UnitedHealth Group’s $9.1 Billion First Quarter Wasn’t Enough to Keep Wall Street Happy

By Wendell Potter - UnitedHealth Group’s stock price has been in free fall since it announced first-quarter 2025 earnings last Thursday, but not because the company failed to report huge profits during the first three months of the year. In fact, the nation’s largest insurer – and the world’s largest health care conglomerate – posted record-breaking profits of $9.1 billion during the first three months of this year, considerably more than the $7.9 billion it made in the first quarter of 2024. Read Full Article…

HVBA Article Summary

1. Historic Stock Crash Triggered by Lowered Earnings Forecast: UnitedHealth’s stock plummeted 22% in one day—the biggest single-day drop in 26 years—after the company sharply downgraded its 2025 earnings forecast. This revised guidance, a drop of nearly $3 per share from earlier estimates, spooked investors and erased $110 billion in market capitalization, highlighting how sensitive Wall Street is to future expectations, not just current performance.

2. Heavy Reliance on Government Programs Backfires: UnitedHealth’s deep dependence on Medicare Advantage and Medicaid—now responsible for 77% of its health plan revenue—has become a liability. The company underestimated care utilization among new Medicare Advantage enrollees and is facing smaller-than-expected government reimbursements. Meanwhile, its commercial insurance business has stagnated, and rising premiums have driven some individual market consumers away.

3. Profit Pressures Could Lead to Tougher Consumer and Policy Impacts: As executives scramble to restore investor confidence, there’s concern UnitedHealth may tighten access to care in Medicare Advantage plans and intensify lobbying to defend high government reimbursements. The situation raises broader questions about whether prioritizing shareholders is undermining patient care and responsible use of taxpayer funds.

Eli Lilly opens a new legal front in its battle against compounded GLP-1s

By Ed Silverman and Katie Palmer - Amid ongoing battles over alternate supplies of blockbuster weight loss drugs, Eli Lilly filed new lawsuits against four telehealth firms and their affiliates, but is using a new line of attack — the drugmaker accused two of the companies of engaging in the corporate practice of medicine. To date, Lilly and its rival, Novo Nordisk, have filed dozens of suits against numerous companies involved in compounding versions of semaglutide and tirzepatide, the obesity and diabetes drugs known as GLP-1s. Read Full Article… ^{_{(Subscription required)}}

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1. Lilly’s Lawsuits Target Alleged Corporate Control of Prescribing: Eli Lilly has filed lawsuits against Mochi Health and Fella Health, claiming the companies violated corporate practice of medicine laws by influencing prescribing decisions through affiliated medical groups and compounding pharmacies. Lilly alleges these firms altered prescriptions for compounded GLP-1 drugs, including tirzepatide, without medical justification or provider input, prioritizing profits over clinical judgment.

2. Corporate Practice of Medicine Scrutinized Amid Telehealth Growth: The case underscores concerns that some telehealth firms exploit regulatory gray areas by exerting indirect control over physician-owned medical groups. Legal experts warn that even if these business models comply “on paper,” they may still violate the spirit of laws meant to protect clinical autonomy, especially if they limit a physician’s ability to prioritize patient care.

3. Broader Implications for Telehealth and Compounding Practices: A ruling in favor of Lilly could set a precedent with implications beyond GLP-1 drug compounding, potentially triggering heightened enforcement of corporate practice of medicine laws and challenging the structural models used by many telehealth providers. The lawsuits spotlight the tension between innovation and regulation in digital health as states revisit legal boundaries around corporate influence in medical care.

Telehealth Fraud & Compliance: Preventing ‘Pill Mills’ While Ensuring Access to Care

By Josh Rosaasen - Telehealth unlocked new doors and allowed patients to access healthcare with simple clicks but has undergone rapid changes recently. As with the advent of new technologies, new problems arise and virtual “pill mills” stand to be one of the greatest complications as they abuse the loopholes created from telehealth platforms to distribute controlled substances free from comprehensive medical attention. Read Full Article…

HVBA Article Summary

1. Telehealth’s Pill Mill Problem and Public Health Risks: The rise of digital “pill mills” — telehealth operations that prioritize quick prescriptions over proper evaluations — has triggered investigations and eroded public trust in telemedicine. These fraudulent practices, involving ADHD medications and black-market GLP-1 drugs like Ozempic and Mounjaro, endanger patient safety and contribute to a growing shadow economy of unregulated treatments.

2. Regulatory Crackdown vs. Access Equity: In response to digital health abuse, regulators are tightening enforcement through updated guidelines and state-level laws, emphasizing provider vetting, video consultations, and stricter documentation. However, these actions risk reducing access to care for underserved groups, especially those managing chronic conditions in rural areas, highlighting the need for balanced, equitable policies.

3. Restoring Trust Through Standards and Transparency: To sustain the growth of telehealth, platforms must validate providers, implement risk-based patient intake, and ensure human oversight in prescribing — especially for controlled substances. Ethical transparency, patient education, and collaboration among industry, regulators, and clinicians will be essential in distinguishing quality digital care from exploitative practices.

   

Benefits Think: 5 ways adaptive intelligence is reimaging benefits

By Kimberly Dunwoody - In the rapidly advancing HR technology space, artificial intelligence is transforming key workforce responsibilities, not the least of which is optimizing the employee benefits experience. Today's consumers expect seamless, personalized interactions in nearly every aspect of life — and employees are no different. AI is enabling HR to meet these growing demands — and not a moment too soon. Specifically, a subset of AI we call adaptive intelligence is blazing the path to scalable, personalized precision for every employee. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Adaptive intelligence enhances HR's emotional and operational engagement tools: Adaptive AI stands out by creating emotionally responsive, real-time interactions that elevate the employee experience. With 45% of HR leaders prioritizing engagement, AI is being used to personalize benefits education and decision support, especially at enrollment, where 79% of employees reported confidence in their choices when guided by AI-powered tools.

2. Personalization and empathy drive stronger benefits utilization: Adaptive intelligence personalizes the benefits journey, using virtual assistants and tailored messaging to increase awareness and use of programs like wellness initiatives. This has led to a threefold increase in visibility and 18% more engagement when personalized nudges are deployed, showing employees don’t need to master benefits—they just need intuitive, AI-enabled support.

3. AI delivers actionable insights and automation that reduce cost and confusion: From interpreting employee sentiment via intelligent call analysis to translating healthcare jargon into plain English, adaptive intelligence gives HR the tools to respond faster and with greater clarity. Visual AI applications like document verification are also cutting costs significantly—saving some clients up to $500,000 annually—by automating claim and dependent validations.

The Problem With Healthcare? It’s Stuck In The Past

By Jeffrey Wessler - For all the advances in medicine—AI-assisted imaging, wearable diagnostics, personalized drug therapies—I think the way healthcare is delivered still feels like it was designed for a different era. Patients often navigate a maze of phone calls, referrals, prior authorizations and multi-week waits just to see a specialist, let alone receive timely intervention. Read Full Article…

HVBA Article Summary

1. Tech Without Delivery Redesign Falls Short: Healthcare has seen impressive strides in innovation—from AI diagnostics to wearable monitoring devices—but outcomes remain constrained by outdated delivery models. The problem isn’t the technology itself; it’s the failure to redesign care around it. In fields like cardiology, cutting-edge tools are undermined by referral delays and legacy systems, showing that tech-first thinking alone won’t transform patient care.

2. A Delivery-First Model Enables Real Impact: Real transformation requires a shift from traditional, episodic, and physician-led care to a model that prioritizes continuous monitoring, team-based coordination, and data integration. By embedding technology into proactive workflows—such as routing real-time alerts directly to clinical teams—healthcare organizations can respond faster and more effectively to high-risk conditions, improving both outcomes and system efficiency.

3. The True Measure of Innovation: Speed to Intervention: Innovation in healthcare should not be gauged solely by technological sophistication, but by how quickly it helps patients receive necessary care. Seamless integration of digital tools into clinical pathways is what turns potential into progress. Reducing the time from diagnosis to treatment must become the new gold standard for evaluating the value of health tech investments.

Pharmacists want employers to pay them for providing flu shots and screening tests

By Allison Bell - Pharmacists want employers' health plans to pay for the patient care services pharmacists provide the same way the plans pay physicians. The American Pharmacists Association delivered that message Monday in a new set of coverage recommendations for health plans. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Expand Reimbursement for Pharmacist Services: The American Pharmacists Association (APhA) encourages self-insured employer health plans to incorporate pharmacist-provided services—such as flu shots, COVID tests, and strep screenings—into standard medical benefits. Without formal reimbursement mechanisms, APhA warns, it becomes challenging to scale and sustain these services across broader populations.

2. Leverage Data to Demonstrate Value: APhA recommends that pharmacists actively engage health benefits brokers and supply data-driven reports demonstrating how pharmacist-led care contributes to better clinical outcomes, lowers overall healthcare costs, and improves the quality of coverage. These efforts align with broader trends among non-physician providers seeking expanded roles and recognition in the healthcare system.

3. Recognize Pharmacists’ Role in Health Policy and Benefits Strategy: The APhA emphasizes the strategic importance of pharmacists in influencing health policy, especially in key states like Arkansas, Oklahoma, and Texas. Employers are encouraged to support and align with pharmacists’ advocacy efforts to protect employer-sponsored benefits—such as the federal tax exclusion—and to ensure continued pharmacist influence in shaping healthcare policy and plan design.

Food companies agree to phase out synthetic dyes, handing MAHA a victory

By Sarah Todd and Lizzy Lawrence - Food manufacturers will phase out eight synthetic dyes from all U.S. products by the end of 2026, the federal government announced today in a move that reflects the growing reach of the Make America Healthy Again movement. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. FDA Push to Eliminate Artificial Dyes Tied to Chronic Health Concerns: FDA Commissioner Marty Makary linked synthetic food dyes to rising rates of ADHD, obesity, and other preventable chronic conditions, especially in children. He announced that while no official ban exists, food companies are voluntarily beginning to remove eight petroleum-based dyes from both foods and medications as part of a broader Trump administration public health initiative.

2. Mixed Industry and Expert Reactions to Voluntary Dye Removal: Some manufacturers, like dairy companies serving school programs, are proactively phasing out dyes by 2026, while others warn of steep reformulation costs and supply chain disruptions. Consumer advocates support the initiative but stress that systemic FDA reform is needed to truly protect public health from harmful additives.

3. Call for Overhaul of FDA’s Chemical Oversight System: Critics argue that the GRAS (Generally Recognized as Safe) loophole allows food companies to bypass federal safety review of new additives. They say lasting reform requires not just voluntary action, but stricter regulation, better FDA staffing, and a renewed focus on evidence-based chemical safety assessments.