UnitedHealth Group’s Financial Woes
UnitedHealth Group painted a bleak picture in its revised outlook for 2025. It significantly downgraded its projections for 2025 and reported a steep drop in earnings per share. Net income declined 19% to $3.4 billion.
United says it will deemphasize sales of Medicare Advantage (MA) PPOs, eliminate unprofitable MA plans in 2026 that cover more than 600,000 people, and may exit some Exchange markets in 2026.
United is seeing its MA costs spike well over forecast and they could go even higher, to as much as 10%. While most plans are hurting in MA, United’s problems seemingly came out of the blue and are right now worse than others. Costs are high in other business lines, too. Its normally strong services unit, Optum, also is feeling the pinch.
And given its continuing financial woes, Humana is offering certain employees voluntary early retirement buyouts. Employees age 50 or older with at least three years of service are eligible for the program, although those working in certain business-critical areas will be ineligible.
Additional articles: https://www.modernhealthcare.com/insurance/mh-humana-buyouts-voluntary-early-retirement/ and https://www.modernhealthcare.com/insurance/mh-unitedhealth-group-q2-earnings-guidance/ and https://www.healthcaredive.com/news/unitedhealth-2025-outlook-lower-earnings/754243/ and https://www.beckerspayer.com/payer/unitedhealth-group-sets-new-earnings-guidance-amid-19-q2-profit-dip/ and https://thehill.com/policy/healthcare/unitedhealth-earnings/
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#unitedhealthcare #medicareadvantage #humana #margins #layoffs
Arkansas PBM Law Stayed By Federal Judge
A new law in Arkansas banning pharmacy benefit managers (PBMs) from owning pharmacies has been stayed by a federal judge, who said the law could violate the commerce clause. PBMs have targeted the Arkansas and other state laws in legal suits. Whether I like it or not, many of the state laws, including Arkansas,’ are on shaky ground.
#pbms #drugpricing
Direct Primary Care Could Take Off
The ability to use a health savings account (HSA) for direct primary care (DPC) premiums could mean the innovative product could take off and also help stabilize independent practices. The change was included in the recent budget reconciliation bill. Both a consumer via an HSA and an employer on behalf of an employee can pay for a DPC plan. Comprehensive coverage can result from also having an HSA with a high-deductible health plan (HDHP). It is likely more employers will pair HDHP, HSA, and DPC products.
#coverage #healthcare
https://www.medpagetoday.com/practicemanagement/reimbursement/116730
— Marc S. Ryan
