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UnitedHealth Group anticipates enrolling more Medicare Advantage members than expected this year despite regulatory changes to the program designed to <\/strong>curb health insurance companies’ excessive profits, executives said Friday.\u00a0<\/p>\n The Centers for Medicare and Medicaid Services\u2019 decision last month to phase in risk-adjustment changes over a three-year period will give the company time to adjust its operations and minimize cuts to the benefits it offers members, UnitedHealth Group CEO Andrew Witty said during its first-quarter earnings call.<\/p>\n He said he expects to add more than 900,000 Medicare Advantage members this year, ahead of the company\u2019s projections. Signing up members dually eligible for Medicare and Medicaid remains a company focus, in spite of CMS\u2019 consolidation and removal of more than 2,200 risk codes used to catalog complex conditions.\u00a0<\/p>\n \u201cWe feel good, we intend to grow in 2024 and we expect the marketplace to continue to grow in 2024,\u201d Witty said. \u00a0<\/p>\n Additionally, UnitedHealth does not expect regulatory changes to the Medicare Advantage program to lessen providers\u2019 appetite for inking shared risk contracts.\u00a0<\/p>\n Parent company\u00a0UnitedHealth Group, the largest insurer and employer of physicians, increased net income 16% year-over-year to $8.1 billion on revenue growth of 15% to $91.9 billion.\u00a0<\/p>\n The UnitedHealthcare insurer’s net income rose 14% to $4.3 billion, driven by increased membership and slow recovery of non-urgent procedures. Revenue grew 13% to $70.5 billion. The insurer counted 52.8 million members this year, up 3.7% from 50.9 million.\u00a0<\/p>\n During the call, executives addressed UnitedHealth\u2019s plan for physician acquisitions, lawmakers’ rising scrutiny of the pharmacy benefit manager industry, coverage of pricey new weight-loss drugs and more. Here\u2019s what to know.<\/p>\n Optum’s net income increased 19% to $3.7 billion on revenue growth of 25% to $54.1 billion, primarily due to more patients visiting OptumHealth clinics and growth in OptumRx pharmacy scripts processed.\u00a0 Optum expects to add 10,000 physicians this year, Witty said. The healthcare provider\u00a0reported employing more than 70,000 clinicians at the end of 2022. In February,\u00a0Optum paid an undisclosed sum for Crystal Run Healthcare, a network for nearly 400 providers in New York.\u00a0<\/p>\n UnitedHealthcare\u2019s decision last month to remove prior authorizations from approximately 20% of its services will not pressure the company\u2019s finances, UnitedHealthcare\u00a0CEO Brian Thompson said during the call. The company also plans to remove all prior authorizations requirements for some physician practices, which will translate to another 10% reduction in prior authorizations, he said. The insurer expects to launch most of these changes during the third quarter.<\/p>\n While pharmacy spending represented 20% of the company\u2019s total medical expenditures in the first quarter, less\u00a0than 1% of those charges were for\u00a0GLP-1 weight loss drugs, such as Novo Nordisk\u2019s Ozempic\u00a0or\u00a0Wegovy. \u201cThe price has to be affordable, that\u2019s going to be a key element of how this will evolve,\u201d Witty said. \u201cWe\u2019ll keep a close eye of prices in Europe.\u201d<\/p>\n Lawmakers\u2019 scrutiny of the PBM industry has not slowed business at OptumRx, Witty said. OptumRx\u2019s revenue grew 14.9% to $27.4 billion, with \u201crecord levels of retention\u201d among employer customers, he said. OptumRx is the third-largest PBM, controlling 21% of the market in 2021, according to the latest data from Drug Channels, a research group. \u201cThere needs to be a counterbalance to drug company pricing and the only players really advocating hard for reducing costs are the PBMs,\u201d Witty said. \u201cWe\u2019re very happy when people cut list prices, and we\u2019re very happy when we secure increased rebates, because that cuts costs.\u201d\u00a0More doctors hired<\/h2>\n
Removal of prior authorization<\/h2>\n
Ozempic spending is low<\/h2>\n
Regulatory scrutiny not slowing down OptumRx<\/h2>\n
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