Stunning Admission By United HealthGroup CEO
It was the roasting that was expected, with both sides of the aisle attacking Andrew Witty when he appeared on Capitol Hill. The United HealthGroup CEO made a stunning admission when he said that Change Healthcare had legacy architecture and technology based largely on internal data centers. It says it is rebuulding all of it on a cloud-based, modern infrastructure. This alone substantiates a lack of business continuity and disaster recovery readiness. In the last few days, United also admitted that simple multi-factor authentication was not in place and that is how the cyber criminals got into the Change platforms.
The testimony adds to my theory that when massive consolidation occurs, technology is not modernized and as I call it “spaghetti-ed together.” The testimony will lead to additional scrutiny of United, a review of vertical integration and consolidation in healthcare, as well as more lawsuits and eventual fines for United.
See my blog and podcast on the Change debacle: https://www.healthcarelabyrinth.com/17-what-happened-when-change-healthcare-suffered-a-major-cyberattack-and-what-will-it-mean-to-the-broader-healthcare-system-moving-forward/ and https://www.healthcarelabyrinth.com/the-change-healthcare-cyberattack-what-it-is-and-its-implications/
Additional articles: https://www.fiercehealthcare.com/payers/too-big-fail-consolidation-concerns-loom-over-hearing-change-healthcare-cyberattack and https://www.modernhealthcare.com/politics-policy/unitedhealth-andrew-witty-change-healthcare-hearings and https://www.medpagetoday.com/washington-watch/washington-watch/109918 and https://www.beckershospitalreview.com/finance/a-crisis-of-your-creating-unitedhealth-ceo-grilled-by-congress-on-cyberattack.html
(Some articles may require a subscription.)
#changehealthcare #cyberattacks #unitedhealthcare
https://thehill.com/homenews/4635480-unitedhealth-ceo-heat-cyberattack-senate/
Two Parties Agree On Price Transparency
Both the Biden administration and former Trump administration agree that price transparency is here to stay and the policy likely will not change with the 2024 election.
#pricetransparency #healthcare
https://www.fiercehealthcare.com/payers/heres-how-price-transparency-could-evolve-after-election
CVS Health Reports Huge Surge In MA Costs
While CVS’ Aetna subsidiary did remarkably well during the open enrollment season for Medicare Advantage (MA), like United and Humana it is reporting a huge surge in utilization and medical costs, with a medical loss ratio over 90%. CVS says part of the costs are seasonal (perhaps due to the huge surge in enrollment), but it also promises like the other plans to rein in benefits to get back to target profitability. I contend the trend will continue with higher utilization and a bad prior authorization rule placed on the plans. Indeed, CVS mentioned the impact of the rule, which requires plans to follow the unfettered fee-for-service (FFS) guidelines. CVS slashed earnings for 2024.
Additional articles: https://www.fiercehealthcare.com/payers/cvs-lowers-2024-guidance-it-misses-profit-revenue-q1 and https://www.modernhealthcare.com/finance/cvs-health-aetna-medicare-advantage and https://www.healthcaredive.com/news/cvs-2024-forecast-cut-medicare-inpatient-q1/714807/
(Some articles may require a subscription.)
#cvshealth #aetna #medicareadvantage #healthplans
Modern Healthcare Reports On Health Plan CEO Pay
Modern Healthcare culled together executive compensation for publicly traded health plan CEOs. The numbers are big and could attract attention on Capitol Hill. Provider lobbies are sure to use the info.
(Article may require a subscription.)
#healthplans #managedcare
https://www.modernhealthcare.com/executive-compensation/unitedhealth-andrew-witty-insurance-ceo-pay
Mark Cuban To Continue Tackling Drug Shortages
Mark Cuban and his Cost Plus Drugs say they have other deals being cultivated to produce pediatric cancer and other drugs in shortages. Cuban just struck a deal with Community Health Systems (CHS) to supply drugs.
Additional article: https://www.beckershospitalreview.com/pharmacy/another-system-partners-with-cost-plus-drugs.html
(Some articles may require a subscription.)
#drugshortages #drugpricing
Court Says Class Action On Redeterminations Can Proceed
A federal court in Florida says a class-action lawsuit against Florida can proceed involving how the Medicaid agency approached the return of Medicaid redeterminations. The suit says Florida did not properly inform people before dropping them from the Medicaid rolls.
#medicaid #redeterminations #fl
FTC Challenges GLP-1 Patent Claims
The Federal Trade Commission (FTC) continues to fight invalid patent claims in the Food and Drug Administration’s (FDA) Orange Book. The claims mean fewer organizations will introduce generics for high-costs drugs. FTC now is saying invalid claims exist for some GLP-1 drugs for weight loss.
#weightlossdrugs #drugpricing #ftc #fda #brandrugmakers
https://www.medpagetoday.com/washington-watch/washington-watch/109911
Why Walmart Health Failed
Interesting article on why Walmart Health failed. A provider-side view.
#walmart #primarycare #retailmeetshealthcare
— Marc S. Ryan
