Latest news with #UHC
New York Post
13 hours ago
- Health
- New York Post
Nearly 20K cancer patients at NYC's Memorial Sloan Kettering at risk of losing critical care over insurance spat
Nearly 20,000 patients at Memorial Sloan Kettering could lose access to critical care because of a contract battle between the renowned cancer hospital and health insurance behemoth UnitedHealthcare. The two sides have until the end of June to hash out a new deal over reimbursement rates — but are trading blame while patients, many in need of lifesaving care, anxiously wait to see if they will keep in-network treatment. Patient Lee Kassler, of Plainview, Long Island, said he was in 'disbelief' and 'shocked' when he found out that he could lose care on July 1 if the Manhattan hospital and health insurance company don't reach an agreement by June 30. 'Full of anxiety, full of stress, saddened, angry, worried, just a whole host of emotions that I was faced with when I was diagnosed with cancer,' Kassler, who has had a rare, incurable gastric cancer since 2022, told The Post Friday. The new grandfather, 61, said he goes to MSK with '110 percent' confidence, and couldn't imagine using another medical center for his 'life and death situation.' MSK officials have been pushing for a higher reimbursement rate for services, claiming the current yearly increase of 1.6% over the last five years isn't on par with rising costs the hospital is facing. 'MSK has worked hard to reach a long-term agreement with UHC — one that reflects the real cost and value of our specialized cancer care,' the hospital said in a statement. 'UHC refused to agree to that.' But UHC argued that the top-rated cancer treatment center is pushing a 35% spike in reimbursement rates over the next three years — which could cost the health insurance provider nearly $470 million. Memorial Sloan Kettering says UnitedHealthcare needs to increase the reimbursement. Christopher Sadowski 'Our top priority is to reach an agreement with MSK that is affordable for consumers and employers,' the company, which also covers Oxford plans, said in a statement to The Post. 'We have proposed meaningful rate increases that would continue to reimburse MSK at levels significantly higher than other National Cancer Institute-designated health systems in the New York City metro area.' The company, whose CEO Brian Thompson was fatally shot by alleged gunman Luigi Mangione last year, has also publicly worked to make its case to consumers. MSK chief medical officer Cardinale Smith, meanwhile, argued in an interview the proposal from the health insurer is not financially sustainable. UnitedHealthcare claims MSK's demands are too high. Getty Images 'Bottom line is that there are thousands of patients who need our care and UHC is just not putting them first,' Smith said. About 19,225 patients, including Kassler, could have treatment disrupted, hospital reps said. Sloan Kettering has gotten into past contract fights with Anthem and Cigna before deals were reached. Even if a new agreement with UHC isn't inked by June 30, a New York state law requires a cooling-off period in which at least some patients will get in-network care at the hospital through the end of August. The grace period applies to patients with fully insured UnitedHealthcare or Oxford plans for hospital care, both MSK and the health insurer said. Patients can also apply for continuity of care that would possibly give them a temporary extension of in-network treatment. With his birthday coming up in a few days, Kassler said all he wants is to receive news of a deal. 'The best birthday present was my grandson but the second best would be let's put this behind us,' Kassler said. 'Let me just be under the treatment of Sloan for a long time.'
Yahoo
3 days ago
- Health
- Yahoo
How Much Would It Cost You in Taxes If We Had Universal Healthcare in America?
Universal healthcare (UHC) guarantees every citizen of a given country access to healthcare without regard to their ability to pay. According to Visual Capitalist, 72 countries, representing 69% of the global population, use some version of this system, including Canada, Australia, Japan, Brazil, China, India and most of Western Europe. The United States joins some of South and Central America, most of Eastern Europe and nearly all of Africa in the 31% that does not. According to Healthcare Now, the formal movement to establish UHC began in the 1930s when healthcare was omitted from the Social Security Act. However, it has never proven politically feasible — and the potential tax implications often take center stage in the heated national debate on the subject. Find Out: Read Next: The most recent legislation to implement UHC was a bill called the Medicare for All Act of 2022, introduced by Vermont Sen. Bernie Sanders (I) in the 118th Congress. If passed, the bill would require the program to: Cover every U.S. resident. Automatically enroll residents at birth or upon residency in the U.S. Cover all medically necessary services and items needed for diagnosis, treatment and rehabilitation. That includes prescription drugs, hospital services, substance abuse and mental health treatment, vision, dental, long-term care and reproductive and gender affirming care. Discover More: For decades, the UHC debate has included impassioned discussions on familiar hot-button issues like equity, access and control over personal healthcare. However, feasibility always comes down to cost — and a government-administered plan would require trillions of taxpayer dollars. Sen. Sanders' bill contained several funding provisions that were more specific and comprehensive than many that came before, including: Employers would pay a 7.5% income-based premium with an exemption for small businesses on the first $2 million in payroll. Sanders stated that this alone could save a family of four earning $50,000 a year more than $9,000 annually compared to employer-based insurance. Households would pay a 4% premium based on income, which Sanders claimed would save the typical household $4,400. The elimination of several tax exemptions that the bill would render obsolete, most notably, the exemptions for employer-paid premiums from income and payroll taxes. Sanders said this will generate $4.2 trillion in revenue over 10 years. Sanders also suggested taxing capital gains as ordinary income, closing several loopholes that favor high earners and increasing some taxes on the wealthiest households, which he said would raise a combined $4.49 trillion in revenue over 10 years to fund the plan. Unsurprisingly, Sanders' political opposition in the Republican Policy Committee did not agree with the liberal senator's arithmetic. It countered with a claim that UHC would increase your taxes by 20%. With so many complexities and variables, rival politicians can and do manipulate the data to favor their position. However, the Committee for a Responsible Federal Budget, which platforms like Media Bias Fact Check and InfluenceWatch describe as genuinely nonpartisan, highly credible and factual in its analyses and reporting, identified seven ways that Congress could fund UHC if the Medicare for All bill were to become law: 25% income surtax 32% payroll tax 42% value-added tax Doubling all current income tax rates Mandatory $7,500 per capita public premium Reducing non-healthcare spending by 80% Increasing the debt to 105% of the national GDP Note: Some of the stated figures are from when Congress and its many affiliated special interest groups were actively debating the Medicare for All proposal and generating data that supported their positions. However, all are either percentages that remain unchanged today or are part of 10-year projections that accounted for inflation and population increases. More From GOBankingRates Warren Buffett: 10 Things Poor People Waste Money On This article originally appeared on How Much Would It Cost You in Taxes If We Had Universal Healthcare in America?
Scoop
4 days ago
- Health
- Scoop
Unite Health Systems With Community-led Health Services To Deliver On UHC
We cannot deliver on universal health coverage (UHC) unless we reach the unreached people with standard health services – with equity and human dignity. Uniting Health systems with Community-led health services should be the new lens to look at UHC. Despite mounting evidence of how key population or community-led health services have bridged the gap between public health system and those unreached, we are yet to optimally integrate community-led health service delivery model into public health system effectively, said Dr Nittaya Phanuphak. Dr Nittaya Phanuphak is the Executive Director of Institute for HIV Research and Innovation (IHRI), Governing Council member of International AIDS Society (IAS), and Convener of 2nd Asia Pacific Conference on Point-of-Care Diagnostics for Infectious Diseases. Sterling examples of high impact key population or community-led health service deliver models come from the land of smiles – Thailand. HIV key populations continue to play a major role in delivering Pre-Exposure Prophylaxis (PrEP for HIV prevention) to those who are at a heightened risk of HIV acquisition. Thailand has the largest PrEP rollout in Asia Pacific region, 80% of people using PrEP in Thailand receive it from a clinic led and staffed by members of the community that it serves. Key populations are groups of people who are disproportionately affected by HIV (which includes gay men and other men who have sex with men, transgender women and sex workers). 'On the ground, despite successes, we have faced challenges too over the last decade in our efforts to integrate community-led health service delivery model into the national public health system in Thailand. Key population lay providers are still the main providers and carers who are initiating and maintaining key population clients in PrEP services,' said Dr Phanuphak. Over two years ago, Thai government changed regulations which adversely impacted the community-led health services. For example, due to these regulatory changes by the government, PrEP medications were not allowed to be stocked at the clinics run by key populations. Key population service providers were only allowed to give PrEP if it was prescribed by government doctors (and not NGO doctors). 'These regulations are still there but, on the ground, we are upholding our core values of delivering health services in a people-centred way. Many public hospitals work closely with key population led clinics since more than a decade now. These hospitals have seen the impact of key population led health services at the provincial level. They too feel that the best way forward is to continue and maintain the original flow of having client come to the key population led clinics, get tested for HIV by lay providers, and then have the PrEP prescription made through TeleHealth by a government doctor. PrEP can be given out to the client within an hour of entering the clinic,' said Dr Phanuphak. Funding cuts have made community-led services even more vital Trump's decisions have snapped funding majorly to a range of health-related projects in the Global South. Dr Nittaya opines that with limited resources it becomes even more critical to ensure we are serving those most in need and most likely to be left behind. 'We need to continue integrating key population led health services into country's healthcare system and make sure that key population led clinics are receiving their reimbursements from the government in a fair way. We also need to ensure that the cadres of lay providers are recognised and endorsed at the country level,' said Dr Nittaya Phanuphak. Community-led services are not just limited to HIV 'Key population or community-led health services is not only limited to HIV services. It can also be expanded to services for sexually transmitted infections (STIs), mental health, harm reduction, among others. This would be a real game changer for public health in Thailand,' said Dr Phanuphak. Other countries in southeast Asian and western pacific region such as the Philippines, Viet Nam, Myanmar, and Laos, are also following Thailand-model by adapting community-led health services in their own unique in-country contexts and realities. Communities and countries need to learn from each other too, says Dr Nittaya Phanuphak. 'We learn from the Philippines that there are members of key populations within the healthcare providers including medical professionals. In Viet Nam, we are seeing a good role of private sector in developing key population led clinics – many of which are social enterprise models too.' End delays in translating scientific breakthroughs into public health impact Among the biggest breakthrough scientific announcements in 2024 was lenacapavir - a medicine (twice yearly injections) that showed 100% protection against HIV among women who took part in the study. The study called PURPOSE-1 had cisgender women as participants and lenacapavir demonstrated 100% efficacy in preventing HIV infection. PURPOSE-2 study enrolled a more diverse population of cisgender men, transgender men, transgender women and non-binary individuals who have sex with partners assigned male at birth. PURPOSE-2 study results showed that twice-yearly lenacapavir cut HIV incidence by 96%. Dr Nittaya Phanuphak shares her disappointment because when the HIV prevention medicine lenacapavir was announced last year, she was rightly hoping for a rapid rollout to protect many more people from HIV acquisition. But it has not happened so far. "Despite the progress over the last 2-3 decades in HIV response, we still had 1.3 million people who were newly diagnosed with HIV in 2023 worldwide. Around a quarter of these new infections occurred in Asia Pacific region. We have HIV prevention tools in our region but pace at which these are being rolled out is not acceptable. No one needs to get newly infected with HIV because we have the science-based tools to prevent the transmission. For example, PrEP rollout is barely 2% of the target rollout for 2025 (target was to ensure that at least 8.2 million people have used PrEP at least once in a year by end of 2025). This is a huge gap," she said. Unless all science-based new and old HIV prevention tools would not be offered to people to choose from, we would not be able to protect everyone from the virus. "When research and development of these new health technologies have taken place in our countries in the Global South so that we can have enough scientific evidence for approvals from US FDA or European Medicine Agency, then why cannot people of our own countries access these approved products?" asks Dr Phanuphak. "This is not fair." Deploying health technologies developed by the Global South equitably at the point-of-need Dr Phanuphak calls for uniting our community power in the Global South and leverage upon our regional purchasing power to negotiate lowest possible prices for quality assured screening and diagnostic tools and generic medicines - especially those developed in the Global South. She also underlines the importance of taking services for multiple diseases and health conditions to the communities in people-centred and rights-based manner. She says that when a health technology is approved by the regulators, it should be developed and made accessible to the people in the Global South without any delay. Not doing so, is not acceptable. 1st Asia Pacific Conference on Point-of-Care Diagnostics for Infectious Diseases was held in Australia. Dr Phanuphak was among those who worked hard to bring the 2nd POC 2025 to Thailand which will be held during 19-21 June 2025 with her being its convener. She rightly calls for deploying scientifically validated point-of-care health tools closer to the communities to strengthen multiple disease responses, such as for TB, HIV, STIs, vector-borne diseases like malaria or dengue, hepatitis, HPV, among others. She calls for accelerating innovations in developing more health technologies to serve the most-in-need communities in a rights-based, gender transformative and people-centred manner. "Point-of-care technologies is not only limited to testing for example, but also point-of-care sample collection tools too, so that sample collection not only gets enhanced but also it can be done in a way that it becomes self-care. We should not have to rely on people going to healthcare facilities for sample collection by healthcare providers, but if science-based tools become available, then sample collection can perhaps be done by the clients themselves and sent to the nearest testing centre." "We cannot talk about new point-of-care technologies without talking about game-changing health financing, policies and political commitment too. At the POC 2025, I hope that we can bring all these aspects together so that we can not only transition in deploying point-of-care health technologies where they are needed most in people-centred manner, but also how can we sustain the implementation," she said. Integration may not mean the same for everyone Dr Phanuphak reflects that integration may have different meanings for different people. "A programme manager may think of integrating services together, such as those for TB and HIV. For grant managers it may mean integrating testing platforms, such as those for TB and HIV. We have seen on the ground already that community-led clinics have naturally integrated HIV, hepatitis and STIs services to serve people better. Lay providers have also gone beyond the laboratory integration by integrating mental health, harm reduction, social and legal services." She calls for reimagining integration in a people-centred way so that we can deliver on WHO Multi-Disease Elimination Approach at the local level and scale up those that have demonstrated impact. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here
Yahoo
13-06-2025
- Health
- Yahoo
Expecting parents are expecting the worst with UAB and UnitedHealthcare negotiations
BIRMINGHAM, Ala (WIAT) – UAB facilities across Alabama could become out-of-network for the thousands of Alabamians insured by UnitedHealthcare. 'Obviously, the hope is they find an agreement and I don't have to swap providers,' Christian Holly said. Holly and his wife are getting ready to welcome their first child into the world. Their due date is in October and their doctors are at UAB. 'My wife was big on using UAB,' Holly said. 'They've got the best trauma center, the best neo-natal care, all of those sorts of things.' UAB and UnitedHealthCare (UHC) have until July 31 to finalize an agreement. Each party sent out statements that read in part: 'We are deeply disappointed that UnitedHealthcare has created this uncertainty for our patients…UAB Hospital alone provides more than $100 million a year in care for which it is not paid; and United reimburses care providers less than other insurers.' – UAB Statement. 'UAB continues to drive up health care costs for people and businesses throughout Alabama through its acquisitions…Our goal is to reach an agreement that is affordable for consumers and employers while providing continued, uninterrupted network access to UAB.' – UHC Statement. The two parties have seven weeks to make that happen. 'If this doesn't get squared away in the next month, we'll have to swap providers,' Holly said. If UAB becomes out-network for the Holly's, they have two options: pay out of pocket or find a new doctor to deliver their first born. But it's possible both could happen. In the chance his wife needs emergency medical attention during delivery, or their child needs emergency medical care – they'll have to go to UAB and pay out of pocket. 'If she does have an issue, they'll have to swap her to UAB so it just adds a lot of worry to everything,' Holly said. CBS 42 News requested the total number of Alabamians who are insured through UHC. As of Thursday, we were still waiting for that number. However, thousands of retired public school teachers and their dependents are insured through UHC. 'We have about 80,000 lives that are covered currently through PHIP United Plan,' The Government Media Relations Manger for the Alabama Education Association, Allison King said. Anyone who worked for the Alabama Public School system for at least 25 years qualifies for Public Education Employees' Health Insurance Plan King said. That plan provides those state retirees with UHC. 'We'll certainly be working to advocate on the behalf of our retirees and make sure they have quality programs both in service providers and health care options,' King said. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
11-06-2025
- Health
- Yahoo
UHC Medicare Advantage patients will lose coverage at Brown Health hospitals on July 1
PROVIDENCE, R.I. (WPRI) — A spokesperson for Brown University Health confirmed to 12 News on Wednesday that negotiations with UnitedHealthcare have ended, and UHC's Medicare Advantage plans will not be accepted at Brown Health's four Rhode Island hospitals starting July 1. Target 12 initially reported back in May that UHC had notified affected patients about the ongoing negotiations via a letter. According to a spokesperson for Brown Health, the hospital system had asked UHC to increase its reimbursement rate, as well as 'eliminate their administrative policies that deviate from traditional Medicare, such as unnecessary prior approval and utilization management, that cause frustration for patients and result in extra cost to our health care system.' 'Since both parties held firm in their positions, we mutually decided to end our Medicare Advantage hospital contract,' the Brown Health spokesperson said. 'We proposed extending our contract through the end of the year to provide Medicare Advantage members continued access to Brown University Health's hospitals while we negotiate,' a UHC spokesperson said in a statement on Wednesday. 'Unfortunately, the health system refused.' Both Brown Health and UHC emphasized that this change only applies to Hasbro Children's Hospital, The Miriam Hospital, Newport Hospital, and Rhode Island Hospital. Physicians associated with Brown Health and the group's urgent care clinics will continue to accept UHC's Medicare Advantage plans through Dec. 31, 2025, as will St. Anne's Hospital and Morton Hospital in Massachusetts. Medicare Advantage is a type of health plan offered by Medicare-approved private companies as an alternative to original Medicare. Like Medicare, it is available for Americans 65 and older, as well as those with certain severe disabilities or illnesses. Federal data shows that about 60% of Rhode Island Medicare recipients utilize Medicare Advantage plans. In Rhode Island, they're offered by Aetna, Blue Cross & Blue Shield, and UHC. (UHC has not answered repeated requests for comment on the number of patients who will be affected by the change.) Brown Health hospitals will continue accepting UHC's Medicaid and commercial health insurance plans, as well as Medicare Advantage plans from other providers. Starting July 1, treatments at Brown Health hospitals will be billed to UHC Medicare Advantage patients as 'out-of-network' care. However, a UHC spokesperson stressed that in an emergency, members should go to the nearest hospital even if it's not 'in-network,' as the company covers emergency visits at its in-network benefit level. Dr. Johnny Luo, a health insurance expert from Doctor's Choice, told 12 News there are ways to get a new insurance plan if needed. Outside of Medicare's open enrollment period, which lasts from Oct. 15 to Dec. 17, Luo said, the Centers for Medicare and Medicaid Services have been known to offer special election periods throughout the year on a case-by-case basis. Brown Health also encouraged UHC Medicare Advantage members to find out if they're eligible for 'continuity of care' protections by calling UHC Customer Service at 1-800-711-0646. Download the and apps to get breaking news and weather alerts. Watch or with the new . Follow us on social media: Close Thanks for signing up! Watch for us in your inbox. Subscribe Now Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
