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United Did Pay Ransom In Cyberattack

United HealthGroup confirmed that personal health information (PHI) and personally identifiable information (PII) was exposed in the attack and “could cover a substantial proportion of people in America.” It also confirmed a ransom was paid. It will take awhile to get to what was exposed and who was impacted. Experts have data which points to the payment of a $22 million ransom by United.  United confirms that while some systems are functioning near normal, others are not yet up and will be restored over time.

In additional news, the United CEO will appear before a House subcommittee on May 1: https://www.reuters.com/business/healthcare-pharmaceuticals/unitedhealth-ceo-testify-before-us-house-panel-cyberattack-tech-unit-2024-04-19/ .

Additional article: https://www.modernhealthcare.com/cybersecurity/change-healthcare-update-unitedhealth-ransom

(Some articles may require a subscription.)

#united #changehealthcare #cyberattacks

https://www.fiercehealthcare.com/payers/unitedhealth-offers-update-cyberattack-data-analysis-systems-restoration

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Optum Appears To Be Laying Off Employees Over Cyberattack

Given the fallout from the Change Healthcare cyberattack, Optum appears to be laying off hundreds if not thousands of employees.  United HealthGroup has not commented on the matter at this point. I have heard that some of the laid off employees are even within the Change Healthcare unit, which could be impacting the return to normal business operations for some plans and providers. If this is true, that is outrageous.

#changehealthcare #optum #cyberattacks

https://www.fiercehealthcare.com/payers/optum-undergoes-mass-layoffs-scale-unclear

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Elevance Health Reports Positive Q1 News

Elevance Health reported overall good numbers for Q1 2024.  While membership has dropped in Medicare Advantage (MA) and Medicaid, margins were up and it reported little fallout on the Medicare medical expense or Change cyberattack front. Due to the MA rate cut, Elevance will balance business expansion with margin. On the call, the CEO also discussed the need to excel at Star measurement in MA.  It also continues to build its Carelon services unit.

Additional articles: https://www.fiercehealthcare.com/payers/elevance-health-sees-double-digit-profit-growth-q1-posting-22b-earnings and https://www.modernhealthcare.com/insurance/elevance-health-medicaid-medicare-advantage-earnings

(Some articles may require a subscription.)

#elevancehealth #medicareadvantage

https://www.healthcaredive.com/news/elevance-health-earnings-q1-change-cyberattack-medicaid-medicare-advantage/713521

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Many Healthcare Bankruptcies Linked To PE Firms

I often talk about the pernicious impact that private equity firms have on healthcare.  Where the firms are successful, they tend to drive up costs in the system by buying provider groups, including owning emergency room providers, and pushing for huge payouts in No Surprises Act (NSA) arbitrations.  They also own hospitals where they cut costs due to high debt. Quality of course suffers and patient care takes a back seat. Such firms also force providers to practice at high-cost hospital places of service (the same is true for hospitals who are independent but are buying up doc groups).

But the other pernicious impact is on shoddy investments and the churn and fallout that occurs.  PE firms tend to saddle the entities they buy with debt.  What’s more, some of the investments are questionable and speculative.  A new report says that more than a fifth of the healthcare companies that filed for bankruptcy last year were owned by private equity firms. This is double the year prior.  And Moody’s Investor Services says there will be more PR-firm bankruptcies down the road. KKR and H.I.G Capital are repeat offenders with bankruptcies.  

Congress is investigating the far-reaching impacts PE firms have on healthcare. The Federal Trade Commission is looking too. They both should. I am all in favor of a private market in healthcare, but it should be accountable.

(Some articles may require a subscription.)

Additional articles:https://www.modernhealthcare.com/finance/private-equity-healthcare-2023-bankruptcy-envision-genesiscare-no-surprises-act and https://www.healthcaredive.com/news/private-equity-stakeholder-project-healthcare-bankruptcy/713297/

#privateequityfirms #healthcare #hospitals #providers

https://www.fiercehealthcare.com/finance/bankruptcies-among-pe-backed-healthcare-companies-spiked-2023-report-finds

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Affiliate Of BlackCat Reportedly Published PHI From Change Cyberattack

While the main operator of BlackCat ransomware appears to have kept a rumored $22 million ransom paid by United HealthGroup, an affiliate published data from the Change Healthcare cyberattack after United did not pay an additional ransom.  The affiliate controlled the captured PHI and data.

#changehealthcare #cyberattacks

https://www.fiercehealthcare.com/payers/optums-change-healthcare-responding-cybersecurity-issue

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Some Big Insurers May Lose Medicaid Contracts In Florida

Humana, Centene, and Elevance Health were the three big plans to win Florida Medicaid awards moving forward along with a number of local plans. But UnitedHealthcare, Aetna, Molina Healthcare, and AmeriHealth Caritas Florida were not given awards. Many states are seeking to cultivate local plans. Appeals will likely follow from the three big plans not selected.

Additional article here: https://www.fiercehealthcare.com/payers/unitedhealth-cvs-molina-big-losers-florida-medicaid-contract-awards

#medicaid #fl #managedcare #healthplans

https://www.healthcaredive.com/news/florida-medicaid-awards-centene-elevance-humana-unitedhealth-cvs-molina/713154

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Physician Pay Increases, But Hurt By Inflation

A survey of physicians shows that pay increased by about 3% in 2023, but it was offset by high inflation.

#physicians #providers

https://www.fiercehealthcare.com/providers/physician-pay-rose-modest-3-2023-here-are-specialties-saw-biggest-gains

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New Alzheimer’s Drug Spending Will Leap In Medicare

The Centers for Medicare & Medicaid Services (CMS) says spending on the new Alzheimer’s drug Leqembi will leap well over estimates. CMS estimates that per member per month spending on Leqembi will rise from $1.67 in 2024 to $4.67 in 2025. This will bring spending across all Medicare to $3.5 billion in 2025. This threatens to add demonstrably to Medicare troubles and will hike Part B premiums.

#drugpricing

https://www.fiercehealthcare.com/regulatory/report-cms-projects-spending-leqembi-will-hit-35b-next-year

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Community Health Centers Suffering From Medicaid Disenrollment

A new study of patients at community health centers are reporting major Medicaid disenrollments, which impacts the level of care that can be provided to these individuals.  Community health centers largely serve those in low-income areas.

It also finds that about 75% of people who have lost Medicaid coverage are still disenrolled. Further, 32% have chronic conditions, 24% are children, 12% were adults older than 65 years of age and 12% had disabilities.

#medicaid redeterminations #primarycare

https://www.fiercehealthcare.com/payers/one-year-after-unwinding-community-health-centers-struggle-medicaid-reenrollment

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CMS Cuts Off Broker Access To SSNs

Kudos for Kaiser Health News’ articles and focus on fraudulent switching in the Exchanges by untrustworthy agents.  The trend has caused a lot of misery for enrollees.  One problem was the access by agents and brokers to full social security numbers (SSNs).  As of today, that has been cut off by the Centers for Medicare and Medicaid Services (CMS) in the federal Marketplace.  Henry Kaiser is smiling from heaven.

#kff #khn #fwa #exchanges #aca

Link to Article

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