UnitedHealth Group executives assured Medicare Advantage beneficiaries Friday that supplemental benefits, including those affiliated with home care, will likely stay intact as the company prepares for the phase-in of a new Medicare risk adjustment model over three years.
UnitedHealth Group CEO Andrew Witty told Wall Street analysts during an earnings call Friday the company should be able to maintain benefits. He also voiced appreciation to the Centers for Medicare & Medicaid Services for giving MA plans breathing room to prepare for the change to the new risk adjustment model.
“It really allows for the transition to be managed effectively,” Witty explained. “Our goal is to have a transition that protects the beneficiaries and to make sure that it doesn’t damage the [MA] program and of course it requires us to do things differently in some areas.”
CMS announced the three-year transition to the risk adjustment model earlier this month when it issued its final MA rule for 2024. The rule also addressed complaints by government watchdogs of MAOs delaying or denying care to beneficiaries.
Just days before CMS announced the rule related to the risk adjustment model, UnitedHealth Group preemptively announced it would reduce prior authorizations by 20% in the third quarter of this year. UnitedHealth CEO Brian Thompson told analysts during the call the company might cut up to 10% additional prior authorizations to providers who “demonstrate high quality care” to MA beneficiaries.
“We are constantly reviewing our prior authorizations,” Thompson said. “We have to obviously balance what we reduce with the need to guard against clinical quality and patient safety. I would say that this really robust process that we started over the past several months has really demonstrated the importance of the authorizations that we do have in place.”
UnitedHealth Group is the nation’s largest MA organization and is also the parent company of home care and hospice unit LHC Group, which it acquired earlier this year. On Friday, the Minnetonka, MN-based firm reported first quarter earnings of $6.26 a share on revenues of $91.9 billion. That was a 16% increase over the $5.49 a share on $80.1 billion in revenues during the same period last year.
