Okay, I’ll admit it: I was already angry at UnitedHealthcare for yanking up the premium for my supplemental plan G in the middle of the year, after previously raising the premium just a few months prior. And then I read this disturbing article in the New York Times about how big insurers like UnitedHealthcare work with the analytics firm, Multiplan, to reduce reimbursements for out of network care — costs that are passed along to patients, sometimes resulting in thousands of dollars in unfair medical bills. As the Times investigation found, there is an built-in incentive for Multiplan to come up with the lowest reimbursements possible for doctors and hospitals, who as I mentioned before, often pass the unpaid bills along to patients who can ill afford to pay.
As a long-time medical writer, I know that UnitedHealthcare has a history of such unscrupulous dealings. And indeed, as the Times article points out, the New York attorney general went after a similarly rigged pricing scheme 15 years ago. The central player, once again UnitedHealthcare, agreed to pay $350 million to patients and medical professionals who said they had been shortchanged. Along with other major insurers, it acquiesced to reforms meant to ensure this wouldn’t happen again. Unfortunately, the deal contained a clause saying its terms were only good until 2014. Is it any surprise that after that, UHC and other big insurers, like Cigna and Aetna, found another way to shortchange patients? Multiplan was the next weapon in their arsenal.
If you think this story can’t get any more sordid, think again. Multiplan used to offer a traditional approach to managing out-of-network claims by negotiating rates with doctors. Insurers got discounts and assurances that patients would not have to make up the difference. But after the company was sold to private equity investors, it took a more aggressive approach. According to another Times article, it installed pricing tools that used algorithms to recommend lower payments, and patients were no longer protected from having to pay the difference.
As a result, the wealthy investors behind the various private equity companies that have owned Multiplan over the years have grown richer while many patients are burdened with astronomical medical bills. This is why I support universal health care, if only to get for-profit companies like Multiplan, Hellman & Friedman (the private equity company that currently owns Multiplan), and UnitedHealthcare out of the health care equation.
But it’s not just for-profit companies that benefit from such associations. AARP (American Association for Retired Persons) has long partnered with UHC to offer retired people insurance plans, including the supplement plan G that I belong to. I don’t understand why AARP works with a health insurer with such a long history of shameless behavior, so I recently emailed the media office of AARP and asked if I could interview Jo Ann Jenkins, the CEO of AARP, about why it persists in partnering with UHC. Despite two email requests, I haven’t heard anything back. AARP bills itself as an advocate for folks over the age of 50, but this makes me question just how much of an advocate for senior citizens AARP really is. What do you think?
This blog is also posted on medium.com.
