Dr. Bricker , you really nailed it. With recent ransomware why no mention of this huge impact by MSM. Very stunning to know the data breach impact and consequence.

@ahealthcarez

3 ай бұрын

Thank you for watching and for your comment.

This should be illegal

Great explanation. I worked for Change Healthcare during the announcement of UHC's acquisition. Most talented people have retired or left. I left in August 2021.

@ahealthcarez

Жыл бұрын

Thank you for sharing your experience.

@Angel-ec6ow

4 ай бұрын

You were fortunate when you left, Some of us were re-deployed to OptumServe, it’s a call center where most of us have left. UHG, lie like rugs. These people have everyone’s information and that should never be allowed.

Thank you for exposing this

Another well presented subject Dr. Bricker. There is the potential for concern and time will tell how this all works out.

@ahealthcarez

Жыл бұрын

Thank you for watching and for your feedback.

This aged well

@ahealthcarez

4 ай бұрын

Thank you for noticing. 😉

@edenscreek

4 ай бұрын

I thought the same thing! Lol!

@josryder7841

4 ай бұрын

What a predictor of sorts this video is! This is not over

@synsormed

3 ай бұрын

Agreed - I would be curious which Judge thought it was a good thing to let this M&A go through

@Jsimonlane

2 күн бұрын

Why did this age poorly? (Please forgive my uninformed-ness!)

Hey Dr Bricker, love your videos, another side to the Change Health Acquisition: They have access to every Rx transaction on the network. They will be able to see how much pharma is paying on all of the manufacturer assistance programs, what are the pay rules and how much is going to the PBM/plan. In addition, every other PBM reimbursment terms. This is bad for America.

@ahealthcarez

Жыл бұрын

Thank you for the additional information. Appreciate you watching!!

@Angel-ec6ow

4 ай бұрын

It’s bad…Period!

I don't think this is over yet. I can't imagine that Aetna, the Blues and Cigna, not to mention other regional/local payers are going to sit idly by while UHC has access to their allowed amounts and group utilization data.

@ahealthcarez

Жыл бұрын

We shall see. Appreciate you watching and leaving a comment.

Another thing to note for MA signups, is that avoiding sick patients may not be the best strategy. Why? Medicare risk adjustment. Sure the first year turning 65 their RAF will be pure demographic, but after that, due to MLR regulation of 0.85 and uncapped RAF for MA, it’s not obvious that any particular risk profile is advantageous. One could argue easier that targeting sicker patients may be the better play.

@ahealthcarez

Жыл бұрын

Great point. Thank you for sharing.

Although this is inherently anticompetitive, the lawyers have yet to prove that vertical integrations in the healthcare space will necessarily result in negative outcomes for patients. Vertical integration is already prevalent, this is more of the same (in my view)

@ahealthcarez

Жыл бұрын

Thank you for sharing your thoughts, Rick. Appreciate you watching.

I think another important factor that was not brought up enough was provider contracts with payers. They basically could see all of the contracts with their competitors and either start lowballing reimbursement or cutting what they currently pay regionally for specific providers or procedures.

@ahealthcarez

Жыл бұрын

Great point. Thank you for watching and for your comment.

@Angel-ec6ow

4 ай бұрын

Bingo

this reminds me how the SEC tried to separate investment banks from consumer banks as a reaction to the great depression, which got merged back together in the late 1990s leading directly to the 2008 financial crash

@ahealthcarez

3 ай бұрын

Good point. Thank you for sharing.

This is exactly what I was hoping to stumble into regarding this topic… I’ve been trying to puzzle over the move… thank you!!!

@ahealthcarez

Жыл бұрын

Thank you for watching and for your feedback.

THANK YOU.

@ahealthcarez

3 ай бұрын

Thank you for watching.

As a person who works for a clearinghouse the process explained is not completely accurate. It’s not about all about the data it’s the technology that is why UHG acquired Change. Furthermore there are many clearinghouses that utilize one another for claim delivery and ERA delivery ie Availity, Trizetto, Experian and many more.

@ahealthcarez

Жыл бұрын

Thank you for watching and for sharing the additional information.

@dr.richardcohen3306

3 ай бұрын

You are correct. I am a chiropractor and we use Availity and Office Ally but were still crippled by the cyberattack on Change Healthcare...

You’re absolutely right about seamless advantage of data in this acquisition. As a pharmacist turned Data Analyst/Product Manager, I already imagine prescription $$$ that UHG will make from access to member clinical records, through their pharmacy subsidiaries such as OptumRx!

@ahealthcarez

Жыл бұрын

Thank you for sharing your perspective.

Daaaaaaang and now Change Healthcare/UHC/Optum got hacked last week….

@ahealthcarez

4 ай бұрын

Yes. Thank you for watching.

@jenniferdang1863

Ай бұрын

They deserve it lol. Karma is a bitch. Now only time will tell if they or some other insurance company acquires dental xchange. Guess snail mail is the only secure way unless each insurance portal themselves has their own portal to send claims etc

Just another reason why (when I turn 65 in April 2024) that I will not be choosing UHC for my MedSupp plan. The prime reason is their affiliation with AARP which I loath.

@ahealthcarez

10 ай бұрын

Good point. Thank you for your comment.

I’m Starting my career with United. They are allowing me to work remotely and I plan on continuing my education. Concurrently and maybe climb up within or pivot and do my own revenue cycle management consulting and services. I’ll add that this merger is just what is going to be the norm for insurance and healthcare. So we just need to ensure patient outcomes and cost by members remain relatively stable or improved.

@ahealthcarez

4 ай бұрын

Thank you for sharing your thoughts.

WELL they're all screwed now

@ahealthcarez

4 ай бұрын

Thank you for your comment.

@kirbyman1kanden7pf

4 ай бұрын

@@ahealthcarez any time, I enjoy the videos, I worked in a different medical billing clearinghouse than Change Healthcare

videos with a white board are so much better than random clip art as well. well done

@ahealthcarez

3 ай бұрын

Thank you for your feedback.

Dr. Bricker, love your videos as always. I seriously use them to stay up to date with the healthcare space. I'm currently launching my own health tech company and would love to have your input on it!

@ahealthcarez

Жыл бұрын

Thank you for watching and for your comment.

Insurance should be socialized- without a doubt.

@ahealthcarez

Жыл бұрын

Thank you for sharing your thoughts.

@presterjohn1697

Жыл бұрын

Absolutely. It immediately cuts all the rampant fuckery and stabilizes the system.

They hook enployers with low premiums and deductibles, but then they wont pay claims and put everything out of network. The can offer lower rates because they cheat providers and members.

@ahealthcarez

11 ай бұрын

Thank you for sharing your perspective.

Some of KP pharmacy claims go through Optum that is owned by UHG too. Saw it on my EOB.

@ahealthcarez

Жыл бұрын

#True.

United health care lies lies lies to me when i sign up

@ahealthcarez

Жыл бұрын

I’m sorry. Thank you for sharing your experience.

Do you know how vertical integration gets around the Stark anti-kickback laws?

@ahealthcarez

Жыл бұрын

If it’s internal, it appears to not be an issue.

Is it legal to use the health information of members of a self-insured group and use it in underwriting/quoting? I felt it has to be strictly based on census.

@ahealthcarez

11 ай бұрын

Thank you for watching… Do you mean quoting on fully insured groups? Thank you for the clarification.

Several hospitals in my area will no longer take United Healthcare forcing me to change doctors I have had for years

@ahealthcarez

5 ай бұрын

Thank you for sharing your experience.

Do healthcare insurance have a limited number of policies they can give? Meaning in that example will healthy 65+ people be competing with people like the copd patient

@ahealthcarez

Жыл бұрын

Great question. No.

Aren't participating MA plans required to not engage in marketing practices that discriminate based on health status?

@ahealthcarez

Жыл бұрын

MA plans cannot deny coverage based on health status, but MA plans can do targeted marketing. Appreciate you watching and thank you for your question.

Who are Change Healthcare's competitors?

@ahealthcarez

Жыл бұрын

None. Thank you for watching and for your question.

@sekhonkamal

3 ай бұрын

Milliman (Milliman Clinical Guidelines) is a the biggest competitor of InterQual (Change Healthcare's price transparency rate card @@ahealthcarez @leahkamin1562

Does the divestiture of ClaimsXten change this outcome?

@ahealthcarez

Жыл бұрын

Appears to be other software and data products that would still give UHC access to important data.

@MarkStanley57

Жыл бұрын

It's pretty frightening.

Long $UNH 🎉🎉😊😊

Shady

aannnnnnnd it just got hacked. 22 million ransom sent

@ahealthcarez

3 ай бұрын

Yup. Thank you for watching.

United health care sucks!

@ahealthcarez

6 ай бұрын

Thank you for sharing your thoughts.

Yea I have to disagree with you on this one. Although I am a big fan. This assumes that United Health Group is going to disregard HIPPA and HITECH standards around data security and usage. United Healthcare will not have rights to the data that Optum (the company that Change will be merged into) has access to. So the company would have to break the law to do this. Now I am not saying that large Healthcare companies have not broken the law for profits before, but I think it is very dangerous to just assume that is what companies are going to do. Not to mention the fact that if other insurance companies even suspect that is what is happening you can be sure they will take their claims processing elsewhere.

@ahealthcarez

Жыл бұрын

Thank you for sharing your perspective.

@presterjohn1697

Жыл бұрын

I can't help but think of Ancestry being bought out by a private equity firm. A firm who told the press it will not access data from Ancestry. Yeah right.......and I told Toyota I promise not to open the glove compartment on a car I bought yesterday. I warned family members about sending DNA specimens to these companies years ago.

@davidroberts6774

Жыл бұрын

It's analogous to large retailers initially having embedded Amazon stores, then scattering when they realized the potential vulnerability. I suspect other payors will move eventually as a precaution.

@ferndog1461

Жыл бұрын

United Health group will hire legal talent and " bend " the law instead of breaking it. " Grey area, " " bend the law," are phrases for areas where companies draw new profits. Nothing new under the sun.

@bryanh8292

Жыл бұрын

Good one, but there are many ways to bypass HIPPA and HITECH legally. MA plans and brokers have been doing it for years to get access to patient info.