Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis. It was begun in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services (CMS).
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001.
The Cigna Group is an American multinational managed healthcare and insurance company based in Bloomfield, Connecticut. Its insurance subsidiaries are major providers of medical, dental, disability, life and accident insurance and related products and services, the majority of which are offered through employers and other groups. Cigna is incorporated in Delaware.
Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. In 2023, the company ranked 42 on the Fortune 500 list, which made it the highest ranked company based in Kentucky. It is the fourth largest health insurance provider in the U.S.
Health Net, LLC, a subsidiary of Centene, is an American health care insurance provider. Health Net and its subsidiaries provide health plans for individuals, families, businesses and people with Medicare and Medicaid, as well as commercial, small business, and affordable care insurance.
Dual-eligible beneficiaries refers to those qualifying for both Medicare and Medicaid benefits. In the United States, approximately 9.2 million people are eligible for "dual" status. Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately 36% of Medicaid expenditures. Similarly, duals total 20% of Medicare enrollment, and spend 31% of Medicare dollars. Dual-eligibles are often in poorer health and require more care compared with other Medicare and Medicaid beneficiaries.
UnitedHealth Group Incorporated is an American multinational health insurance and services company based in Minnetonka, Minnesota. Selling insurance products under UnitedHealthcare, and health care services and care delivery aided by technology and data under Optum, it is the world's eleventh-largest company by revenue and the largest health care company by revenue.
Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs. Part D was enacted as part of the Medicare Modernization Act of 2003 and went into effect on January 1, 2006. Under the program, drug benefits are provided by private insurance plans that receive premiums from both enrollees and the government. Part D plans typically pay most of the cost for prescriptions filled by their enrollees. However, plans are later reimbursed for much of this cost through rebates paid by manufacturers and pharmacies.
Medicare Advantage is a type of health plan offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage. Under Part C, Medicare pays a sponsor a fixed payment. The sponsor then pays for the health care expenses of enrollees. Sponsors are allowed to vary the benefits from those provided by Medicare's Parts A and B as long as they provide the actuarial equivalent of those programs. The sponsors vary from primarily integrated health delivery systems to unions to other types of non profit charities to insurance companies.
SCAN Health Plan (SCAN) is a not-for-profit, Medicare Advantage based in Long Beach, California. Founded in 1977, SCAN provides healthcare coverage to Medicare beneficiaries in California, Arizona, Texas and Nevada, serving more than 285,000 members. It is one of the largest not-for-profit Medicare Advantage plans in the country. SCAN Health Plan is part of SCAN Group.
Blue Cross and Blue Shield of Alabama (BCBSAL) is a nonprofit health insurance company headquartered in Birmingham, Alabama. The company was founded in 1936, provides coverage to more than 3 million people and is a member of the Blue Cross and Blue Shield Association (BCBS). BCBSAL employs nearly 5,000 people, which includes almost 3,500 people at its corporate headquarters in Birmingham. The company also operates Cahaba Government Benefit Administrators and Cahaba Safeguard Administrators, both headquartered in Birmingham. It commands over 90 percent of the health insurance market in Alabama, a state with half a million uninsured people, one of the highest uninsured rates in the nation at 10 percent of the population.
Inovalon is an American technology company that provides cloud-based tools for healthcare.
An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to patients and third-party payers for the quality, appropriateness and efficiency of the health care provided. According to the Centers for Medicare and Medicaid Services, an ACO is "an organization of health care practitioners that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it".
Elevance Health, Inc. is an American health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Anthem Blue Cross in California, Wellpoint, and Carelon. It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within its affiliated companies' health plans.
Chamath Palihapitiya is a Sri Lankan-born Canadian and American venture capitalist, engineer, SPAC sponsor, founder and CEO of Social Capital. Palihapitiya was an early senior executive at Facebook, working at the company from 2007 to 2011. Following his departure from Facebook, Palihapitiya started The Social+Capital Partnership, through which he invested in several companies, including Yammer and Slack. He is a co-host of a technology podcast, All-In, along with David Sacks, Jason Calacanis, and David Friedberg.
Social Capital, formerly known as Social+Capital Partnership, is a venture capital firm based in Palo Alto, California. The firm specializes in technology startups, providing seed funding, venture capital, and private equity.
Arjun Sethi is an American internet entrepreneur, investor and executive. He is co-founder and partner at venture capital firm Tribe Capital. He previously was partner at Social Capital and served as an executive at Yahoo! where he launched Yahoo! Livetext. Before that, he was co-founder and CEO of MessageMe and he was CEO of Lolapps, the developer behind Ravenwood Fair. In December 2023, he became Tribe Capital's chairman and CIO.
Nu Ride Inc. is an American electric vehicle automaker located in Lordstown, Ohio. The company was based at the Lordstown Assembly plant, previously a General Motors factory. Lordstown Motors was known for its Lordstown Endurance electric pickup truck. In March 2024, the company emerged from its September 2023 bankruptcy restructuring as Nu Ride Inc., headquartered in New York City.
Opendoor Technologies Inc. is an online company that buys and sells residential real estate. Headquartered in San Francisco, it makes instant cash offers on homes through an online process, makes repairs on the properties it purchases and relists them for sale. It also provides mobile application-based home buying services along with financing. As of November 2021, the company operates in 44 markets in the US.
Hindenburg Research LLC is a U.S. investment research firm with a focus on activist short-selling founded by Nathan Anderson in 2017. Named after the 1937 Hindenburg disaster, which they characterize as a human-made avoidable disaster, the firm generates public reports via its website that allege corporate fraud and malfeasance. Companies that have been the subjects of their reports include Super Micro Computer, Adani Group, Nikola, Clover Health, Block, Inc., Kandi, and Lordstown Motors. These reports also feature defenses of the practice of short-selling and explanations of how short-sells can "play a critical role in exposing fraud and protecting investors."
