Report: UnitedHealth rewarded nursing homes for delaying hospital transfers

A new report accuses UnitedHealth of paying out bonuses to nursing homes and rehabilitation facilities as an incentive to reduce the number of hospital transfers, using a metric of “admits per thousand” as the measure of success.

According to the Guardian, the cost-cutting program saved UnitedHealth millions of dollars it would have paid out as reimbursement. However, patients allegedly paid the price in the form of negative health outcomes.

Further, the outlet alleges, the bonuses themselves were a “secret” and the insurance company had representatives stationed at facilities whose sole job was to cut costs, largely through the reduction of expensive hospital transfers.

Citing several examples, the report details stories of patients in need of emergency care who never received it. In one instance, an individual apparently suffered permanent brain damage as a result of a delayed transfer. That incident is backed by recordings and photo evidence, the Guardian stated.

The outlet based its report on “thousands of confidential corporate and patient records obtained through sources, public records requests and court files,” in addition to interviews it said it conducted with more than 20 current and former UnitedHealth and nursing home employees.

Further, claims made in the report are backed by two whistleblowers who have submitted reports to Congress with the help of a nonprofit legal group.

The Guardian said evidence points to UnitedHealth influencing the day-to-day operations of nearly 2,000 nursing homes across the U.S. as part of a scheme that helped the insurer boost Medicare Advantage enrollment while using the facilities for recruitment.

The company denied claims made in the report, particularly that it prevented any hospital transfers. It added that the bonuses in question were only paid out as an incentive to prevent unnecessary hospitalizations, the Guardian said.

The full report is available at the link below.