In case you missed it, a new investigation by STAT is the latest in a growing body of evidence that corporate insurers are pursuing profits at the expense of those who need care most.
Providing yet another example of the abusive practices of corporate insurance companies, STAT uncovered that “[h]ealth insurance giant UnitedHealth Group used secret rules to restrict access to rehabilitation care requested by specific groups of seriously ill patients, including those who lived in nursing homes or suffered from cognitive impairment,” revealing how “many patients enrolled in Medicare Advantage plans were routed for a quick denial based on criteria neither they, nor their doctors, were aware of.”
With its latest investigation, STAT adds to a long and growing string of reports that reveal how the profit-driven practices of corporate insurers have serious consequences for patients. The publication previously exposed how the same corporate insurer “pressured its medical staff to cut off payments for seriously ill patients in lockstep with a computer algorithm’s calculations,” while reporting and analysis from other outlets also detail how corporate insurance companies routinely delay and deny care for patients.
STAT’s most recent investigation also found:
- The company systematically issued denials that “appear to have had little or no basis in clinical evidence” and “expose a more direct and deliberate strategy to restrict access to rehab care even before patients began receiving it.”
- “By first restricting access to rehab care and then limiting how much care patients ultimately receive, the company has increased profits by hundreds of millions of dollars a year in Medicare Advantage, one of its most lucrative lines of business … Denials of rehab services often upend the lives of extremely sick patients who are forced to either forgo treatment or pay thousands of dollars out-of-pocket to continue their recoveries.”
- “Even in cases where patients had wounds that exposed their bone, the clinical workers had to send those cases to the physicians, where they were frequently denied,” with one company employee saying: “You’ve got these big, gruesome wounds, and they’re not going to [approve] it.”
It should come as no surprise that a growing chorus of bipartisan voices is expressing serious concerns as corporate insurance companies bank record profits by delaying and denying care for patients while also buying up physician practices to exert even more control over Americans’ healthcare. A recent poll also reveals that voters are concerned about corporate insurance companies’ role in higher healthcare costs and their practice of delaying and denying patients’ care.
Policymakers should hold corporate insurance companies accountable and work toward long-term, sustainable solutions to the challenges of healthcare costs and access.
- To read STAT’s latest report, click here.
- To learn more about how corporate insurers are delaying and denying care, click here.