UnitedHealth Group Has Made $24.5 Billion in Profits This Year (So Far) But Still Takes Beating on Wall Street

By Wendell Potter - UnitedHealth Group has taken a beating on Wall Street this week after admitting that its Medicare Advantage plans had to pay out more in medical claims in the third quarter of this year than investors had expected. Read Full Article… 

HVBA Article Summary

1. Wall Street Reacts to Higher MLR: UnitedHealth’s stock dropped 8.11% due to its medical loss ratio rising to 85.2%, signaling higher spending on patient care, which investors dislike despite strong profits.

2. Strong Profits Despite Stock Drop: UnitedHealth earned $8.7 billion in Q3 and $24.5 billion year-to-date, but saw a decline in Medicaid enrollments due to the post-pandemic "unwinding."

3. Optum Outperforms Insurance Arm: UnitedHealth’s Optum division earned $4.5 billion in Q3 profits, surpassing the $4.2 billion from its health insurance unit, with PBMs becoming key profit drivers.

Ransomware Attacks In Healthcare Are Increasing, Creating Longer Recovery

By Jay Asser - Cybersecurity has become a major pain point for CEOs in 2024 as the number of incidents have gone up. Read Full Article…

HVBA Article Summary

1. Ransomware Surge: Ransomware attacks in healthcare have more than doubled since 2021, with 67% of organizations impacted in 2024.

2. Higher Recovery Costs: Recovery times are getting longer, and the average cost of recovering from ransomware has nearly doubled to $2.57 million.

3. CEO Focus on Cybersecurity: CEOs must prioritize cybersecurity, as 37% of organizations lack a response plan, putting their operations at risk.

Down to the wire: 2024 elections impacting health care and employee benefits

By Alan Goforth - As former news anchor Dan Rather once remarked on election night, "This race is hotter than a Times Square Rolex." Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Election Outcomes and Impact: The election results could lead to divided government or narrow Democratic/Republican sweeps. This will affect healthcare policies, including the Affordable Care Act, Medicare, Medicaid, and drug pricing, with transparency and cost control as key issues.

2. Tax and Healthcare Policy Concerns: The expiration of the Tax Cuts & Jobs Act and potential changes to employer-sponsored health insurance tax exclusions are major concerns for advisors and employers. Prescription drug cost transparency is also a priority, with bills aiming to regulate PBMs and TPAs.

3. Advisor Preparedness: Benefits advisors must stay proactive and adapt to new healthcare policies. They should provide clients with alternative options like ICHRAs to control rising costs, while anticipating regulatory changes at both federal and state levels.

Independent pharmacies may skip low-cost Medicare drugs

By Maya Goldman - More than half of independent pharmacies are considering not stocking the first 10 drugs that were subject to Medicare price negotiations over concerns they'll have to absorb upfront costs. Read Full Article… 

HVBA Article Summary

1. Access to Medication at Risk: Independent pharmacies may not stock Medicare's negotiated drugs due to high costs, potentially limiting seniors' access to lower-priced medications when price cuts take effect in 2026.

2. Financial Strain on Pharmacies: Independent pharmacies face $27,000+ monthly costs to stock drugs, with more than half considering not carrying them due to delayed rebates.

3. Reimbursement Uncertainty: Medicare's final guidance lacks mandatory dispensing fees, adding financial uncertainty for pharmacies, though CMS will monitor complaints and encourage fair compensation.

5 keys to a successful voluntary benefits open enrollment

By Nick Rockwell - When the Muzak you hear in stores over the coming months croons about "the most wonderful time of the year," it's probably not referring to open enrollment season. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Choose the Right Enrollment Methods: Select from online, in-person, or telephonic options to meet your clients' specific needs and ensure smooth enrollment for diverse employee groups.

2. Leverage Carrier Support and Technology: Partner with carriers offering robust support and integrated technology platforms to streamline enrollment and enhance service.

3. Increase Voluntary Product Participation: Implement effective communication and decision-support tools to educate employees and boost participation in voluntary benefits.

U.S. News unveils annual Medicare Advantage, Part D ratings

By Paige Minemyer - Medicare's annual enrollment period is officially underway, and, to assist beneficiaries in selecting plans, U.S. News & World Report has released its list of the best Medicare Advantage (MA) and Part D insurers. Read Full Article…

HVBA Article Summary

1. Aetna's Top MA Score: Aetna scored four out of five stars for Medicare Advantage, with U.S. News basing ratings on 34 CMS measures.

2. Top MA Plans: Devoted Health and Blue Cross Michigan both scored 4.2 stars, while Highmark Health followed with 4.1.

3. Part D Leaders: Medica topped Part D with 3.9 stars, while Elevance, Centene, and Humana also ranked, with Centene being the largest provider.

Aetna introduces SimplePay Health

By PR Newswire - Aetna, a CVS Health company (NYSE: CVS), now offers SimplePay Health, an alternative health plan designed to further meet the diverse needs of our clients and members. Read Full Article… 

HVBA Article Summary

1. Cost Savings and Simplified Payments: SimplePay Health offers a copay-only plan with no deductibles, providing price certainty and a simple monthly statement with 0% interest payment options.

2. Empowering Provider Choices: Members use an app to select top-quality, low-cost providers, leading to a 60% increase in quality provider use and 12% total care cost savings.

3. Improved Health Experience: The plan streamlines care with bundled payments, covering all services from start to finish, ensuring a seamless, affordable healthcare experience.