Warren Blasts United Health CEO for Monopolistic Practices that Harm Patients

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UnitedHealth Pays Its Own Physician Groups More Than Others

https://www.medpagetoday.com/special-reports/features/11314

UnitedHealth Group pays many of its physician practices “significantly more” than other groups “in the same markets for similar services,” a STAT investigation found

The “above-market payments” were discovered in an analysis conducted in partnership with health analytics company Tribunus Health. It looked at data that UnitedHealth reported to the federal government revealing what its commercial insurance unit pays 16 Optum-branded physician groups for common or expensive services.

Ultimately, the analysis found that insurance subsidiary UnitedHealthcare paid 13 of the Optum practices more on average for common services than market price, STAT reported. The finding varied from 3% to 111% above market price.

“The higher prices reward UnitedHealth at the expense of almost everyone else,” STAT wrote. “Patients end up paying more when they see their doctors and struggle to afford recommended follow-up care. Employers counting on the insurance giant to control ever-rising costs get little or no relief. And doctors trying to compete with UnitedHealth’s practices find themselves frozen out of the higher rates the company is paying its own providers, making it more difficult to remain independent and keep their doors open.”

STAT noted that its analysis had limitations and was not comprehensive. UnitedHealth’s data files were “imperfect” and did not include certain information, the outlet noted. And the analysis included just a subset of common services.

Prior to publication, STAT shared its analysis and a list of questions with UnitedHealth. Though the company declined to make a representative available for an interview, spokesperson Eric Hausman provided a statement to STAT that called the analysis “flawed.”

The company further told STAT that it ran its own analyses and asserted that, “UnitedHealthcare pays Optum Health consistent with other payers in the market.” It declined to share its analyses with the outlet.

Filed under: General Problems