In case you have not paid attention lately to what appears to be happening here there’s a big battle going on with contracts with health insurers.  This has been a big area with the Tri-Care contracts as well with United recently winning the west coast contract to administer.  But even in the midst of all of this with the subsidiary companies, United apparently found it necessary to award a portion of the contract they won to a Blue Cross subsidiary, as I am guessing all the IT infrastructure that was in place presently would be a huge project to move quickly.  It’s all about that IT infrastructure and algorithms.

United HealthCare Awards Contract to One Blue Cross/Blue Shield Subsidiary to Process Tri-Care Claims While The Other BlueCross BlueShield Company Lost the Over All Tri-Care Bid To United In the West

Here’s another recent example below of a battle between the two insurance giants duking it out over who gets the contract, all about those cost and risk algorithms and their respective parameters of predictions that keep falling off the scales today as things change so rapidly. 

Blue Cross and United Healthcare Duking It Out In Nebraska Over State Health Insurance Contract–We Have More Subsidiaries My Cost Algorithms Are Better Than Yours?

Blue Cross Protesting Award of Texas Employee Retirement Health Plan to United Healthcare–Price Cut by $25 Million With Little or No Out of Network Coverage for Members


In addition of late, WellPoint also bought this company who makes contact lens and perhaps this was in answer to United and their “cheap hearing aides” company they bought a few months ago, so one may have a deal on contact lenses and glasses and the other has hearing aides. 

WellPoint to Purchase 1-800 Contacts Eyewear and Contact Lens Retailer For Around $900 Million–Subsidiary Watch

UnitedHealthCare Throws in Free Hearing Aids for Those Who Enroll In AARP Medicare Advantage, HMO & POS Plans in Miami-Dade County From Their New Subsidiary

This activity is noted to somewhat prepare for State insurance exchanges which in itself will be interesting to see how that works as IT infrastructure is becoming so complex these days and “will they” be able to do it without a huge array of flawed data in there, and of course usual and customary legal battle of who received which contract.  All of this stuff just fills the news wires today and continues to keep consumers in an uproar and state of confusion until someone settles the matter and then again even when that is accomplished, flawed data and spasmodic algorithms live on.  The VC firm owned by the Blues just recently moved to San Francisco and started an incubator for start ups and let me see, I can bet some of the new companies will be focusing on the payable areas as well as new parameters that will help determine risk and benefits…that’s what they do out there today. 

Here’s one more example of WellPoint and their preparation for exchanges..they bought their own but still want to be in the game for what the government is going to dole out too.  WellPoint may have an disadvantage here to a degree as the former HHS executive who wrote the healthcare laws is now on the payroll at United Healthcare as an Optum VP, so loopholes or other items in the complex IT contracts could be easier to locate, again this is a battle of IT to determine risk and how to profit. 

WellPoint & Partners Buy Bloom Private Health Insurance Exchange From Their Own Venture Capital Company (Sandbox) –Subsidiary Watch

Meantime back at the consumer ranch, when we get sick we just hope there’s someone around to pay the bill so we don’t end up filing for bankruptcy and losing what we have left, i.e. homes.  Both of the carriers are also buying up HMOs such as CareMore bought by WellPoint and then you have a few giants under the care of United in southern California to include Memorial Care and Monarch and there’s more out there too that are smaller that have been gobbled up by insurers.   

As I read this article, this would put WellPoint in the number one imagespot for having the most covered under Medicaid contracts and at this point it looks like United still holds the number one spot for Medicare, I think?  This is the world we live in today and hopefully by the time all the big corporations figure out their algorithms and what risk and profit exists for them, as consumers we can hopefully still get some decent care and have doctors that are not cut to the absolute brim to where more private practices continue to close. 

That’s a big issue out there today as of course insurers drive those rates and we get shuffled from one area into another, like a cattle call with contracts as it’s in constant motion and keeping up with the contracts is a complex issue for not only consumers but also doctors and hospitals.  In the meantime too, let’s not over look the money that stands to be made from combined efforts here too with selling data, insurers make billions do this as well as other industries.  With all these mergers and acquisitions, the very least we can do is to at least start taxing these huge profits on a quarterly basis and think about devaluating some algorithms before the big bubble bursts, as at some point in time it will as something has to give here.  BD   

“Devaluate the Algorithm” And “Tax the Data Sellers”–A Cure for Both Healthcare and an Economy Based Heavily on Intangibles–We’ve Lost Our Balance

WellPoint Inc., the second-biggest U.S. health insurer, agreed to buy Amerigroup Corp.for $4.9 billion in cash to expand the number of Medicaid patients it serves as the U.S. health plan for the poor undergoes broad changes in how it is managed.

Amerigroup stockholders will receive $92 a share, the companies said in a statement today. The price is 43 percent higher than the closing level on July 6 for the Virginia Beach, Virginia-based company. WellPoint, based in Indianapolis, rose 5% to $62.89 at 6:30 a.m. Pacific time.

The acquisition will make WellPoint the top private manager of Medicaid benefits in the U.S., with 4.5 million members in the program. The deal should also boost the value of other insurers focusing on Medicaid, includingWellCare Health Plans Inc.andMolina Healthcare Inc., said Thomas Carroll, a Stifel Nicolaus & Co. analyst in Baltimore.

UnitedHealth Group Inc., based in Minnetonka, Minnesota, is the largest Medicaid contractor with 3.5 million members. Medicaid is the joint state-federal program for the poor, while Medicare serves the elderly and the disabled.,0,7872259.story


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