Value-based care
Search documents
Hematology Oncology of Indiana and American Oncology Network Welcome Dr. Amy Braden
Globenewswire· 2026-02-03 13:00
INDIANAPOLIS, Feb. 03, 2026 (GLOBE NEWSWIRE) -- Hematology Oncology of Indiana (HOI) and American Oncology Network (AON), one of the nation’s fastest-growing networks of community-based oncology practices, is pleased to announce that Amy Braden, DO, has joined the practice’s physician team and is now accepting new patients. Dr. Braden is a Board-certified medical oncologist and hematologist with more than 10 years of experience in patient care. She earned her Doctorate of Osteopathic Medicine degree from N ...
UnitedHealth(UNH) - 2025 Q4 - Earnings Call Transcript
2026-01-27 14:02
Financial Data and Key Metrics Changes - The company reported adjusted earnings per share of $16.35 for 2025, slightly ahead of expectations, with a full-year revenue of nearly $448 billion, reflecting a 12% growth from 2024 [4][24] - The 2026 outlook anticipates adjusted earnings per share of greater than $17.75, indicating a growth of at least 8.6% [6][25] - The medical care ratio for 2025 was 89.1%, slightly better than expected, while the operating cost ratio was 13.3% [24][26] Business Line Data and Key Metrics Changes - UnitedHealthcare's Medicare segment experienced a medical cost trend of approximately 7.5% in 2025, with expectations of a 10% trend for 2026 [9] - The company anticipates a contraction of 1.3 million to 1.4 million members in Medicare Advantage for 2026 due to competitive market dynamics [10] - Optum is expected to see adjusted earnings growth across all three segments, with growth rates ranging from low to high single digits [15][16] Market Data and Key Metrics Changes - The Medicaid business is projected to face incremental pressure in 2026 due to state funding shortfalls, with expected membership contraction of approximately 565,000 to 715,000 [11] - The commercial pricing and cost management efforts have been aligned with increased care activity for 2026, with expectations of margin recovery [12][13] Company Strategy and Development Direction - The company is focusing on operational discipline, leveraging technology and AI, and renewing its commitment to innovation and accountability [4] - A strategic refocus on integrated value-based care is emphasized, with plans to align Optum Financial Services with Optum Insight [7][19] - The company aims to invest nearly $1.5 billion in 2026 to enhance operational capabilities and drive growth [30] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in returning to historical earnings quality and growth, despite challenges such as Medicare funding reductions and rising medical costs [6][8] - The company is committed to improving customer experience and operational efficiency through AI and machine learning [14][21] - Management highlighted the importance of transparency and accountability in operations, with plans to publish performance metrics in 2026 [31] Other Important Information - The company reported a $1.6 billion net charge primarily related to restructuring and other actions, which is expected to set a solid foundation for future performance [5][22] - Cash flows for 2025 were strong at $19.7 billion, approximately 1.5 times net income, supporting the company's financial stability [24] Q&A Session Summary Question: Decline in traditional MA lives and future margins - Management acknowledged the decline in Medicare Advantage lives and indicated that margin recovery efforts are underway, with expectations for improvement in 2027 [34][36] Question: Fourth quarter Optum Health performance - Management noted that fourth quarter results were slightly disappointing due to restructuring actions but expressed confidence in future stability and performance improvements [43][46] Question: Medicaid rate relief and margin assumptions - Management confirmed expectations of some margin contraction in Medicaid due to ongoing dislocation of rates and elevated medical trends, despite some rate relief [57] Question: Optum Rx performance and new clients - Management highlighted strong performance in Optum Rx, with 800 new clients acquired, driven by affordability, transparency, and execution [61][66] Question: Breakdown of commercial risk lives decline - Management indicated that the largest share of the membership decline is connected to the exchange business, with expectations for margin recovery in 2026 [72][75]
ALHC Stock Surges 400%—Here’s Why the Bulls Aren’t Done
Yahoo Finance· 2026-01-26 13:04
Green stock chart rising beside medical caduceus and DNA icons, signaling Medicare Advantage rally for ALHC. Key Points Alignment Healthcare stock is up more than 400% since April 2024, as improving Medicare Advantage cost trends and disciplined growth have driven a fundamental re-rating. ALHC’s value-based care model positions the company to benefit from a Medicare rebound as hospital economics stabilize and utilization normalizes into 2026. While ALHC stock remains technically overextended, the bulli ...
Astrana Health, Inc. Schedules 2025 Fourth Quarter and Year-End Financial Results Release and Conference Call
Prnewswire· 2026-01-26 13:00
ALHAMBRA, Calif., Jan. 26, 2026 /PRNewswire/ -- Astrana Health, Inc. ("Astrana," and together with its subsidiaries and affiliated entities, the "Company") (NASDAQ: ASTH), a leading provider-centric, technology-powered healthcare company enabling providers to deliver accessible, high-quality, and high-value care to all, today announced that it will release financial results for the fourth quarter and year ended December 31, 2025, before the open of the stock market on Monday, March 2, 2026. The Company wil ...
Centene Expands Palliative Care Access in Ohio Through Tuesday Health
ZACKS· 2026-01-21 19:31
Core Insights - Centene Corporation (CNC) is expanding its supportive care services in Ohio through a partnership with Tuesday Health, launching on January 1, 2026, to provide structured palliative care for members with serious illnesses [1][4] Group 1: Partnership and Services - The program will offer eligible Buckeye members support from a diverse team including nurses, social workers, nurse practitioners, and physicians, aiming to manage symptoms and assist caregivers [2] - The initiative is designed to provide 24/7 access to clinicians, addressing issues early to prevent unnecessary hospital admissions [2][3] Group 2: Market Context and Strategy - The partnership is timely as Ohio faces increasing caregiver strain and a growing population with complex medical needs, with palliative care focusing on comfort and coordination [3] - This initiative aligns with CNC's value-based care strategy, particularly relevant for Medicaid, Medicare Advantage, and dual-eligible populations that typically incur higher medical costs [4] Group 3: Future Implications - The Ohio rollout creates a scalable framework for potential expansion of similar partnerships across other states if performance metrics are met [5] - While the immediate financial impact may be limited, this initiative could enhance the company's role in whole-person care and its commitment to managing complex populations [5] Group 4: Stock Performance - Over the past three months, CNC shares have increased by 23.8%, contrasting with a 6.8% decline in the industry [6]
Astrana Health (NasdaqCM:ASTH) FY Conference Transcript
2026-01-13 02:17
Summary of Astrana Health Conference Call Company Overview - **Company**: Astrana Health - **Industry**: Healthcare, specifically value-based provider organization Core Points and Arguments 1. **Healthcare Infrastructure Issues**: The U.S. healthcare system is described as fundamentally broken due to accessibility, patient and provider satisfaction, and limited technology integration [2][3] 2. **Astrana's Model**: Astrana aims to transform healthcare delivery through a coordinated, aligned network that improves patient outcomes while generating financial savings for itself and its partners [4][5] 3. **Single Payer Model**: Astrana operates a pseudo-single payer model that simplifies the reimbursement process for providers, allowing for better care coordination and reduced administrative burdens [9][12] 4. **Member Engagement**: The company engages members longitudinally, allowing for proactive investments in their health, which is not typically feasible for traditional payers [5][6] 5. **Financial Performance**: Astrana has achieved a 33% CAGR in revenue over the past six years and plans to continue growing in the mid-20s in the medium term [17] 6. **Membership and Revenue Growth**: The company focuses on growing membership and revenue per member, with a significant shift towards full-risk arrangements, increasing from 0% in 2021 to approximately 80% of revenue by early 2023 [22][24] 7. **Cost Control**: Astrana has managed to control medical costs effectively, achieving 67% fewer hospital admissions compared to Medicare fee-for-service benchmarks [25] 8. **Technology Utilization**: The proprietary technology platform developed by Astrana enhances care management and administrative functions, leading to improved patient outcomes and operational efficiencies [26][28] 9. **Market Expansion**: Astrana has expanded to 16 markets, focusing on areas with high population density and diverse provider networks [48] 10. **Acquisition of Prospect Health**: The acquisition of Prospect Health is expected to yield $12-$15 million in synergies and strengthen Astrana's market position [21][39] Additional Important Content 1. **Regulatory Adaptation**: Astrana is adapting to changes in Medicaid and health insurance exchange markets, with a focus on maintaining a strong Medicare Advantage business [42][43] 2. **Industry Challenges**: The company acknowledges challenges such as increased scrutiny on risk adjustment and high utilization trends but believes it can manage these effectively [30][33] 3. **Collaborative Approach with Payers**: Astrana emphasizes a partnership approach with payers, aiming to create win-win scenarios rather than treating negotiations as zero-sum games [50] 4. **Long-term Outlook**: Despite short-term headwinds in Medicaid and exchange markets, Astrana is positioned to grow due to its focus on quality and cost management [45][46] This summary encapsulates the key points discussed during the Astrana Health conference call, highlighting the company's innovative approach to healthcare delivery and its strategic growth initiatives.
Astrana Health (NasdaqCM:ASTH) FY Earnings Call Presentation
2026-01-13 01:15
Investor Presentation January 2026 Forward Looking Statements This presentation contains forward -looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 , Section 27A of the Securities Act and Section 21E of the Exchange Act. Forward - looking statements include any statements about the Company's business, financial condition, operating results, plans, object ive s, expectations and intentions, expansion plans, estimates of our total addressable market, our ability to ...
U.S. Neurology Associates Partners with M33 Growth to Transform Neurological Care
Globenewswire· 2026-01-09 21:45
Core Insights - M33 Growth has partnered with U.S. Neurology Associates (USNA) to enhance community-based neurology care [1][2] - Nitin Jain has been appointed as CEO of USNA, with Brad Hively as Chairman and co-founder [1] - The partnership aims to leverage innovative diagnostics and treatments to improve patient care in neurology [2][3] Company Overview - U.S. Neurology Associates (USNA) is focused on transforming neurology practices by providing comprehensive and coordinated care [2][5] - USNA aims to alleviate operational challenges for physicians, allowing them to concentrate on patient care [3] - The organization is committed to improving access, operational excellence, and clinical innovation in neurology practices across the U.S. [5] Industry Context - Neurology is experiencing a significant increase in patients with chronic conditions requiring long-term treatment [2] - The current delivery of neurological care is at an inflection point, with opportunities to integrate technology and clinical quality [3] - USNA recognizes the high costs associated with specialty care and aims to provide cost-effective solutions through integrated community clinics [3]
Cityblock Health and Meridian Health Plan of Illinois Announce Partnership to Serve 10,000 Medicaid Members
Prnewswire· 2026-01-07 13:00
Core Insights - Cityblock Health and Meridian Health Plan of Illinois have partnered to provide comprehensive, community-based care to 10,000 Medicaid beneficiaries across 17 counties in Illinois [1][2] Group 1: Partnership Overview - Meridian is a leading managed care organization in Illinois and a subsidiary of Centene Corporation [2] - Cityblock Health focuses on value-based healthcare for Medicaid and dually eligible beneficiaries and has been operating in Illinois since 2024 [2] - This partnership marks the fourth regional collaboration between Centene and Cityblock, following previous partnerships in New York, Ohio, and Florida [2] Group 2: Care Model and Services - The partnership aims to enhance clinical and care coordination for Medicaid members by integrating Meridian's primary care services with Cityblock's wrap-around care services [3] - Cityblock's wrap-around model includes 24/7 access to primary and urgent care, behavioral health, social care, clinical pharmacy, care management, and support services [3] - The care model leverages multidisciplinary clinical expertise, advanced technology, and data insights to improve care quality and member experience [4] Group 3: Market Context and Need - Nearly one in four residents in Illinois are enrolled in Medicaid, highlighting the need for improved access to quality care for this population [4] - Cityblock Health serves over 100,000 members and collaborates with various Medicaid health plans and health systems across more than ten states [6]
HealthLynked Announces Strategic Consulting Partnership With PBACO to Accelerate Payer Integration and Value-Based Care
Globenewswire· 2025-12-23 14:00
Core Insights - HealthLynked Corp. has announced a strategic consulting partnership with PBACO Holding, LLC to enhance its AI-enabled patient-care coordination and healthcare interoperability solutions [1][3] Group 1: Partnership Overview - PBACO operates in 26 states, managing over 400,000 patient lives and supporting a network of more than 15,000 physicians [2][10] - The partnership aims to strengthen HealthLynked's integration with large insurance payers and deploy scalable, AI-driven care-coordination solutions [3][4] Group 2: Strategic Benefits - PBACO will provide strategic advisory and operational support to HealthLynked, leveraging its experience in managing covered lives and collaborating with insurers [4] - The partnership is expected to accelerate the deployment of HealthLynked's technology platform, improving care coordination and reducing avoidable healthcare utilization [5] Group 3: Executive Commentary - Dr. Michael Dent, CEO of HealthLynked, emphasized that PBACO's expertise aligns with HealthLynked's goals of delivering value-based care at scale [6] - David Klebonis, President of PBACO, highlighted the opportunity to deploy HealthLynked's platform to improve outcomes while lowering healthcare costs [6]