Humana and seniors hit hardest with Medicare Advantage plans disappearing
Written by Alyssa Clark
We have all been patiently waiting to see how the issue of private Medicare plans would do underneath the new Obamacare legislation, and it appears that the public is beginning to get some answers. More and more cuts have been applied to these “Medicare Advantage” plans, making it nearly cease to exist at all in the upcoming year. It was also recently announced that there will be another additional round of reductions in the 2015, which will inevitably force the Medicare choice for seniors to slip away because of the pressure that insurance companies are placing on them.
Researchers and analysts speculate that the reason for the Medicare slowdown is due to a severe decrease in Medicare spending, since the slack of the economy has forced programs to reduce utilization of certain available medical services. Since numbers are already trending extremely low for the upcoming year, Medicare programs recently stated that the low per capita costs will force Medicare Advantage plans to take another big hit in 2015. The private plans are receiving this news, and the public is reacting to it.
Following these projected totals, the rates that the federal government would pay these Medicare Advantage plans would change from an estimated 1.7 positive percent to a negative 2 percent decrease. This decrease being the cherry on top to the other cuts which have already been set in stone for the year of 2014, those who depend upon these Medicare Advantage plans seem to be running out of luck— and quickly at that. With these plans expecting and preparing for small increases, those patients underneath these suffering plans are beginning to look for ways out, seeing as how there doesn’t seem to be any light at the end of this tunnel for senior Medicare patients.
Most importantly, the public fears for the healthcare of much-in-need senior citizens, but this kind of change is forcing the public to consider big-picture industry ramifications as well. What does/will this mean for corporations who have invested in these Medicare plans?
Forbes reports on this issue, discussing Humana’s ties and investments in these programs and what it stands to lose as a result as it.
“Hardest hit are going to be the health plans that have made the biggest investments in Medicare Advantage. At the top of this list is Humana.”
“Humana has about 2.5 million Medicare Advantage members and 3.3 million participants in Medicare Part D drug plans. The company’s Medicare business accounts for 70 percent of its revenue. So watch the plan as a bellwether for the impacts of these policy trends.”
The government has attempted to appease the public and ratify the problem, but the “solutions” have their fair-share of shortcomings. Many Medicare Advantage plan holders have been transferred over to state-run healthcare programs, enrolling seniors in HMO’s used by similar Medicaid programs. The backlash is going to be tough to argue against, seeing as how it’s difficult to argue that state-run HMOs are better off than the private Medicare SNPs.
How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.