University of Minnesota Medical School Nixes Its Classroom “Partnership” with UnitedHealth Group after HEALTH CARE un-covered’s Expose

By Wendell Potter and Joey Rettino – The University of Minnesota Medical School has announced it will end a UnitedHealth Group-sponsored course following original reporting by Dr. Allison Leopold in HEALTH CARE un-covered, which detailed (with receipts, including UnitedHealth Group’s campus guide for student tours, curriculum materials, and course syllabi) how the course blurred the line between education and corporate propaganda. “This is a win as far as I am concerned,” Dr. Leopold told us over text. “U of M say they’re ‘revising’ the course, in my opinion, to save face because they don’t want to admit to being part of UnitedHealth Group’s machine.” Read Full Article...

HVBA Article Summary

1. Course Cancellation Following Investigative Reporting: The University of Minnesota Medical School decided to discontinue its UnitedHealth Group-sponsored course after investigative reporting highlighted concerns about the course's content and intent. The reporting revealed that the course materials and structure closely aligned with UnitedHealth Group's corporate messaging, raising questions about the influence of private companies on academic curricula. The university stated it would revise the course, but the move is seen by some as an attempt to address public criticism rather than fully acknowledge the underlying issues.

2. Concerns Over Corporate Influence in Medical Education: The course involved direct participation from UnitedHealth Group executives and included presentations that promoted the company's perspective on health care delivery and value-based care. Critics, including Dr. Allison Leopold, argued that this approach risked prioritizing corporate interests over unbiased medical education. The situation has sparked broader debate about the appropriateness and potential consequences of corporate involvement in shaping medical training.

3. Ongoing Relationship and Financial Ties Remain: Despite ending UnitedHealth Group's involvement in the classroom, the university and the company are not severing all connections. UnitedHealth Group has contributed significant financial support to the University of Minnesota Foundation, and both parties have indicated that their partnership will continue in other forms. This ongoing relationship underscores the complexities and potential conflicts that can arise when academic institutions rely on funding from large health care corporations.

SIIA Government Relations Update 2.13.2026

By SIIA – The new normal these days in Washington, DC, is a Government Shutdown. And we have one again…well, sort of. This time, it’s a “partial” Government Shutdown. But actually, it’s even more limited than that. This particular Government Shutdown is limited to the Department of Homeland Security (DHS). Driven by the politics surrounding ICE and the Trump Administration’s immigration policies, both Democrats and Republicans are dug into their respective positions, resulting in Republicans rejecting Democrats’ demands for reforming how ICE agents operate and Democrats refusing to agree to fund DHS in the absence of any reforms. Read Full Article...

HVBA Article Summary

1. DHS Shutdown and Political Stalemate: A Department of Homeland Security (DHS) shutdown began at 12:01 a.m. as Congress left for a week-long recess without reaching a funding agreement. The shutdown is expected to last at least through the 23rd and may extend longer, potentially affecting DHS-related agencies and programs such as TSA and airport security operations. The timing underscores ongoing legislative gridlock and its operational consequences for federal agencies.

2. Stalled ACA Subsidy Extension and Election-Year Implications: Efforts to extend the ACA’s enhanced premium subsidies have largely collapsed, despite previously dominating national headlines during a prolonged government shutdown. Although public attention has shifted, the expiration of these subsidies—along with reductions in Medicaid coverage—is expected to reemerge as a significant campaign issue ahead of the mid-term elections. The lack of compromise signals continued partisan division over healthcare funding policy.

3. Expanded PBM Transparency and Compensation Disclosure Requirements: The Department of Labor has released proposed regulations clarifying that Pharmacy Benefit Managers (PBMs) and other entities providing pharmacy benefit management services to self-insured plans are subject to expanded compensation disclosure requirements under ERISA §408(b)(2)(B). New federal legislation further strengthens transparency by requiring PBMs to disclose payment practices, pass through 100% of manufacturer rebates to plans, and broaden compensation reporting obligations to additional service providers, including TPAs and potentially stop-loss carriers. These developments increase compliance responsibilities for stakeholders in the self-insurance market.

Payers sign pledge to join CMMI ACCESS Model

By Emma Beavins – The Medicare ACCESS model will reach 165 million more Americans in other payer markets by 2028, according to an announcement by the Centers for Medicare & Medicaid Services (CMS) Thursday. While the initial ACCESS model would allow Medicare beneficiaries to benefit from health technology for the treatment and management of chronic conditions, other healthcare payers have now signed on to a pledge that would expand the model to the Medicare Advantage, Medicaid and commercial markets. The voluntary model focuses on conditions affecting more than two-thirds of people with Medicare, including high blood pressure, diabetes, chronic musculoskeletal pain and depression. It will help pay for telehealth software, wearables and wellness apps that address the conditions. Read Full Article...

HVBA Article Summary

1. Expansion to Multiple Payer Markets: The ACCESS model, originally designed for Medicare beneficiaries, is now being adopted by a broad range of payers including Medicare Advantage, Medicaid, and commercial insurers. This expansion is expected to significantly increase the reach of the program, potentially impacting millions of Americans by 2028. The inclusion of major commercial payers demonstrates a growing consensus on the value of technology-enabled chronic disease management.

2. Focus on Technology and Chronic Disease Management: The model emphasizes the use of telehealth, wearable devices, and wellness applications to address chronic conditions such as high blood pressure, diabetes, musculoskeletal pain, and depression. By supporting these technologies, the ACCESS model aims to improve health outcomes and streamline care for individuals with chronic illnesses. The approach also encourages collaboration between payers and providers to ensure consistent, outcome-based payments for technology use.

3. Standardization and Administrative Support: CMS is developing reference materials, standardized billing codes, and a FHIR-based reporting infrastructure to facilitate the implementation of the ACCESS model across different payers. These tools are intended to support consistent administrative workflows and make it easier for providers and payers to participate in the program. The move is expected to reduce administrative burdens and promote widespread adoption of value-based care practices.

This Feature of Obamacare Was Supposed to Cut Costs. It Did the Opposite.

By Lawrence Wilson – Insurance premiums are just one piece of the health care affordability puzzle for many Americans. Out-of-pocket expenses, which are less predictable, also impact the family budget. Those out-of-pocket costs for deductibles, copayments, and the like now average more than $1,600 a year per person. That’s on top of insurance premiums, which run about $27,000 for a family plan. Read Full Article...

HVBA Article Summary

1. Rising Out-of-Pocket Costs: The article highlights that Americans are facing increasing out-of-pocket health care expenses, which are less predictable than insurance premiums. These costs include deductibles and copayments, and they now represent a significant financial burden for many families. The unpredictability of these expenses makes it harder for individuals to budget for health care needs.

2. Insurance Premiums Remain High: In addition to out-of-pocket costs, insurance premiums for family plans remain substantial. The combination of high premiums and rising out-of-pocket expenses means that overall health care affordability continues to be a challenge for many Americans. This situation suggests that intended cost-saving measures have not fully achieved their goals.

3. Policy Changes and Unintended Consequences: The article points to a judge’s ruling that certain payments to insurers were illegal, which contributed to a spiral of rising costs. This legal decision appears to have had the opposite effect of what was intended by the original policy feature in the Affordable Care Act. It underscores how changes in health care policy can have complex and sometimes unintended financial impacts on consumers.

Employers find new option for workers' GLP-1 demand

By Maya Goldman – Employers who are wary of paying for workers' pricey weight-loss drugs are discovering a workaround: Offer coverage through a telehealth vendor and split the cost. Why it matters: Workers want access to GLP-1s, and employers want to avoid the cost of obesity-related illness. But fewer than 20% of employers covered the medications for weight loss last year, according to KFF — and some later ditched them due to cost pressures. Read Full Article...

HVBA Article Summary

1. Employer-Focused GLP-1 Access Model Launched: Telehealth company eMed is partnering with CVS Caremark to introduce a new option for employers that want to provide access to GLP-1 obesity medications without covering the full cost. Through the arrangement, eligible employees can purchase the drugs online via eMed while receiving comprehensive weight management services. Employers can choose how much to subsidize prescriptions obtained through the platform, offering flexibility in managing benefit expenses.

2. Comprehensive Support and Early Pilot Results: The program combines online cash-pay drug purchasing with structured clinical support, including 24/7 assistance for side effects, weekly check-ins and biannual blood testing. According to eMed, internal reviews suggest that this approach may improve medication adherence. Aon piloted the program for its employees, reporting about 9% enrollment among eligible workers and indicating that participants have experienced improvements in weight and BMI.

3. Growing Trend Amid Pricing Uncertainty: The partnership reflects broader trends in employer-sponsored GLP-1 access, with other companies such as WeightWatchers offering similar workplace benefit models and some employers using health reimbursement accounts to offset drug costs. Experts note that these arrangements could gain popularity if employers secure favorable pricing, but their long-term appeal may depend on whether cash-pay prices continue to decline and employees can access medications independently.

$13,000 annual drug costs still threaten older Americans' security

By Alan Goforth – Retail prices for brand-name prescription drugs widely used by older Americans declined by an average of 1.4% in 2024, according to the latest AARP Rx Price Watch Report. This was the first overall decrease in the 20-year history of the report. The decline was driven largely by targeted price cuts for certain insulins and asthma inhalers after years of advocacy and intense public scrutiny. Even so, most drug companies continued to raise prices, with three-quarters of brand-name drugs increasing in cost and nearly half of these increases exceeding inflation. Read Full Article...  ^{_{(Subscription required)}}

HVBA Article Summary

1. Mixed Trends in Drug Pricing: While there was an overall decline in average retail prices for brand-name prescription drugs in 2024, this decrease was primarily due to targeted reductions in specific medications like insulins and asthma inhalers. Despite this, the majority of drug companies still raised prices on most brand-name drugs. This suggests that isolated price cuts do not necessarily reflect a broader trend of affordability for older Americans.

2. Financial Burden Remains High: The report highlights that the average annual cost for a single brand-name drug remains substantial, and for those taking multiple prescriptions, the total yearly expense can far exceed the median income of Medicare beneficiaries. This ongoing financial strain poses significant challenges for older adults who rely on these medications for their health and well-being. The gap between drug costs and income underscores the persistent issue of prescription drug affordability.

3. Policy and Legislative Implications: Experts and advocacy groups emphasize that voluntary price reductions by pharmaceutical companies are not a reliable solution for long-term affordability. Legislative measures, such as Medicare drug price negotiation, are seen as critical for ensuring sustainable access to necessary medications. Policymakers are encouraged to pursue strategies that balance the need for pharmaceutical innovation with the imperative of making drugs accessible and affordable for consumers.

The fall of personalization and rise of anticipatory benefits

By Paola Peralta – For benefit leaders, it's no longer enough to just respond to employees' requests — staying competitive now means anticipating needs before they arise. Sixty-five percent of employees want more personalized benefits, according to Aon. But the new way to stay ahead is to predict and address benefit needs before they surface. In an effort to do just that, business management company Businessolver launched a new AI-backed benefit administration process aimed at getting employees helpful support as early as possible. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Shift from Personalization to Anticipation: The article highlights a strategic shift away from traditional personalization, which reacts to employee actions, toward an anticipatory model that predicts employee needs in advance. By analyzing multiple data sources — including chatbot transcripts, feedback submissions, service calls, personal information, and on-platform behavior — the company’s AI tool, Sophia, identifies patterns that may signal upcoming needs. This enables proactive nudges to employees or alerts to benefit leaders before an issue becomes more serious.

2. Proactive Support Aims to Improve Outcomes and Reduce Costs: Rather than waiting for employees to experience problems and file claims, the anticipatory approach seeks to intervene earlier with relevant information, resources, or preventive guidance. For example, instead of responding after a workplace injury occurs, the system could suggest ergonomic tips or highlight applicable benefits beforehand. This proactive strategy is intended to improve employee well-being while potentially reducing expensive claims and reactive support efforts.

3. Redefining Success Metrics and Reducing Administrative Burden: The article encourages employers to rethink how they measure benefits success. Traditional metrics like engagement rates may not fully reflect whether employees are truly benefiting from available resources. Instead, more meaningful indicators might include reduced benefits-related inquiries, improved health outcomes, or fewer costly claims. Additionally, AI tools that consolidate data and surface actionable insights can ease administrative strain on HR and benefits leaders, helping them focus on strategy rather than manual analysis.