Health Plan Weekly
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News Briefs: DOJ, Two States Appeal Ruling in UnitedHealth/Change Antitrust Case
The U.S. Dept. of Justice, Minnesota and New York have filed an appeal in their antitrust case against UnitedHealth Group’s now-completed acquisition of Change Healthcare, Inc. The DOJ and state attorneys general filed their notice of appeal on Nov. 18, roughly two months after Judge Carl Nichols of the U.S. District Court of the District of Columbia dismissed their case against the $13 billion transaction. Regulators had argued that the deal would give UnitedHealth’s OptumInsight division too much power over health care data, but Nichols ruled that Change’s planned divestiture of its claims-editing technology, ClaimsXten, would assuage any anticompetitive concerns. UnitedHealth has now officially closed its deal with Change, and press reports indicate that the firm TPG Capital has finalized its acquisition of ClaimsXten. -
Payer Lobbying May Pale Next to Pharma, but Experts Say Industry Still Packs Clout
While lobbying expenditures from the health care industry have been rising in recent decades, drugmakers and providers — not insurers — are the main drivers of that spending growth, according to recent research. Still, experts tell AIS Health, a division of MMIT, that the managed care sector’s influence over policy shouldn’t be underestimated.
“Overall, the fact that the industry keeps lobbying means that this investment has some good return; otherwise, they would have stopped,” says Ge Bai, Ph.D., a professor at Johns Hopkins University’s schools of business and public health.
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Health Care Lobbying Rose 70% in 20 Years
Lobbying spending by the health care industries reached $713.6 million in 2020, a 70% increase over the past two decades, according to a recent JAMA Health Forum analysis based on data compiled by OpenSecrets. The growth was mainly driven by pharmaceutical and health product manufacturers and providers. Expenditures were highly concentrated among a small subset of firms, especially for payers, with the top 10% of health plans responsible for 70.4% of spending. -
Cigna-Walgreens Joint Venture Means New Risk-Based Contracting Test
Cigna Corp. on Nov. 7 took a $2.5 billion position in VillageMD, a primary care provider owned by Walgreens Boots Alliance, Inc., contributing to VillageMD’s move to acquire a fellow provider. The Cigna investment is just the latest of a flurry of cash-funded insurer deals involving providers, tech startups and brick-and-mortar retail firms. Health care insiders say the spending spree is far from over, and that the deal is a chance for Cigna’s Evernorth division to field-test its value-based contracting services at its largest scale yet. -
UnitedHealth Survey Finds Large Increase in Number of People Using Virtual Care
A recent survey from UnitedHealthcare found that 71% of respondents said they would likely use virtual care in the future, up from 53% in last year’s survey. Donna O’Shea, M.D., UnitedHealth’s chief medical officer of population health, tells AIS Health that the results indicate the use of virtual care is more than just a COVID-19-specific trend and is likely to become a permanent part of health care.
Still, that’s not to say that people prefer virtual care over visiting doctors in their offices. In fact, the 2022 UnitedHealthcare Consumer Sentiment Survey found that 60% of respondents preferred in-person appointments for non-emergency issues such as allergies, flu or rashes, while 26% preferred virtual appointments and 14% had no preference. The question assumed that the quality and costs of care were comparable between in-person and virtual settings.
