Tag: Risk Adjustment

UnitedHealth Group Faces Profitability Challenges in OptumHealth Amid Medicare Advantage Utilization Spike

UnitedHealth Group reports significant OptumHealth underperformance driven by higher Medicare Advantage utilization and risk adjustment challenges, raising profitability concerns and prompting strategic prioritization of patient engagement.

Reveleer Expands AI-Driven Value-Based Care Platform with Novillus Acquisition

Reveleer acquires Novillus to enhance its AI-driven value-based care platform, improving payer-provider collaboration, care gap closure, and clinical intelligence for health plans.

Medicare Advantage Costs, Challenges, and Broker Roles: Insights from SCAN Health Plan CEO

Medicare Advantage increases federal spending but offers lower out-of-pocket costs for seniors. SCAN CEO Sachin Jain highlights program flaws, risk adjustment abuses, and broker roles.

UnitedHealth Group Faces Medicare Advantage Utilization and Payment Challenges in Q1 2025

UnitedHealth Group's Q1 2025 earnings reveal increased Medicare Advantage care utilization and regulatory payment changes impacting financial performance, highlighting challenges in the evolving health insurance market.