcare headquarters in Long Beach, California Photo: Jeff Gritchen/Digital First Media/Orange County Register via Getty Images

A newly unsealed lawsuit accuses Molina Healthcare of cutting corners in its mental health services for children and defrauding Medicaid in the process.

The big picture: Molina provides Medicaid managed-care plans in more than a dozen states. The whistleblower suit accuses the company of overbilling specifically for children's behavioral health services, to the tune of at least $20 million across multiple federal, state and local agencies.

Aug 12, 2020 - Health

The top-selling drugs in the U.S. in 2019

Data: IQVIA, company financial documents; Note: Data has been corrected for Biktarvy, Enbrel, Januvia, Remicade and Stelara (more info below). Chart: Andrew Witherspoon/Axios

The 10 highest-selling drugs in the U.S. last year gave away more than $23 billion in rebates to insurance intermediaries, but still netted $50 billion in sales.

The big picture: The U.S. drug pricing system is filled with confusing numbers, and many entities profit off the flow of drugs, but pharmaceutical companies retain a vast majority of the proceeds.

Aug 6, 2020 - Health

The health care sector imploded in Q2

Data: U.S. Bureau of Economic Analysis via FRED; Chart: Andrew Witherspoon/Axios

The pandemic has been very good for health insurers — largely because they don't need to pay for procedures that haven't been happening.

By the numbers: The value of health care services performed in America in the second quarter plunged to $1.69 trillion, from $2.26 trillion in the fourth quarter of 2019. The unprecedented drop was enough on its own to account for 9.5 points of the 32.9% annualized fall in second-quarter GDP.

Aug 6, 2020 - Health

Teladoc and Livongo merge into virtual care giant

The coronavirus has increased demand for remote care. Photo: Teladoc Health

Teladoc's $18.5 billion acquisition of Livongo creates the health care industry's largest company devoted to multiple forms of digital care.

The big picture: The coronavirus has accelerated the shift toward virtual doctors' visits.

Aug 5, 2020 - Health

Whistleblower lawsuit alleges Medicare Advantage fraud at Cigna

Photo: Rafael Henrique/SOPA Images/LightRocket via Getty Images

A three-year-old whistleblower lawsuit alleges Cigna fraudulently mischaracterized the health of its Medicare Advantage enrollees as a way to receive higher federal payments.

The bottom line: This lawsuit was unsealed this week, months after the Department of Justice sued Anthem over similar allegations. However, the federal government declined to intervene in this Cigna case.

Aug 3, 2020 - Health

The pandemic hasn't hampered the health care industry

Illustration: Rebecca Zisser/Axios

The economy has been tanking. Coronavirus infections and deaths have been rising. And the health care industry is as rich as ever.

The big picture: Second-quarter results are still pouring in, but so far, a vast majority of health care companies are reporting profits that many people assumed would not have been possible as the pandemic raged on.

Trump signs executive orders claiming lower drug prices

Photo: Samuel Corum/Getty Images

President Trump on Friday signed executive orders that revive several of the administration's previous drug pricing ideas — including attempts to require Medicare to pay no more for drugs than the lowest prices paid by other countries and changing how drug rebates work within industry middlemen.

Reality check: The Trump administration has not enacted any major policies on drug prices. Today's executive orders on their own have limited authority and could take a long time to go into effect, if they go into effect at all.

Jul 24, 2020 - Health

FDA approves third type of advanced cancer therapy

Photo: Josh Edelson/AFP via Getty Images

The Food and Drug Administration has approved an advanced treatment for mantle cell lymphoma, a rare type of cancer affecting white blood cells. The one-time therapy, made by Gilead Sciences, is branded as Tecartus.

Why it matters: This is the third federal approval of a CAR-T therapy, a new-age cancer treatment in which a person's own immune system cells are extracted, reengineered, and then infused back into the person's bloodstream.

Jul 22, 2020 - Health

Hospital chain HCA posts massive Q2 profit despite pandemic

Photo: Rafael Henrique/SOPA Images/LightRocket via Getty Images

HCA Healthcare, the largest for-profit hospital chain in the country, smashed Wall Street's second-quarter profit expectations even though the coronavirus outbreak forced hospitals to halt elective procedures for several weeks during the quarter.

The bottom line: Medical claims and revenues noticeably declined among hospitals during the height of the pandemic, which has benefited health insurers. But that didn't prevent hospitals from making a lot of money, a large chunk of which was directly subsidized by taxpayers in the form of bailout funds.

Jul 17, 2020 - Health

Judge rules hospital outpatient payment cuts are valid

Photo: John Moore/Getty Images

A panel of federal judges upheld the Trump administration's cuts to Medicare payments for routine medical visits in a hospital outpatient office — a blow to the hospital industry, which will lose hundreds of millions of dollars annually.

The big picture: Hospitals last year successfully quashed a similar rule, which would have equalized Medicare's pay rates for basic doctor visits, regardless of whether they took place in a hospital-owned or independent clinic. The American Hospital Association said in a statement it is "carefully reviewing the decision to determine our next steps."

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