Podcasts about united healthcare

In this episode, Jakob Emerson, Associate News Director at Becker's Healthcare, discusses escalating contract disputes between payers and providers and the Department of Justice's expanded investigation into UnitedHealthcare, highlighting the growing pressures across the insurance landscape.

“Crime apologist” is not a strong enough term to describe the hysteria and vitriol that's infected the modern-day Left.   For the sake of ideology, left-wing leaders and activists are willing to sacrifice public safety and justice—from sanctuary cities releasing violent offenders to outrage over federal intervention that actually reduced crime in Washington, D.C. Victor Davis Hanson warns of the dire consequences of this mindset if left unchecked on today's episode of “Victor Davis Hanson: In His Own Words.” “ Do you remember the UnitedHealthcare CEO, Brian Thompson? He was a person from the middle class, was born without status or advantages or money, and he worked himself up to the leadership position of one of the largest health care concerns in the United States. And Luigi Mangione—a 25- or 26-year-old wealthy, well-educated kid, high status, privileged—decided that he was an enemy of the people because health care was not universal and UnitedHealthcare may have refused coverage to certain people in need. So, he decided he was going to kill him. And he did kill him. He murdered him. It's on tape. And what was the reaction of the Left? Some on the left canonized him. 

In this episode of Healthcare Americana, host Christopher Habig sits down with Dr. Marion Mass, pediatrician and co-founder of Practicing Physicians of America, to uncover widespread fraud and abuse in the Medicare Advantage program. They break down how insurers use practices like upcoding, assigning patients exaggerated or false diagnoses, to collect billions in taxpayer dollars each year, with UnitedHealthcare highlighted as a major offender. Dr. Mass explains the systemic conflicts of interest, lack of accountability, and the urgent need for audits, penalties, and transparency to protect both patients and federal budgets. The conversation also highlights the importance of informed healthcare choices and explores how direct care models offer a more sustainable alternative. This episode is a must-listen for anyone concerned about Medicare, insurance oversight, and the integrity of America's healthcare system.More on Freedom Healthworks & FreedomDoc HealthSubscribe at https://healthcareamericana.com/More on Dr. Marion Mass & Practicing Physicians of AmericaFollow Healthcare Americana: Instagram & LinkedIN

Subscribe to UnitedHealthcare's Community & State newsletter.On August 12, A Health Podyssey's Rob Lott chatted with Kenton Johnston of Washington University about his paper in the August 2025 edition of Health Affairs that explores changes in clinician's participation across Medicare value-based payment models.Order the August 2025 issue of Health Affairs. Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone. Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Senior Editor Kathleen Haddad back to the pod to take a look at recent news that HHS terminated 22 mRNA projects. The two explore the agency's reasoning, political and Wall Street reactions, and what it could mean for health care innovation.Join us for these upcoming events:8/26: Provider Prices in the Commercial Sector: Independent Dispute Resolution (FREE TO ALL)9/3: Theme Issue Briefing: Insights About The Opioid Crisis (FREE TO ALL)9/17: Lunch & Learn: The Current Opioids Policy Landscape & What's Ahead (FREE TO ALL)9/23: Prior Authorization: Current State and Potential Reform (INSIDER EXCLUSIVE)Become an Insider today to get access to exclusive events like the ones highlighted above.Related Articles:HHS abandons mRNA vaccine research (BioPharma Dive)1 big thing: RFK Jr.'s anti-vaccine revolution (Axios)Moderna Stock Jumps as NIH Chief Tempers Administration's Attack on mRNA (Barron's)750 HHS employees send signed letter to RFK Jr. asking him to stop spreading misinformation (ABC News)Industry frets Kennedy's mRNA decision will curb cancer breakthroughs (Politico Pro) Subscribe to UnitedHealthcare's Community & State newsletter.

The first report today is entitled:                                                                   "Medicare Advantage Legislation in Congress - Five Bills to Know!"                    That is today's Medicare Advantage Minute segment! The "Your Medicare Advantage 2025" reading tells us how Medicare is likely to cover Ostomy supplies.  United Healthcare is going through some unsettling times. Here we present twelve updates for your insurance news reading pleasure! Why do I have to call somebody to get a Medicare supplement (medigap) quote? In my opinion, the reasons presented in this article are bogus. If you go to my website MedicareForTheLazyMan.com and fill out a questionnaire, you will receive quotes for several  (usually at least 1/2 dozen) Medicare supplement companies drawn from my portfolio of excellent insurance companies by return e-mail.        No need to call anyone! Finally, where are the most beautiful hospitals in the USA located?                     Hint: the facility judged most beautiful of all is NOT located in Massachusetts!   Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; SIMPLEST & EASIEST GUIDE EVER!" "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" "MEDICARE FOR THE LAZY MAN: BARE BONES!" For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to  help future readers. Official website: https://www.MedicareForTheLazyMan.com.

Rants, Raptors, and Political Rebuke: A Libservative SmackdownJoin Dan and Corey for another raucous episode of Libservative, where they dive into the latest controversies, including JD Vance's unfortunate trending nickname and a deep dive into Michigan football's NCAA scandal. They also ponder the ineptitude of the NCAA, discuss the enduring geopolitical friction with Russia and Ukraine, and critique the current political landscape in the U.S. Expect a hearty laugh as they expose UnitedHealthcare's dark secrets and tear into APAC's controversial influence. Tune in for unapologetic commentary, comical rants, and unfiltered political analysis.00:00 Welcome to Libservative: Setting the Stage01:06 JD Vance Controversy: The Couch Incident02:19 Michigan Football Scandal: A Deep Dive04:13 NCAA's Power and College Football's Cheating Culture06:12 The Future of NCAA and College Football15:51 Putin-Trump Summit: A Disappointing Outcome17:38 Geopolitical Realities: Ukraine, Russia, and the West36:19 Marjorie Taylor Greene's Controversial Comments on Israel43:35 Political Realignment: The Future of U.S. Politics46:55 Discussing Lost Voters and Electoral Strategies48:33 The Rise of New Media and Its Consequences52:42 Marjorie Taylor Greene and Controversial Decisions59:57 Humanitarian Visas and Political Reactions01:14:28 Critique of APAC and Lobbying Influence01:19:11 UnitedHealthcare Whistleblower Revelations01:26:55 Senator Financial Integrity and Corruption01:29:38 Concluding Remarks and Sign-Off

Ever had your surgery interrupted… by UnitedHealthcare? Yeah, me neither. But that's exactly what happened to our guest this week, the incredible Dr. Elisabeth Potter. She went viral after exposing the absurdity of insurance meddling in patient care, right down to getting pulled out of the OR for a phone call about prior authorization. In this episode, Kristin and I dig into how Dr. Potter stood up to a massive insurance company, why they tried (and failed) to shut her down with a cease-and-desist, and how she's paying the price for telling the truth. It's raw, it's maddening, it's inspiring, and it's a reminder that sometimes the bravest thing you can do in medicine is refuse to be quiet. Takeaways: Hear the unbelievable story of insurance calling Dr. Potter mid-surgery to question her patient care. Find out how a viral video and a cease-and-desist letter turned one doctor into a national advocate. Learn why hospital lawyers installed cameras in ORs after her posts and how she fought back. Discover how retaliation from UnitedHealthcare threatened her new surgery center and practice. Why thousands of people rallied behind her with donations, comments, and support and why she's not backing down. — Want more Dr. Elisabeth Potter? Instagram: @drelisabethpotter X (Twitter): @EPotterMD TikTok: @drelisabethpotter Facebook: Dr. Elisabeth Potter YouTube: @DrElisabethPotterMD Bluesky: @drelisabethpotter.bsky.social To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

MSNBC is rebranding. “Involuntary commitment got a bad rap. The streets got more dangerous.” from The Washington Post. The story of Luigi Mangione, alleged murderer of UnitedHealthcare chief executive Brian Thompson, is now the inspiration of a satirical musical comedy stage show. See omnystudio.com/listener for privacy information.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Rob Lott interviews Cal Chengqi Fang of the University of Chicago about his recent paper that explores how pay gaps grew between nonprofit hospital CEOs and employees from 2009–23. Order the August 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast Subscribe to UnitedHealthcare's Community & State newsletter.

Are you looking to save time, make money, and start winning with less risk? Then head to https://www.ovtlyr.com.Is it finally time to buy UnitedHealthCare? With Warren Buffett stepping in and the stock climbing, traders everywhere are asking the same question. In today's OVTLYR Trading Room, we break down not just UNH, but the broader market setup, sector signals, and specific trade opportunities you need to know about right now.Inside this session, you'll see exactly how the OVTLYR Trend Template works: the 10 EMA crossing above the 20 EMA, price holding above the 50 EMA, and why those signals matter. We look at real-time market breadth, analyzing how many stocks are in uptrends versus downtrends, and what that says about overall strength. You'll also see how OVTLYR buy signals often flash before Wall Street's biggest names make their moves, like the UNH signal that came before Buffett disclosed his position.We cover:➡️ Why the OVTLYR Trend Template is essential for catching big moves➡️ How to read sector-wide buy and sell signals to stay on the right side of the market➡️ Live trade management, including rolling options, trailing stops, and risk reduction➡️ Real trades like Delta Airlines, SoFi, SGI, and others, with clear entry and exit logic➡️ How to use the Fear & Greed Heatmap to spot when investors are getting overly greedy or terrifiedYou'll also learn why managing risk with half-ATR stops and trailing exits keeps you from blowing up trades, even when a setup looks perfect. We dive into multiple tickers from Crispr Therapeutics to Amazon and explain not just what looks good, but also what to avoid when the chart doesn't align with the market and sector backdrop.The OVTLYR Trading Room is not about random stock picks. It is about building a repeatable system. Whether it is spotting trapped buyers in order blocks, using unusual options volume as a clue, or filtering trades through market breadth, this approach is designed to give you an edge.This episode also highlights the shift to invite-only livestreams for OVTLYR members. At just $0.82 a day, members get access to daily live trading, the OVTLYR Nine, the Golden Ticket Trading Strategy, and the tools needed to save time, make money, and start winning with less risk. With OVTLYR 4.0 on the way, now is the time to get in before access closes.By the end, you'll understand why going to cash is a trade, how to avoid anchoring to profit targets, and why trading is about process, not prediction. If you are serious about trading smarter, this breakdown of market signals, sector strength, and trade setups will give you actionable insights you can put to work immediately.Subscribe now and join the OVTLYR community where traders learn to think differently, act decisively, and capture the moves that matter.Gain instant access to the AI-powered tools and behavioral insights top traders use to spot big moves before the crowd. Start trading smarter today

Wall Street exists to sell us its products.And right now, retail investors are so greedy that they're buying whatever they can get their hands on.So this is a "bonanza" time for Wall Street, says portfolio manager Lance Roberts, which is happily selling us all of the junk it ever wanted to unload.Prices may continue for a good while longer, but be warned, says Lance: history is clear that periods of indiscriminate buying like this always end in tears.For everything that mattered to markets this week, watch this weekly Market Recap.WORRIED ABOUT THE MARKET? SCHEDULE YOUR FREE PORTFOLIO REVIEW with Thoughtful Money's endorsed financial advisors at https://www.thoughtfulmoney.com#marketcorrection #speculation #stocks 0:00 - Markets near all-time highs, ignoring economic slowdown1:56 - High speculation reminiscent of 1999 and 20213:22 - Concerns about young investors taking excessive risks6:26 - High valuations and narrow moats in new IPOs like FIG11:32 - Brent Johnson echoes correction risk by September18:44 - Earnings growth concentrated in tech and major banks21:26 - Tech earnings driven by capex, potential for crest28:23 - Record insider selling and $1.1T share buybacks in 202535:05 - Rotation into healthcare, Buffett's United Healthcare stake 48:14 - Simplevisor platform for DIY investors and managed portfolios58:44 - Retail sales data shows economic slowdown1:03:05 - Fed likely to cut rates in September, market expects three cuts1:16:22 - Life was hard historically, affluenza saps younger generations1:24:26 - Parents enabling affluenza, need to foster resilience1:37:34 - Risk of home price decline if supply glut hits market_____________________________________________ Thoughtful Money LLC is a Registered Investment Advisor Promoter.We produce educational content geared for the individual investor. It's important to note that this content is NOT investment advice, individual or otherwise, nor should be construed as such.We recommend that most investors, especially if inexperienced, should consider benefiting from the direction and guidance of a qualified financial advisor registered with the U.S. Securities and Exchange Commission (SEC) or state securities regulators who can develop & implement a personalized financial plan based on a customer's unique goals, needs & risk tolerance.IMPORTANT NOTE: There are risks associated with investing in securities.Investing in stocks, bonds, exchange traded funds, mutual funds, money market funds, and other types of securities involve risk of loss. Loss of principal is possible. Some high risk investments may use leverage, which will accentuate gains & losses. Foreign investing involves special risks, including a greater volatility and political, economic and currency risks and differences in accounting methods.A security's or a firm's past investment performance is not a guarantee or predictor of future investment performance.Thoughtful Money and the Thoughtful Money logo are trademarks of Thoughtful Money LLC.Copyright © 2025 Thoughtful Money LLC. All rights reserved.

In this episode, Scott Becker shares four key takeaways on UnitedHealth's recent surge, fueled by Berkshire Hathaway's investment, a sharp 13% stock rise, improved year-to-date performance, and a significant push to Dow Jones records.

In this episode, Scott Becker shares four key takeaways on UnitedHealth's recent surge, fueled by Berkshire Hathaway's investment, a sharp 13% stock rise, improved year-to-date performance, and a significant push to Dow Jones records.

Subscribe to UnitedHealthcare's Community & State newsletter.In the wake of Medicare and Medicaid's 60th anniversary, Health Affairs' Jeff Byers welcomes Jamila Michener of Cornell University to the pod to discuss her recent Forefront article on organized power and its impact on the future of Medicaid.Also, join us for these upcoming events:8/26: Provider Prices in the Commercial Sector: Independent Dispute Resolution (FREE TO ALL)9/3: Theme Issue Briefing: Insights About The Opioid Crisis (FREE TO ALL)9/23: Prior Authorization: Current State and Potential Reform (INSIDER EXCLUSIVE)Become an Insider today to get access to exclusive events like the ones highlighted above.Related Articles:Order Fragmented Democracy: Medicaid, Federalism, and Unequal Politics (Cambridge University Press)Medicare and Medicaid at 60 Forefront Series Subscribe to UnitedHealthcare's Community & State newsletter.

In this episode, Scott Becker shares four key takeaways on UnitedHealth's recent surge, fueled by Berkshire Hathaway's investment, a sharp 13% stock rise, improved year-to-date performance, and a significant push to Dow Jones records.

Plus, the Audible version is also out at a reasonable price, far below that $10 I mistakenly stated. SHEESH! Do you like prior authorization requirements and "aggressive claim denials"? Well, neither does Johns Hopkins Hospital in Baltimore. That is the reason they may split from United Healthcare's networks in our Medicare Advantage Minute. In the "Your Medicare Benefits 2025" segment we learn what expenses Medicare will cover when it comes to organ transplants.                                                       The organs in question: heart, lung, kidney, intestine, liver & pancreas. The rest of the episode is filled with a glowing report on my new book, the most powerful book in all of Medicare: Medicare for the Lazy Man: BARE BONES!    Priced at $1 for the Kindle E-book, $4.60 for the paperback and the Audible book coming soon! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; SIMPLEST & EASIEST GUIDE EVER!" "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" "MEDICARE FOR THE LAZY MAN: BARE BONES!" For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to  help future readers. Official website: https://www.MedicareForTheLazyMan.com.

En el episodio de hoy te comento mi opinión sobre la compra de UNH por parte de Warren Buffett, que conocimos ayer, y si puede suponer una oportunidad de inversión o no en bolsa ahora mismo.Únete al canal GRATUITO de WhatsApp: https://whatsapp.com/channel/0029VaTrH1L72WTwHEGtyr0mSígueme en instagram: ⁠https://instagram.com/arnau_invertirbolsa⁠Todo lo que hacemos en Boring Capital: ⁠https://boringcapital.net/⁠Consulta nuestras rentabilidades pasadas en Boring Capital: ⁠https://boringcapital.net/informes-rentabilidad⁠Sígueme en Twitter: ⁠https://twitter.com/ajnogues⁠Suscríbete a nuestra newsletter: ⁠https://mailchi.mp/1a1f327fc3d5/ideas-de-swing

AP correspondent Ed Donahue reports on cyberthreat allegations connected to the family of a murdered CEO.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Rob Lott interviews Steven M. Lieberman of the University of Southern California, Los Angeles on his recent paper that explores how Medicare Advantage has seen significant enrollment growth and what reform efforts can be attempted to rebalance traditional Medicare and MA.Order the August 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast Subscribe to UnitedHealthcare's Community & State newsletter.

Wild Police Chase & Shocking Courtroom Twist in CEO Shooting Case! Retired NYPD Sergeant Bill Cannon brings the latest news regarding the Luigi Mangione trial, who is accused in the shooting of Brian Thompson. Get the facts and explore the latest news with a seasoned expert, as we discuss court testimony. Stay tuned for more updates!

Texas surgeon Dr. Elisabeth Potter says UnitedHealthcare stopped her mid-surgery to question if the patient's procedure was necessary – despite the fact the patient was already on the operating table. Dr. Potter was even threatened with legal action after sharing her astonishing story on social media. The health insurance giant denies that it would ever ask a doctor to interrupt care. But this incident follows an alarming pattern with UnitedHealthcare. According to Daily Mail, “UnitedHealthcare has also been accused of using an AI program with a 90 percent error rate to deny claims.” “Without insurance,” the Mail says the surgery being performed by Dr. Potter “costs anywhere from $30,000 to $50,000.” The Mail also reports a spokesperson from UnitedHealthcare claimed “There are no insurance related circumstances that would require a physician to step out of surgery… We did not ask nor would ever expect a physician to interrupt patient care to answer a call.” Dr. Elisabeth Potter details UnitedHealthcare's legal threats against her for speaking out. Dr. Eric Weiss shares his pioneering work in stem cell therapy for autism, drawing from his son's journey and a suppressed CDC study showing a 1135% autism increase linked to thimerosal in vaccines. Dr. Elisabeth Potter is a board-certified plastic surgeon who earned her MD from Emory University and completed a fellowship at MD Anderson. She specializes in natural breast reconstruction, performing over 1,000 DIEP flap surgeries. Formerly a regulatory analyst of FDA law, she monitors BIA-ALCL risks. Follow at https://x.com/epottermd Dr. Eric Weiss is board-certified in plastic surgery and a leader in regenerative medicine. Founder of North Florida Stem Cells Clinic, he treats autism with stem cell therapy. He co-authored Educating Marston, a memoir about his son's autism journey. Follow at https://instagram.com/northfloridastemcells 「 SUPPORT OUR SPONSORS 」 Find out more about the brands that make this show possible and get special discounts on Dr. Drew's favorite products at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drdrew.com/sponsors⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠• FATTY15 – The future of essential fatty acids is here! Strengthen your cells against age-related breakdown with Fatty15. Get 15% off a 90-day Starter Kit Subscription at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drdrew.com/fatty15⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ • PALEOVALLEY - "Paleovalley has a wide variety of extraordinary products that are both healthful and delicious,” says Dr. Drew. "I am a huge fan of this brand and know you'll love it too!” Get 15% off your first order at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://drdrew.com/paleovalley⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ • VSHREDMD – Formulated by Dr. Drew: The Science of Cellular Health + World-Class Training Programs, Premium Content, and 1-1 Training with Certified V Shred Coaches! More at https://drdrew.com/vshredmd • THE WELLNESS COMPANY - Counteract harmful spike proteins with TWC's Signature Series Spike Support Formula containing nattokinase and selenium. Learn more about TWC's supplements at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://twc.health/drew⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 「 MEDICAL NOTE 」 Portions of this program may examine countervailing views on important medical issues. Always consult your physician before making any decisions about your health. 「 ABOUT THE SHOW 」 Ask Dr. Drew is produced by Kaleb Nation (⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://kalebnation.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠) and Susan Pinsky (⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://twitter.com/firstladyoflov⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠e⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠). This show is for entertainment and/or informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment. Learn more about your ad choices. Visit megaphone.fm/adchoices

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Senior Editor Leslie Erdelack back to the pod to discuss the proposed rule change to the Medicare Physician Fee Schedule for 2026, which includes payment conversion factors for doctors, alternative payment models, add-on codes for Advanced Primary Care Management services, a new mandatory value-based payment model, and more.Order the August 2025 issue of Health Affairs.Join us for a live taping of A Health Podyssey on Tuesday August 12 where Rob Lott will discuss recent findings about changes in clinician's participation across Medicare value-based payment models with Kenton Johnston.Upcoming Events include:8/20: 340B w/ Sayeh Nikpay (INSIDER EXCLUSIVE)8/26: Provider Prices in the Commercial Sector: Independent Dispute Resolution (FREE TO ALL)9/23: Prior Authorization: Current State and Potential Reform (INSIDER EXCLUSIVE)View all Upcoming Events.Become an Insider today to get access to exclusive events like the ones highlighted above.Related Articles:PRESS RELEASE: Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule (CMS-1832-P)CMS proposes rule aligning Medicare physician payment with ‘Big Beautiful Bill,' MACRA (Healthcare Dive)CMS proposes 3.6% pay bump for docs, takes aim at chronic conditions in physician fee schedule (Fierce Healthcare)Physicians will see Medicare payments rise in 2026 (AMA)Medicare proposes ‘efficiency' pay cuts that would hit highly paid specialists the most (STAT News) Subscribe to UnitedHealthcare's Community & State newsletter.

August 8, 2025 In this episode, Scott, Mark, and Ray discuss the troubling expansion of automatic E/M downcoding by payers—and what your practice can do about it. Mark explains which payers are leading this trend, how to identify if your claims are being affected, and practical steps to reverse these denials and protect revenue. Then, the team unpacks the recent news about UnitedHealthcare dropping certain Medicare Advantage plans, what it really means, and how to prepare your front desk and billing staff for potential patient coverage changes. Stay informed, stay proactive!PRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

In the Medicare Advantage Minute we hear even more detail about the difficulties United Healthcare seems to be mired in. The Department of Justice is investigating charges of Medicare fraud & anti-trust violations.  So what else is new? Your Medicare Benefits 2025: Obesity Behavioral Therapy and how Medicare might cover that if you needed it. Soon-to-be-client Mary is wondering what action she should take to find out where her Part B Medicare application is hung up. Fortunately, Mary is an overachiever who has submitted her application early enough before her deadline that there is unlikely to be a troubling delay. That is not true for many other applicants! "Big Fan Terry" checks in to report that his choice of a High Deductible Plan G worked out great. His Medical treatment has resulted in only a small out-of-pocket expense and his recent 8%rate increase amounted to a frightening $4 per month! Finally, Stalker Susie has promised to try out the Kindle version of  "Medicare Drug Plans; A Simple D-I-Y Guide" and report back on how useful it was in her search for the "best" (cheapest) Part D drug plan. Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" "MEDICARE FOR THE LAZY MAN: BARE BONES! For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to  help future readers. Official website: https://www.MedicareForTheLazyMan.com.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Rob Lott interviews Jonathan Perlin of The Joint Commission about the origins of this commission, the impacts made on health care through quality improvement and patient safety, the role of accreditation, the public policy levers that drive change, and more. Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcast Subscribe to UnitedHealthcare's Community & State newsletter.

In the Medicare Advantage Minute segment, United Healthcare cites the murder of their CEO in a move to stifle criticism from the press.                                           Gee, that should make them a lot of friends! In a selection from "Your Medicare Benefits 2025" we learn how Medicare would cover Nebulizers and Nebulizer medications. A couple of valued clients inform me about trouble in Paradise! They move from Minnesota to Green Valley, AZ and some alert employee of their Part D prescription drug plan decided to do a little snooping. Eventually, the Minnesota plan was cancelled and the husband was unable to obtain any more meds. During that investigation another mystery presented itself, this one centering on a theft of enrollment; a Medicare participant was notified that her drug plan had been automatically cancelled due to enrollment in a Humana Medicare Advantage plan. That would have netted some thief a $600+ sales commission. Fortunately, the Content Curator took quick action and the damage was reversed. Listen carefully for a hint as to how one can improve a drug plan customer service encounter. Susan is so eager to become a client she wants to lock in her Medicare supplement plan six months ahead of time. Didn't work out exactly as planned for her. Finally, Dirk needs some guidance as to when to enroll in Medicare, his 65th birthday month or the month his wife retires.  Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; SIMPLEST & EASIEST GUIDE EVER!" "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" "MEDICARE FOR THE LAZY MAN: BARE BONES!" For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to  help future readers. Official website: https://www.MedicareForTheLazyMan.com.

Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Dr. Aaron Carroll, President and CEO of AcademyHealth, to the pod to discuss his recent Forefront article that takes a closer look at the disappearance of public health information and how this could have an impact on infrastructures that scientists, clinicians, health policy makers, and community leaders rely on daily. Become an Insider today to get access to our trend reports, events, and exclusive newsletters.Related Links:AcademyHealth Situation ReportsPRESS RELEASE: AcademyHealth Joins Lawsuit to Restore Public Health Data Removed from Federal WebsitesBecome an AcademyHealth Member Subscribe to UnitedHealthcare's Community & State newsletter.

Dr. Ravi Johar joins the show to discuss Deion Sanders having bladder Cancer and much more

Howie and Harlan discuss Dr. Vinay Prasad's departure from the FDA after a backlash against his decisions on Sarepta's Duchenne muscular dystrophy gene therapy. Also examined: AI in clinical settings, changes in NIH grantmaking, and the 60th anniversary of Medicare and Medicaid. Links: Sarepta and the FDA “STAT breaks down the confusing, heartbreaking Sarepta saga” “Sarepta Therapeutics' Duchenne therapy faces ‘arduous' path back to market, senior FDA official says” “For many Duchenne families, halt to gene therapy is heartbreak upon heartbreak” “FDA launches probe into new Elevidys death as Sarepta, Roche stress gene therapy not at fault” “FDA Recommends Removal of Voluntary Hold for Elevidys for Ambulatory Patients” “FDA takes U-turn on Sarepta's Elevidys, backing Duchenne gene therapy again in ambulatory patients” “Controversial FDA official Dr. Vinay Prasad departs agency” “Top F.D.A. Vaccine Official Resigns, Citing Kennedy's ‘Misinformation and Lies'” “Vinay Prasad Is a Bernie Sanders Acolyte in MAHA Drag” “Timeline: The Rise and Fall of Vioxx” “What have we learnt from Vioxx?” THC in pizza dough “C.D.C. Ties 85 Cases of THC-Related Symptoms to Wisconsin Restaurant” “Tetrahydrocannabinol Intoxication from Food at a Restaurant — Wisconsin, October 2024” NIH funding “NIH is shrinking the number of research projects it funds due to a new Trump policy” NIH: Supporting Fairness and Originality in NIH Research Applications “Fearful of AI-generated grant proposals, NIH limits scientists to six applications per year” “Trump budget draft proposes NIH consolidation and 40% spending cut” Raw milk “Outbreak of Salmonella Typhimurium Infections Linked to Commercially Distributed Raw Milk — California and Four Other States, September 2023–March 2024” “The Dangers of Raw Milk: Unpasteurized Milk Can Pose a Serious Health Risk” AI in healthcare update “Ambience Healthcare Announces $243 Million Series C to Scale its AI Platform for Health Systems” “As ambient scribes face off, Doximity lures doctors with a free option” Aidoc: “AI Empowering Radiologists” “Clinical Implementation of a Combined Artificial Intelligence and Natural Language Processing Quality Assurance Program for Pulmonary Nodule Detection in the Emergency Department Setting” “Large Language Models as an Inexpensive and Effective Extra Set of Eyes in Radiology Reporting” “Current Trends in Remote and Flexible Work Options in Radiology and Perception of Impact on Radiologist Well-being” Medicare and Medicaid 60th anniversary CMS' program history “Medicare and Medicaid turn 60 – and face historic cuts decades in the making” UnitedHealth and Medicare Advantage “UnitedHealth says 2025 earnings will be worse than expected as high medical costs dog insurers” “UnitedHealthcare to exit certain Medicare Advantage markets as costs balloon, impacting 600K enrollees” “Novo Nordisk slides further on US competition, new CEO concerns” “Dems Must Really Fix Medicaid, Not Just Undo Trump's Damage to It”   Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

In this episode, Scott Becker examines UnitedHealthcare’s recent 5% stock drop and its broader 47% year-to-date decline, driven by rising medical loss ratios and a Department of Justice investigation.

In this episode, Scott Becker highlights five publicly traded companies experiencing significant downturns, including Novo Nordisk, UnitedHealthcare, Spotify, UPS, and Stellantis.

In this episode, Scott Becker highlights five publicly traded companies experiencing significant downturns, including Novo Nordisk, UnitedHealthcare, Spotify, UPS, and Stellantis.

In this episode, Scott Becker examines UnitedHealthcare’s recent 5% stock drop and its broader 47% year-to-date decline, driven by rising medical loss ratios and a Department of Justice investigation.

Carol Price Guthrie has spent over three decades working in the field of intellectual and developmental disabilities (IDD), beginning as a direct support professional in Tennessee. Her career journey includes roles in case management, program development, and managed care, with experience founding her own case management agency and contributing to projects at UnitedHealthcare. Currently, she serves as Senior Director of Waiver and Program Development at StationMD, a telehealth company specializing in medical services for individuals with IDD. Guthrie is deeply committed to health equity, advocating for specialized, ongoing training and personalized support that enables people with IDD to access community-based services and live with dignity and independence.

This episode features Amy Jordan, Vice President of Consumer Digital Engagement at UnitedHealthcare, discussing the launch of Smart Choice, a data-driven provider search tool designed to simplify healthcare navigation. Amy shares how the platform uses personalization and quality metrics to improve member experience and how it fits into UnitedHealthcare's broader digital transformation strategy.

In this episode, Scott Becker discusses the mounting challenges for UnitedHealthcare, including a Department of Justice investigation into its Medicare Advantage billing and a 50 percent stock drop over the past year.

In this episode, Scott Becker discusses the mounting challenges for UnitedHealthcare, including a Department of Justice investigation into its Medicare Advantage billing and a 50 percent stock drop over the past year.

We're marking 100 episodes by getting real about a moment that I've feared all my life. The moment where they asked if there was a doctor onboard this plane! Also: we talk about Dr. Elisabeth Potter, a breast cancer surgeon who stood up to UnitedHealthcare after they told her how to do her job—and then punished her for it. It's infuriating. But it's also revealing. Takeaways: There was a medical emergency onboard my latest flight. Dr. Elisabeth Potter tried to do what was best for her patient. UnitedHealthcare had other ideas. There's a quiet war happening between doctors and insurers—and it's not just about money. Reaching Episode 100 made us reflect on where we've been, and the messy, human parts of medicine we still need to talk about. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

There was some activity over at the headquarters of the U.S. Central Bank. It was a show and tell about the $2.5 billion restoration going on and why that happened today.  This is the Business News Headlines for Thursday the 24th day of July, coming to you again from Norfolk, Virginia. In other news, like the U.S. Central Bank the European Central Bank has delayed cutting rates…and why.  Looks like the railroad merger might be happening. We'll share what we know at this point. President Trump weighs in on Tesla in a surprise Truth Social Post. From the entertainment world…remember Lindsey Buckingham and Stevie Nicks?  Long before Fleetwood Mac's successful LP Rumors there was the Buckingham Nicks Album…we have some news. We'll take a look at the Wall Street Numbers from today and United Health Care is the subject of a Department of Justice review…think Medicare Billing.  Ready?  Let's go! Thanks for listening! The award winning Insight on Business the News Hour with Michael Libbie is the only weekday business news podcast in the Midwest. The national, regional and some local business news along with long-form business interviews can be heard Monday - Friday. You can subscribe on  PlayerFM, Podbean, iTunes, Spotify, Stitcher or TuneIn Radio. And you can catch The Business News Hour Week in Review each Sunday Noon Central on News/Talk 1540 KXEL. The Business News Hour is a production of Insight Advertising, Marketing & Communications. You can follow us on Twitter @IoB_NewsHour...and on Threads @Insight_On_Business.

In episode 1901, Jack and Miles are joined by host of American Hysteria, Chelsey Weber-Smith, to discuss… Epstein Panic Check In, That ‘Uber With Guns’ App Is Expanding and more! Reporter: Why doesn’t the President just order the FBI to release the full Epstein files? Deputy attorney general seeking meeting with Epstein associate Ghislaine Maxwell Trump 'won't make a deal' with Washington Commanders if team refuses to change name 'Uber With Guns’ App Contracts With Police Officers Accused Of Misconduct ‘Uber with guns’ app launches in Los Angeles A New Uber Clone With Armed Drivers Is the App for a Violent and Paranoid America 'Uber for bodyguards': New app provides armed security teams at the push of a button Protector: We revisit the tragic murder of UnitedHealthcare’s CEO and examine how the presence of a Protector may have changed the outcome. (Clip) Protector Launches Patrol App to Bring Elite Protection to Los Angeles Homes and Families Dystopian Startup Lets the Wealthy Rent Off Duty Cops on Demand The Blurred Blue Line LISTEN: Just Can't Explain by Alps CruSee omnystudio.com/listener for privacy information.

Angel Studios https://Angel.com/ToddJoin the Angel Guild today and stream Testament, a powerful new series featuring the retelling of the book of Acts. Alan's Soaps https://www.AlansArtisanSoaps.comUse coupon code TODD to save an additional 10% off the bundle price.Bioptimizers https://Bioptimizers.com/toddEnter promo code TODD to get 10% off your order of Berberine Breakthrough today.Bizable https://GoBizable.comUntie your business exposure from your personal exposure with BiZABLE.  Schedule your FREE consultation at GoBizAble.com today.  Bonefrog https://BonefrogCoffee.com/toddThe new GOLDEN AGE is here!  Use code TODD at checkout to receive 10% off your first purchase and 15% on subscriptions.Bulwark Capital https://KnowYourRiskPodcast.comHear directly from Zach Abraham as he shares insights in this FREE “Halftime” Webinar, THIS Thursday, July 24th at 3:30 Pacific.  Register now at Know Your Risk Podcast dot com. Renue Healthcare https://Renue.Healthcare/ToddYour journey to a better life starts at Renue Healthcare. Visit https://Renue.Healthcare/ToddLISTEN and SUBSCRIBE at:The Todd Herman Show - Podcast - Apple PodcastsThe Todd Herman Show | Podcast on SpotifyWATCH and SUBSCRIBE at: Todd Herman - The Todd Herman Show - YouTubeCode is the new medicine. Silicon valley and big pharma have converged, which is why I still believe that the fight against the medical technocrat elite is the battle of our time.Episode Links:I still stand by my message and my warning, research us before we dieHHS Secretary RFK Jr. announces the Trump administration has rejected U.S. participation in the World Health Organization's IHR regulations and pandemic response measures:The press and others consistently shout out the vaccines are safe and effective. Vaccinate your family … We all vaccinated our families. Everybody sitting here bar two vaccinated their families with catastrophic results. Over 12,000 signatures on those two buses of death, death, death."Emily Tarsell, a retired psychotherapist, stood before Senate to share the heartbreaking story of her daughter, Christina—a vibrant, healthy 20-year-old whose life was cut short by the HPV vaccine.American surgeon records her peer-2-peer call with UnitedHealthcare trying to get a patients surgery approved they deniedThe infamous Letter. ~

This episode features Amy Jordan, Vice President of Consumer Digital Engagement at UnitedHealthcare, discussing the launch of Smart Choice, a data-driven provider search tool designed to simplify healthcare navigation. Amy shares how the platform uses personalization and quality metrics to improve member experience and how it fits into UnitedHealthcare's broader digital transformation strategy.

We talk about cancer with Dr. Rhonda Randall, Chief Medical Officer for United Healthcare, one of the country's leading medical insurers.

In this powerful episode of The Faith for Work Podcast, Sarah Guldalian opens up about her deeply personal journey. Her story takes a transformative turn during her college years, where a surprising invitation from a coworker reignites her faith and sets her on a path of purpose.Now the Executive Director of The Rooted Sisters™, Sarah shares how she uses her gifts in communication to lead, evangelize, and uplift professional women through Bible study, prayer, and leadership development. With humility and wisdom, she offers practical advice on being a light in the workplace and embracing spiritual gifts with obedience.Whether you're seeking encouragement, leadership inspiration, or a reminder of God's faithfulness, this episode will leave you uplifted and empowered.About Sarah:Sarah Guldalian is grateful to serve as Executive Director for The Rooted Sisters™.Sarah is a Telly & AVA award-winning marketer and producer of 25 years. She is passionate about using her vocational gifts to glorify God which she has done throughout her career by advancing the mission of ministries and Christian businesses. Her personal mission is to inspire, encourage, and evangelize to the world through her gifts in writing, marketing, and communications.Sarah attended Drake University where she earned a Bachelor's in Journalism & Mass Communication with a major in Broadcasting. She worked in television and advertising for ABC, WB-TV, and Emmis Communications, where she served as an assistant producer, an account executive, and in promotions. Once recognizing her heart for Christian outreach, she made a shift to focusing on evangelistic organizations.She has owned three Christian marketing agencies – Top Notch Brand Company, Rhino Hyde Productions, and Semi-Gloss Marketing – all of which have had an emphasis on advancing the mission of ministries, in addition to serving Fortune 5 companies, such as United Healthcare. She has had the blessing of serving as a leader for Lutheran Hour Ministries, Joyce Meyer Ministries, Pathfinder Church, Valley Church, and Grace Church STL, which has included producing and marketing events with Christian speakers such as Tim Tebow, Dr. Ben Carson, and Joyce Meyer.Since 2005, Sarah has also been a Christian speaker and producer in the United States and Canada on the topics of Evangelism, Community Outreach, Digital Outreach, and Inner Healing. She produces and speaks at national Christian conferences, churches, Women's events, and professional events.Above all things, Sarah identifies herself as a daughter to the King, wife to Justin, and mom to two beautiful children. Support the showTransforming the workplace one Bible study at a time - DONATE today! CONNECT WITH US:B-B-T.org | News | LinkedIn Biblical Business Training (“BBT”) equips busy, working people to grow in the grace and knowledge of Jesus Christ and empowers them in small-group Bible study settings to apply Biblical principles to their every day lives - especially in the workplace. BBT is a nonprofit 501(c)(3) organization which exists to help people develop their Christian “Faith for Work – Leadership for Life!”

In this episode, Scott Becker analyzes the performance of key managed care companies, highlighting Oscar Health's resilience, UnitedHealthcare's challenges, and Centene's steep decline as rising patient acuity strains the industry.

This week, we plunge headfirst into the moral void—starting with Cristiano Ronaldo, who just inked another Saudi contract big enough to make oil executives blush and human rights quietly weep. Then we introduce the world's most jealous woman, a walking red flag with night vision goggles and a court order pending. Ever wondered which profession cheats the most? We've got the stats—and let's just say your next physical might include an emotional scar. Finally, BlackRock is suing UnitedHealthcare in a corporate Thunderdome so savage, even Satan called it “a bit much.”Grab your headphones, hide your spouse, and prepare to lose a little more faith in humanity.

Episode 197: Continuous Glucose MonitoringWritten by William Zeng, MSIII, and Chris Kim, MSIII. University of Southern California.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Will: IntroToday we're exploring Continuous Glucose Monitoring, or CGM. We'll break down what CGM is, who benefits, how to access it, options available for our patients, the pros and cons, and a few final reflections on where this technology is heading. Chris, So what is CGM?Chris:Continuous glucose monitoring refers to the use of a small wearable sensor placed just under the skin to track glucose levels in real time throughout the day and night. These sensors measure glucose in the interstitial fluid and transmit readings to a receiver or smartphone at regular intervals, allowing for 24/7 glucose trend tracking. Will:CGM has been shown to improve glycemic control, increase “time in range,” and reduce hypoglycemia. Let's review some evidence.Chris:A 2023 meta-analysis published in Diabetes Technology & Therapeutics reported a mean Hemoglobin A1c reduction of 0.43% across multiple trials. Will:In people with Type 1 diabetes, the IMPACT and DIAMOND studies showed sustained improvement in Hemoglobin A1c and hypoglycemia reduction over 6–12 months. CGM use in insulin-treated Type 2 diabetes patients also resulted in significant benefits, including reduced variability and fewer severe glucose excursions. Chris:Clinically and economically, CGMs help prevent long-term complications such as cardiovascular disease, nephropathy, and retinopathy. Chris, What patients specifically benefit the most from CGM?Will: CGMs are most commonly indicated for people with Type 1 diabetes and for those with Type 2 diabetes who are using intensive insulin regimens—typically defined as multiple daily injections or insulin pump therapy. Chris:And what are the qualifications in order to be covered by insurance?Will:In the United States, Medicare covers CGM as durable medical equipment for qualifying patients, and coverage requires a prescription, documentation of insulin use, and regular follow-up. Most major private insurers—including Blue Cross, Aetna, UnitedHealthcare, Cigna, and Kaiser—follow similar guidelines. Coverage is generally granted for patients with Type 1 diabetes or insulin-requiring Type 2 diabetes who monitor glucose at least four times daily or use an insulin pump. Chris:Some plans require demonstration of hypoglycemia unawareness or frequent glucose variability. For patients not on insulin, OTC CGMs may be an option, but coverage is typically not provided. That said, new FDA decisions are allowing over-the-counter access to CGMs like Abbott's FreeStyle Libre and Dexcom's Stelo, expanding availability for lifestyle or preventive purposes.Will:[There are a lot of products on the market. Which are the main products and how are they different?]Chris:The three main players in the CGM space are Dexcom, Abbott (FreeStyle Libre), and Senseonics (Eversense), each with unique offerings.Let's start with Dexcom. Dexcom G7 is a real-time CGM system approved for both Type 1 and Type 2 diabetes. It combines a sensor and transmitter into one compact wearable patch worn on the abdomen or upper arm for up to 10 days. It updates glucose readings every 5 minutes and connects directly to a smartphone or Apple Watch via Bluetooth. Dexcom also integrates with insulin pumps like Tandem's t:slim and the Omnipod 5. Data can be shared with providers through Dexcom Clarity, which integrates into electronic medical records (EMRs) like Epic. OTC access is not yet available for DEXCOM G7, but a new non-prescription product called Dexcom Stelo is being rolled out in 2025, targeting non-insulin-using Type 2 patients. Dexcom Stelo will also offer 15-day wear, smartphone integration, and factory calibration. The estimated OTC cost for Dexcom Stelo is expected to be around $99 for a 15-day sensor, or about $198/month.Will:$200! Abbott FreeStyle Libre comes in several versions. The Libre 2 offers 14-day wear and requires users to scan the sensor with their smartphone or reader to retrieve a glucose value. It has optional real-time alarms for high and low readings and transmits data to LibreView, which can integrate with most EMRs. Libre 3 is a real-time CGM with 1-minute interval updates, Bluetooth transmission, and a slimmer profile. Libre sensors are widely used in primary care and available OTC for non-insulin users. Libre 2 sensors cost approximately $70–$85 for a 14-day sensor, while Libre 3 is slightly higher, around $85–$100 per sensor—totaling about $140–$200/month out of pocket without insurance.Chris:Senseonics Eversense E3 is the only implantable CGM on the market. It involves a minor in-office procedure to insert the sensor under the skin of the upper arm, which lasts up to 180 days (and a newer version, Eversense 365, lasts up to one year). A removable transmitter worn on top of the skin sends data every 5 minutes to a mobile app and vibrates for alerts. It requires 1–2 calibrations per day using a traditional fingerstick meter. It integrates with Eversense DMS software for physician monitoring. The total cost for Eversense depends on the insertion procedure and insurance, but cash pay for the full 6-month system is estimated at $2,400–$3,000, or about $400–$500/month including follow-up visits.Will:Additional lower-cost CGMs such as the Medtrum A6 TouchCare are available internationally and in select U.S. pilot programs. These devices offer 14-day wear, smartphone syncing, and daily calibration, but are not yet FDA-approved for wide use and lack full EMR integration.Chris:In terms of performance and value, Dexcom G7 offers the most advanced real-time feedback and integration, making it ideal for those on insulin pumps or needing tight control. Will:FreeStyle Libre offers the best affordability and convenience, especially for non-insulin users or those who prefer not to deal with constant alerts. Eversense offers a niche but compelling option for people who want to avoid frequent sensor changes. Chris, [Are there any downsides or risks that patients should be aware of before trying out CGM?]Chris:CGMs are generally safe and well-tolerated, but they do have limitations. Dexcom G7 has a known failure mode where sensors sometimes fail prematurely, often before the full 10-day duration. Some users have reported “signal loss” errors or random disconnections, especially when switching between phone models or operating systems. There are occasional reports of inaccurate highs or lows due to compression during sleep or dehydration. Though the G7 is factory-calibrated, abrupt changes in hydration or blood flow can affect its readings.Will:FreeStyle Libre systems, particularly Libre 2, require the user to scan the sensor to retrieve data unless alerts are enabled. These devices may be affected by vitamin C (ascorbic acid), which can falsely elevate glucose readings, and they do not currently allow for automated insulin delivery integration. Some Libre 2 users have noted adhesive-related rashes or spontaneous detachment. Libre 3, while more advanced, still may lose Bluetooth connection intermittently, particularly if the phone is out of range or the app is not running in the background.Chris:Senseonics Eversense carries procedural risks due to its implantable nature. Minor scarring or infection at the insertion site has been reported. The transmitter must be worn during waking hours to provide alerts, and users report anxiety over losing the transmitter since data logging is interrupted without it. Calibration is still required, which adds to daily tasks. Additionally, the sensor does not communicate with insulin pumps or closed-loop systems.Will:All CGMs can cause mild skin irritation from adhesive, particularly in users with sensitive skin. Alert fatigue is another consideration, as frequent low- or high-glucose warnings may cause stress or lead users to silence notifications entirely. Finally, relying solely on CGM without periodic fingerstick confirmation in symptomatic scenarios can be a risk, especially during rapid glucose changes.Chris:Conclusion[***] Continuous glucose monitors have reshaped the way we manage diabetes, offering unprecedented insight into glucose trends, diet responses, and insulin timing. While CGMs are not flawless, the technology continues to evolve. Will: If your patient is on insulin or struggling with glucose variability, consider whether CGM is right for your patient. For those not using insulin, consider newer OTC options like FreeStyle Libre or Dexcom Stelo, which offer accessible entry points without the need for prescriptions. As AI integration, longer sensor life, and non-invasive monitoring enter the market, CGM will only become more useful.Dr Arreaza: Personal experience with CGMs. I do not have diabetes, but I have a strong family history of diabetes (including father, 2 grandmas, and about 15 uncles, aunts, and cousins.)I wanted to try it so I could teach my patients about CGM. My first experience was with Freestyle Libre 2: Pros: Painless placement, easy to use, scanning with phone was easier than fingersticks.Cons: Required some assembling to be placed, mild discomfort at night, and nighttime alarms.Dexcom G7:Pros: No need for scanning, feels more stable in your armCons: High readings (had to calibrate for a more accurate reading)Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

In this episode, Jakob Emerson, Associate News Director at Becker's, unpacks the political and financial ripple effects of the GOP reconciliation bill. He also shares insights into major concerns for payers like Centene and UnitedHealthcare, looming Medicaid and ACA enrollment losses, and the long-term implications for healthcare access, hospitals, and insurers alike.