The fraud to American’s that is Medicare Advantage
https://www.removepaywall.com/search?url=https://www.wsj.com/health/healthcare/unitedhealth-medicare-payments-doctors-c2a343db
Had to link from a non-paywall version. One of the most detrimental creations for the Medicare system is the Medicare Advantage program. It preys on the elderly who are offered a cheaper monthly premium, with some added goodies like a coupon voucher for groceries. But what does Advantage plans do? They “take Advantage”.
As this article shows quite well, there are many ways to make money, and creating more diagnoses on your chart that make you appear “sicker” is a great way to do just that. Sicker people require more healthcare interventions. More interventions mean more money.
“More diagnoses make for higher scores—and larger payments. A Wall Street Journal analysis found sickness scores increased when patients moved from traditional Medicare to Medicare Advantage, leading to billions of dollars in extra government payments to insurers.
Patients examined by doctors working for UnitedHealth, an industry pioneer in directly employing large numbers of physicians, had some of the biggest increases in sickness scores after moving from traditional Medicare to the company’s plans, according to the Journal’s analysis of Medicare data between 2019 and 2022.
Sickness scores for those UnitedHealth patients increased 55%, on average, in their first year in the plans, the analysis showed. That far outpaced the 7% year-over-year rise in the sickness scores of patients who stayed in traditional Medicare, according to the analysis. Across Medicare Advantage plans run by all insurers, including UnitedHealth, scores for all newly enrolled patients rose by 30% in the first year.”
You can also guarantee that another little perk comes with this increased sickness score: more medications. The “sicker” you are, the “more meds” they decide you need. So big pharma gets a healthy kickback from this as well. Especially if the provider to increased your sick score is also a fan of brand name pharma drugs. I won’t even get started on the financial incentive that the phone representative gets who signs up a person for an Advantage plan. There are people who are employed for the sole purpose of making a bonus by getting people who are disabled or over age 65 to sign up for Advantage plans instead of traditional Medicare. They are akin to any other sales job.
If you or someone you know is considering a Medicare Advantage plan, do NOT do it. Stay with your traditional Medicare.
I read this great piece of investigative journalism by the WSJ yesterday. Thanks Jennifer for alerting us all. A few additional points:
"A December 2023 compensation plan for one UnitedHealth-owned practice offered doctors bonuses of up to $37.50 a year for each of their Medicare Advantage patients if they confirmed or ruled out more than 90% of the suggested diagnoses. That means a doctor seeing 800 Medicare Advantage patients in a year could see a bonus of as much as $30,000 a year."
Remember the bonuses pediatricians and GPs scooped up for a high % of their captive practice submitting to the jab?
Also had to laugh at the incentives to diagnose hyperaldosteronism and "qualitative platelet disorder" The Medical Industrial Complex/Pharma can only prosper more by employing doctors whose ethics are corrupted by being owned by the big insurers.
My advice? Find an independent doctor...if you still can. Look at your list of ICD-10 diagnoses. Pay for the print version of the WSJ and Epoch Times. Oh and cancel NYT and WaPo. They stopped doing real reporting like this a long time ago.
The government knows that Advantage is full of fraud and outright criminal acts and yet it’s still trying to get more people to join it.
I’d find it hard to believe that the government doesn’t give a rat’s ass about we the people except I’ve seen what it’s been doing all through the Covid scam that they created and then they released the dangerous vaccines that they know are harming and killing millions.
When people fear the government there is tyranny. We are here.