UnitedHealth Group (Part 3)

This is Part 3 of The Guardian’s investigation into UnitedHealth Group.

Internal emails show that UnitedHealth supervisors gave their teams “budgets” that showed how many hospital admissions they had “left” to use on nursing home residents. Additionally, two current and three former UnitedHealth NPs told the Guardian that managers from UnitedHealth pressured NPs to lie and
persuade Medicare Advantage members to change their code statuses to DNR, despite their requests to use all measures to keep them alive.

“They’re pretending to make it look like it’s in the best interest of the member, but it’s really not,” said another current NP with UnitedHealth.

UnitedHealth responded to questions and said their nursing home initiative ultimately improves the level of care for older residents by providing “on-site nurse practitioners, tailored care plans for chronic conditions, and enhanced communication between staff, families, and providers.” UnitedHealth denied that they had prevented hospital transfers nor persuaded patients to change their code status to DNR.

These cost-cutting schemes were only possible because of the “sprawling nature” of UnitedHealth. This $300 billion-plus conglomerate has grown to become one of the nation’s largest companies, embedding itself in every aspect of the healthcare industry. They cover nearly a million more Medicare Advantage seniors than any of their competitors. Nursing homes participating in the bonus program and allowing UnitedHealth and its medical team to work in their facilities are allowing this “corporate giant” to influence critical care steps and decisions for their residents.

Nursing homes are largely unaware of this takeover, as the program offers larger sums for every senior enrolled through UnitedHealth insurance. In some cases, these payments even incentivize nursing homes to disclose confidential resident records, allowing UnitedHealth to use this information to its advantage when soliciting elderly residents and their families.

A former UnitedHealth employee in Georgia even admitted to getting a nursing home to leak confidential resident records and backdate consent forms to
bypass federal rules that protect seniors from aggressive forms of marketing. This employee was later terminated for failing to meet her sales quota. After a nursing home near Savannah, Georgia, provided confidential patient records to UnitedHealth, families complained that their cognitively impaired residents were enrolled in UnitedHealth’s Medicare Advantage plan without proper consent.

According to court filings and leaked documents, nursing homes annually earn an additional hundred thousand dollars just by enrolling more residents and cutting medical expenses. Residents are unaware of the secret payments and limited care measures, which leads these elderly adults to be vulnerable to UnitedHealth. UnitedHealth declined to share the amount it paid to nursing homes but claimed that the incentives were intended to improve care quality.

We all know this is false.

Former UnitedHealth NP Maxwell Ollivant filed a congressional declaration this month alongside a Whistleblower Aide asking the federal government to hold the healthcare giant accountable. In Ollivant’s first-ever public comment on the nursing home being inactive, he urged lawmakers to ensure that UnitedHealth was “not skimping out on care” and that patients were not “signing up for a service and not receiving the service when the time comes.”

Ollivant had previously filed a lawsuit in federal court in Washington state, accusing UnitedHealth of withholding necessary services to nursing home residents. The NP dropped the suit in 2023 after the Department of Justice declined to intervene.

In response, UnitedHealth stated that Ollivant “lacks both the necessary data and expertise” to evaluate the effectiveness of its programs. “The US Department of Justice investigated these allegations, interviewed witnesses, and obtained thousands of documents that demonstrated the significant factual inaccuracies in the allegations,” the company said. “After reviewing all the evidence during its multi-year investigation, the Department of Justice declined to pursue the matter.”