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HouseCalls provides home visits for UnitedHealthcare Medicare Advantage members where advanced practice clinicians spend 45 minutes to an hour assessing health and social needs. How can health care be provided in a truly integrated, holistic way, addressing not just the patient's physical health concerns but also their behavioral health needs and the social drivers of health? In-depth visits, in-depth insightsA HouseCalls visit is quite different from a clinical appointment in a doctor's office. While the majority of HouseCalls visits focus on general health and wellbeing and address common health concerns in older adults such as high blood pressure, they occasionally take a more dramatic turn and lead to life-saving health care interventions. Learn more about how UnitedHealthcare's HouseCalls can help improve health outcomes by bringing care to patients' doorsteps.
Persons: HouseCalls, Alexander Billioux, Billioux, Susan Sanner, Sanner, Organizations: UnitedHealthcare, Insider Studios, 2Optum, Income Group Locations: Atlanta
A report by Mental Health America found that 85% of workers reported job stress affected their mental health. Impact on productivity and health care expensesStruggling with mental health can lead to diminished quality of life and decreased motivation at work. A study of people with employer-sponsored health coverage found that 27% of the top 10% of health care spenders had behavioral health needs, accounting for 57% of total health care costs. The goal is to make every interaction within the health care system a chance to promote mental health, treating it like routine physical checkups. Enhance access to mental health services through virtual careWith an anticipated shortage of about 245,000 behavioral health professionals by 2025, the need for accessible mental health services is more pressing than ever.
Persons: spenders, UnitedHealthcare, , onboarding Organizations: Mental Health America, EAP, Insider Studios
President-elect Donald Trump selected Robert F. Kennedy Jr. to lead the Health and Human Services Department, the United States' top health agency. This cabinet appointment has created jitters among various healthcare stocks. I want to find a way to hedge my healthcare exposure and also capitalize on further potential downside in the lagging healthcare sector by using options in Health Care Select Sector SPDR ETF (XLV) . The trade I want to buy a put spread to express my short-term bearish view on healthcare. BEFORE MAKING ANY FINANCIAL DECISIONS, YOU SHOULD STRONGLY CONSIDER SEEKING ADVICE FROM YOUR OWN FINANCIAL OR INVESTMENT ADVISOR.
Persons: Donald Trump, Robert F, Kennedy Jr, SPDR, Eli Lily, UnitedHealthcare, Johnson Organizations: Health, Human Services Department, CNBC, NBC UNIVERSAL Locations: United States, crosshairs
Employers can use health data to offer personalized support for employees with type 2 diabetes. "It's a growing epidemic," said Dr. Donna O'Shea, chief medical officer of population health, UnitedHealthcare. These stark differences emphasize the crucial role of data in helping employers support the health of their workforce. That leads to more targeted, precise and customized interventions for diabetes care, and in turn, healthier, more productive employees and lower health care costs," Kurtzweil said. Learn more about Level2's role in supporting safe and effective diabetes care.
Persons: Donna O'Shea, Craig Kurtzweil, Kurtzweil, Level2, O'Shea Organizations: Diabetes, American Diabetes Association, Health Action, UnitedHealth, Insider Studios Locations: , UnitedHealthcare, New York, America
CVS Health on Wednesday reported mixed third-quarter results as higher medical costs squeezed its bottom line. The earnings report is CEO David Joyner's first at the helm of the troubled retail drugstore chain. CVS will provide commentary on what it expects "directionally" during its earnings call, the spokesperson said. "Establishing credibility and earning the trust of our investors is one of my top priorities as the new leader of CVS Health," Joyner said in a statement. CVS expects those premium deficiency reserves "to be substantially released" during the fourth quarter, which will benefit results in that period.
Persons: David Joyner's, Joyner, " Joyner, Steve Nelson, Nelson, Prem Shah, Karen Lynch Organizations: CVS Health, CNBC, CVS, Aetna, UnitedHealth, LSEG
Companies like Aetna or AARP/UnitedHealthcare are merging their coverage plans, while previous insurers like Mutual of Omaha are leaving the market. AdvertisementWhile beneficiaries with Part A and B Medicare could see premium adjustments, most major changes will occur for people with supplemental Part D and Medicare Advantage plans. Healthpilot found that 10% of Medicare Advantage plans will be at the maximum deductible — up from 5% last year. Most Medicare Advantage beneficiaries will still have prescription drug coverage in the new year, but they may face higher out-of-pocket costs. Baby boomers are already struggling with healthcare costsThese changing Medicare costs come as many low-income baby boomers are struggling to keep up with medical bills.
Persons: , Elizabeth Ayoola, Ayoola, Healthpilot, boomers, Lisa Callejas, Callejas, Betty, Betty —, Betty isn't Organizations: Medicare, Social Security, Service, Insurance, Companies, Aetna, AARP, BI, Healthpilot, Business, Security, Social Locations: Omaha, Mexico, Illinois
It's a modern employer-sponsored health plan designed to help simplify the process of choosing where to receive care by offering members the information they need upfront, enabling them to comparison shop for care. What's different with the Surest health plan? The result, according to a recent study, is that Surest members pay 54% less out of pocket compared to those in traditional plans. "The Surest health plan addresses many of the obstacles that consumers face, including by eliminating complicated math with clear, upfront cost and coverage details," Richards said. People who've tried the Surest plan usually like itConsumers cite ease of use, price clarity, and cost savings as some of the top advantages.
Persons: Surest, Alison Richards, " Richards, coinsurance, Aon, Dan Kueter, who've, It's Organizations: Employers, Insider Studios Locations: It's, Surest, Hawaii
While there's a lot of buzz around prior authorization, it applies to fewer than 2% of claims. UnitedHealthcare is reducing prior authorization requirements with new initiatives to ease administrative tasks and other challenges. According to Dr. Anne Docimo, chief medical officer at UnitedHealthcare, prior authorization is an oft-maligned but necessary part of our health care system. *Understanding when prior authorization is neededDocimo said UnitedHealthcare may seek prior authorization in several scenarios. Modernizing and streamlining the prior authorization processPeople may be surprised to learn that scenarios where prior authorization often comes into play are relatively rare.
Persons: it's, Dr, Anne Docimo, Docimo, UnitedHealthcare, It's Organizations: Card, Insider Studios, UnitedHealthcare, Medicare Locations: UnitedHealthcare's
Wolfe Research is laying out some potential stock winners if former president Donald Trump wins the White House and Republicans sweep both houses of Congress in November. Here are some of the stocks that could benefit from what Wolfe called "a GOP Trifecta" in the fall: Trump Media & Technology Group is one name that could win big from a Trump sweep. Coinbase is another potential winner from a Trump victory. Among other financial stocks, Wolfe Research also highlighted Charles Schwab . Wolfe also highlighted 3M , Halliburton , Dow and Sempra on a lengthy list of stocks that should benefit from a Trump win.
Persons: Wolfe, Donald Trump, Joe Biden, Biden, Coinbase, Charles Schwab, Ben Hendrix Organizations: White House, Trump Media & Technology, Trump, Wolfe Research, Health, UnitedHealthcare, RBC Capital, GOP, SolarEdge Technologies, Halliburton, Dow, Sempra
download the appSign up to get the inside scoop on today’s biggest stories in markets, tech, and business — delivered daily. The subsequent uproar resulted in Thomas updating financial disclosures to indicate his ties to the conservative donor. "I think what you are going to find and especially in Washington, people pride themselves on being awful. It is a hideous place as far as I'm concerned," Thomas told his Friday audience, per the AP. Representatives for Thomas and the Supreme Court did not immediately respond to a request for comment.
Persons: , Clarence Thomas, he's, Thomas, Justice, Kathryn Kimball Mizelle —, Donald Trump, it's, Harlan Crow, Ginni Thomas Organizations: Service, Circuit Judicial, Associated Press, Business, US, The New York Times, Finance Locations: Clear , Alabama, Washington
Change Healthcare offers payment and revenue cycle management tools, and other solutions such as electronic prescription software. On Feb. 21, UnitedHealth Group , which owns Change Healthcare, discovered that hackers compromised part of the unit's information technology systems. UnitedHealth told CNBC earlier this month that there is "no evidence of any new cyber incident at Change Healthcare." It's just one of the ways Change Healthcare touches cash flow within the health-care sector. A controversial mergerSheldon Cooper | Sopa Images | Lightrocket | Getty ImagesUnitedHealth's ownership of Change Healthcare has raised eyebrows from the outset.
Persons: Omar Marques, Dr, Angeli Maun Akey, Akey, she's, UnitedHealth, I've, Andrew, Mike Bradley, Barbara McAneny, McAneny, Sarah Carlson, Carlson, Sheldon Cooper, Optum, Michael Nagle, Tyler Kisling, Kisling, he's, There's, it's, Purvi, Parikh hadn't, they've, Amit Phull, Phull, Igor Golovniov Organizations: Lightrocket, CNBC, Healthcare, UnitedHealth, U.S . Securities, Exchange Commission, Change, Inc, Bloomberg, Getty, U.S, American Medical Association, AMA, U.S . Department of Justice, DOJ, U.S . Department of Health, Human Services, Wall Street, New York Stock Exchange, Change Healthcare Locations: Gainesville , Florida, U.S, Minnetonka , Minnesota, UnitedHealth's, New Mexico, Boulder , Colorado, California, New York City, UnitedHealth
Taking Account of Rising Health Care Costs
  + stars: | 2024-04-18 | by ( Josh Ocampo | ) www.nytimes.com   time to read: +1 min
Navigating the health care system in the United States can often feel like being lost in a maze. For that reason, Chris Hamby, an investigative reporter, has devoted much of his five-year career at The New York Times to guiding readers through such dizzying questions. His latest article, which was published online this month, explored the complex subject of insurance bills. Last year, Mr. Hamby began investigating MultiPlan, a data firm that works with several major health insurance companies, including UnitedHealthcare, Cigna and Aetna. After a patient sees an out-of-network medical provider, the insurer often uses MultiPlan to recommend how much to reimburse the provider.
Persons: Chris Hamby, Hamby, MultiPlan Organizations: The New York Times, Times Locations: United States, Cigna, Aetna
UnitedHealth Group reported better-than-expected revenue in its first-quarter results on Tuesday, though the company is still dealing with the fallout from the cyberattack on its subsidiary Change Healthcare. UnitedHealth reported revenue growth of close to 9% from $91.9 billion in the same period last year. Direct response efforts, like UnitedHealth's effort to restore Change Healthcare platforms, amounted to an impact of 49 cents per share in the quarter. Business disruption costs, like lost Change Healthcare revenue, amounted to 25 cents per share. In 2022, Optum completed a $13 billion merger with Change Healthcare, which offers tools for payment and revenue cycle management.
Persons: UnitedHealth, Optum, Andrew, UnitedHealthcare Organizations: UnitedHealth Group, Healthcare, LSEG, Change, U.S Locations: LSEG, Brazil
UnitedHealth Group struck a deal in March to buy the nine-state doctor group of the struggling hospital system Steward Health Care. AdvertisementDoctors are hot commoditiesIt's tough to lump the many buyers of medical practices together, as they're pursuing different strategies. Insurers like UnitedHealthcare and CVS' Aetna are required by federal law to spend most of the money they collect in premiums on medical care. Plus, running a modern medical practice is expensive, requiring investments in staffing, technology, and electronic health records. Advertisement"The corporate practice of medicine is the reason why healthcare costs are out of control," Li said.
Persons: , UnitedHealth's Optum, That's, UnitedHealth, there's, They're, Farzad Mostashari, UnitedHealth's chokehold, Chas Roades, Yashaswini Singh, Singh, Roades, Nick Jones, they're, Optum, Jones, Mitch Li, Li, Michelle Cooke, Cooke, she's, Ben Bowman, Bowman Organizations: Service, UnitedHealth, Health Care, CVS Health, Walgreens, Physicians, Research, US Justice Department, CVS, Aetna, Brown University, Harvard Medical School, Oregon Medical Group, JAMA, Amazon, The Washington Post, Federal Trade Commission, US Department of Justice, Department of Health, Human Services, Oregon State, Corvallis Clinic Locations: Oregon, New York, UnitedHealth, Optum, California, The, Atlanta
Read previewSome One Medical patients may soon lose affordable access to their doctors because of an ongoing clash between a preeminent New York hospital system and the country's biggest health insurer. For months, Mount Sinai Health System and UnitedHealthcare have been fighting over payments. Mount Sinai is also asking for higher rates in the middle of its three-year contract, which isn't typical, said Fitch analyst Brad Ellis. AdvertisementUnitedHealthcare argues that Mount Sinai demanded "outlandish" price hikes that would increase healthcare costs by $574 million over the next three years. The Mount Sinai representative said close to 100,000 patients, including One Medical patients, have been affected.
Persons: , Sinai, UnitedHealthcare, Mount Sinai, Meggi Carr, Brad Ellis, it's, Mount Organizations: Service, Sinai Health, Business, Amazon, Fitch, UnitedHealthcare, Mount Locations: New York, Sinai, Mount, Mount Sinai, New York City, UnitedHealthcare
Change Healthcare's systems are down for the seventh day after a cyber threat actor gained access to its network last week. Change Healthcare offers tools for payment and revenue cycle management, and its system outages have disrupted operations in pharmacies and health systems across the country. Change Healthcare merged with Optum in 2022. Rising number of health-care cyberattacksThe attack on Change Healthcare comes after 2023 set a grim record for health-related cybercrime. Impact of Change Healthcare's breachUnitedHealth has not specifically disclosed exactly which Change Healthcare systems have been affected, but the fallout from the cyberattack has caused a ripple of problems across the U.S. health-care system.
Persons: UnitedHealth, John Riggi, Riggi, Cliff Steinhauer, Steinhauer, Cary Brazeman, Brazeman, hadn't Organizations: New York Stock Exchange, UnitedHealth Group, U.S . Securities, Exchange, Change Healthcare, Change, Optum, Healthcare, Palo Alto Networks, Google, CNBC, American Hospital Association, National Cybersecurity Alliance, CVS Health, Walgreens Locations: U.S, Palm Springs
A cyberattack on a unit affiliated with UnitedHealthcare, the nation’s largest insurer, has disrupted drug prescription orders at thousands of pharmacies for nearly a week. The assault on the unit, Change Healthcare, a division of United’s Optum, was discovered last Wednesday. The attack appeared to be by a foreign country, according to two senior federal law enforcement officials, who expressed alarm at the extent of the disruption on Monday. UnitedHealth Group, the conglomerate, said in a federal filing that it had been forced to disconnect some of Change Healthcare’s vast digital network from its clients, and as of Monday, had not been able to restore all of those services. The company was acquired by UnitedHealth Group for $13 billion in 2022.
Organizations: UnitedHealthcare, UnitedHealth, UnitedHealth Group Locations: United’s
Change Healthcare's systems are down for a fourth straight day after parent company UnitedHealth Group disclosed that a suspected cybersecurity threat actor gained access to part of its information technology network on Wednesday. UnitedHealth, the biggest health-care company in the U.S. by market cap, owns the health-care provider Optum, which merged with Change Healthcare in 2022. Optum services more than 100 million patients in the U.S., according to its website, and Change Healthcare offers solutions for payment and revenue cycle management. ET Saturday, Change Healthcare said the disruption is expected to continue "at least" through the day. The AHA declined to comment on the Change Healthcare cyberattack.
Persons: UnitedHealth, We're, CISA Organizations: UnitedHealth Group, Healthcare, U.S . Securities, Exchange Commission, CNBC, CVS Health, CVS, American Hospital Association, AHA, Department of Health, Human Services, FBI, Infrastructure Security Agency, HHS Locations: U.S
Just a few years ago, a crop of venture-backed health insurance startups embarked on planting a flag in the crowded but lucrative health plan business for seniors. Bright Health, which has exited the insurance business entirely as of this year, sold its Medicare Advantage plans in December. However, there are signs that the Medicare Advantage business isn’t as much of a goldmine as it used to be. It takes an enormous amount of capital to grow big in the insurance business, Fidel said. Its Medicare Advantage membership totals about 4 million.
Persons: haven’t, Stephens, underscoring, Oscar Health, Clover, Cowen, Gary Taylor, didn’t, Scott Fidel, it’s, they’ll, Fidel, UnitedHealthcare Organizations: Alignment Healthcare, Medicare, Business, Bright, Oscar, Services, Humana, CVS Health, Aetna, CVS Locations: California, New Jersey
Read previewHealth insurance giant Cigna is exiting the lucrative senior business that's been a boon to insurers' bottom lines for years. It's a sign that the glory days of Medicare Advantage might be coming to an end. Cigna's senior business isn't the biggest, but it's also nothing to sneeze at. In January, Humana, the second-largest Medicare Advantage insurer with 6 million members, slashed its profit projections because of these costs. AdvertisementIn late 2023, rumors swirled that Cigna was looking to sell its Medicare Advantage plans so it could pull off a merger with Humana—the second-largest Medicare Advantage insurer.
Persons: , that's, Cigna, it's, It's, David Cordani, Cordani, Gary Taylor, Cowen, Taylor, Dean Ungar, Humana, Ungar Organizations: Service, Health Care Service Corp, Medicare, Business, Kaiser Family Foundation, Competition, Humana, Moody's Investors Service Locations: Illinois
The way Dan Miller told it, his startup Spora Health was crushing it, providing high-quality care to "thousands" of people online. The startup had secured at least one big contract, with Apple, according to three former Spora employees and another source close to Spora. Four of them told Insider they either no longer worked with Spora or hadn't seen Spora patients in a year. Two doctors listed on Spora's website as "featured Spora providers" also told Insider that they no longer worked for the startup. Another former clinician said she only ever treated a handful of Spora patients.
Persons: Dan Miller, Miller, Spora, it's, UnitedHealthcare, Aetna didn't, paychecks, hadn't, he's, It's, , we've, " Miller, Shelby Livingston, Rob Price, Emmalyse Brownstein, Ryan Pickrell, Gloria Dawson, Stephanie Hallett, Alcynna Lloyd, Hayley Peterson Organizations: Company, TechCrunch, Spora, US Securities and Exchange Commission, Apple, Aetna, Stanford Graduate School of Business, Human Ventures, MaC Venture, SEC Locations: Spora, Level's, slivingston@insider.com
Ozempic Boom Is an Opportunity for Health Insurers
  + stars: | 2023-10-20 | by ( David Wainer | ) www.wsj.com   time to read: 1 min
WSJ’s Daniela Hernandez breaks down the science of how diabetes drugs work—and how they could change psychiatry. Photo illustration: Elizabeth SmelovYou would think a new class of high-price weight loss drugs taken by millions of Americans would be a problem for health insurers. But it is more complicated than that: Some insurance giants actually stand to profit from the Ozempic craze. The industry has been calling out the costs of GLP-1 drugs, which are used for both diabetes and obesity. But federally supported Medicare and Medicaid still don’t cover the drugs for obesity, and much of the commercial market is self-insured.
Persons: WSJ’s Daniela Hernandez, Elizabeth Smelov, Aetna
ATLANTA (AP) — The state of Georgia will start paying for gender-affirming health care for state employees, public school teachers and former employees covered by a state health insurance plan, settling another in a string of lawsuits against Georgia agencies aiming to force them to pay for gender-confirmation surgery and other procedures. The December lawsuit argued the insurance plan illegally discriminated by refusing to pay for gender-affirming care. But Brown said Thursday's settlement requires the health plan to pay for care deemed medically necessary for spouses and dependents as well as employees. That means the health plan could be required to pay for care for minors outside the state even though it's prohibited in Georgia. “The plan can’t treat the care any differently from other care that’s not available in the state,” Brown said.
Persons: , ” David Brown, Micha Rich, Benjamin Johnson, Brown, it's, ” Brown, John Doe, ” Rich, Jeff Amy Organizations: ATLANTA, State, of Community Health, Civil, University, Georgia, University of Georgia, Department of Community Health, Circuit, Appeals, Georgia Department, School District, Family, Children Services, U.S, Opportunity Commission Locations: Georgia, Atlanta, Clayton County, Houston, Houston County, U.S, Bibb, Macon ., Paulding County, North Carolina, Wisconsin, West Virginia, Iowa, Florida, Arizona
Other recent regulations require hospitals to post prices online, and while these efforts offer important protections for people, there are various other ways to help avoid an unexpected medical bill. To help avoid that, confirm with your health plan that any services or tests are covered under your benefits. Negotiate surprise billsIn the event of a surprise bill, there are several steps to pursue. No one wants a surprise medical bill. Learn more about how to avoid surprise medical bills at surest.com.
Persons: Donna O'Shea, Organizations: Population Health, Insider Studios Locations: surest.com
Supreme Court Justice Clarence Thomas purchased a $267,000 RV with the help of a wealthy friend. A spokesperson for the Supreme Court did not immediately respond to a request for comment. In a statement to the Times, Welters said he had provided Thomas a loan so he could buy the RV. But Welters refused to say how much money he had lent the Supreme Court justice, nor on what terms. The revelation comes amid a push to impose new ethics requirements on Supreme Court justices.
Persons: Clarence Thomas, Thomas, Anthony Welters, Welters, Barack Obama, Ginni, , Reagan, Beatrice, Obama, Harlan Crow, Sen, Dick Durbin Organizations: The New York Times, Service, Supreme, New York Times, Times, Historical Society, Illinois Democrat Locations: The, Wall, Silicon, America, Illinois
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