NJ Insurer Dumps 100s of Doctors

https://www.medpagetoday.com/publichealthpolicy/ethics/85090

Insurer Steers Patients to Its Own Practice

UnitedHealthcare appears to be shifting Medicaid patients to a large group practice that it owns, taking them away from their long-time doctors — hundreds of whom were unceremoniously dumped from the insurer’s network, NJ.com and Kaiser Health News report.

UnitedHealthcare has dropped many physicians in its central and northern New Jersey Medicaid physician network while bringing more patients to Riverside Medical Group, a large practice owned by its sister company Optum. Patients told the news outlets that in some cases UnitedHealthcare directed them to Riverside when informing them that their doctors were no longer in-network.

UnitedHealthcare said the changes are part of a larger cost-control effort and aren’t intended to boost Riverside’s business.

Rasha Salama has been taking her two kids to Inas Wassef, MD, a pediatrician in her home town of Bayonne, New Jersey, for five years. Wassef speaks their native Arabic and has office hours at convenient times: “She knows my kids, answers the phone, is open on Saturdays, and is everything for me,” Salama told KHN/NJ.com.

Wassef and two dozen other doctors filed a federal lawsuit in September to get reinstated in UnitedHealthcare’s network and continue seeing their patients.

Could this be an example of how pts will be treated if we get a SINGLE PAYER NATIONAL HEALTH CARE SYSTEM. United Health is the same entity that has the ENDORSEMENT OF AARP…

This currently only affecting MEDICAID PTS.. those who have little/no freedom of choice of what healthcare providers they can chose as their healthcare providers and as the article states…   UnitedHealthcare said the changes are part of a larger cost-control effort and aren’t intended to boost Riverside’s business.

But “boosting Riverside’s Business” means MORE PROFITS for United Healthcare and it appears that it has little to do with better pt care and better outcomes and quality of life for those Medicaid pts having United Health dictate who will provide be their healthcare provider.

CVS/Caremark/Silver Scripts/Aetna has some 40+ million covered lives under their Aetna insurance and they have there Immediate Care Centers in many of their pharmacies and they are starting to create HealthHub centers https://www.cvs.com/content/health-hub and those who have Silver scripts Part D insurance knows that prescriptions filled at pharmacies other than CVS pharmacies pay a HIGHER PRICE on all  of their prescriptions.

With United Health doing this… how much longer before CVS gets on the same path of optimizing profits on each of the pts that have CVS in control of their Part D prescriptions and/or has Aetna insurance.

Filed under: General Problems