April 24, 2024

Humana Bounced Back But Has Challenges

Humana’s Q1 2024 investor call was better than its Q4 one.  It reported better results, including a slightly improved medical loss ratio for its large Medicare Advantage (MA) business. Costs seem to be coming down but the delay in claims due to the cyberattack could cause a re-evaluation. Humana projects flat margins in 2024 and long-term margins to decline to a floor of 3%, which is noticeably down. It will cut $700 million in response in 2024. It pulled its 2025 projections for now.

It continued to note that the 2025 rate hike will mean reductions in benefits and retreating in some geographies. 

Additional article: https://www.modernhealthcare.com/finance/humana-medicare-advantage-profit-2024 and https://www.healthcaredive.com/news/humana-withdraws-2025-earnings-outlook-q1-2024/714105/ and https://www.beckerspayer.com/payer/humana-reported-741-million-in-net-income-in-the-first-quarter-of-2024.html and https://www.beckerspayer.com/payer/humana-plans-to-leave-some-medicare-advantage-markets-in-2025.html

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#humana #medicareadvantage


Notable Layoffs Hitting Healthcare

These are not the first announced layoffs due to tightening times, but more announcements have come.  Optum has laid off throughout the service enterprise, including NaviHealth. UPMC is laying off across its integrated delivery system enterprise.

Additional articles: https://www.modernhealthcare.com/insurance/optum-layoffs-navihealth-unitedhealth-group-uhg and https://www.modernhealthcare.com/labor/upmc-layoffs-administrative-employees

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#healthcare #layoffs


U.S. Chamber And Others Sue Over Non-Competes

Business groups led by the Chamber of Commerce are suing the Federal Trade Commission (FTC) in a friendly district court in Texas to block the prohibition of non-competes.

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#noncompetes #healthcare


Interesting Article On Conservatives Obsessed With Anti-Competitiveness

Interesting article on conservatives’ obsessions with progressives on competition issues in healthcare.  Among the leaders is Sen. Roger Marshall. They seem to be channeling Teddy Roosevelt as I often do.  The noticeable skepticism of these conservatives on some business practices is a good thing and should mean some significant reforms over time.

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#antitrust #competition #healthcare


California And Oregon Back At Universal Healthcare

Both California and Oregon continue planning on universal healthcare that look a lot like Medicare for All.  There are significant barriers, though to passage as well as implementation, including the federal government approving many aspects.

#ca #or #universalcoverage #medicareforall


New Analysis Suggests GLP-1 Costs In Medicare Part D Will Further Rise

A new study by the Kaiser Family Foundation (KFF) finds that the number of people eligible to receive a GLP-1 will rise dramatically with the approval of Wegovy for those who are overweight or obese and have cardiovascular disease.  Costs for GLP-1s have already risen dramatically from 2019 to 2022 because of GLP-1s for use in those with weight issues who have diabetes. 

As of 2022, gross Medicare spending on Ozempic alone placed it sixth among the 10 top-selling drugs in Medicare Part D, with annual gross spending of $4.6 billion (prior to rebates).

The Hill article: https://thehill.com/policy/healthcare/4615310-medicare-coverage-wegovy-obesity-cardiovascular-disease-kff/

KFF press release: https://www.kff.org/medicare/press-release/an-estimated-1-in-4-medicare-beneficiaries-with-obesity-or-overweight-could-be-eligible-for-medicare-coverage-of-wegovy-an-anti-obesity-drug-to-reduce-heart-risk/

#weightlossdrugs #branddrugmakers #drugpricing


Those On Levemir Already Facing Shortages

Diabetics on Novo Nordisk branded insulin are facing supply disruptions and formulary issues from health plans.  When will the federal government get serious about investigating drug makers who pull drugs off the American market while continuing to sell it in other developed countries.  This is what is occurring with Novo Nordisk, which dropped its insulin prices only later to say it was discontinuing certain of its insulins in the U.S.  Yet these insulins will be sold in other countries at even cheaper prices. Like other drug makers, Novo Nordisk earns a majority of its profit from the U.S. market, yet it disadvantages those in need here.  Something should be done.  It is not easy to switch insulins given many factors.  And oh by the way, Novo is a Danish company. Lawmakers are beginning to focus.

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#drugpricing #drugshortages #branddrugmakers


— Marc S. Ryan

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