A new study looking at what UnitedHealthcare pays its sister providers could bring scrutiny of vertical integration in healthcare.
About The Podcast:
Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.
Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.
Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.
Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.
Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.
Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.
About The Episode:
On this episode, Marc discusses a new study looking at what UnitedHealthcare pays its sister providers. This could bring scrutiny by CMS and Congress of vertical integration in healthcare.
Key Takeaways:
Vertical integration in healthcare is all the craze.
Large healthcare entities are especially plotting vertical integration strategies to grow.
Vertical integration leads to intercompany transactions among sister companies within the controlling entity.
These agreements occur between plans, PBMs, providers, service entities, and pharmacies.
Between 10% and 20% of Big Plan insurer spending is with sister companies.
These agreements are shown to have higher than arm’s length or market reimbursement.
A recent study shows that UnitedHealthcare pays its sister company providers well more than other providers.
While vertical integration may not be a bad thing in some cases, insurers need to reform how they approach such agreements so as not to disadvantage consumers and businesses.
Congress and CMS, too, need to look at consolidation overall and these inside deals.
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Resources:
The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
