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Health Insurers React as Medicare Advantage Rates Stagnate

Health insurance stocks took a tumble as US regulators opted not to increase payments for private Medicare plans as anticipated, signaling a shift from previous years’ trends. The decision, met with surprise on Wall Street, presents a new challenge for insurers grappling with rising medical costs. The Biden administration’s adherence to proposed Medicare Advantage rates for 2025 marks a departure from historical norms, with only one instance in the past decade where final rates remained unchanged from initial proposals. The industry, already contending with mounting expenses, faces additional hurdles amid the unexpected policy stance. Humana Inc., heavily reliant on Medicare, saw a 9.4% decline in extended trading, while UnitedHealth Group Inc. and CVS Health Corp. experienced respective drops of 4.6% and 5.2%. Other major insurers like Elevance Health Inc. and Centene Corp. also registered significant declines. Although US payments to Medicare Advantage plans will increase by 3.7% on average in 2025, consistent with January’s proposal, the lack of a substantial hike poses challenges for insurers. The announcement, framed as a payment boost by the Centers for Medicare and Medicaid Services, underscores the program’s growing costs, expected to surpass half a trillion dollars. The decision casts a shadow over the health insurance industry’s growth prospects, particularly for key players like Humana, UnitedHealth, and CVS. Analysts suggest that insurers might respond by adjusting benefits or premiums, given the constrained payment environment. America’s Health Insurance Plans, an industry association, voiced concerns over the policy’s impact, especially amid broader shifts in Medicare Advantage regulations. The decision comes against a backdrop of mounting healthcare expenses, particularly notable at UnitedHealth and Humana, prompting investor apprehension. With earnings targets potentially in jeopardy and cost pressures mounting, insurers are bracing for a challenging period ahead, navigating uncertainties in a pivotal segment of the healthcare market.  

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Healthcare Tech Firm HealthEC LLC Faces Massive Data Breach Affecting 4.5 Million Patients

HealthEC LLC, a leading provider of health management solutions, has fallen victim to a significant data breach, potentially compromising the sensitive information of approximately 4.5 million patients. The breach occurred between July 14 and 23, 2023, but the company only disclosed the incident on December 22. The compromised data includes a range of personal and medical information, such as names, addresses, dates of birth, Social Security numbers, medical records, and health insurance details. The breach also exposed billing and claims information, including patient account numbers and treatment cost details. HealthEC’s population health management platform, used by healthcare organizations for data integration, analytics, and care coordination, suffered unauthorized access during the cyberattack. The investigation into the breach concluded on October 24, 2023, confirming the theft of files containing sensitive information. HealthEC urges affected individuals to remain vigilant against identity theft and fraud by regularly reviewing account statements and monitoring free credit reports for suspicious activity. While HealthEC initially refrained from specifying the number of affected individuals, a recent submission to Maine’s Attorney General’s office revealed that one of the firm’s clients, MD Valuecare, accounted for 112,005 affected persons. However, a new listing on the U.S. Department of Health and Human Services’ breach portal indicates that the total number of impacted individuals is a staggering 4,452,782. Seventeen healthcare service providers and state-level health systems have been identified as victims of this cyberattack on HealthEC. Notable organizations impacted include Corewell Health, HonorHealth, Beaumont ACO, State of Tennessee – Division of TennCare, the University Medical Center of Princeton Physicians’ Organization, and the Alliance for Integrated Care of New York. HealthEC advises affected individuals to promptly report any suspicious activity to relevant parties, such as insurance companies, healthcare providers, and financial institutions. This incident underscores the escalating threat to healthcare data security, emphasizing the critical need for robust cybersecurity measures in the healthcare technology sector.

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