UnitedHealth and AARP Shake Hands on $9 Billion Deal

By Wendell Potter – In 2024, UnitedHealth Group (UNH) — the nation’s largest health insurer — paid AARP a one-time upfront royalty payment of just over $9 billion for the rights to use AARP’s name in marketing Medicare Advantage-type plans and Medicare supplement policies. According to financial statements for AARP, this windfall came as part of a restructured deal with UNH’s insurance unit, UnitedHealthcare, extending their partnership for an additional 12 years and recording a balance of about $8.72 billion in deferred revenue as of December 31. Read Full Article...

HVBA Article Summary

1. Financial Ties Between AARP and UnitedHealth: In 2024, UnitedHealth Group paid AARP over $9 billion upfront for rights to use AARP’s name in marketing Medicare Advantage and supplement plans. This deal extends their partnership for 12 more years and creates a significant financial dependency of AARP on UnitedHealth. Such a large financial arrangement raises concerns about AARP's impartiality as a trusted advocate for older Americans.

2. Concerns About Medicare Advantage Plans: Medicare Advantage plans, promoted by UnitedHealth and endorsed by AARP, often restrict access to providers and require prior authorizations that can delay or deny care. These plans cost taxpayers nearly $100 billion more annually than traditional Medicare and have been associated with higher denial rates of services. Many seniors experience confusion about coverage and surprise bills, highlighting the trade-offs involved in choosing Medicare Advantage over original Medicare.

3. AARP's Influence and Lobbying Efforts: AARP is a powerful lobbying organization with significant expenditures and a large number of lobbyists, many with connections to government. While AARP claims its subsidiary managing the UnitedHealth deal is separate from policymaking, the financial relationship may influence its advocacy. AARP’s lobbying and policy recommendations have substantial impact on legislation, but critics argue that its ties to UnitedHealth compromise its role as an independent advocate for seniors.

Why every generation needs a unique message around voluntary benefits

By Jimmy Nesbitt – Offering a strong package of voluntary benefits can make a company stand out in today's competitive workforce. But experts say the key lies in explaining how these cost-effective solutions work, an area where benefit managers should take the lead. Employees need more education on voluntary benefits, and it's equally important to have a wide range of messaging to explain how the plans work, according to Stephanie Shields, head of employee benefits at Equitable. How to deliver that messaging depends on who the audience is, Shields added. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Tailored Messaging is Crucial for Different Generations: The article highlights that younger generations, such as Generation Z, prefer digital platforms like TikTok, Instagram, Reddit, and YouTube for benefits information, whereas 55% of employees still rely on traditional HR materials and sessions. This indicates that benefit managers need to customize communication strategies to effectively reach diverse age groups within the workforce. Personalized videos and social media content tailored to a company's specific benefits portfolio can help mitigate misinformation and improve understanding.

2. Voluntary Benefits Address Financial Concerns Related to Healthcare: According to Equitable's survey, 80% of Americans worry about unexpected medical expenses disrupting their financial goals, with younger generations being more concerned than older ones. Voluntary benefits can provide financial support for expenses such as hospital bills, child care, and transportation, offering a safety net that helps employees manage unforeseen medical costs. This support is increasingly important as many employees might otherwise resort to credit cards or retirement account withdrawals, which can have long-term negative effects.

3. Financial Advisers are an Underutilized Resource in Benefits Selection: While 80% of survey respondents acknowledge the importance of financial advisers, only 20% consult them during open enrollment. Financial professionals can assist employees not only with investing and retirement planning but also in making smarter benefits choices. Employers can enhance overall financial wellness by facilitating access to financial information and advisers, helping employees navigate complex financial decisions amid rising living costs.

Elevance posts $1.2B profit in Q3

By Elizabeth Casolo – Elevance Health posted a net income of about $1.2 billion during the third quarter, up 17.8% from roughly $1 billion at the same time last year, according to an Oct. 21 earnings statement. “Our third-quarter results were in line with expectations and reflect disciplined execution across Elevance Health. In a dynamic healthcare environment, we’re focused on advancing affordability and elevating the member experience through our growing value-based care partnerships and AI-enabled digital solutions that simplify access and improve outcomes,” Elevance President and CEO Gail Boudreaux said in an Oct. 21 company news release. Read Full Article...

HVBA Article Summary

1. Revenue and Expense Growth: Elevance Health reported strong top-line growth with total revenues rising 12% year over year to $50.7 billion. However, this was nearly offset by a 13% increase in total expenses, which reached $49.3 billion. The narrow gap between revenue and expense growth highlights ongoing cost pressures and the importance of disciplined financial management.

2. Segment and Earnings Performance: The company’s healthcare services arm, Carelon, demonstrated robust growth, with operating revenues jumping 33% from the same quarter in 2024 to $18.3 billion. Despite this, operating gains held steady at around $1 billion, suggesting efficiency challenges or increased investment. Elevance also reaffirmed its full-year guidance, expecting adjusted diluted earnings per share to reach approximately $30.

3. Membership and Cost Pressures: Total medical membership declined slightly to 45.4 million, largely due to decreases in BlueCard and Medicaid enrollment. The company currently serves about 8.6 million Medicaid members and 2.2 million in Medicare Advantage. Meanwhile, the benefit expense ratio rose by 180 basis points to 91.3%, driven by higher-than-expected cost trends, especially within the Medicare segment, indicating mounting pressures on profitability

The Future of Buy-and-Bill Market Access: Five Drivers of Wholesalers’ Vertical Integration with Physician Practices

By Adam J. Fein, Ph.D. – Vertical integration continues to reshape U.S. healthcare, as detailed in DCI’s new 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Our latest analysis shows how the Big Three companies—Cencora, Cardinal Health, and McKesson—are extending their reach far beyond drug distribution, building influence throughout the drug channel. In recent years, these companies have spent more than $16 billion to acquire management service organizations (MSOs) that oversee physician practices in such specialties as gastroenterology, oncology, ophthalmology, and urology. Read Full Article...

HVBA Article Summary

1. Over 2,400 Physician Practices Acquired in a Roll-Up Surge Led by Private Equity and Wholesalers: From 2013 to 2024, private equity firms acquired more than 2,400 specialty physician practices, with oncology alone accounting for about 25% of these deals. Initially led by private equity using roll-up strategies, the Big Three wholesalers—McKesson, Cencora, and Cardinal Health—have entered the space aggressively. They’ve collectively invested over $16 billion in just eight MSO-related transactions with disclosed values. This marks a significant shift from earlier trends, where McKesson’s 2010 acquisition of US Oncology was the only major example of such vertical integration.

2. Wholesaler MSO Ownership Enables Control of Market Share, Prescribing, and Revenue Diversification: By acquiring MSOs that manage physician practices, wholesalers are securing control over provider-administered drug channels, allowing them to:

   • Redirect purchasing and GPO relationships away from competitors (e.g., Florida Cancer Specialists switched from Cencora to McKesson after a new MSO partnership),

   • Influence biosimilar selection through deeper visibility into prescribing patterns, and

   • Access high-margin revenues from clinical and diagnostic services, which are typically more profitable than traditional drug distribution.
     For instance, the OneOncology transaction involved 65% private equity (TPG) and 35% Cencora, giving Cencora an eventual path to full control while limiting immediate capital exposure.

3. MSO Strategy Positions Wholesalers to Withstand Headwinds and Transform Business Models: The traditional wholesale model—“buy low, sell high, collect early, pay late”—is under pressure from industry changes, including the Inflation Reduction Act and a steep Medicare Part B reimbursement drop starting in 2028. Wholesaler-owned MSOs may help offset these risks by consolidating influence over therapy access and contracting, and by aligning distribution with value-based care trends. However, long-term success depends on whether wholesalers can evolve into market makers by integrating expertise in benefit management and health insurance, not just logistics.

Nearly One-Quarter of Companies Report Adding New Executive Benefits

By Emily Boyle – A significantly higher percentage of companies (24%) reported adding new benefits than in previous years (a 20-year average of 8%) in 2025 according to Goldman Sachs Ayco’s 2025 Executive Benefits Survey, the results of which were released Wednesday. More companies reported considering introducing executive benefits in the next two years (20%) than eliminating them (5%), suggesting corporate decision makers continue to make significant investments in benefit offerings to recruit and retain top executives. Read Full Article...

HVBA Article Summary

1. Executive Benefits as a Strategic Retention Tool: With 56% of executives reporting they are likely to leave their roles within the next two years, companies are increasingly leveraging non-monetary benefits to attract and retain top leadership talent. These benefits are seen not only as rewards for achieving executive status but also as enablers that allow leaders to better focus on company priorities, according to Goldman Sachs' survey of 291 compensation and benefits professionals.

2. Heightened Focus on Security and Wellness Benefits: In response to increased threats, personal security benefits for CEOs rose by 10 percentage points, cybersecurity benefits by 12 points, and home security benefits reached their highest levels since 2003 (27% for CEOs and 11% for senior executives). Physical and fiscal perks also saw notable growth: 41% of companies added financial counseling, 18% added executive physical exams, and 11% added tax preparation services over the past two years. Additionally, 27% of companies are considering adding financial counseling, and 15% are considering adding personal security benefits.

3. Decline of Traditional Perks, Rise of Business-Justifiable Benefits: “Old-time status benefits” are being phased out: among companies that eliminated at least one benefit (7%), the top cuts included company aircraft for personal use (19%), executive life insurance (14%), and executive physical exams (14%). Meanwhile, first-class air travel increased by 6 percentage points for CEOs (to 32%) and by 4 points for senior executives (also to 32%), and personal aircraft use dropped 5 points for senior executives (to 17%). Companies are favoring benefits that are easier to justify to shareholders, such as those supporting efficiency, safety, and executive well-being—trends that are now rebounding toward or exceeding 2005 levels after a decline from 2005 to 2011.

Trust in health insurers ‘nearing the point of no return,’ survey finds

By Caroline Catherman – As people across the country consider their 2026 health insurance options, there’s a massive elephant in the room: Some aren’t thrilled with the industry right now. As part of a Sept. 24 report, global research and advisory firm Forrester found only 54% of 12,036 insurance customers describe health insurers as trustworthy. Though several 2023 and 2024 surveys found the vast majority of consumers were satisfied with their coverage, that is the past. Forrester found waning trust may impact business. Read Full Article...

HVBA Article Summary

1. Declining Trust in Health Insurers: The Forrester report reveals that only 54% of surveyed insurance customers currently view health insurers as trustworthy, marking a significant decline from previous years. This erosion of trust is notable despite past surveys indicating high consumer satisfaction with coverage. The decline in trust is consequential as it correlates with a much higher likelihood of customers switching insurers, increasing from 2.4 times more likely in 2024 to 10.3 times more likely in 2025 among those with low trust.

2. Impact of Negative Publicity and Industry Challenges: Allegations and investigations, such as the 2023 Stat investigation into UnitedHealthcare's use of algorithms to limit patient care, have contributed to public skepticism and damaged the reputation of health insurers. Such reports have reinforced negative perceptions and created a challenging environment for insurers to regain consumer confidence. Additionally, high-profile events like the killing of UnitedHealthcare's CEO have intensified public discourse around the industry's trust issues.

3. Efforts to Rebuild Trust and Improve Transparency: In response to declining trust, some health insurers have committed to initiatives aimed at improving customer experience, such as simplifying prior authorization processes and enhancing clarity in claim explanations. For example, UnitedHealth and other insurers pledged to ease prior authorization, which is known to delay patient care, while companies like CareFirst are working to make explanations of benefits more understandable. However, public skepticism remains high, with many consumers doubting insurers will follow through on these promises, indicating that rebuilding trust will require sustained and genuine efforts beyond marketing.

Personalization, data privacy, and compliance in benefits administration

By Jim Priebe – In today’s benefits landscape, the race to personalize is real. So is the risk. HR leaders face growing pressure to deliver benefits experiences that feel as personalized as a Spotify playlist or their Netflix dashboard. According to LIMRA, nearly 90% of workers want benefits tailored to their individual needs. Yet only 27% are comfortable with employers using personal data to make that happen. That gap between expectations and privacy concerns is more than an inconvenience. It’s a trust gap that benefits professionals can’t afford to ignore. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Growing Demand for Personalized Benefits: Employees increasingly expect benefits that reflect their diverse needs, with nearly 90% wanting tailored options. Different generations prioritize different benefits, such as mental health support for Gen Z and retirement plans for older workers. The rise of hybrid and remote work has also increased demand for digital tools that provide personalized guidance anytime and anywhere.

2. Balancing Personalization with Privacy and Compliance: Benefits leaders must navigate complex regulations like GDPR, CCPA, and HIPAA while implementing data-driven personalization. Employee trust is critical, as many workers, especially younger generations, view employer monitoring as a privacy invasion. Privacy missteps can lead to backlash, legal risks, and damage to the credibility of benefits programs.

3. Practical Strategies for Trustworthy Personalization: The article outlines five key steps for benefits leaders: adopting consent-first design, limiting and anonymizing data, communicating transparently and regularly, involving legal and compliance teams early, and continuously monitoring employee sentiment. A case study from the energy sector demonstrates that trusted personalization, with clear data boundaries and opt-in models, can significantly improve engagement and satisfaction.