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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

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

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

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

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