UnitedHealthcare To Leave Some Medicare Advantage Markets
Hit by rising medical care costs and squeezed by government changes, the health care conglomerate acknowledges “pricing and operational mistakes” affected its bottom line and has outlined steps to profitability. Other companies making news include Humana, Novo Nordisk, P&G, and more.
Fierce Healthcare:
UnitedHealthcare To Exit Certain Medicare Advantage Markets As Costs Balloon, Impacting 600K Enrollees
It has decided to exit certain markets largely with plans that are more loosely designed, such as PPOs, in a move that will impact 600,000 beneficiaries. (Minemyer, 7/29)
Bloomberg:
UnitedHealth Slumps As New Outlook Disappoints Yet Again
UnitedHealth Group Inc.’s bad year is getting even worse. The health-care conglomerate offered fresh profit guidance that was far below its early projections and below all analyst expectations. Executives also declined to explicitly affirm a long-term growth outlook that the company has pointed investors to for years, a sign that its challenges aren’t going away any time soon. The key problem facing UnitedHealth is it didn’t anticipate Americans would use medical care at the rate they did when setting premiums last year. (Tozzi, 7/29)
The Baltimore Sun:
UnitedHealthcare, Johns Hopkins Medicine At Odds Over Health Insurance Contract
Doctors at Johns Hopkins Medicine hospitals and facilities could stop accepting insurance from national health insurance provider UnitedHealthcare in about a month if an agreement to maintain the health plan is not reached. Just under 60,000 patients on UnitedHealthcare plans see Hopkins providers in Maryland, Virginia and Washington, D.C. (Mirabella, 7/29)
In other health industry developments —
Modern Healthcare:
Humana Buyouts Offered To Some Employees Near Retirement
Humana is offering certain employees voluntary early retirement buyouts. Employees age 50 or older with at least three years of service are eligible for the program, although those working in certain business-critical areas will be ineligible, a company spokesperson said Tuesday. He said the window to apply for voluntary early retirement will be open for several weeks. The Louisville, Kentucky-based health insurer said the offers are part of ongoing evaluations Humana conducts to adjust staffing and drive organizational efficiency. (Eastabrook, 7/29)
Bloomberg:
Novo Nordisk Picks Insider As CEO After Selloff From Wegovy Slump
Novo Nordisk A/S named its head of international operations as chief executive officer after slumping weight-loss drug sales led to a profit warning that wiped $93 billion off its market value. The Danish drugmaker promoted Maziar Mike Doustdar, who has spent more than three decades with the company, to the top spot. The surprise choice disappointed investors who were hoping for a high-profile outsider to lead a fresh challenge to Eli Lilly & Co., which has been pulling ahead of Novo in the obesity market. (Kresge, 7/29)
Bloomberg:
P&G Open To Acquisitions In Consumer Health Care, CEO Says
Procter & Gamble Co. said it’s open to an acquisition in the consumer health care category, citing its successful purchase of a Merck business unit in 2018. “There are a couple of categories that we currently compete in where we might be interested in acquisitions if they offer an opportunity to significantly improve the growth rate and margin structure,” P&G Chief Executive Officer Jon Moeller told analysts during an earnings call on Tuesday. (Neumann, 7/29)
Modern Healthcare:
Sword Health Launches AI Program To Streamline Admin Tasks
Sword Health, a virtual care and artificial intelligence company, has launched an AI program aimed at streamlining administrative tasks. Sword Intelligence offers several AI-powered tools designed to ease operational challenges in healthcare, including insurance enrollment, patient triage, coverage eligibility and outreach to high-risk members, the company said in a news release Tuesday. (DeSilva, 7/29)
Modern Healthcare:
J-1 Visa Restrictions Push Phoenix Children's To Recruit Earlier
Health systems expect recruiting overseas clinicians and technicians to take longer and cost more over the next year as the federal government restricts immigration. President Donald Trump’s administration temporarily paused visa processing, increased visa information requests and banned travel from certain countries. These changes are expected to further bog down an already backlogged system, potentially reduce access to care and inflate administrative costs, hospital executives, lawyers and policy experts said. (Kacik, 7/29)
MedPage Today:
Direct Primary Care Will Become Much More Popular Thanks To New Law, Experts Predict
A new provision related to direct primary care (DPC) in the recently enacted reconciliation bill will create more opportunities for physicians in small towns to open independent practices, Jeff Davenport, MD, of Edmonton, Oklahoma, said Tuesday. "What an opportunity for small-town America to have a doctor be able to practice in a model like this and have more expanded opportunities," Davenport said at an event sponsored by the American Academy of Family Physicians. (Frieden, 7/29)
