Tuesday, February 27, 2024

Yet Another Front, In The US Anti-Competitive Practices Wars -- In Health Care Delivery, And Reimbursement -- United Healthcare (Insurance) Now...


So just as we said -- in both life science and health care delivery and reimbursement, antitrust is going to be an important gating variable.

Today the WSJ sourced a story saying that United Health, and its Optum (docs' practice groups) businesses. . . are under a non-public civil investigation, centered on potential Sherman and Clayton Act (anticompetitive practice) issues. We will keep an eye on this, just like the M&A marketplaces, for buying and selling companies. Here's a Reuters summary (since the WSJ is a paywalled site):

. . .UnitedHealth's unit, Optum Health, offers a range of healthcare solutions, from pharmacy benefit management to financial consultation and mental health support.

Americans are facing soaring healthcare costs, with the estimated healthcare spending per person standing at about $13,493 in 2022, according to federal data released late last year. . . .

Lawmakers and the Federal Trade Commission (FTC) have been investigating the role of these middlemen in rising healthcare costs. Several bills have been in the works since last year that would require them to make their business dealings public, including the fees they earn on transactions.

The WSJ also reported that the DOJ is examining the company's Medicare billing practices to see if doctors are aggressively characterizing their patients' illnesses to wrongly increase payments from the government. . . .


Onward -- while it was 75 degrees (the warmest February day in Chicago's history here) this afternoon, it fell almost 40 degrees in 45 minutes. . . and now we await overnight snows. Hail has already blown through. Hilarious!

नमस्ते

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