Thread regarding Optum layoffs

There is a new sheriff in town

Have the chickens finally come home to roost? What happens to UHG's slim margins if we can't upcode to game the system? What happens to Optum when the products we sell to facilitate this for UHC and other Payers can't be sold?

Is real time settlement all we have and why can't Epic or someone else do it better, cheaper, faster? Layoffs are just getting started! I worry for the 110k of us working in the USA doing anything other than payment transfers.


Dr. Oz on the future of US healthcare: 'There is a new sheriff in town'
https://finance.yahoo.com/news/dr-oz-on-the-future-of-us-healthcare-there-is-a-new-sheriff-in-town-202833620.html

“The whole point of launching Medicare Advantage was to give seniors options," Oz said. "But in the middle of all this, if it turns out that Medicare Advantage is costing us a lot more than fee-for-service, you’re violating the whole premise.”

Oz said CMS is now taking aggressive steps to recover funds [paid out due to upcoding FWA] and send a message: “We have a process called RADV that allows us to go back to the late teens and, for the first time, audit Medicare Advantage companies,” he said. “Based on what we find, we’re going to pull money back from them. We expect it will be billions and billions of dollars. But more importantly, we’re sending a message to the industry: Listen, I want you to succeed. I want you to thrive, but not at the expense of the American taxpayer.”

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| 1681 views | | 5 replies (last August 1) | Reply
Post ID: @OP+1k1dny2t0

5 replies (most recent on top)

The house of cards is falling .

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Post ID: @j6+1k1dny2t0

Talk is cheap and Dr OZ is a neophyte regarding the cogs of government. There are way too many parasites profiteering of the mess as it is to let it go easy. Lets see how he fares against the lobbyist army since he is just an opportunist like all the rest of them All of the big insurers do the same thing not just UHG.

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Post ID: @gh+1k1dny2t0

Sheriff vs UHC lobbyists, how shall that go? Oz was a TV personality so not exactly a top patient care/concern/advocate guy, he was making the bucks. He pushed a lot of garbage products for money on his show, he is a disgrace, not a herald or beacon of quality medical care. He will easily cave to any offerings UHC provides to get themselves out of trouble. Just IMO

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Post ID: @d0+1k1dny2t0

Thank God for the new sheriff. This cost the American taxpayers a lot and it benefits no one. The UR nurses see the game. They see what the plan does on a daily basis and yet many sit there and follow what corrupt manager,directors want them to do. Do chart reviews in 2.5 seconds and escalate for a quick denial. But it will get exposed.

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Post ID: @a2+1k1dny2t0

bye bye house calls!

“In Medicare Advantage, I do think that there’s been an ability for the private companies to game the coding system,” Oz said. “Instead of just saying, ‘I got what I got, I’m going to take care of them and be honest about how sick they are,’ they expertly devised tactics to upcode to pretend the patients were sicker than they really were. That got them more money.”

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Post ID: @a1+1k1dny2t0

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