Insurers cast themselves as MAHA allies

Driving the news: Executives with UnitedHealth, Elevance and the industry trade group AHIP are due to participate in a panel discussion with a top Medicare official at an annual gathering of MAHA faithful at Washington's Waldorf Astoria hotel.

• Elevance plans to announce new billing policies designed to clarify the setting where patients are receiving care, to ensure that services are paid at the correct rate.
• The announcement dovetails with growing bipartisan interest by the federal government in paying the same rates for the same services, regardless of where they're performed.
• UnitedHealth plans to highlight how health plans can place more emphasis on preventive care and long-term health, instead of waiting to treat patients when they're sick.

The big picture: Health insurers are in hot water with both political parties.

• Congressional candidates have been vowing to take on powerful health interests and make care more affordable, casting insurers alongside pharmaceutical companies as culprits responsible for ever-rising prices.
• Many in the MAHA movement are deeply skeptical of the health care establishment — and convinced that government regulators have been looking out for the powerful interests.
• But the insurers are trying to flip the script and pitch themselves as allies on some key priorities.

"The content on the panel is designed to show overlapping interest between the public and private payers," one source familiar with the event planning said.

• That includes alignment with the administration on addressing waste, fraud and abuse and the MAHA movement's focus on "nutrition, food and ... [Health Secretary Robert F. Kennedy Jr.'s] leadership on highlighting whole health and moving beyond a sick care system," the source said.
• "AHIP welcomes opportunities to engage in dialogue about how to reduce the incidence of chronic disease and make health care more affordable and accessible for Americans," said spokesperson Chris Bond.

Details: Elevance's new policies, shared first with Axios, are "intended to address increasingly common situations where care provided at [a hospital's] off-campus location is billed at a higher hospital rate," according to the company's press release.

• The insurer will require hospitals to identify the physical location where care was provided, check billing information against hospital addresses to confirm where care took place, and pay certain off-campus hospital services at the appropriate rate.
• The policies will apply across Elevance's commercial, Medicare Advantage and Medicaid plans.
• "When the same service costs more because a hospital owns a doctor's office or clinic, workers and families are saddled with higher premiums and cost sharing," said James Gelfand, CEO of the ERISA Industry Committee, in a statement. "This kind of innovation should become the norm."

What they're saying: "It's hard to really understand why a commercial insurer should be paying more for the exact same service to be done in a hospital versus a doctor's office," said Loren Adler, a fellow and associate director at the Brookings Institution's Center on Health Policy.

• But "I don't have a great sense why they didn't do this earlier," he added.
• Though the policy will have a downward effect on prices, Adler said, "the magnitude is unlikely to be terribly large."

Between the lines: Insurers' presence at a tentpole MAHA event hasn't been welcomed by all members of the movement.

• Robert Malone, a former member of Kennedy's handpicked vaccine advisory panel, wrote on his Substack that he was "genuinely taken aback" by a who's who of corporate interests on the summit agenda.
• "We all thought MAHA was founded to challenge entrenched interests," he wrote. It "has somehow convened a panel on medical affordability dominated by the insurance industry itself, while the physicians and patients who live under that system have been completely excluded from the discussion," Malone wrote in a post titled "The Capture of MAHA."
• "MAHA was supposed to expose the revolving door between money, industry and government, not build its own," he added.

The bottom line: If there's anything almost everyone at the conference can agree, it's the need to confront today's problems to stave off momentum for Medicare for All.

• That, if anything, creates an odd-bedfellows alliance between conservatives and insurers that's likely to endure, despite the populist campaign rhetoric.