Report: UnitedHealth’s Tactics To Make Medicare Advantage Patients ‘Look As Sick As Possible On Paper’
The latest story in Stat's investigation of UnitedHealth's influence looks at the company's strategy to enlist its doctors to pile moneymaking diagnoses onto patients covered by Medicare Advantage, using incentive tools like $10,000 bonuses and a doctor leaderboard. Other Medicare news is on low-cost drugs, value-based care, and more.
Stat:
UnitedHealth Gave Doctors Bonuses, Praise For Medicare Advantage Visits
The emails from UnitedHealth Group managers were filled with exclamation marks and pleasantries about the weather. But the underlying message to doctors in late 2020 was persistent and urgent: Hit your targets to see more patients. We need to bring in more money. (Bannow, Herman, Ross and Lawrence, 10/16)
Modern Healthcare:
CMS' 2030 Value-Based Care Goal At 'Inflection Point'
The Biden administration's goal to move all Medicare beneficiaries into accountable care arrangements by 2030 may be just within reach, but is at a turning point. The most immediate question that could determine the initiative's future is whether Congress extends a bonus program meant to help providers transition away from fee-for-service reimbursement and toward value-based payment before it expires this winter. (McAuliff, 10/15)
Modern Healthcare:
How Biden Transformed Medicare Advantage
The clock is running out on one of the most consequential eras for Medicare Advantage since its inception nearly three decades ago. President Joe Biden’s single term in office has featured some of the most high-velocity policymaking on Medicare Advantage — both in quantity and potency — since George W. Bush's presidency. The Biden administration has overseen dozens of changes to the financing and the rules governing the private sector alternative to fee-for-service Medicare. (Early, 10/16)
Axios:
Independent Pharmacies May Skip Low-Cost Medicare Drugs
More than half of independent pharmacies are considering not stocking the first 10 drugs that were subject to Medicare price negotiations over concerns they'll have to absorb upfront costs. If the drug stores decide it's not worth it to carry these drugs, seniors could have a harder time benefiting from the first round of reduced drug prices that take effect in 2026 — especially as more chain pharmacies close. (Goldman, 10/16)
Modern Healthcare:
UnitedHealth Group's Andrew Witty Bullish On Medicare Advantage
UnitedHealth Group remains optimistic about its Medicare Advantage business after a challenging year and a half for the program at large, CEO Andrew Witty said Tuesday. The healthcare conglomerate that owns UnitedHealthcare, the leading Medicare Advantage carrier by market share, responded to financial and regulatory setbacks for the sector by emphasizing stability in its offerings, and will continue efforts to improve its star ratings quality scores, Witty told investor analysts when announcing the company's third-quarter results. (Berryman, 10/15)
Also —
The Hill:
Extra Check Coming To Some Social Security Recipients In November: Here’s Why
It may be hard to believe, but November is fast approaching. With it will come Election Day, Thanksgiving, and, for some 7 million Supplemental Security Income beneficiaries, an extra check. It’s all thanks to a quirk in the 2024 calendar. (Bink, 10/15)
