Investigation into UnitedHealth Group’s Practices
Senators Ron Wyden from Oregon and Elizabeth Warren from Massachusetts are launching an inquiry into UnitedHealth Group (UHG). Reports suggest the company may be steering elderly patients away from hospital visits to save on costs.
In a letter directed to UHG CEO Stephen J. Hemsley, Wyden and Warren referenced articles from various sources, including the Guardian. These articles indicated that UHG has financially incentivized nursing homes to limit hospital transfers for unwell patients.
The senators mentioned that UHG representatives had discussed incentives for nursing homes, aimed at encouraging adherence to certain quality standards.
One specific program allows nursing homes to earn bonuses by achieving designated vaccination rates for influenza and pneumococcal diseases, as well as meeting cholesterol medication compliance rates while keeping hospitalizations per 1,000 residents under a specific threshold.
Additionally, concerns were raised about UHG’s institutional special needs plans, which reportedly eliminate what they describe as “medically unnecessary hospitalizations and emergency room visits.” There’s also mention that the plans might pressure nursing home residents into signing “Do Not Resuscitate” (DNR) and “Do Not Intubate” (DNI) orders.
When the Guardian published its report in May, UHG denied any claims of obstructing hospital transfers or pressuring patients into signing DNR and DNI directives.
“These accusations imply that UHG is prioritizing financial outcomes over the health and safety of nursing home residents associated with its I-SNP. Families should not be anxious about for-profit healthcare entities withholding crucial care,” the senators stated.
While Wyden and Warren expressed their support for models that effectively reduce “unnecessary hospitalizations for nursing home residents,” they noted that meetings with UHG representatives did not address their serious concerns regarding these allegations.
The lawmakers have requested detailed information regarding UHG’s I-SNP model, Optum’s strategy for transferring I-SNP residents to hospitals, and the specifics of the bonus programs.
“Exploiting vulnerable nursing home residents for the profit of commercial insurance companies is intolerable. UHG must address these alarming reports and provide comprehensive answers to our inquiries,” Wyden and Warren concluded.
