I keep saying to people, "Why do you suppose your Medicare Advantage is free?" but many don't want to hear. This investigative piece looks at all the strategies UnitedHealth, the single largest vendor of for-profit insurance Medicare Advantage, did to cut patient care and pump up their profit margins in nursing homes. Via The Guardian:
UnitedHealth Group, the nation’s largest healthcare conglomerate, has secretly paid nursing homes thousands in bonuses to help slash hospital transfers for ailing residents – part of a series of cost-cutting tactics that has saved the company millions, but at times risked residents’ health, a Guardian investigation has found.
Those secret bonuses have been paid out as part of a UnitedHealth program that stations the company’s own medical teams in nursing homes and pushes them to cut care expenses for residents covered by the insurance giant.
In several cases identified by the Guardian, nursing home residents who needed immediate hospital care under the program failed to receive it, after interventions from UnitedHealth staffers. At least one lived with permanent brain damage following his delayed transfer, according to a confidential nursing home incident log, recordings and photo evidence.
But that's not even the most shocking part:
Internal emails show, for example, that UnitedHealth supervisors gave their teams “budgets” showing how many hospital admissions they had “left” to use up on nursing home patients.
The company also monitored nursing homes that had smaller numbers of patients with “do not resuscitate” – or DNR – and “do not intubate” orders in their files. Without such orders, patients are in line for certain life-saving treatments that might lead to costly hospital stays.
Two current and three former UnitedHealth nurse practitioners told the Guardian that UnitedHealth managers pressed nurse practitioners to persuade Medicare Advantage members to change their “code status” to DNR even when patients had clearly expressed a desire that all available treatments be used to keep them alive.
The majority of physicians in the U.S. (70,000+) are now employed by UnitedHealth's Optum subsidiary. Oh, and OptumRX (guess who owns them?) is the pharmacy benefit manager that distorts your prescription medicine costs. No problems there, amirite?
As we've seen in numerous circumstances, once a company places profit over patients, and supervisors pressure workers to reach a goal, it is inevitable that some people will lie to keep their jobs. In this case, lies would kill people. God bless the American way!
