UnitedHealth Group (Part 1)

The Guardian investigated the nation’s largest healthcare conglomerate, UnitedHealth Group. Under Medicare Advantage, insurers like UnitedHealth receive lump sums from the government to cover senior care. They profit as the less they spend on that care, the more money they can keep. This is what UnitedHealth is capitalizing on, especially within the long-term care sector.

United has been secretly paying nursing homes thousands in bonuses to halt hospital transfers for nursing home residents. This gross and reckless cross-cutting tactic has saved the company millions but has put the resident’s health at risk and decreased their level of quality care.

These secret bonuses are given to the company’s medical teams on behalf of UnitedHealth and encourage them to reduce care expenses for residents covered by the company’s insurance. In several cases by the Guardian, nursing home residents who need immediate hospital care under this program fail to receive adequate care after interventions from UnitedHealth staffers. According to a confidential nursing home incident log, one resident is suffering from permanent brain damage as a result of this delayed transfer.

“No one is truly investigating when a patient suffers harm. No one” said one current UnitedHealth nurse practitioner who recently filed a congressional complaint about the nursing home program. “These incidents are hidden, downplayed, and minimized. The sense is: ‘Well, they’re medically frail, and no one lives for ever.'”

The Guardian’s investigation is based on thousands of confidential corporate and patient records, as well as various interviews, public records, and court files. These documents and sources provide a “never-before-seen” insight of window into the company’s success in maintaining control over nearly 2,000 nursing homes in small towns and urban commercial strips across the nation.

UnitedHealth stated that its employees are preventing hospital transfers, which is “verifiably false.” They noted that these bonus payments help prevent unnecessary hospitalizations within the nursing home, which are both costly and dangerous to residents.

UnitedHealth argues that their partnership with nursing homes ultimately improves the health outcomes of their residents.