Transitioning from volume-based to value-based healthcare World Health Expo
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Transitioning from volume-based to value-based healthcare – World Health Expo
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UnitedHealthcare eliminating commissions on Medicare drug plans – InsuranceNewsNet
UnitedHealthcare dealt another blow to its Medicare agents when it announced last week it will not pay commissions on Medicare prescription drug plans sold after June 1.
The announcement was the latest in a list of carriers who said in late 2024 that they would stop paying commissions on certain Medicare Advantage products.
Agents who are authorized to sell UnitedHealthcare plans were notified by letter May 16 that initial year and renewal year premiums on prescription drug plans would be cut to $0. In November, UnitedHealthcare said it would eliminate agent commissions on 106 of its Medicare Advantage plans.
The announcement came on the heels of UnitedHealth Group’s suspending its 2025 outlook as “care activity continued to accelerate while also broadening to more types of benefit offerings than seen in the first quarter, and the medical costs of many Medicare Advantage beneficiaries new to UnitedHealthcare remained higher than expected,” the insurer said in a news release.
UHG will incorporate the “higher cost experiences and expectations” into its 2026 Medicare Advantage bids that are due soon, as well as its pricing in other markets, Chief Financial Officer John Rex said during the company’s quarterly earnings call last week.
Carriers that announced in late 2024 they will not pay agent commissions on certain plans include:
Antonette Vanasek is president of Vanasek Insurance Solutions, with offices in Chino and Pasadena, Calif. She told InsuranceNewsNet UnitedHealthcare notified her that her contract with the carrier would be amended and that the carrier would pay her $0 for new and renewal prescription drug plan business.
“The stipulation with this amendment says, ‘If you don’t agree with it, let us know, and we’ll terminate your appointment.’ And of course, you know that also terminates your book of business,” she said.
“There’s no negotiating, there’s no talking about it. There’s no meeting of the minds. It’s just a take it or leave it proposition.”
Vanasek took to LinkedIn to bring awareness of the impact this decision has on brokers.
“We’re expected to take calls, resolve claims, explain benefits, navigate doctor networks, and assist with Rx issues without receiving compensation. The message? “Do the work, carry the liability, absorb the cost, but don’t expect to be paid.”
Let’s be clear: We are not barred from helping clients. We are just not paid to do so anymore. The carriers benefit from our continued support, while brokers take the hit.
This isn’t a one-off. Five major carriers have now taken this action mid-year. There was no notice, no negotiation, just unilateral action cutting off critical revenue streams from agents, often small business owners.
We’re not salaried employees. We run businesses. We rely on fair compensation for our education, enrollment, and year-round service. This model is now financially unsustainable.
And what about seniors? They are genuinely the ones left behind. The carriers promoting “trusted local agents” hinder our ability to assist unless we do it without charge. That’s not advocacy; that’s exploitation.
If brokers are squeezed out of Medicare, seniors lose the personalized guidance that call centers and AI bots can’t provide. Without compensation, no broker can afford to keep showing up.”
Health Agents for America has been attempting to get the Centers for Medicare and Medicaid Services to address the issue of carriers eliminating agent commissions on Medicare Advantage plans and prescription drug plans. HAFA President and CEO Ronnell Nolan told InsuranceNewsNet her association “wants to get in front of the CMS folks and ask them why this is allowed to happen and what they’re going to do about it.”
“CMS has to take these carriers to task for what they’re doing,” she said, adding, “They shouldn’t be allowed to make changes after rates are filed, contracts are signed and things have been done, because the only thing it does is hurt seniors, and it causes a lot of steerage,” (i.e., steering people into other plans that make more money for the carrier).
Nolan questioned whether carriers are eliminating commissions on certain plans in an attempt to get agents to steer clients into plans that make more money for the carriers. “It’s causing one plan to stand out better than the other, and it’s hurting seniors,” she said.
“Why does anyone think agents should work for free? But the only thing is that carriers are trying to steer folks from one product to the other, to the products that they make more money on. Somebody should stop them. Why isn’t anybody seeing that but us? You know, we see it, so CMS either has to see it, or their eyes are closed.”
UnitedHealthcare did not respond to a request for comment.
© Entire contents copyright 2025 by InsuranceNewsNet.com Inc. All rights reserved. No part of this article may be reprinted without the expressed written consent from InsuranceNewsNet.com.
Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents’ association and was an award-winning newspaper reporter and editor. Contact her at [email protected].
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State Health Plan Board of Trustees votes on benefit changes for state employees – EdNC
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by Anna Pogarcic, EdNC
May 20, 2025
The State Health Plan Board of Trustees approved changes to benefits for state employees on Tuesday.
This vote comes after the board has spent the last several months working to address an expected deficit of $500 million for the plan, which could grow to an estimated $1.4 billion by 2027.
Board members are hoping that some of this deficit will be offset by additional funding from the state legislature. Both the House and Senate budget proposals fully fund the plan’s request of an additional 5% in funding per year.
However, board members said on Tuesday that changes to plan benefits are necessary to avoid even higher premium increases for members.
The plan provides health care coverage to nearly 750,000 teachers, charter school employees, community college employees, other state employees, retirees, and dependents.
“As fiduciaries of the plan, we are either voting for benefit changes or more substantial premium increases. Just fundamentally, the two options right now kind of given the reality,” said Tom Friedman, executive administrator of the State Health Plan, on Tuesday.
In his opening remarks to the board, state Treasurer Brad Briner, who chairs the board, said they have worked hard to listen to member feedback and keep costs low for the lowest-paid state employees.
“We began this conversation in January around premium increases for the first time in eight years,” he said. “Buried in the materials here, you’ll see that what was going to be a $20 premium increase at the lowest tier is now a $5 rate of increase. … It is in part just us listening to the feedback that we’ve gotten from so many constituent groups, which we really appreciate, to try to figure out what the highest and best use of the dollars we have are, and making sure that we insulated our lowest compensated state employees from those premium increases as much as we possibly can.”
EdNC previously reported on example changes the board was considering, which would have seen a $20 premium increase at the lowest tier.
During the public comment period, N.C. Association of Educators (NCAE) President Tamika Walker Kelly urged the board to not make changes to the plan.
“Considering the state of educator pay here in North Carolina, asking them to shoulder higher health care costs is not only unfair, but it is unsustainable. Raising premiums means some employees — our bus drivers, cafeteria workers, teacher assistants, and even teachers themselves — will have to make difficult and impossible choices,” she said. “For many of them, this could be the final push out of the profession entirely. We are already facing a critical staffing shortage. More than 8,000 school positions were vacant at the start of this year, and one in five teachers left the classroom over the past two years. If we increase the cost for those who stay, how will we fill the gaps, and who will be there for our students?”
“Now I am aware and I understand the financial challenges that you are facing as fiduciaries of the State Health Plan. But let’s be clear, the burden should not fall on the backs of underpaid public employees. The legislature and our health plan partners must be asked to do more.”
Kimberly Jones, the 2023 Burroughs Welcome Fund North Carolina Teacher of the Year, was the only board member who voted against the plan design changes.
The vote the board took on Tuesday only affects what benefits will look like for the State Health Plan starting on Jan. 1, 2026. The board previously voted to pave the way to charge salary-based premiums, but has not yet voted on what those premiums will be. That vote is expected to take place on Aug. 15.
In general, there are cost increases across the board. As mentioned above, Briner said the board prioritized keeping premiums and out-of-pocket maximums low in response to feedback from members.
One of the major changes is to the names of the plans. What was previously referred to as the 70/30 plan will be called the Standard PPO Plan, while the 80/20 plan will now be Plus PPO Plan.
The other major changes are to deductibles, particularly on the standard plan.
When it comes to monthly premiums, under the current proposal, costs would go up $5 for the lowest-paid state employees on the standard plan and $20 on the plus plan. However, premiums won’t be finalized until the board votes in August.
You can see all of the changes that were approved on Tuesday in the graphics below.
Board member Dr. Brian Miller highlighted a report from the Kaiser Family Foundation, which looks at employee health benefits annually. The 2024 survey found that “average annual premiums for employer-sponsored health insurance in 2024 are $8,951 for single coverage and $25,572 for family coverage.”
Based on this, he said, keeping premiums below the average market rate for employer-sponsored health insurance and protecting the out-of-pocket maximum are good things for the plan to do.
“So the average single employee in the private insurance market is paying $119 a month for an insurance premium, and then for family coverage, it’s around $532,” he said later. “So we are way — and should strive to be — way below that, recognizing that state wages are lower than the private market. Having a small premium increase, but still very low premiums, is definitely the right way to go.”
In an effort to keep costs down, Friedman told the board about several substantial changes they are exploring. These changes include implementing a preferred provider program that will replace the clear pricing project, which will end on Dec. 31, 2025.
Among other things, the preferred pricing program would involve bundling payments on the administrative side, partnering with certain independent providers, and removing prior authorizations in an effort to improve access to lower cost, high-quality care.
The thought here is that by making primary care easier to access and by providing steady payments to providers, costs can be lowered for members and the plan itself in the long run. Under this plan, members would still be able to use any in-network provider, but would be financially incentivized to see the plan’s preferred providers. If you look back at the graphic of the plan design changes, the co-pays on the far right would apply to preferred providers.
In another vote, the board voted unanimously on Tuesday for State Health Plan workers to begin implementing this program.
“We appreciate that deductible is a big number increase, but we are trying to create a very clear path forward to making that number as close to zero as possible when you need it most,” Friedman said. “We are not going to get to everything year one.”
State Health Plan leaders and board members have continually said they understand this is not an ideal situation to be in and that members don’t want increased premiums. However, Friedman said, they are trying to meet in the middle.
“I understand this is all very different. We have to do something different here to be successful,” he said. “…The more successful we are in these programs by members electing to save money and opt in, the more successful these premium conversations will be in future years. So we all have a role in driving costs down going forward.”
Plan members are expected to receive more information regarding the changes approved on Tuesday before open enrollment takes place in October.
Anna Pogarcic is the Director of Content for EducationNC.
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Can tax credits save California’s film and TV industry? Here’s what legislators have proposed – SiliconValley.com
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Los Angeles has seen its dominance as the film and television capital of the world start to chip away as companies leave California for other states and countries with lower production costs.
But it’s not just Hollywood’s pride that’s at stake.
Those worried about the mass exodus of production companies say that when film crews and others in the industry leave, it has a negative ripple effect on the local and state economies.
When workers relocate out of L.A., for example, they’re not spending their money at local shops or restaurants.
That loss in economic activity and tax revenues can lead to small businesses folding or even cause local schools to suffer, said Pamala Buzick Kim, co-founder of Stay in LA, a grassroots movement that advocates for keeping production in Los Angeles and, more broadly, within California.
“If we’re not paying attention, we’re becoming the next Detroit,” said Buzick Kim, referring to the decline of the automobile industry in America’s “Motor City” that contributed to its economic collapse.
Buzick Kim isn’t alone in being concerned about the future of the film and television industry in Southern California.
Gov. Gavin Newsom, along with a number of elected officials from the L.A. area, have been sounding the alarm that Hollywood is losing its edge unless California updates its film and television tax credit program to compete with places like New York, Georgia, Canada and the United Kingdom that are luring production companies away.
In October, Newsom proposed more than doubling the state’s annual cap under its film and television tax credit program from $330 million to $750 million.
Because that idea requires legislative approval, two identical state bills that would advance Newsom’s proposal are scheduled to be heard in committees next week.
AB 1138, introduced by Assemblymembers Rick Chavez Zbur, D-Hollywood, and Isaac Bryan, D-Culver City, and SB 630, from Sens. Ben Allen, D-Santa Monica, Caroline Menjivar, D-San Fernando Valley, and Henry Stern, D-Sherman Oaks, would “modernize” the California Film and TV Tax Credit Program to keep production companies in L.A. — and to win back others, the bill sponsors hope.
Zbur, in an interview, said the tax credit program is really about creating and retaining jobs in California.
“Everyone understands — all of the stakeholders, which includes the unions, small businesses, the movie studios and independent producers — that our film and television industry and the jobs are really at crisis levels right now, and we need to make sure our tax program, which is really a jobs bill, is competitive with those of the other states,” Zbur said.
Concerns over L.A.’s loosening grasp on the film and television industry have also reached L.A.’s City Hall and members of Congress.
Councilmember Adrin Nazarian, who represents Studio City — a neighborhood in L.A. with its own history inextricably linked to Hollywood’s film and television industry — recently introduced a council motion to cut down on regulations and permit requirements to film in Los Angeles. He’s hoping to retain and lure back some production companies by making it easier and less expensive to film in L.A.
At the same time, 10 members of Congress, most of whom represent the city or the greater Los Angeles area, recently sent a letter to the chair of the Motion Picture Association expressing concerns about the number of production companies leaving Southern California. The effort was led by Rep. Laura Friedman, D-Glendale.
As far as what lawmakers in Sacramento are proposing, the pair of state bills to be discussed in committees next week proposes to increase the base film and television tax credit rate from 20% to 35%. Companies that film outside of what’s known as the “L.A. Zone” could qualify for an additional 5% tax credit — for a total credit of 40%.
Zbur said modernizing California’s film and television tax credit program would make the state competitive with Georgia, which offers up to 30% tax credit.
One key difference is that California’s tax credit only applies to “qualifying” expenses, which Zbur said supports middle-class workers and small businesses.
In comparison, Georgia’s program generally allows production companies to count their full budget — which includes wages for highly-paid directors and actors — when applying for tax credits, Zbur said.
The assemblymember’s proposed bill would also broaden the types of shows or projects that could qualify for tax credits in California to include 20-minute TV shows (not counting commercials), animation and certain “large-scale competition” shows, like “Dancing with the Stars.”
Jon Coupal, president of the Howard Jarvis Taxpayers Association, said while targeted tax credits aren’t always bad, he’d rather see “broad-based tax reductions.”
“Tax credits enacted by the California Legislature seem to go to those organizations and businesses that are politically powerful,” Coupal said. “We’d love to see some tax credits for ordinary, middle-class taxpayers who would love a tax credit for gasoline purchases.”
FilmLA, the official film office for the city and county of Los Angeles, reported in January that the number of on-location “shoot days” in L.A. for production companies dipped 5.6% in 2024 compared to 2023.
Another FilmLA report this month showed that on-location production in the greater L.A. area plummeted 22.4% during the first quarter of 2025 versus the same period a year ago.
The January wildfires that ravaged Pacific Palisades and Altadena had only a small impact overall on filming in greater Los Angeles, the report found.
The loss of filming activity in the region can be costly.
Between 2015 and 2020, half of the 312 projects that applied for but did not receive a state tax credit for filming in California took their business elsewhere, according to the Los Angeles County Economic Development Corporation. Those moves cost the state $7.7 billion in generated economic activity, 28,000 jobs, and state and local tax revenues totaling $354.4 million.
But a separate analysis by California’s nonpartisan Legislative Analyst’s Office found “weak evidence” that California’s film and television tax credits benefit the state as a whole.
“While the film tax credit likely increases the size of California’s film industry … there is currently no compelling evidence to suggest that film tax credits have a positive effect on the size of the state’s economy overall,” according to the LAO report.
The report went on to say that findings by the L.A. County Economic Development Corporation are likely overstated.
Zbur, in turn, criticized the LAO’s analysis as “significantly flawed.”
“For every dollar we spend in tax credit, it results in over $24 in economic activity in California, over $8 in labor income, and it more than pays for itself,” Zbur said. “We actually bring in $1.07 in tax revenues for every $1 we spend in tax credit.”
Zbur’s bill will be considered by the Assembly Committee on Arts, Entertainment, Sports, and Tourism on Tuesday, April 22.
The upper chamber’s Revenue and Taxation Committee will take up the Senate version of the bill on Wednesday, April 23.
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New neurobiological analysis maps links between health of various organs and mental health – psypost.org
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New research reveals multiple pathways through which poor organ health may contribute to poor mental health. Researchers propose that exercise, sedentary behavior, diet, sleep quality, smoking, alcohol intake, education, and socioeconomic status may influence mental health through their impact on specific organ physiology and brain structure. The paper was published in Nature Mental Health.
Depression and anxiety are two of the most common mental health conditions, often co-occurring and significantly affecting daily life. Depression is characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. Anxiety involves excessive worry, fear, and physical symptoms such as a racing heart or restlessness.
These mental health conditions are particularly prevalent in individuals with chronic physical health conditions. For example, in individuals with chronic illnesses such as coronary heart disease, respiratory disease, diabetes, musculoskeletal disorders, and cancer, the risk of developing depression and anxiety is several times higher than in those without such medical conditions.
Scientists have proposed that this increased risk may occur because of shared genetic factors underlying chronic physical illnesses and mental health disorders, as well as behavioral and lifestyle factors that heighten the risk of both categories of conditions.
Study author Ye Ella Tian and her colleagues sought to explore the association between the functioning of various organ systems in the body and mental health. They analyzed a subset of UK Biobank participants, comparing individuals with no major medical or mental health conditions to those diagnosed with schizophrenia, bipolar disorder, depression, and generalized anxiety disorder.
The UK Biobank is a large-scale biomedical database and research resource containing in-depth genetic, health, and lifestyle information from over 500,000 participants. It is designed to support research on the prevention, diagnosis, and treatment of a wide range of diseases and is accessible to researchers worldwide.
From this database, the researchers used data from 7,749 healthy individuals, as well as 67 individuals with schizophrenia, 592 with bipolar disorder, 9,817 with depression, and 2,041 with generalized anxiety disorder. Participants ranged in age from 40 to 70 years, with an average age of 54 years.
The researchers assessed the health of seven organ systems—cardiovascular, pulmonary, musculoskeletal, immune, renal, hepatic, and metabolic. They also utilized brain imaging data collected using magnetic resonance imaging 4 to 14 years after the assessment of organ health (when participants were aged 45 to 83). Additional assessments included depressive symptom severity (the Recent Depressive Symptoms Scale), neuroticism (the Eysenck scale), and symptoms of generalized anxiety disorder, which were measured at a separate time point.
Results showed that, for each of the seven organ systems, poorer organ health was associated with higher depressive symptoms, even after controlling for age and sex. Similarly, poorer organ health—except for renal and pulmonary health—was associated with higher anxiety symptoms and greater neuroticism.
The researchers proposed a statistical model suggesting that worse organ health leads to reduced gray matter volume in the brain, which in turn contributes to more severe symptoms of depression and anxiety. Results supported this link for the association between pulmonary system health and depression. A similar model suggested that reduced white matter volume in the brain mediated the relationship between cardiovascular system health and anxiety.
Additionally, the analysis indicated that poor physical and brain health might jointly mediate the relationship between lifestyle factors and depression. The model proposed that exercise, sedentary behavior, diet, sleep quality, smoking, alcohol intake, education, and socioeconomic status influence organ and brain health, which subsequently affect mental health. Results showed that this chain of relationships is plausible.
“Our work provides an integrated model linking physical health, neurobiology and mental health outcomes. Our findings suggest a crucial role of the brain in mediating the relationship between physical and mental health, which is an important step toward bridging the mind–body dualism,” the study authors concluded.
The study sheds light on the association between physical and mental health. However, it should be noted that the study design does not allow causal inferences to be drawn from the results. The models tested are statistical in nature, outlining possible causal pathways but not definitive ones.
The paper “Brain, lifestyle and environmental pathways linking physical and mental health” was authored by Ye Ella Tian, James H. Cole, Edward T. Bullmore, and Andrew Zalesky.
Research shows that pornography use, which often begins in early adolescence, can impact brain development, sexual expectations, and relationship dynamics. While not formally classified as an addiction, problematic use is linked to emotional detachment, reduced satisfaction, and increased impulsivity.
A pair of studies offer differing perspectives on gender-affirming care: one finds surgery associated with increased psychiatric diagnoses, the other links hormone therapy with better mental health. The results suggest treatment context and measurement methods matter.
Scientists have discovered that senescent sensory neurons accumulate with age and nerve injury, releasing inflammatory molecules that heighten pain sensitivity. The findings suggest that targeting these dysfunctional cells could reduce chronic pain, particularly in older adults.
New research shows that teens who spend more than two hours a day on screens—especially passively scrolling through content—are more likely to report anxiety and emotional or behavioral problems, even when accounting for age, gender, and existing vulnerabilities.
Researchers found that interoceptive awareness—the ability to sense internal bodily states—predicts whether people’s moral judgments match group norms. Brain scans revealed that resting-state activity in specific brain regions mediates this relationship.
A mouse study published in Science shows that stimulating a specific set of brain cells activated by a psychedelic drug can reduce anxiety without triggering hallucination-like behavior, pointing to new possibilities for targeted mental health treatments.
People with depression who were more optimistic at the start of treatment—and whose optimism increased during treatment—were more likely to benefit from SSRIs, according to a recent study, raising the possibility of tailoring treatments based on psychological traits.
A new study reveals that creative metaphor generation involves shifting patterns of brain activity, with alpha oscillations playing a key role at different stages of the process, offering fresh insight into the neural dynamics behind verbal creativity.
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Kemi Badenoch stands by Nigeria comments after criticism – BBC
Kemi Badenoch has stood by her past comments about Nigeria, after the vice-president of the West African country accused her of denigrating it.
The Conservative Party leader, who was born in the UK but mostly raised in Nigeria, has repeatedly described growing up in fear and insecurity in a country plagued by corruption.
On Monday, Nigerian Vice-President Kashim Shettima suggested Badenoch could "remove the Kemi from her name" if she was not proud of her "nation of origin".
Asked about Shettima's comments, Badenoch's spokesman said she "stands by what she says" and "is not the PR for Nigeria".
"She is the leader of the opposition and she is very proud of her leadership of the opposition in this country," he told reporters.
"She tells the truth. She tells it like it is. She is not going to couch her words."
During a speech on migration in Nigerian capital Abuja, Shettima said his government was "proud" of Badenoch "in spite of her efforts at denigrating her nation of origin."
Shettima was met with applause when he said: "She is entitled to her own opinions; she has even every right to remove the Kemi from her name but that does not underscore the fact that the greatest black nation on earth is the nation called Nigeria."
He compared Badenoch's approach to that of her predecessor, Rishi Sunak – the UK's first prime minister of Indian heritage – as "a brilliant young man" who "never denigrated his nation of ancestry".
It is unclear which comments Shettima was referring to, but Badenoch has frequently mentioned her Nigerian upbringing in speeches and interviews.
Born Olukemi Adegoke in Wimbledon in 1980, she grew up in Lagos, Nigeria, and in the United States where her physiology professor mother lectured.
She returned to the UK at the age of 16 to live with a friend of her mother because of the worsening political and economic situation in Nigeria, and to study for her A-levels.
After marrying Scottish banker Hamish Badenoch, she took her husband's surname.
At the Conservative Party conference this year, Badenoch contrasted the freedoms she experienced in the UK to her childhood in Lagos "where fear was everywhere".
She vividly described the city as lawless, recalling hearing "neighbours scream as they are being burgled and beaten – and wondering if your home will be next".
Last week during a tour of the US, she described her home city as "a place where almost everything seemed broken".
Her experiences helped shape her conservative ideals and set her against socialism, she said.
President Bola Tinubu defeated Peter Obi in the 2023 elections – and may face off again in 2027.
Nearly 80% of the 1.9 million students who sat the exams did not get high enough marks to get into university.
The Doctor will be transported to Lagos in the first ever episode set primarily in an African country.
The Conservative leader insists she is not quitting at "the first sign of trouble".
The trade deal gives a tax break to Indian professionals, which critics say undercuts UK businesses.
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