60 some PBMs and 3 control 80%+ of the cost and availability of your prescription


Suppose you ever wondered why you can’t get your Rx paid for by your insurance and the med your doctor prescribed. In that case, your insurance company will only pay for another medication and/or require your doc transverse some sort of paper shuffle nightmare to get your medication paid for. If you ever ask why your prescription costs so much. Pay attention to the alphabet soup of middlemen that the person in this video just starts to mention. Each one of these middlemen has an operational cost overhead and a desire to show a profit.

 

 

Why I Hope to Die at 75

This article was written by Dr. Ezekiel J. Emanuel    back in Sept 2014 the director of the Clinical Bioethics Department at the U.S. National Institutes of Health and head of the Department of Medical Ethics & Health Policy at the University of Pennsylvania helped develop President Obama’s health care reform law. AKA Obamacare

https://www.pharmaciststeve.com/you-stop-contributing-to-society-at-75/

Could this concept have been covertly adopted over the last decade?

An Older Woman’s Chronic Pain Is Not ‘All in Her Head’

https://www.medpagetoday.com/opinion/second-opinions/110495

There are serious consequences of under-managed pain

It was the second time she had been to the emergency department with pain. It was also the second time she was sent home without answers. With each visit, I felt increasingly helpless as a nurse and a daughter, as my mom called me in excruciating pain on her way to the hospital.

After the first visit, I had helped her navigate the healthcare system and get appointments with various specialists and her primary care provider. Yet, here she was, in the emergency department a second time with unresolved, under-managed, and unbearable pain.

Many factors within the healthcare system contribute to under-managed pain in women — which is especially prevalent in older and middle-age women. I am all too familiar with the fact that we have a taxed healthcare system, but there is also an unfortunate history of dismissal of women’s pain. Pain in middle-age and older women is frequently dismissed as a “normal part of aging,” both within society and within healthcare. My mother, my patients, and my research participants have expressed far too many times that they left a visit with no plan for their pain, and were told it was just arthritis and to work on losing weight.

Under-managed pain in middle-age and older women is a deeply concerning issue. Yet, many fail to recognize the dire consequences. We need this to change.

The Consequences of Unmanaged Pain

Among those experiencing chronic pain, 70% are women. Under-managed pain in older women can lead to reduced quality of life, frailty, difficulty with physical activity, and poor mental health outcomes. Among middle-age and older women from underserved and underrepresented groups, under-managed pain only further expands the gap in access to necessary healthcare and contributes to health disparities. All this and I haven’t even gotten to the cost: chronic pain costs the nation an estimated $560-635 billion each year (in 2010 dollars) in pain management care, disability payments, and lost work productivity.

This is clearly an issue affecting not only those patients living in pain and their families, but society at large.

Acknowledging Their Voices and Responding to Their Pain

It’s high time to take action beyond just being aware of this burden of pain.

Chronic pain in women should be at the forefront of research agendas. We must find innovative ways to build on our previous work to better assess, treat, and understand chronic pain mechanisms and experiences among women. With the new White House Initiative on Women’s Health Research, it is imperative that researchers recognize chronic pain as a condition that disproportionately affects women and has severe consequences. As First Lady Jill Biden stated, no woman should have to hear “it’s all in your head.

We, as clinicians, must move forward from simply acknowledging that pain exists for middle-age and older women and make it a priority for their voices to be heard. It is imperative that we provide space and opportunities for women to go beyond the limited 0-10 pain scale and express their unique pain experiences. Using culturally aware assessment methods is also an important aspect of providing space for women to voice their pain and ask questions about it.

Through my research, I’ve learned that putting women at the center of their pain management is a crucial component in improving their pain and quality of life. For example, women in my study identified their goals in pain management, such as being able to sit or stand for longer periods at work, or to better manage their pain while at home. Building on their experiences, it is important that women can identify the goals they would like to achieve in their pain management rather than clinicians setting the goals and pain management regimens for them. We have found that when women express what is meaningful to them, their pain management plans are more sustainable and realistic, and their pain and mood also start to improve.

For clinicians specifically, pain management should be founded in shared decision making with middle-age and older women. In addition, developing pain management plans that are tailored to women’s needs is imperative in managing their pain and improving long term outcomes.

A Worthy Investment

We have the potential to change healthcare as we know it for women experiencing chronic pain. At first, it may cost more to go this extra mile, but in the end the costs of pain management and lost productivity would likely decrease. Most importantly, we owe it to women like my mom and the women in my research studies to hear and believe them.

It is the heartbeat of healthcare to believe our patients, and our duty to hear their stories and work with them to manage their pain. It is the duty of researchers and clinicians to respond to their stories to help improve outcomes.

Judge Sends 75-year-old Pro-Lifer to Prison for Two Years; Mocks Her Faith

Would appear to be this judge Colleen Kollar-Kotelly https://en.wikipedia.org/wiki/Colleen_Kollar-Kotelly  https://ballotpedia.org/Colleen_Kollar-Kotelly

According to Ballotpedia, politically she is a Nonpartisan but she received both her BS and JD degrees from the Catholic University of America. So apparently she was raised in the Catholic faith. Her ruling on this particular case would suggest that she is like our President, who professes to be a good-practicing Roman Catholic but appears to be pro-abortion. She is also another octogenarian bureaucrat who probably should have stepped down. This decision by this judge seems to have little empathy for a sickly 75 y/o woman who was “praying” at an abortion mill and is sentencing her to TWO YEARS IN PRISON. There is a high probability that this is LIFE SENTENCE for this poor woman. So much for her First Amendment rights of freedom of religion. You should read some of the judge’s rulings that are listed in the wikipedia.com link above on her, it would also appear that she has little use for our Second Amendment as well.  According to this article, Harlow was praying at a notorious late-term abortion mill in Washington, D.C.  Some believe that late-term abortion is – or should be defined as – infanticide.

Judge Sends 75-year-old Pro-Lifer to Prison for Two Years; Mocks Her Faith

A federal judge openly mocked a 75-year-old grandmother’s faith in the courtroom during a sentencing hearing. Paulette Harlow faces two years in jail for praying at an abortion mill.

https://www.toddstarnes.com/crime/judge-sends-75-year-old-pro-lifer-to-prison-for-two-years-mocks-her-faith/

Judge Colleen Kollar-Kotelly handed down the sentence, along with 36 months of supervised release, because of her part in a prayer and hymn sing at a notorious late-term abortion mill in Washington, D.C.

Harlow had been under house arrest since November 2023 because of her rapidly declining health.

Harlow’s husband pleaded with the court for mercy because of his wife’s declining health and feared that she might die in prison.

“In my heart, I think she’s having a hard time staying alive,” John said, according to LiveAction. “We’ve tried to be good people,” he later added. “I love my wife dearly… We’re throwing ourselves on the mercy of the court.”

Judge Kollar-Kotelly dismissed his concerns and mocked Harlow’s faith in Christ.

The judge quipped that she hoped Harlow would “make an effort to remain alive” because that is a “tenet of [Harlow’s] religion.”

In November 2023, Paulette was convicted of violating the Freedom of Access to Clinic Entrances Act and of “conspiracy against civil rights.”

Sen. Mike Lee condemned the federal judge’s callous remarks.

“This judged mocked Harlow’s religious beliefs while sentencing the 75-year-old woman in poor health to two years in prison — all for the offense of (gasp) praying at an abortion clinic,” Lee wrote on X. “Moloch is a vile monster.”

In May 2024, Paulette’s eight co-defendants were also sentenced to various lengths of time in prison followed by supervised release. On May 14, Harlow’s co-defendant Lauren Handy was sentenced to almost five years in prison. 

Paulette has remained under house arrest since November 2023 due to her medical needs. 

In her statement for the government, prosecutor Rebecca Ross insisted the case was “not about the defendant’s beliefs,” but rather about “violent obstruction of reproductive healthcare” and “violating the civil rights of others.”

Ross accused Harlow of attempting to use her poor health as an “excuse” to “escape the consequences” of her actions and of lying under oath at her trial, though exactly how Harlow allegedly did the latter was not made clear.

The attorney claimed that Harlow “denied empathy and compassion” to women attempting to abort their children on the day of the rescue, and recommended a sentence of 33-41 months.

 

 

 

Another online pharmacy bypasses the FDA to offer cut-rate weight loss drugs

I have watched these “GLP-1” ads on TV.  I found it curious that these ads were promoting “GLP-1” injectables for “diet”. GLP-1 is just the “category” of this group of medications.  The FDA rule is that a pharmacy CANNOT compound a medication that is similar/same to a commercially available product – unless the commercial product is unavailable or in a shortage status.

This is the same thing that pain clinics use in having a pharmacy to compound meds that go into the implanted pumps.  They have the pharmacy compound Hydromorphone because there is no commercially available preservative-free Hydromorphone or they will add some lidocaine-type product, clonidine, or other meds to just about any opioid to get the pharmacy to compound the meds to go into a pump. There is only one FDA-approved med to be used in implanted pumps – Infumorph – which is Morphine in a preservative-free injectable. Just read this article and see the price these companies charge for the GLP-1 compounded meds vs the cost of the FDA-approved GLP-1 category of brand-name injectables. This should give you a general idea of why pain clinics use compounded meds to be put in implanted pumps. You have to follow the $$$.

Another online pharmacy bypasses the FDA to offer cut-rate weight loss drugs

https://www.theverge.com/2024/5/20/24160884/hims-hers-ozempic-weight-loss-wegovy-pharmacy

Hims & Hers Health, one of the online pharmacies that got its start prescribing dick pills, is now offering knockoff versions of GLP-1 weight loss drugs. Hims & Hers says it will offer drugs that mimic Ozempic and Wegovy, the active ingredient of which is semaglutide.

The copycat versions are made by compounding pharmacies. The formulations aren’t the same as the FDA-approved versions of the drug and haven’t been directly evaluated by the FDA, either. But they’re cheaper than the real thing: $199 a month, compared to the branded version, which can cost more than $1,000 a month without insurance.

Compounding pharmacies can make knockoff versions of branded drugs when they are in shortage, as the GLP-1 drugs — prescribed for diabetes and weight loss — currently are. The FDA has already received reports of adverse events for compounded versions of semaglutide.

Hims & Hers says it “conducted extensive research for over a year” into finding a supplier but does not name the one it chose to partner with. “Over the last year, we have grown in our conviction — based on our medical experts’ evaluation and the strength of our infrastructure — that if done properly, compounded GLP-1s are safe and effective,” the company said in its statement.

Hims & Hers introduced its weight loss program in December 2023, according to an investor presentation. Its weight loss program costs $79 a month and is expected to “deliver $100m+” in 2025. Hims & Hers makes most of its money through subscriptions; more than 90 percent of its revenue is “recurring.” Expanding its number of subscribers is how it plans to grow. GLP-1 weight loss drugs must be taken continuously in order to sustain weight loss; one study has shown that people regain two-thirds of the pounds they lost once they quit semaglutide.

In the first quarter of 2024, the company added “a record 172k net new subscribers,” it said in its shareholder letter. The company has splashed out on TV advertising during NBA and NFL games as well as Keeping Up With the Kardashians and The Bachelorette.

Ro, another online pharmacy that started with dick pills, is also already prescribing compounded versions of these drugs, Bloomberg reports. Ro previously advertised weight loss drugs on the New York City subway system.

This helps explain why the PBMs want you to use their mail order pharmacy

This is a price quote from one of the major PBM’s websites and a Medicare Part D prgm.

The TOP PRICE is for 30 days supply and labeled as IN-STORE. The second price is for a 90-day supply labeled as MAIL ORDER. The mail order – I PRESUME – is the mail order pharmacy owned by the PBM managing the Part D Rx billing/payment.

Generally, mail-order pharmacies have a mandatory 90-day supply of all Rxs they fill. Would a prescriber willingly change the C-II they wrote for 30 days to a 90-day supply?

Would the fact that the mail order pharmacy wants to charge the pt 5-6 times the cost/dose of filling their Rx at a local community pharmacy?

According to GoodRx… the lowest quoted prices were $32 & $67 respectively for the two quantities.  Either one of those issues could cause the pt to go without their needed medication. The Prescriber is unwilling to prescribe a  90-day supply and/or the patient can’t afford the PRICE!

There is little question why the PBM industry is trying to run as many pharmacies – especially independent pharmacies – in rural areas. So that they can create an untold number of “pharmacy deserts” so that the PBM industry can “persuade” all these pts with no nearby pharmacies, to utilize their PBM mail-order pharmacies and more profits to their bottom line.

You may have to CLICK TWICE ON THE IMAGE to get it more readable

Navigating The American Healthcare System | South Park: The End Of Obesity

FTC: Healthcare Corps selling your HIPAA PHI is worth abt $10/pt fine

Is $10 the Best BetterHelp Could Do for Violating Patient Privacy?

https://www.medpagetoday.com/opinion/prescriptionsforabrokensystem/110292

In healthcare, privacy is paramount. It is an essential component of building trust with patients and, well, protecting patient privacy is also the law.

Or it is supposed to be.

According to charges broughtby the Federal Trade Commission (FTC), the online therapy provider BetterHelp (now a part of Teladoc Health) allegedly used and disclosed sensitive user data — including internet protocol (IP) addresses, email addresses, and information in health questionnaires — to social media giants like Facebook, Pinterest, and Snapchat, among others. In its findings, the FTC said BetterHelp misrepresented its compliancewith the Health Insurance Portability and Accountability Act (HIPAA).

While it remains unclear whether BetterHelp’s actions constituted a direct violation of HIPAA, the allegations in this case are alarming. BetterHelp allegedly disregarded the implicit confidentiality patients believe exists with their therapists, no matter the medium through which care is delivered.

Patient Privacy Is Worth More Than $10

In 2023, BetterHelp reached a $7.8 million settlementwith the FTC in its case. Patients were to receive a payment as a part of BetterHelp’s settlement.

The total value of the refund per consumer? Just under $10 — a fraction of the $260 to $400 average monthly costof care through BetterHelp.

That figure clearly trivializes the potential damage to those affected. Beyond not adequately reimbursing patients financially, $10 does not begin to address the emotional and psychological impact of knowing one’s private data may have been used without consent. That violation may have compounded the hurt and trauma for which these patients sought care in the first place.

The violation also arguably damaged the reputation of all providers, especially those that operate exclusively online. When confidentiality is compromised, and trust is breached, it potentially deters people from seeking essential mental health services.

Is $10 the best BetterHelp could do?

Systemic Issues in Privacy Breaches

The privacy concerns highlighted by the BetterHelp case are not isolated. The industry has seen a surge in data breachesover the last several years.

The recent Change Healthcare cyberattackwas widely publicized, and, perhaps better than any other story, highlighted the fragility of our integrated billing and prescription transmission system for both patients and practitioners. (Side note: UnitedHealth Group may want to use multi-factor authentication

As a result of the Change Healthcare security lapses, nearly 80% of physiciansopens in a new tab or window have faced reimbursement backlogs or lost revenue, and patients have seen delays in procedures and prescriptions. While it appears timely reimbursements were the top-line issue reported in this case, patient privacy concerns should have been at the forefront too, with the House Energy and Commerce Committee finding that patient informationfrom the attack likely made its way onto the dark web.

Similar privacy concerns exist within traditional healthcare settings, particularly involving third-party scheduling software services that have sold patient information.

Privacy concerns are exacerbated by incentives to monetize consumer information. A study published in JAMAin April 2024 found that 96% of hospital websites transmitted user information to third parties such as Meta and Google. It is unclear what Meta, the owner of Facebook and Instagram, does with this information, but similar practices have been suspected to be used to inform health-related advertising

These incidents clearly demonstrate the pressing need for stringent data protection measures across all healthcare platforms, digital and traditional.

Washington Must Enhance Data Protections

The expansion of telehealth has transformed healthcare delivery, making it more accessible and, often, more efficient. But the rapid growth of this sector must not outpace the development of robust safeguards for patient privacy.

The House currently is considering a bipartisan data privacy bill(the American Privacy Rights Act [APRA]), that if approved by the chamber and the Senate and signed into law, would provide a data privacy regime for all sectors of the U.S. economy, including healthcare. More specifically, the bill would give consumers the opportunity to gain access to, correct, and delete any of the personal data companies gather and share about them. While organizations subject to HIPAA would be mostly exempt, they would need to comply with APRA’s data security provisions.

The APRA would also enhance consumer rights when it comes to non-HIPAA-protected information, like search queries and information recorded on mental health apps. Finally, APRA would allow consumers to sue companies that unlawfully transmit or collect covered data. (Maybe they would get more than $10.)

This draft bill is a good start.

Ensuring the security of patient data is a critical ethical obligation. As we continue to navigate the complexities of healthcare in the digital age, it is imperative that all stakeholders in the healthcare marketplace, including regulators, providers, and technology partners, reaffirm their commitment to protecting patient information. This task involves not only adhering to existing laws and regulations, but actively advocating for stronger protections and more transparent practices. It is also essential that patients stay informed and vigilant about their rights and the ways their data is used.

The BetterHelp settlement serves as a stark reminder of the vulnerabilities in telehealth and data security. Patients and livelihoods are at risk. As we embrace the immense promise of technology in healthcare, we must also prioritize the protection of the very individuals we aim to serve, and we must have strong regulatory protections, as well as penalties, for breaches.

The integrity of medicine, particularly mental healthcare, depends on our ability to safeguard patient data.

An Epidemic of Racism in Peer Review: Killing Access to Black and Brown Physicians

Here is an interesting article, and I did not have time to convert all 35 pages to *.jpg format.  I have shared the first page of the report and there is a hyperlink to upload and read all 35 pages.

AHLA – An Epidemic of Racism in Peer Review Killing Access to Black and Brown Physicians – An Epidemic of Racism in Peer Review- Killing Access to Black and Brown Physicians-Welch and Hoffer 5-2022

 

2/6/23, 6:18 PMAHLA – An Epidemic of Racism in Peer Review: Killing Access to Black and Brown Physicians

Page 1 of 35

https://www.americanhealthlaw.org/content-library/journal-health-la…4-c09f-4843-b0c9-07f106057b84/An-Epidemic-of-Racism-in-Peer-Review

ABSTRACT: Recently, the medical profession has experienced a signicant increase in
the number of adverse medical sta actions against physicians of color. Tis crisis is one of
epidemic proportions and impact, threatening the economic, physical, and mental well-
being of African American physicians and taking a corresponding toll on the health and
lives of Black patients, who are already negatively impacted by the systemic racism in the
health care system. Tis article will explore the history, context, and nature of medical
sta actions and corresponding legal challenges; health outcomes and the importance of
access to physicians of color; the perversion of the peer review process with underlying
themes of economic competition, preservation of power, racism, and unconscious bias;
and some suggested actions for tangible reform.
An Epidemic of Racism in Peer Review: Killing
Access to Black and Brown Physicians
 May 23, 2022
Sidney Welch, Akerman LLP | Tricia “CK” Hoffler, CK Hoffler Firm
May 2022 Volume 16 | Issue 1
Journal of Health and Life
Sciences Law
2/6/23, 6:18 PMAHLA – An Epidemic of Racism in Peer Review: Killing Access to Black and Brown Physicians
Page 2 of 35
Introduction
Medicine is not immune to the larger societal ills. Te past few years have shined a
spotlight on racial inequities, leading the American Public Health Association, American
Academy of Pediatrics, and the American Medical Association, among others, to
publicly declare that racism is a public health crisis and to suggest redress in a myriad of
dierent ways.
Mirroring this national crisis at a focused level, the health law bar and the media have
reported a signicant increase in the number of adverse medical sta actions against
physicians of color—raising a question among some physicians whether this increase is
attributable to an increase in medical sta actions motivated by racism or an increase in
the number of physicians of color coming forward to challenge some of these actions.
Nonetheless, it is a crisis of epidemic proportions and impact, threatening the economic,
physical, and mental well-being of African American physicians, ofen with devastating
impacts to the availability of care to many already underserved patients in this country.

How private equity rolled Red Lobster

Back in the 1960s, there was this guy – Albert J. Dunlap https://en.wikipedia.org/wiki/Albert_J._Dunlap who was known at the peak of his career as a professional turnaround management specialist and downsizer.

He was known by the nickname “Chainsaw Al”. He would break up a company and sell off “parts”, because the parts were worth more than the company was a whole.

Just do a web search on “private equity acquisitions in the healthcare sector”  Below is a paragraph from an online article about private equity acquiring office practices and hospitals. Private equity companies are probably the worst part of our capitalist markets.

It would appear that the pt is just considered a conduit to move money from the pt’s insurance company to their bottom line. Maybe the pt gets the best care and outcome for the least amount of money that can be spent on pt care.

Unfortunately, those pts who tend to be “passive” – don’t speak up and/or advocate for themselves may be at risk for some of the worst-case health outcomes.

https://sph.brown.edu/news/2024-02-14/private-equity-health-care  The healthcare sector is witnessing a significant transformation as private equity (PE) firms step up their acquisition of physician practices. This trend reflects a broader shift within the healthcare industry of corporate investors acquiring healthcare providers, driven by the allure of short-term profitability and efficiency gains. It also raises questions about the implications for healthcare quality, accessibility, and the overall impact on the U.S. healthcare system.

Image: bankruptcy protection red lobster

https://www.nbcnews.com/news/amp/rcna153397

Angry that your favorite Red Lobster closed down? Wall Street wizardry had a lot to do with it.

Red Lobster was America’s largest casual dining operation, serving 64 million customers a year in almost 600 locations across 44 states and Canada. Its May 19 bankruptcy filing and closing of almost 100 locations across the country has devastated its legion of fans and 36,000 workers. The chain is iconic enough to be featured in a Beyoncé song.

Assigning blame for company failures is tricky. But some analysts say the root of Red Lobster’s woes was not the endless shrimp promotions that some have blamed. Yes, the company lost $11 million from the shrimp escapade, its bankruptcy filing shows, and suffered from inflation and higher labor costs. But a bigger culprit in the company’s problems is a financing technique favored by a powerful force in the financial industry known as private equity.

The technique, colloquially known as asset-stripping, has been a part of retail chain failures such as Sears, Mervyn’s and ShopKo as well as bankruptcies involving hospital and nursing home operations like Steward Healthcare and Manor Care. All had been owned by private equity.Asset-stripping occurs when an owner or investor in a company sells off some of its assets, taking the benefits for itself and hobbling the company. This practice is favored among some private-equity firms that buy companies, load them with debt to finance the purchases and hope to sell them at a profit in a few years to someone else. A common form of asset-stripping is known as a sale/leaseback and involves selling a company’s real estate; this type of transaction hobbled Red Lobster.

In recent years, private-equity firms have invested heavily in all areas of industry, including retailers, restaurants, media and health care. Some 12 million workers are employed by private equity-backed firms, or 7% of the workforce. Companies bought out and indebted by private equity go bankrupt 10 times more often than companies not purchased by these firms, academic research shows. In a report this month, Moody’s Ratings said leveraged buyouts like those pursued by many private-equity firms drive corporate defaults higher and reduce the amounts investors recover when the companies are restructured.

The sale/leaseback that helped sink Red Lobster involved the July 2014 sale of premium real estate underneath 500 of its stores, which generated $1.5 billion. But that money didn’t go back into Red Lobster; it went instead to the private-equity firm to finance its purchase of the chain, Red Lobster’s press release said. That firm was San Francisco-based Golden Gate Capital, with $10 billion in assets.Golden Gate had paid $2.1 billion to buy Red Lobster in May 2014, so the real estate sale was crucial to the firm’s financing. “Red Lobster is an exceptionally strong brand with an unparalleled market position in seafood casual dining,” Josh Olshansky, managing director at Golden Gate, said at the time, a press release announcing the deal shows.

The $1.5 billion sale crippled Red Lobster. After the real estate was sold, Red Lobster had to pay rent on stores it had previously owned, significantly increasing its costs. According to the bankruptcy filing, by 2023 its rents totaled $200 million a year or approximately 10% of its revenues.

Asked about the negative impact the sale/leaseback had on Red Lobster, a Golden Gate spokeswoman declined to comment.

The company that bought the properties, American Realty Capital Partners, got a very good deal, the press release announcing the sale/leaseback said. It characterized the Red Lobster stores it had purchased as “irreplaceable locations” and “high-quality real estate located at main intersections in strong markets,” but noted the properties were sold “at below replacement cost.” Under the terms of the sale, Red Lobster would also see regular rent increases of 2% a year, the release noted.

American Realty Capital Partners was acquired by Realty Income in 2021. Realty Income did not respond to a request for comment on the sale/leaseback.

The sale of the Red Lobster stores hurt the company several ways. First, it meant the chain would not benefit from any upside in the commercial real estate market. In addition, the new owner of the real estate did not appear to give Red Lobster good deals on rents. As Red Lobster’s CEO noted in a bankruptcy court filing, “A material portion of the Company’s leases are priced above market rates.”

As is typical in private-equity buyouts, Golden Gate’s purchase of Red Lobster significantly increased the chain’s debt, adding higher interest costs to its burden. In 2017, Moody’s Ratings, an independent ratings agency, downgraded Red Lobster to a negative outlook from stable. Moody’s cited the chain’s “persistently high leverage,” or debt.

“Carrying a lot of debt and not owning your real estate puts companies at a disadvantage,” said Andrew Park, senior policy analyst at Americans for Financial Reform, a nonprofit and nonpartisan organization advocating for a stable and ethical financial system. “Red Lobster is yet another example of that private-equity playbook of harming restaurants and retailers in the long run.”

In 2020, Golden Gate exited its Red Lobster investment, selling to Thai Union Group, a Bangkok-based company, and an investor group. Thai Union calls itself the “world’s seafood leader” and its brands include Chicken of the Sea tuna products and King Oscar sardines. Terms of the transaction were not disclosed.

Regarding the bankruptcy, a company spokesman provided a statement saying, “Thai Union has a been a supplier to Red Lobster for more than 30 years, and we intend for that relationship to continue. We are confident that a court-supervised process will allow Red Lobster to restructure its financial obligations and realize its long-term potential in a more favorable operating environment.”

Bankruptcies of companies like Red Lobster have a multiplier effect on the overall economy and contribute to a sense of unease among consumers and workers, said Robert Reich, a former labor secretary under President Bill Clinton.“One of the reasons people feel so insecure is you’ve got in the background, behind the curtain, a lot of these financial games that ultimately are making the very rich richer, and hurting America’s working and middle class,” Reich said in an interview. “All of the people who were supplying Red Lobster, all of the people who are essentially providing services to Red Lobster, the small businesses in the communities affected by mass layoffs, they are next in line, they are experiencing the ripple effect.”

Red Lobster’s employees are bearing the brunt of the collapse. Austin Hurst is one, a former grill master at a Red Lobster in Arizona. In an interview, he said he learned from a friend his store had closed and has not heard from his manager or any higher-ups at the company. He said he was told his store had been profitable until about 3 months ago.

“About a month before the close, the district manager came in and was like, ‘Yeah, this Red Lobster is looking really bright. And you guys are going to stay open for sure,’” Hurst recalled. 

Hurst said he was offered a job at another Red Lobster location but it requires a longer commute and pays $17 an hour, down from the $19 he was making before.

Sen. Edward Markey, a Democrat from Massachusetts, where eight hospitals operated by bankrupt Steward Health Care are, recently held hearings on private equity and health care. He has also proposed legislation that would require greater transparency from health care entities owned by private-equity firms, including the disclosure of sale/leaseback arrangements as well as fees collected by the private-equity firm, and dividends paid by the health care entity to the private-equity fund.“My legislation is quite simple,” Markey said in an interview. “To make sure that these financial shenanigans don’t have a profound impact upon communities across our country, the Department of Health and Human Services has to determine whether or not the sale of the land underneath these hospitals and then having that land rented back to the hospitals isn’t having a negative impact on the provision of health care in that community.”

Private equity is emerging in all parts of our economy, Markey added, but its most profound impact is in health care. “The more private equity gets into the hospital business,” he said, “the more this is just a preview of coming atrocities affecting our health care system.”

Optum ditching facilities and staff to protect bottom line?

Optum is a PBM, the FDA and many state legislatures are looking into how the PBM industry functions financially and Pres Biden is claiming that he is going to lower Rx prices. Is this how Optum is trying to get a head start on any impact that all of these things could do to protect their bottom line? Closing a 93,000 sq ft facility – that is about 1.5 times the size of your average Walmart store.  The second article states that RN case managers are being laid off. Are these part of the process dealing with prior authorizations? Does this mean that more PAs will be denied and/or take longer to get one approved?

Optum laying off 129, closing Ohio facility

https://www.beckershospitalreview.com/finance/optum-laying-off-129-closing-ohio-facility.html

Optum is closing a Change Healthcare facility in Toledo, Ohio, resulting in the termination of 129 employees located in Ohio or working remotely.

The layoffs will occur in three waves from July 15 to Sept. 6, according to regulatory documents filed with the state on May 16. The 93,000-square-foot facility is located at 100 North Byrne Road in Toledo.

In April, former employees with Optum and its subsidiaries took to social media regarding a reduction in force they say occurred across the company. Optum declined to provide more information about the layoffs at the time, and it is unclear if they are connected to the Toledo layoffs.

Optum also laid off an unknown number of employees in August. Affected facilities included the Everett (Wash.) Clinic and the Polyclinic in Seattle; Morgantown, W.Va.-based MedExpress Urgent Care; and San Antonio-based WellMed.

Here is a earlier article concerning these layoffs

Optum enacts layoffs, workers say

https://www.beckershospitalreview.com/workforce/optum-enacts-layoffs-workers-say.html

Former employees with UnitedHealth Group’s Optum and its subsidiaries took to social media beginning April 18 regarding a reduction in force they say occurred across the company.

Optum declined to provide more information April 19. Becker’s has not confirmed an exact number or range of employees who may have been terminated or when layoffs would be effective.

Across LinkedIn, former employees with Optum and affiliated providers have detailed layoffs enacted at their organizations. A range of roles appear to have been affected, from RN case managers to senior director and management positions.

In 2023, many large insurers conducted large workforce reductions due to financial or operational challenges in certain segments, along with restructuring strategies. 

Optum also laid off an unknown number of employees in August. Affected facilities included the Everett (Wash.) Clinic and the Polyclinic in Seattle; Morgantown, W.Va.-based MedExpress Urgent Care; and San Antonio-based WellMed.

UnitedHealth is still recovering from the cyberattack on Change Healthcare in February — the company had reinstated 80% of the functionality for its claims, payment and pharmacy services as of April 16.

UnitedHealth Group posted a $1.4 billion net loss in the first quarter of 2024, primarily due to the sale of its Brazil operations, along with the cyberattack. Despite the losses, the company beat investor expectations.