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UnitedHealth CEO addresses shooting + more · Becker’s Payer Issues Podcast

• 0:00
  This is Jacob Emerson with the Becker's payer
• 0:02
  issues podcast
• 0:03
  here's your biweekly industry news briefing for December
• 0:06
  9th
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  in an internal video message to employees on
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  December 6th UnitedHealth Group CEO Andrew Witty addressed
• 0:14
  the fatal shooting of UnitedHealthcare
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  CEO Brian Thompson
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  along with the wave of public scrutiny and
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  online vitriol the event has unleashed.
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  To quote mister Witty, he said, I'm sure
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  everyone has been disturbed by the negative and
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  in many cases, vitriolic media and commentary that
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  has been produced over the last few days
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  particularly in the social media environment.
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  There were very few people in the history
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  of the US health care industry who had
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  a bigger positive effect on American health care
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  than Brian.
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  To continue quoting mister Witty, he said our
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  role is a critical role and we make
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  sure that care is safe, appropriate,
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  and is delivered when people need it. We
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  guard against the pressures that exist for unsafe
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  care or for unnecessary care to be delivered
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  in a way which makes the whole system
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  too complex and ultimately unsustainable.
• 1:02
  Brian Thompson was fatally shot the morning of
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  December 4th in a brazen and targeted attack
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  according to the NYPD.
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  As of the morning of December 9th, the
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  police are still actively searching for the suspect.
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  A motive is currently unknown, but the words
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  deny, defend, and depose
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  were written on shell casings found at the
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  crime scene.
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  The killing of the CEO of the nation's
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  largest health insurer has sparked a firestorm of
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  online hostility toward the health insurance industry moradly.
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  Individuals took to social media to share their
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  experiences with delayed and denied care.
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  1 federal lawmaker described the situation as unjustified
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  but not surprising, while another said the anger
• 1:43
  should be directed towards congress.
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  Mike Tuffin, the CEO of AHIP, wrote in
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  the December 5th on post on LinkedIn that
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  the association condemns any suggestion that threats against
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  our colleagues or anyone else in our country
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  are ever acceptable.
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  Insurers have quickly tightened security around their executives,
• 2:00
  moving conferences to virtual formats and removing biographical
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  information online.
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  To quote mister Witty again, he said, I
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  encourage you to tune out the critical noise
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  that we're hearing right now. It does not
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  reflect reality. It is simply a sign of
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  an era in which we live. What we
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  must do is focus on what we know
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  to be true and what we know to
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  be true is that the health system needs
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  a company like UnitedHealth Group and it needs
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  people like Brian within it.
• 2:28
  Well a health care entrepreneur
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  and former federal health official is reportedly guiding
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  a president-elect Donald Trump's new government efficiency panel.
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  Mister Trump announced the department of government efficiency
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  in November, tapping Elon Musk, owner of Tesla
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  and X, formerly known as Twitter, and Vivek
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  Ramaswamy,
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  founder of Royvin Sciences, to spearhead its creation.
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  Brad Smith, founder and CEO of the health
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  care investment firm Russell Street Ventures,
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  effectively has been leading the panel in recent
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  weeks, though his official role has not been
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  announced according to The New York Times.
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  Mister Smith was named director of the Center
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  For Medicare and Medicaid Innovation in 2020.
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  Prior to that, he served as COO of
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  Anthem's diversified business
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  group. During the pandemic, he also helped coordinate
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  project Airbridge and sat on the board for
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  operation Warp Speed during mister Trump's first term.
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  Mister Smith founded the in home palliative care
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  company,
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  Aspire Health. His latest venture CareBridge is slated
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  to be acquired by Elavance in a deal
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  reportedly worth $2,700,000,000
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  Well AHIP, the trade association representing health insurers
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  has laid off an unknown number of employees.
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  The organization's former director of communications and public
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  affairs posted on LinkedIn December 5th that he
• 3:38
  had been part of quote a layoff.
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  The company or the organization
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  told Politico that AHIP is constantly assessing organizational
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  needs to ensure they are best positioned to
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  advance the interest of their member companies and
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  those that they serve.
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  Well, Anthem Blue Cross Blue Shield has walked
• 3:56
  back a controversial policy, capping the amount of
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  time it would reimburse providers for anesthesia services.
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  In November, Anthem plans in Connecticut, New York,
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  and Missouri said they would implement
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  physician work time values set by CMS for
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  anesthesia reimbursement.
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  Anthem said it would not pay for anesthesia
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  services billed beyond the minutes recommended by CMS.
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  That policy was set to take effect in
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  February.
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  The American Society of Anesthesiologists
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  criticized that policy alleging the insurer would quote
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  arbitrarily
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  predetermined the time allowed for anesthesia care.
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  To continue quoting the association,
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  it's a cynical money grab by Anthem designed
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  to take advantage of the commitment anesthesiologists
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  make thousands of times each day to provide
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  their patients with expert, complete, and safe anesthesia
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  care. Anthem faced additional scrutiny when posts about
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  the policy went viral on Twitter on December
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  4th, prompting lawmakers
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  to weigh in. New York governor, Kathy Hochul,
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  called the policy outrageous.
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  On December 5th, she said Anthem agreed to
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  reverse the policy. To quote her, she said,
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  I shared my outrage. I had a plan
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  from Anthem to strip away coverage from New
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  Yorkers who had to go and under anesthesia
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  for surgery. We pushed Anthem to reverse course
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  and today they will be announcing a full
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  reversal
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  of this misguided policy.
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  A spokesperson for Anthem called the called the
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  coverage of the decision widespread information and
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  said that that's what led them to change
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  course. To quote Anthem, they said to be
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  clear, it never was and never will be
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  the policy of Anthem to not pay for
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  medically necessary anesthesia services.
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  The proposed update to the policy was only
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  designed to clarify the appropriateness of anesthesia consistent
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  with well established
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  clinical guidelines.
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  Anthem is owned by Elevance Health which operates
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  the Blue Cross Blue Shield affiliates in 14
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  states.
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  Well, AM Best has downgraded the outlook for
• 5:46
  Blue Cross Blue Shield of Michigan from stable
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  to negative based on a sharp deterioration in
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  underwriting and operating income.
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  The credit rating agency specializing in insurance said
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  the decline in underwriting performance was driven by
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  higher utilization
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  across Blue Cross's business.
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  Pent up demand for surgeries after the pandemic
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  and high demand for GLP 1 drugs and
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  autoimmune therapies were the major causes of the
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  losses for Blue Cross. Medicare Advantage risk adjustment
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  changes and rising acuity in Medicaid also contributed.
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  Blue Cross reported a $3,200,000,000
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  increase in medical costs in 2023
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  compared to the year prior. The company has
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  made significant efforts to improve its performance, including
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  rightsizing its workforce.
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  The company laid off 64 employees in August
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  as part of that effort to reduce administrative
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  costs.
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  Blue Cross is also ending coverage for GLP
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  ones for weight loss in its largest commercial
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  plan at the beginning of 2025,
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  citing concerns about safety, effectiveness, and cost as
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  the reason for the decision.
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  Well, Humana's CFO, Susan Diamond, is stepping down
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  after 18 years with the insurer.
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  Celeste Millett, the CFO of Global Infrastructure Partners
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  and Investment Fund, will be Humana's next CFO.
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  Miss Millett will assume with the CFO role
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  in January.
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  Miss Diamond will remain with Humana through the
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  end of 2025
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  in an advisory role.
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  And Meridian Health Plan of Illinois, a subsidiary
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  of Centene, has terminated its Medicaid contract with
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  Northwestern Medicine in Chicago effective December 31st.
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  After that, patients with that health plan must
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  select a new plan during open enrollment to
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  continue receiving care at the 11 hospital system.
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  Tens of thousands of Medicaid patients will be
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  affected by that change.
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  If If you like the latest health insurance
• 7:30
  industry news delivered straight to your inbox every
• 7:32
  morning, subscribe to the Becker's Pay Your Issues
• 7:34
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