{"id":10944,"date":"2024-03-11T08:41:05","date_gmt":"2024-03-11T08:41:05","guid":{"rendered":"https:\/\/distilinfo.com\/healthplan\/?p=10944"},"modified":"2024-03-11T08:42:15","modified_gmt":"2024-03-11T08:42:15","slug":"impact-of-change-healthcare-attack-on-four-major-payers","status":"publish","type":"post","link":"https:\/\/distilinfo.com\/healthplan\/impact-of-change-healthcare-attack-on-four-major-payers\/","title":{"rendered":"Impact of Change Healthcare Attack on Four Major Payers"},"content":{"rendered":"

The cyberattack on Change Healthcare has sent ripples through the healthcare industry, affecting major payers like Aetna, Elevance Health, Humana, and Kaiser Permanente. While claims volume has dwindled, prior authorization processes remain intact for some. Aetna is exploring contingency payment options, while Elevance Health adopts a reserving approach. Humana grapples with assessing total medical expenses amid system dependencies, prompting a shift towards alternative services. Kaiser Permanente reassures the integrity of member data but acknowledges potential delays in claims processing. Despite challenges, these payers demonstrate resilience by adapting to alternative processes and mitigating disruptions. Collaboration between stakeholders is essential to fortify defenses and ensure uninterrupted healthcare services.<\/p><\/blockquote>\n

The recent ransomware attack on Optum’s Change Healthcare has reverberated across the healthcare industry, significantly affecting various payers. While there have been substantial reductions in claims volume from providers, the impact on prior authorization processes has varied. Let’s delve into how four major payers\u2014Aetna, Elevance Health, Humana, and Kaiser Permanente\u2014have been affected by this cyberattack.<\/p>\n

Aetna:<\/em><\/h5>\n

Aetna acknowledged the challenge of timely payments to providers across its lines of business and affiliates in a message dated February 27. The payer expressed seriousness about the issue and indicated exploration of contingency payment options, particularly for providers in Medicaid plans. However, Aetna stated it would not relax any prior authorization requirements at the moment. Despite the setback, the company assured providers of alternative processes in place and committed to providing updates if the situation changes.<\/p>\n

Elevance Health:<\/em><\/h5>\n

During the TD Cowen Healthcare Conference on March 5, Elevance Health’s Executive Vice President and CFO, Mark Kaye, revealed that the company initially witnessed a 15% to 20% reduction in daily data volume from providers. Currently, the volume is down by approximately 10% relative to normal daily levels. Mr. Kaye mentioned that some providers have begun submitting claims directly to Availity or switched their clearinghouses. Fortunately, prior authorization volumes remain unaffected at Elevance. The company plans to adopt a reserving approach as it awaits claims volume recovery in the first quarter.<\/p>\n

Humana:<\/em><\/h5>\n

Humana’s CFO, Susan Diamond, disclosed on March 5 at the TD Cowen conference that about 20% of the company’s medical claims pass through Change Healthcare’s system before reaching the payer. This dependency has made it challenging to assess total medical expenses. While Humana is still evaluating the full effects of the attack, CEO Bruce Broussard indicated a shift towards working with alternative services while Change’s systems are offline. Additionally, Humana employs Change within its dental and D-SNP businesses, amplifying the impact across its operations.<\/p>\n

Kaiser Permanente:<\/em><\/h5>\n

Kaiser Permanente’s response to the cyberattack focused on assuring the integrity of its members’ data and system cybersecurity. The healthcare giant reported no known impact on members’ data or cybersecurity infrastructure. However, Kaiser did not specify whether there were delays in claims processing or payments. While some members seeking retail pharmacy prescriptions might face delays, Kaiser pharmacies have remained unaffected. The organization is assisting members with alternatives and acknowledges potential delays in processing claims or sending bills to third-party payers for services rendered to patients.<\/p>\n

The fallout from the Change Healthcare attack underscores the vulnerabilities within the healthcare sector’s digital infrastructure. While some payers like Aetna are actively exploring contingency plans and providing support to providers, others like Humana face challenges in assessing total expenses due to system dependencies. Nevertheless, the resilience displayed by these payers in adapting to alternative processes and mitigating potential disruptions highlights their commitment to maintaining operations amidst adversity.<\/p>\n

As the healthcare industry grapples with the aftermath of the Change Healthcare attack, it’s evident that resilience and adaptability are paramount in overcoming such adversities. Major payers like Aetna, Elevance Health, Humana, and Kaiser Permanente have displayed commendable resilience in the face of unprecedented challenges, implementing alternative processes and mitigating disruptions to ensure continuity in operations. However, the incident underscores the urgent need for collaborative efforts between stakeholders to fortify cybersecurity defenses and safeguard patient data. By leveraging collective expertise and resources, the industry can emerge stronger and more resilient, better prepared to confront future cybersecurity threats and uphold the integrity of healthcare services.<\/p>\n","protected":false},"excerpt":{"rendered":"

The cyberattack on Change Healthcare has sent ripples through the healthcare industry, affecting major payers like Aetna, Elevance Health, Humana,… Continue Reading <\/i><\/a><\/p>\n","protected":false},"author":1,"featured_media":10945,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rank_math_lock_modified_date":false,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[1],"tags":[268],"class_list":{"0":"post-10944","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-distilinfo-originals","8":"tag-change-healthcare","9":"entry"},"_links":{"self":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/10944"}],"collection":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/comments?post=10944"}],"version-history":[{"count":1,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/10944\/revisions"}],"predecessor-version":[{"id":10946,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/10944\/revisions\/10946"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media\/10945"}],"wp:attachment":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media?parent=10944"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/categories?post=10944"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/tags?post=10944"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}