Elevance Health, Inc. (formerly known as Anthem) reported strong first quarter 2024 profits of $2.2 billion, a 12.9% increase from the prior year quarter, beating both analysts’ and Elevance’s internal expectations. First quarter revenues also increased to $42.6 billion compared to $42.2 billion in the prior year quarter. Elevance also reported that BlueCard membership grew […]
UnitedHealth Group (“United”) reported strong revenues of $99.8 billion for the first quarter of 2024, growing nearly $8 billion from the prior year quarter. United’s strong revenues beat analysts’ expectations and caused its stock price to soar by more than 5%. UnitedHealthcare’s revenues were $75.4 billion in the first quarter, an increase of nearly
In an article entitled “Hospitals’ Medicare Advantage problem hits an inflection point,” Becker’s Healthcare reports on hospitals’ increasing problems with collecting payments from Medicare Advantage plans, to the extent that many hospitals are planning or considering terminating their Medicare Advantage contracts. Chip Kahn, President and CEO of the Federation of American Hospitals, was quoted in
In a front-page investigative report headlined “Patients Hit with Big Bills While Insurers Reap Fees,” the New York Times shows how health insurers use MultiPlan to reduce payments to medical providers, which increases the fees employers pay the insurers and MultiPlan, but which frequently results in higher medical bills for patients. Here’s how it works:
On March 19, 2024, New York-based Mount Sinai Health System and UnitedHealthcare announced that they had resolved their disputes and reached agreement on a four-year contract for Mount Sinai’s hospitals and physicians to be in-network with the health insurer. In a statement, Mount Sinai CEO Brendan Carr stated: We are pleased to have reached an
The New York Times has published a video opinion entitled “What’s My Life Worth? The Big Business of Denying Medical Care,” which illustrates how “profit-seeking insurance companies” use the prior authorization process “to create intentional barriers between patients and the healthcare they need.” As stated in the video: “At best, it’s just a minor bureaucratic
Health care providers nationwide have been impacted with substantial disruptions to the health care services they provide following a February 2024 data breach by Change Healthcare (https://www.changehealthcare.com/), a technology-based subsidiary of United HealthCare. Change serves as an intermediary between health insurance companies, providers and patients, and claims on its website to be “a trusted partner
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A study recently published in JAMA Health Forum found “significant differences in home health service intensity” between patients enrolled in Medicare Advantage plans and patients enrolled in traditional Medicare. The study was entitled “Differences in Home Health Services and Outcome between Traditional Medicare and Medicare Advantage.” Some of its key findings were: Medicare Advantage patients
The United States Department of Justice has issued a report listing the settlements and judgments it reached under the False Claims Act for Fiscal Year 2023. The report includes settlements with Medicare Advantage plans in cases alleging that the plans for knowingly submitting inaccurate information regarding the health status of their beneficiaries to increase their
The Federation of American Hospitals (“FAH”) proposal that CMS add a quality measure to its Medicare Advantage star rating system that would require these plans to report their level 1 prior authorization denial rates has been recommended for approval by an expert panel. The “Level 1 Upheld Denial Rate” proposal is intended to add transparency