In the weeks since UnitedHealthcare backed off its decision to retroactively review and deny emergency care claims, provider groups are still hitting back.
Monday, June 28, 2021
 
 

"[W]e write to urge you to rescind these policies permanently, and to express our belief that there is a better way to ensure that patients access the right care, in the right place, at the right time. We invite you to work together with us on these efforts." — Thirty-two provider and patient advocacy organizations, in a letter this month to UnitedHealthcare CEO Brian Thompson.

It's been a couple of weeks since UnitedHealthcare annnounced it would temporarily back off its decision to retroactively deny emergency care claims after facing hurricane-strength blowback from providers and patient advocates. Those stakeholders are urging the giant payer to shelve the idea for good. Alexandra Wilson Pecci reports.

Also this week, a recent PSQH Poll found that among healthcare organizations' biggest concerns, almost half said their top risk is workforce retention. Read the details here.
 

Provider Stakeholders to UnitedHealthcare: A Delay Isn't Enough
Stakeholders—which include the American Medical Association, Emergency Nurses Association, America's Essential Hospitals, Association of American Medical Colleges, and the Federation of American Hospitals —wrote that a temporary delay wasn't enough.
 
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Health Plans and Provider Organizations Need Excess Risk Coverage Too
In a market that continues to see significant growth in catastrophic claim costs, provider organizations, HMOs and other health plans that want to protect their bottom line should consider excess risk coverage.
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Text-Based Solutions Benefit Chronic Care Management and SDOH
Texting works well for healthcare workflows such as scheduling, billing, patient surveys, and day-to-day communication, and applying the technology to much larger challenges such as chronic care management and social determinants of health (SDOH) is promising.
PSQH Quick Poll: Taking the Pulse of Healthcare Risk Management
Asked how often their organization conducts a risk assessment, 59% of respondents said annually. Another 19% said they conducted assessments only when needed, while 8.8% said they conduct assessments only when needed. Nine percent said they conduct risk assessments twice a year, and others wrote in quarterly, when requested by a client, and every three years.
Humana Names New CFO
The Louisville-based payer removed the interim tag from Susan Diamond's title.
A Hospital Charged $722.50 to Push Medicine Through an IV. Twice.
As hospitals disaggregate charges for services, there has been a proliferation of newfangled fees to increase billing. In the field, this is called "unbundling."
Doctors' Lobby Scores 'Major Victory' on Bill to Hold Physicians Accountable
This year's bill was approved by the state Senate after it was amended under pressure from the doctors' group.
Biden Quietly Transforms Medicaid Safety Net
Biden's efforts — which have been largely overshadowed by other economic and health initiatives — represent an abrupt reversal of the Trump administration's moves to scale back the safety-net program.
Hospitals, Insurers Invest Big Dollars to Tackle Patients' Social Needs
After years of testing, the evidence is mixed that these efforts work.
 

Must Reads
 

That's all for this edition of the HealthLeaders Payers newsletter. We'll be back next Monday with the latest updates and insights.

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