United HealthCare Issues Another Study, This One Telling Government To Aggressively Manage Medical Care For Seniors-An Area Where A Large Chunk of Their Revenue Comes From Today, Managing Care

If you listen to the last shareholder reports they have said that more money is coming into the till these days from managing care rather than the sale of policies so guess what, they want more action it might sound like and they are tossing around a number of $500 billion to be saved to create a sense of urgency.  They put out more reports and studies than any other insurance carrier and have been doing that for years, as well as making a lot of money selling data too. 

Big deal, same thing we all have as goals to cut costs and improve care.  Technology will kick in for some savings but its’ not the entire answer.  Here’s one place where they have already cut money with the AAFP showing them a report to where doctors are paid less than Medicare in some parts of the US.  Complex contracts by the time all the algorithms are applied with complex models end up with a net payment of less than Medicare, so let’s cut more they say. 

The AAFP Confronts United Healthcare On Reimbursements, Some Are Below Medicare Rates In Parts of the US–Payment Algorithms/Formulas Calculated Deep Within IT Infrastructures Do the Job

Again all these projected numbers may be good today until tomorrow’s left curve hits, thus again these create a sense of urgency for folks to maybe cooperate in the direction they desire. A couple weeks ago we heard this other report that basically was done to create subliminal thought that the sedentary and obese were at the heart of the US Economy problems.  One person losing 100 pounds is not going to have that impact and yes items as such do need to remain a focus for sure but stop the reports where don’t have the data or models to see exactly what they are talking about.

Media and Press Releases In Healthcare That Go Nowhere–Marketing to Sell You Analytics With Using Fear and Misplaced Guilt Overtones As a Theme

In this article the one spokesman from United says “We’ve got a sense of what works and what doesn’t work”. Why do they have all those lawsuits over the 15 years where they short paid doctors and hospitals, is this part of it?

 

AMA Announces Doctors And Patients Can Expect To See the UnitedHealthCare/Ingenix Class Action Settlement Checks In the Mail Soon - Out of Network Short Payments–Attack of the Killer Algorithms Chapter 19

 

Everyone has good things to contribute everywhere in the world but these folks are known for taking care of shareholders with the CEO that says they will flourish money wise, so keep everything in context. They want to take over and make as much money as they can.  They are pretty aggressive with suing the DOD saying their algorithms were better than Blue Cross and they certainly are much larger to include owning a bank with 1 billion on deposit for one.  Are they so big they just wear everybody down?  With this award they put a Blue Cross subsidiary out of business.  They hired Steve Larson who pretty much wrote the healthcare bill and he works for United as a VP at the Optima side. 

Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?

Is this their next move after the Tri-Care Contract that is worth a few billion to manage?  They just made this big purchase in Brazil. 

 

United Healthcare Negotiated to Buy 90 Percent of the Largest Managed Care Provider in Brazil, Where Insurers Can Own Hospitals and Physician’s Practices

Last year they got into the low income housing business so maybe this is where we will all end up wearing our cheap United Healthcare hearing aides and connected to every device possible so they can collect all the data to sell:)  In some areas right now if you purchase a policy you get a free hearing aid, like in Florida, one of the areas identified where doctors are paid less than Medicare rates.  How is this legal too I wonder?  I thought Medicare reimbursement was supposed to be lower than any commercial insurer.

 

United Healthcare Gets in The Low Income Housing Business With Partnership to Finance Housing Projects in New Mexico

Sebelius and Obama better be ready for some serious Algo Duping here so that Untied makes their profits…as they appear to want to run Medicare now too.  We have no clue on how they assign risk and what models they use but if you read the link below there’s some additional information that tweaking “risk” one way or another, up or down is the Achilles heel of the US economy and these guys are right in there, so please folks in the executive spots in the government, don’t get duped when the world of fictional and fantasy models and reports generated from such clash with the real world. The company is the King of the Algorithmic models to make money so be aware. BD

Hiding, Falsifying, And Accelerating Risk Has Become the Achilles Heel of the US Economy As the “Real” World” Clashes With the Values Created From a World of “Fictional Values” Of Formulas and Math

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The U.S. could save more than $500 billion in Medicare and Medicaid spending over the next ten years, by more aggressively coordinating medical care for seniors and the poor, according to new research from health insurer UnitedHealth Group.

The report is aimed squarely at Washington, as leaders on Capital Hill wrangle over debt reduction options ahead of automatic budget cuts due to take effect in two months.

"It's either going to be a debate that's purely focused on cutting people's benefits, or it's going to be a debate that's focused on further cuts to doctors and hospitals," said Simon Stevens, UnitedHealth executive vice president, who chairs the insurer's Center for Health Reform & Modernization.

http://www.cnbc.com/id/100365131