FLATLINING from Fulcrum Strategies
Ep. 36 - 2023 Medicare and PBMs make money
Ep. 36 - 2023 Medicare and PBMs make money
UHC's PMB made more money than their insurance last year
Medicare Advantage vs. Medicare Supplement: What are the benefits and which  one to choose | Marca

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This week on the FLATLINING Podcast, Ron and Matthew discuss the 2023 Medicare fee schedule. Congress, in the omnibus spending bill last year, averted a 4.5% cut by giving providers a 2.4% increase thus bringing the total cut to 2.1%. (-4.5+2.4=2.1). Ron explains how the math is done and what Medicare looks like for 2024.

In UnitedHealth Group’s 2022 financial report (UNH 0.00%↑), it was disclosed that their pharmacy benefit manager (PBM), Optum, earned more profit than their insurance division, UnitedHealthcare. Ron and Matthew discuss how PBMs make their money and what Congress might do about it in 2023.


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Articles mentioned in this program:

Omnibus bill halts PAYGO cuts to providers - Healthcare Finance

The PBM defense playbook - Axios 🔒

UnitedHealth Group's 2022 Earnings are in, PBM Optum outperforms health insurance division - Wendell Potter via Wendell Potter NOW

FLATLINING from Fulcrum Strategies


The FLATLINING Podcast brings you great healthcare analysis and discussion each week from industry experts who know their way around politics, economics, and a doctors office. Subscribe for more great content and check out the articles at www.FLATLINING.net.