<p>Baird 的一位领先的医疗管理分析师 <strong>Michael Ha</strong> 对 <strong>UnitedHealth Group Inc.</strong> 的 UNH 旗下的 Optum Health 部门发出了警告，他认为由于最近政府对 Medicare Advantage 风险编码的变化，该部门可能面临挑战。</p>
<h2>Optum Health 可能会 ‘结构性受损’</h2>
<p>在周二的 The Real Eisman Playbook 播客中，主持人 <strong>Steve Eisman</strong> 与 Ha 讨论时表示，该公司的问题超出了周期性成本压力或最近的公关挫折。</p>
<p>根据 Ha 的说法，UnitedHealth 问题的核心在于由医疗保险和医疗补助服务中心（CMS）引入的 V28 风险调整模型修订。这些修订将在三年内逐步实施，旨在收紧 Medicare Advantage 计划对患者状况的编码。</p>
<p>他说，在旧的制度下，UnitedHealth 在使用诊断编码以证明更高风险评分和因此获得更高支付方面比同行更为激进。新模型消除了数千个编码类别，从而使得操控变得更加困难。</p>
<p>“仅 V28 的影响……在三年内将达到 110 亿美元，” Ha 说，并补充道，“这可能会结构性地损害 Optum Health，” 这是 UnitedHealth 的医疗服务子公司。</p>
<p>Ha 表示，Optum Health 曾被预计将在未来十年内将 UnitedHealth 的企业收益翻倍，通过价值导向的护理诊所内部管理 Medicare Advantage 患者。</p>
<p>但其长期利润率指导已从 8–10% 削减至 6–8%，而他表示，实际的价值导向护理利润率现在徘徊在 “1%” 附近。</p>
<p>除了运营之外，Ha 还指出了令人担忧的会计做法。“他们将 [资产出售收益] 基本上作为公司的运营收益的一部分，” 他说，指向 2024 年的 33 亿美元收益和 2025 年指导中嵌入的类似数字。</p>
<p>“现在，你有一个表现不佳的情况，” 主持人 Steve Eisman 说。Ha 同意并表示，“我们认为会有更多问题，情况可能会变得更糟。”</p>
<h2>股票从 52 周高点下跌 45%</h2>
<p>UnitedHealth Group 的股票目前比其 52 周高点 630.73 美元每股下跌 45%，在过去一年中，该公司经历了几次风波，始于去年 12 月其首席执行官 <strong>Brian Thompson</strong> 的被刺杀。</p>
<p>随后是另一位首席执行官 <strong>Andrew Witty</strong> 在 5 月的突然辞职，以及现任首席执行官 <strong>Stephen Hemsley</strong> 决定暂停全年的指导。</p>
<p>在 <strong>Warren Buffett</strong> 领导的 <strong>Berkshire Hathaway Inc.</strong> BRKBRK 和著名投资者 <strong>Michael Burry</strong> 上个月披露了对该公司的持股后，股票情况有所好转，导致股价飙升。</p>
<p>UnitedHealth 的股票在周二上涨 1.87%，收于 347.69 美元，隔夜再上涨 0.64%。该股票在动量方面得分较低，在 <strong>Benzinga’s Edge Stock Rankings</strong> 的大多数其他指标中也相对较低，但在短期和中期内价格趋势良好。点击这里获取该股票的更深入见解。</p>
<ul>
<li><strong>15 年前投资 100 美元于 UnitedHealth Group 今天将值这么多</strong></li>
</ul>
<p><em>图片来源：Poetra.RH on Shutterstock.com</em></p>

联合健康

<p>一位 Baird 分析师警告称，联合健康的 Optum Health 部门可能面临重大挑战，原因是医疗保险优势计划的风险编码变化，这可能在三年内导致 110 亿美元的影响。新的 V28 风险调整模型限制了编码类别，影响了收入。Optum 的长期利润率指导已从 8-10% 下调至 6-8%，而实际利润率接近 1%。联合健康的股票自 52 周高点下跌了 45%，受到领导层变动和运营问题的影响，尽管近期的投资提供了一些恢复</p>

<p>A leading Managed Care Analyst at Baird, <strong>Michael Ha</strong>, has a warning against <strong>UnitedHealth Group Inc.’s</strong> UNH prized Optum Health division, which he believes could see headwinds as a result of recent government changes to Medicare Advantage risk coding.</p>
<div class="lb-trans"><p>Baird 的一位领先的医疗管理分析师 <strong>Michael Ha</strong> 对 <strong>UnitedHealth Group Inc.</strong> 的 UNH 旗下的 Optum Health 部门发出了警告，他认为由于最近政府对 Medicare Advantage 风险编码的变化，该部门可能面临挑战。</p>
</div><h2>Optum Health Could Be ‘Structurally Impaired’</h2>
<div class="lb-trans"><h2>Optum Health 可能会 ‘结构性受损’</h2>
</div><p>Speaking on The Real Eisman Playbook podcast, with host <strong>Steve Eisman</strong> on Tuesday, Ha said the company's issues go beyond cyclical cost pressures or recent public relations setbacks.</p>
<div class="lb-trans"><p>在周二的 The Real Eisman Playbook 播客中，主持人 <strong>Steve Eisman</strong> 与 Ha 讨论时表示，该公司的问题超出了周期性成本压力或最近的公关挫折。</p>
</div><p>According to Ha, at the core of UnitedHealth’s problems is the V28 risk adjustment model revisions introduced by the Centers for Medicare &amp; Medicaid Services (CMS). These revisions are being phased in over three years and are designed to tighten how Medicare Advantage plans code for patient conditions.</p>
<div class="lb-trans"><p>根据 Ha 的说法，UnitedHealth 问题的核心在于由医疗保险和医疗补助服务中心（CMS）引入的 V28 风险调整模型修订。这些修订将在三年内逐步实施，旨在收紧 Medicare Advantage 计划对患者状况的编码。</p>
</div><p>He said that under the old regime, UnitedHealth had been more aggressive than its peers in using diagnostic codes to justify higher risk scores and thus higher payments. The new model eliminates thousands of coding categories, thus making it harder to game.</p>
<div class="lb-trans"><p>他说，在旧的制度下，UnitedHealth 在使用诊断编码以证明更高风险评分和因此获得更高支付方面比同行更为激进。新模型消除了数千个编码类别，从而使得操控变得更加困难。</p>
</div><p>“The impact alone from V28… It's $11 billion over three years,” Ha says, adding that “It could structurally impair Optum Health,” which is UnitedHealth’s healthcare services subsidiary.</p>
<div class="lb-trans"><p>“仅 V28 的影响……在三年内将达到 110 亿美元，” Ha 说，并补充道，“这可能会结构性地损害 Optum Health，” 这是 UnitedHealth 的医疗服务子公司。</p>
</div><p>Optum Health was once projected to double UnitedHealth's enterprise earnings over the next decade, Ha said, by managing Medicare Advantage patients in-house through value-based care clinics.</p>
<div class="lb-trans"><p>Ha 表示，Optum Health 曾被预计将在未来十年内将 UnitedHealth 的企业收益翻倍，通过价值导向的护理诊所内部管理 Medicare Advantage 患者。</p>
</div><p>But its long-term margin guidance has been slashed from 8–10% down to 6–8%, and he says, the actual value-based care margins are now hovering near “1%.”</p>
<div class="lb-trans"><p>但其长期利润率指导已从 8–10% 削减至 6–8%，而他表示，实际的价值导向护理利润率现在徘徊在 “1%” 附近。</p>
</div><p>Beyond operations, Ha flagged troubling accounting practices. “They were including [gain on sale of assets] basically as part of the operating earnings of the company,” he said, pointing to $3.3 billion in 2024 gains and a similar figure embedded in 2025 guidance.</p>
<div class="lb-trans"><p>除了运营之外，Ha 还指出了令人担忧的会计做法。“他们将 [资产出售收益] 基本上作为公司的运营收益的一部分，” 他说，指向 2024 年的 33 亿美元收益和 2025 年指导中嵌入的类似数字。</p>
</div><p>“Right now, you have an underperform on it,” host Steve Eisman said. Ha agreed and said, “We think there’s going to be more issues and things could get worse.”</p>
<div class="lb-trans"><p>“现在，你有一个表现不佳的情况，” 主持人 Steve Eisman 说。Ha 同意并表示，“我们认为会有更多问题，情况可能会变得更糟。”</p>
</div><h2>Stock Down 45% From Its 52-Week High</h2>
<div class="lb-trans"><h2>股票从 52 周高点下跌 45%</h2>
</div><p>Shares of UnitedHealth Group are currently down 45% from their 52-week high of $630.73 per share, after the company found itself in the center of several storms this past year, beginning with the assassination of its CEO <strong>Brian Thompson</strong> in December last year.</p>
<div class="lb-trans"><p>UnitedHealth Group 的股票目前比其 52 周高点 630.73 美元每股下跌 45%，在过去一年中，该公司经历了几次风波，始于去年 12 月其首席执行官 <strong>Brian Thompson</strong> 的被刺杀。</p>
</div><p>This was then followed by the abrupt resignation of another CEO, <strong>Andrew Witty</strong> in May, and the current CEO, <strong>Stephen Hemsley’s</strong> decision to suspend its full-year guidance.</p>
<div class="lb-trans"><p>随后是另一位首席执行官 <strong>Andrew Witty</strong> 在 5 月的突然辞职，以及现任首席执行官 <strong>Stephen Hemsley</strong> 决定暂停全年的指导。</p>
</div><p>Things have since turned around for the stock, after <strong>Warren Buffett</strong>-led <strong>Berkshire Hathaway Inc.</strong> BRKBRK and renowned investor <strong>Michael Burry</strong> revealed a stake in the company last month, leading to a surge in the stock.</p>
<div class="lb-trans"><p>在 <strong>Warren Buffett</strong> 领导的 <strong>Berkshire Hathaway Inc.</strong> BRKBRK 和著名投资者 <strong>Michael Burry</strong> 上个月披露了对该公司的持股后，股票情况有所好转，导致股价飙升。</p>
</div><p>UnitedHealth shares were up 1.87% on Tuesday, closing at $347.69, and are up another 0.64% overnight. The stock scores low on Momentum, and is fairly low on most other metrics in <strong>Benzinga’s Edge Stock Rankings</strong>, but it has a favorable price trend in the short and medium terms. Click here for deeper insights into the stock.</p>
<div class="lb-trans"><p>UnitedHealth 的股票在周二上涨 1.87%，收于 347.69 美元，隔夜再上涨 0.64%。该股票在动量方面得分较低，在 <strong>Benzinga’s Edge Stock Rankings</strong> 的大多数其他指标中也相对较低，但在短期和中期内价格趋势良好。点击这里获取该股票的更深入见解。</p>
</div><ul>
<li><strong>$100 Invested In UnitedHealth Group 15 Years Ago Would Be Worth This Much Today</strong></li>
</ul>
<div class="lb-trans"><ul>
<li><strong>15 年前投资 100 美元于 UnitedHealth Group 今天将值这么多</strong></li>
</ul>
</div><p><em>Photo courtesy: Poetra.RH on Shutterstock.com</em></p>
<div class="lb-trans"><p><em>图片来源：Poetra.RH on Shutterstock.com</em></p>
</div>

联合健康的核心资产面临风险：分析师警告称，Optum Health 可能因医疗保险规则的变更而遭受 “结构性损害”