"Central to these tactics is UnitedHealth’s unrivaled leverage over physicians, whose diagnoses help determine how much private insurers get paid for covering older adults. Dozens of former doctors and employees at UnitedHealth medical practices told STAT how they became enmeshed in UnitedHealth’s strategy to make their patients seem as sick as possible. Doctors said the company had a fixation with medical coding to generate more revenue — encouraging clinicians through bonuses and performance reviews to identify more health problems in patients, even if those conditions seemed dubious."
11 replies (most recent on top)
I am a nurse who left over the unethical practices I saw in the coding arena to game the system. This company is horrific and patients pay the ultimate price.
Poster is not jealous. Left LM a year ago and can sleep better. Care management was nothing like nursing in person. I just let myself get stuck there because I was burned out. LM made me burned out another way. Get out while you can. Leave these jobs for nurses who can't work the floor anymore. My friend still works there and whines the job is so tough because she has to get 12 “meaningful touches” every day. Really??!! While tons of us dealing with….so much s$@t on the floor? She was always kind of “diva”. So ya’ll can be butt hurt all you want but plenty enough of us think that way. Yah, I’ll take a tenured nurse but not one thats been doing care management too long. Too much trouble for one reason or another.
To @1hbe+1tI7RPuX. You sound like a jealous uneducated past employee who was terminated. Stop the drama and educate yourself. This isn't a psychology need help board. Please do yourself and your family a favor and seek mental health care. I am in charge of hiring and would definitely hire a tenured nurse.
Nurses fleeing in person care to hide behind a phone. Fact. In person nursing shortage. Fact. Highest number ever of nurses performing “care management” over the phone. Fact. No jealousy. Fact. More medical assistants are being trained on this nursing care management role. Fact. This nurse “flight” to passive roles has contributed to the shortage. Care management on your resume does not impress me, the nurse who is interviewing to fill positions. The longer the time period a nurse spends as a care manager the less likely I will consider you and will more than likely trash your resume and risk hiring a newbie. So nurses who want to keep thinking this is jealousy, keep your head stuck in the sand.
It does not matter what strategy is used, any of them can be said to " incentivize " over billing of Medicare . Congress knows full well this is happening and has done very little . Sixty Minutes " the fleecing of America " should do a story ...
aww+1tI7RPuX. Wow, you sure are coming across as jealous! Leave the nurses alone. Get some professional help as your words are extremely hateful and unprofessional
Strong nurses don’t sit on their duffs all day doing data entry. The NCM role is not real nursing and you know it. This professional nurse is leaving because of delusional people like the poster who claims the issue is jealousy. I actually want to interact with people in person. Stop encouraging this “phone” care which has resulted in delay of care for plenty of patients. Just accept your position is geared for AI because it IS NOT REAL NURSING.
@gbm+1tI7RPuX you sound like a jealous fool belittling the fabulous nurses who selflessly work to help the patients. You have no clue! Educate yourself! Check Boxes?? Again you poor jealous person. Get some self respect and stop belittling strong professional nurses.
The sick part is how everybody needs nurses. A TON of nurses work for UHG, Optum and the little companies they acquired. Landmark is one example. They fill positions with much needed nurses and all they do is sit at home and make calls all day. They pat themselves on the back and say they’re really helping patients. The sad fools don’t realize they’ve helped the insurance companies make the situation worse with all their caring. They have to read scripts of what to say and they complete “notes” full of check boxes. Check boxes for collecting data. Which will be used in some way, in the future, to deny patient care.
Oh please. Its not just the physicians. Ask any nurse at ANY of the “care management” companies how they added codes. Ask the nurses at Landmark. Ask the leadership at Landmark. They were desperate dog eager to please and dug through all the records they could get their eyes on to find conditions that needed to be “treated”. Probably sold the info they found to the other insurance companies they contract with (BCBS) for “quality patient care”. Landmark is wrapping up because the patient info well is running dry. Patient care is a joke. Clinical gets a power point training on complex medical issues but its clearly over the heads of many practitioners. Operations is tripping over their words because they’re on the way out and don’t need to be told anything.
Like it’s a suprise — UHC and Optum does that as a core strategy. What other point does Housecalls have ?
They’ve been investigated for data mining as well