May 14, 2024

Broussard To Step Down As Humana CEO

Bruce Broussard will step down as CEO of Humana on July 1 and be succeeded by Jim Rechtin, who came in as President and COO. Despite some challenges right now financially, he deserves tremendous credit for building a stellar MA business over a decade plus at the helm.  He tripled enrollment. Broussard will serve as a strategic advisor through 2026.

Additional articles: https://www.fiercehealthcare.com/payers/jim-rechtin-step-humana-ceo-role-july-1 and https://www.modernhealthcare.com/insurance/humana-jim-rechtin-bruce-broussard-ceo

(Some articles may require a subscription.)

#medicareadvantage #humana #broussard


Aetna, Humana To Tighten Benefits And Shed MA Members

Both Humana and Aetna have reported they will shed some benefits and likely lose membership in 2025.  CVS Aetna has come off a stellar increase, perhaps too much so as its MA financial turned upside down.  It could shed up to 10% of its membership.  Humana is expected to shed about 5%.  This is not unlike what happened with Centene in 2023 and 2024.  United looks better positioned to gain based on financials right now.

Additional article: https://www.fiercehealthcare.com/ai-and-machine-learning/bofa-cvs-warns-it-could-lose-10-its-members-next-year

(Some articles may require a subscription.)

#medicareadvantage #rates #humana #cvshealth #aetna #centene #unitedhealthcare


Rural Hospitals Unhappy With MA Growth

Interesting article on Medicare Advantage (MA) growth in rural areas and the impact on rural hospitals.  I feel for rural hospitals in general, but it is also hard to argue that MA should be constrained in rural areas when it is providing major benefits to the rural poor.  It is also hard to argue that MA plans should not be allowed to control unnecessary stays to save the system money overall.  The new prior authorization rule could eventually provide relief as the Centers for Medicare and Medicaid Services (CMS) ramp up enforcement in the future.

(Article may require a subscription.)

#ruralhospitals #medicareadvantage #medicare


FTC Chief Says Anticompetition Enforcement A Top Priority

The Federal Trade Commission (FTC) chief said that scrutinizing anticompetitive behavior is a top priority for the Biden administration. At the very top of the list is looking at such behavior among pharmacy benefits managers (PBMs).

(Article may require a subscription.)

#ftc #antitrust #anticompetition #healthcare


Sen. Cassidy Asks For Answers From United Healthcare

Senate Health Committee Ranking Member Bill Cassidy, R-LA, is asking United Healthcare to answer questions related to the Change Healthcare cyberattack.  Among questions include why multi-factor authentication was not in place.

(Article may require a subscription.)

#changehealthcare #cyberattacks


Americans Obtained Coverage But Healthcare Still Unaffordable

Democrats are a bit worried they will not get the credit they think they deserve on healthcare.  Coverage has risen dramatically, but many Americans still complain about affordability, with Americans saying Exchange and employer coverage is expensive and hard to afford.

In fairness, the gains on coverage have been extensive and enhanced premiums subsidies in the Exchange have helped. So have drug price negotiations.  Broader healthcare reform needs the commitment of both parties.

#healthcare #healthcarereform #coverage


The Indefatigable Bernie Sanders Writes Denmark On Drug Prices

You have to hand it to Sen. Bernie Sanders, I-VT, and chair of the Senate health committee.  Sanders has written a newspaper in Denmark urging Denmark to force Novo Nordisk to lower the price of its popular GLP-1 drugs Wegovy and Ozempic. He notes that costs in America are about ten times what they are in Europe.

(Article may require a subscription.)

#weightlossdrugs #drugpricing #branddrugmakers


Article Suggests Unwinding Discriminated Against Those With Disabilities

This Kaiser Health News article recounts how those with disabilities are especially impacted by the poor overall processes for the re-introduced Medicaid redetermination process.

#medicaid #redeterminations


Drug-Maker Study Says GLP-1 Drugs Help Maintain Weight Loss For Up To Four Years

A study supported by drug maker Novo Nordisk finds that weight-loss drugs may be effective for up to four years for those who continually use them.  Sustaining 10% weight loss was found.  The drug maker makes the popular GLIP-1s Wegovy and Ozempic.  GLP-1s have been approved for diabetes and cardiovascular disease as well as in some cases for general weight loss.  Drug makers are seeking approval for other disease states.  Costs in all programs are rising dramatically. The study in part was performed to encourage health plans not to limit the timeframe of coverage.

Additional articles: https://www.newsweek.com/weight-loss-drug-wegovy-ozempic-study-1900106 and https://www.reuters.com/business/healthcare-pharmaceuticals/wegovy-weight-loss-sustained-four-years-trial-novo-nordisk-says-2024-05-13/

#weightlossdrugs #drugpricing #branddrugmakers


Judge Removes PE Firm From Anticompetition Suit

A federal judge removed a private equity firm from a lawsuit brought by the Federal Trade Commission about potentially anticompetitive practices of anesthesia group U.S. Anesthesia Partners (USAP). The lawsuit otherwise stays in place.

#antitrust #anticompetition #ftc #healthcare


— Marc S. Ryan

Leave a Reply

Your email address will not be published. Required fields are marked *

Available Now