UnitedHealth Group expects to enroll more Medicare Advantage members this year despite regulatory changes to the plan designed to curb excessive profits by health insurers, executives said on Friday.
UnitedHealth Group chief executive Andrew Witty said last month’s decision by the Centers for Medicare and Medicaid Services to implement risk-adjusted changes over a three-year period would give the company time. adjust its activities and minimize the reduction of benefits that the company brings to its members. its first quarter earnings call.
He said he hopes to add more than 900,000 Medicare Advantage members this year, far exceeding the company’s projections. Enrolling members who are eligible for Medicare and Medicaid remains the company’s focus, although CMS has consolidated and eliminated more than 2,200 risk codes used to catalog complex conditions.
“We feel good, we plan to grow in 2024 and we expect the market to continue to grow in 2024,” said Witty.
In addition, UnitedHealth does not expect regulatory changes to a Medicare Advantage plan to reduce providers’ desire to enter into risk-sharing contracts.
Parent company UnitedHealth Group, the largest insurer and employer of doctors, increased net income 16% year-on-year to $8.1 billion thanks to 15% revenue growth to 91 ,9 billion dollars.
Insurer UnitedHealthcare’s net income rose 14% to $4.3 billion, driven by increased membership and slow recalls of non-urgent procedures. Revenue rose 13% to $70.5 billion. The insurer counted 52.8 million members this year, up 3.7% from 50.9 million.
During the call, executives mentioned UnitedHealth’s plan to buy doctors, increasing scrutiny by lawmakers of the pharmaceutical benefits management industry, coverage of Expensive new weight loss pills, etc. Here’s what to know.
Many doctors are hired
Optum net income increased 19% to $3.7 billion while revenue increased 25% to $54.1 billion, driven primarily by patient visits to OptumHealth clinics and growth in OptumRx pharmaceutical scenarios are handled. Witty said Optum expects to add 10,000 more doctors this year. The healthcare provider reportedly employed more than 70,000 clinicians by the end of 2022. In February, Optum paid an undisclosed amount to Crystal Run Healthcare, a network for nearly 400 vendors in New York.
Remove pre-authorization
UnitedHealthcare CEO Brian Thompson said on the call that UnitedHealthcare’s decision last month to remove pre-authorization for about 20% of its services would put no pressure on the company’s finances. company. He said the company also plans to eliminate all pre-authorization requirements for some physician operations, which would result in an additional 10% reduction in pre-authorization. The insurer is expected to make most of these changes in the third quarter.
Ozempic spending is low
While pharmacy spending accounted for 20% of the company’s total medical expenses in the first quarter, less than 1% of it was on GLP-1 weight-loss drugs, such as Ozempic or Novo Nordisk’s Wegovy . “Price has to be affordable, which will be a big factor in how this develops,” says Witty. “We will be closely monitoring prices in Europe.”
Regulatory Monitoring Doesn’t Slow OptumRx
Witty said lawmakers’ scrutiny of the PBM industry has not slowed business at OptumRx. He said OptumRx revenue grew 14.9% to $27.4 billion, with “record user retention” among employer clients. OptumRx is the third largest PBM, controlling 21% of the market by 2021, according to the latest data from Drug Channels, a research group. “There needs to be a counterweight to the pricing of the pharmaceutical companies, and the only players really supportive of reducing costs are the PBMs,” says Witty. “We’re happy when people drop the list price, and we’re happy to make sure the discounts go up, because that helps cut costs.”
