Optum To Provide More Than Half Of UnitedHealth’s 2020 Profits

The rapid growth of UnitedHealth Group’s Optum health care services unit will contribute more than 50% of the company’s earnings in 2020, executives disclosed Tuesday.

UnitedHealth chief executive David Wichmann vowed at the start of the company’s annual investor day to continue the momentum and growth of the nation’s largest health insurer at a cumulative annual earnings growth rate of 13% to 16%. This means that the Optum unit will contribute more than 50% of total company earnings.

Optum will generate $112 billion in revenues in 2020, Wichmann said. UnitedHealth Group’s revenues will surpass $260 billion next year, the company has said.

“With more than 50% of our earnings coming from Optum in 2020, it’s a good time to reflect on the accelerating impact diversification has had on the capacities of UnitedHealth Group, now a broad-based, health care company still in its formative stages of development,” Wichmann told the investor day attendees.

While UnitedHealth continues to be the nation’s largest health insurance company, selling commercial, Medicaid and Medicare Advantage plans, its finding growth on the medical care provider side of the healthcare system. Optum owns one of the nation’s largest pharmacy benefit managers in OptumRx as well as an array of medical care provider businesses, including doctor practices, surgery centers and urgent care sites across the country.

“We believe in supporting the whole person throughout their care journey,” Andrew Witty, who is CEO of Optum and was recently promoted to president of UnitedHealth Group, told analysts and investors at the company’s annual investor day in New York.

Witty cited examples in certain markets where Optum is reducing costs, which helps the company’s overall financial growth. In New Jersey, for example, Witty said the company’s OptumCare doctor practices are “seeing 37%” fewer emergency room visits among Medicaid patients.

Meanwhile, UnitedHealth Group and its Optum medical care provider business are rolling out a combined package of medical care and health insurance as insurers meld health benefits with the provision of healthcare services. In southern California, for example, the company has unveiled a new Harmony health plan where UnitedHealth and Optum have created an “accountable care platform” that now serves 1.5 million people through value based arrangements.

Value-based models put doctors and hospitals under an umbrella that is paid based on health outcomes and performance. The goal is to make sure patients are getting the right care at the right time and in the right amount. That is contrary to the fee-for-service approach of insurance payment to doctors that is based on volume of care delivered.

On Tuesday morning, Witty said the company is working to bring Harmony to more markets including Seattle and Texas “initially.”

https://www.forbes.com/sites/brucejapsen/2019/12/03/optum-to-provide-more-than-half-of-unitedhealths-2020-profits/#7d22086a4959

State-Led Medicare For All Would Import All Of Canada’s Problems

Medicare for All is struggling to gain traction at the national level. Some progressives are hoping that left-leaning states will instead be able to lead the way.

Last month, California Democrat Rep. Ro Khanna introduced the “State-Based Universal Health Care Act,” a bill that would let states take all the healthcare money they get from the federal government—for Medicare, Medicaid, veterans care, Obamacare, and the like—as a block grant they could use to help pay for a single-payer system.

“This bill allows states with bold leadership to establish their own successful universal health care programs in order to prove how viable our movement is on the national level,” Rep. Khanna said.

The plan comes with a host of problems. For starters, several states have already ventured down the road to single-payer—and failed to get there.

In 2011, Vermont’s then-governor Peter Shumlin signed a state-based single-payer plan into law. The idea was to get waivers to pool federal funding into a government program that would cover everyone in the state.

Three years later, Gov. Shumlin abandoned the idea after concluding it would double Vermont’s budget and require massive new taxes that he said would pose “a risk of economic shock.”

Rep. Khanna’s home state of California has also tried to enact single-payer—and failed. In 2017, the state Senate approved a government takeover of the state’s health insurance sector. But even though Democrats controlled the governor’s mansion and both houses of the state legislature, the plan died in the Assembly without a vote. That’s because the proposal would have doubled the state budget—and required a $200 billion tax hike.

Nearly 80% of Colorado voters voted against a 2016 ballot initiative, Amendment 69, that would’ve put the state on the path to single-payer. Even the Democratic governor at the time, John Hickenlooper, urged people to vote against the initiative. Concerns about cost were a significant factor. The Colorado Health Institute analyzed the plan and found that funding would fall $8 billion short within ten years despite massive tax increases.

Rep. Khanna doesn’t think that these states’ experiences are relevant. Instead, he cites Canadian history to defend his plan. “Our neighbors in Canada established their own successful national health program by allowing the province of Saskatchewan to lead with a universal hospital care program in 1947,” he said.

In other words, ignore single-payer’s recent history in Vermont. And California. And Colorado. And look instead to Saskatchewan 70 years ago.

Canada’s healthcare system is not one the United States should wish to emulate. Consider the waits that Canadians must endure for care. The median wait time to receive treatment from a specialist following referral from a general practitioner is 19.8 weeks.

Getting to a doctor is also a tremendous challenge. More than one-third of Canadians must travel an hour or more to find a medical facility that can perform an angioplasty—a common procedure to restore blood flow through an artery—according to a 2010 study published in the journal Open Medicine. In the United States, fewer than 20% would have to go that far.

Even a trip to the emergency room in Canada doesn’t guarantee prompt care. One study found that 29% of Canadians waited four or more hours in the emergency room. In Quebec, more than half did.

In the United States, only 11% of patients had to deal with those sorts of waits.

These sorts of delays aren’t just dangerous for Canadians’ health—they’re costly. In 2018, waiting for treatment cost Canadians about $2.1 billion. And that’s only considering hours lost during the standard workday. Add on weekends and time typically spent outside the office, and the total economic cost of those waits is $6.3 billion, or more than $5,800 per person.

Canadians who can afford to opt out of those waits often do so by traveling abroad for care. In 2017 alone, patients made as many as 217,500 trips outside the country for health care, according to a report from SecondStreet.org, a Canadian think tank. They spent roughly $690 million out of pocket on care. That’s in addition, of course, to the thousands or even tens of thousands of dollars that the typical Canadian family pays in taxes to fund their country’s public healthcare system.

Rep. Khanna’s bid for state-level single-payer is unlikely to gain traction as long as Republicans control the Senate and White House. But there’s an election in less than a year that could change all that. Let’s hope Americans wake up to the fact that, they’d face long waits, rationed care, higher taxes, and a doctor shortage under single-payer.

https://www.forbes.com/sites/sallypipes/2019/11/25/state-led-medicare-for-all-would-import-all-of-canadas-problems/#35ae4bc0374e

Pharmacy chains sue Bausch, other drugmakers for diabetes med overcharge

Three pharmacy chains, including Walgreens Boots Alliance, have filed a lawsuit against drugmakers Bausch Health Inc, Assertio Therapeutics and Lupin Ltd, seeking damages for overcharging for Bausch’s diabetes drug Glumetza.

The lawsuit, filed on Monday, alleges that Assertio and Lupin struck a deal with units of Bausch to delay the entry of their generic versions of Glumetza and allowed the companies to “maintain a monopoly” in the sale of the branded drug and its generic copies.

Bausch, Assertio and Lupin did not immediately respond to Reuters’ request for comment.

Albertson Companies Inc and Kroger Inc were among the other defendants.

https://www.marketscreener.com/ASSERTIO-THERAPEUTICS-IN-45324683/news/Pharmacy-chains-sue-Bausch-Health-other-drugmakers-for-overcharging-for-diabetes-drug-29673449/

UnitedHealth projects another big jump in revenue growth in 2020

UnitedHealth Group projected it will generate $242 billion in revenue in 2019 and expects to report another 7% to 8% increase in top-line growth in 2020.

The insurance group presented updated figures during its investor conference that kicked off Tuesday with officials saying they expect to increase the company’s 2020 revenue to between $260 billion and $262 billion.

They project between $21 billion and $22 billion in operating earnings in 2020.

In comparison, UnitedHealth Group generated $11.98 billion in profits on $226 billion in revenue in 2018. The company is projecting to report $19 billion in profits in 2019.

The biggest driver of growth this year has been UnitedHealth’s Optum, the company’s pharmacy benefit manager. Optum revenue is projected to have increased by 11% from 2018 to 2019, earning UnitedHealth $112 billion in revenue compared to $101 billion in 2018.Optum is expected to continue to be a major growth driver for the company in its 2020 earnings projection, with UnitedHealth pegging growth to increase again between 13% to 14%.

https://www.fiercehealthcare.com/payer/unitedhealth-projects-242b-2019-revenue-offers-2020-guidance-262b-revenue

Gene therapy stocks in focus after Astellas/Audentes deal

Gene therapy stocks may see increased buying today in the wake of Astellas Pharma’s $60/share bid for Audentes Therapeutics.

Selected tickers: Editas Medicine (NASDAQ:EDIT) (+1%), Intellia Therapeutics (NASDAQ:NTLA) (+1%), CRISPR Therapeutics (NASDAQ:CRSP) (+1%), Orchard Therapeutics (NASDAQ:ORTX) (+11%), AVROBIO (NASDAQ:AVRO) (+3%), MeiraGTx Holdings (NASDAQ:MGTX) (+1%), bluebird bio (NASDAQ:BLUE) (+0.5%), Homology Medicines (NASDAQ:FIXX) (+4%), Solid Biosciences (NASDAQ:SLDB) (+4%), Abeona Therapeutics (NASDAQ:ABEO) (+10%), Capricor Therapeutics (NASDAQ:CAPR) (+4%), Sarepta Therapeutics (NASDAQ:SRPT) (+2%), BioMarin Pharmaceutical (NASDAQ:BMRN) (+2%), Voyager Therapeutics (NASDAQ:VYGR) (+5%), Sangamo Therapeutics (NASDAQ:SGMO) (+8%)

https://seekingalpha.com/news/3523311-gene-therapy-stocks-in-focus-after-astellas-audentes-deal

Unexpected Psychological Benefits Of Aerobic Fitness

Longstanding research has found that exercise that increases our cardiovascular activity brings a number of health benefits, including lowered blood pressure; improved cardiovascular health; strengthening of the immune system; regulation of weight; and moderation of blood sugar. Interestingly, it appears that vigorous aerobic activity (maintaining more than 60% of aerobic capacity) brings greater cardiovascular health benefit than moderate activity. Exercise therapy has been found to improve a measure called heart rate variability, which is associated with greater levels of psychological well-being and resilience in the face of stress. One strand of research finds that aerobic exercise conducted in a mindful state (i.e., with enhanced self-awareness, such as yoga and Feldenkrais) brings greater mood benefits than routine vigorous or moderate cardio workouts. Many of the activities we associate with self-development, from counseling and psychotherapy to meditation, are pursued in a state of reduced physical activity and enhanced self-awareness. Might it be the case that vigorous aerobic activity is an equally promising path toward emotional well-being and a positive psychology?

According to the National Institutes of Health’s National Center for Complementary and Integrative Health, yoga, a discipline of “meditative movement” is associated with such benefits as stress relief, pain reduction, and emotional well-being. There is also evidence that yoga also improves the aforementioned heart rate variability and lessens symptoms of depression. In an excellent review article, Julia Belluz notes the limitations of much of the research on the benefits of yoga, but cites fascinating evidence that yoga may be uniquely helpful in reducing inflammation in the body. Similar amounts of time spent in yoga and general physical activity yield greater inflammation benefit for the yoga participants, presumably because of the added components of mindfulness.

In a review of brief approaches to psychotherapy that I conducted with two colleagues at SUNY Upstate Medical University in Syracuse, an important conclusion was that these methods are effective to the degree that they generate novel, constructive experiences for clients. Such “corrective emotional experiences” deal with maladaptive patterns of emotion and behavior by activating more constructive ones. Thus, for instance, when a client retreats from a therapist out of fear of rejection, the therapist may encourage engagement and provide an active experience of acceptance and understanding. Such emotional experiences are readily internalized, helping people build new modes of construing and doing. This is the basis for many behavioral and cognitive therapies, where we learn to face and challenge our patterns of anxiety, negative thinking, and depression in emotionally impactful ways.

The unexpected benefits of aerobic exercise, yoga, and similar disciplines may arise from their ability to provide similar corrective emotional experiences, albeit outside of a therapeutic relationship. Through vigorous exercise, we directly challenge our limits and experience ourselves as efficacious and achieving. Through mindful movement, we experience enhanced levels of self-control and mastery. A great example of this occurs among the money managers and traders I work with, who make active use of meditation to deal with the stresses of markets and their inherent risks and uncertainty. In the midst of threat, direct experiences of calm and focus promote a unique experience of the self as being “in control”, facilitating sound decision-making. Exercise, like coaching, counseling, and psychotherapy, is a vehicle for generating fresh experiences of the self, reinforcing and expanding our strengths.

In recent articles, I’ve explored the psychological benefits of living a purposeful life and the importance of emotionally connecting with a positive vision of our future selves. All of these can be paths toward emotional resilience, increased mindfulness, and an enhanced capacity to pursue life goals. In a recent interview, Steven Goldstein and Mark Randall explore the mindfulness associated with special forces operations, highlighting the idea of “mindfitness”. A well-constructed program of exercise, expanding our abilities to extend our limits and sustain self-control and efficacy, provides a uniquely effective form of self-development—a promising therapy for the mentally well and program for mindfitness.

https://www.forbes.com/sites/brettsteenbarger/2019/11/29/the-unexpected-psychological-benefits-of-aerobic-fitness/#6f83a7ba41ea

Bristol, Acceleron : FDA Panel to Review Reblozyl in Myelodysplastic Syndromes

Bristol-Myers Squibb (NYSE: BMY) and Acceleron Pharma Inc. (NASDAQ: XLRN) today announced the U.S. Food and Drug Administration’s (FDA) Oncologic Drugs Advisory Committee will hold a review of Bristol-Myers Squibb’s supplemental Biologics License Application (sBLA) for the use of Reblozyl^® (luspatercept-aamt) in patients with myelodysplastic syndromes (MDS) at its meeting on December 18, 2019. Bristol-Myers Squibb is seeking approval of Reblozyl, an erythroid maturation agent representing a new class of therapy, for the treatment of adult patients with very low- to intermediate-risk MDS-associated anemia who have ring sideroblasts and require red blood cell (RBC) transfusions.

Reblozyl is currently being reviewed by the FDA for an indication in patients with MDS, and the agency has set a Prescription Drug User Fee Act (PDUFA), or target action, date of April 4, 2020 for completion of the review. The agency recently granted approval of Reblozyl for the treatment of anemia in adult patients with beta thalassemia who require regular RBC transfusions. Reblozyl is not indicated for use as a substitute for RBC transfusions in patients who require immediate correction of anemia.

Reblozyl is not approved for the treatment of MDS in any country.

https://www.marketscreener.com/BRISTOL-MYERS-SQUIBB-COMP-11877/news/Bristol-Myers-Squibb-and-Acceleron-Pharma-Announce-FDA-Advisory-Committee-Will-Review-Reblozyl-l-29673770/