Revealed: UnitedHealth secretly paid nursing homes to reduce hospital transfers -- The Guardian

[erronis]

https://www.theguardian.com/us-news/2025/may/21/unitedhealth-nursing-homes-payments-hospital-transfers
George Joseph

A Guardian investigation finds insurer quietly paid facilities that helped it gain Medicare enrollees and reduce hospitalizations. Whistleblowers allege harm to residents

UnitedHealth Group, the nation’s largest healthcare conglomerate, has secretly paid nursing homes thousands in bonuses to help slash hospital transfers for ailing residents – part of a series of cost-cutting tactics that has saved the company millions, but at times risked residents’ health, a Guardian investigation has found.

Those secret bonuses have been paid out as part of a UnitedHealth program that stations the company’s own medical teams in nursing homes and pushes them to cut care expenses for residents covered by the insurance giant.

In several cases identified by the Guardian, nursing home residents who needed immediate hospital care under the program failed to receive it, after interventions from UnitedHealth staffers. At least one lived with permanent brain damage following his delayed transfer, according to a confidential nursing home incident log, recordings and photo evidence.

“No one is truly investigating when a patient suffers harm. Absolutely no one,” said one current UnitedHealth nurse practitioner who recently filed a congressional complaint about the nursing home program. “These incidents are hidden, downplayed and minimized. The sense is: ‘Well, they’re medically frail, and no one lives for ever.’”

The Guardian’s investigation is based on thousands of confidential corporate and patient records obtained through sources, public records requests and court files, interviews with more than 20 current and former UnitedHealth and nursing home employees, and two whistleblower declarations submitted to Congress this month through the nonprofit legal group Whistleblower Aid.

. . .

[bucolic_frolic]

1. Everything seems a con job these days. /.nt

[erronis]

2. As far as this regime goes, you can replace the "seems" with "is".

[dalton99a]

3. Kick

[bif]

4. Why does it take a British paper to report this stuff?

[dalton99a]

7. +1

[malaise]

8. The Guardian is the best newspaper on the planet

Check its ownership make up - the answer is pellucidly clear

[Silent Type]

5. The ugly truth is that even Original Medicare -- and Medicaid -- have programs to do the same.

Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents (NFI)

Overview
The Medicare-Medicaid Coordination Office, in collaboration with the Center for Medicare & Medicaid Innovation, has undertaken efforts to improve the quality of care for people in long-term care (LTC) facilities by reducing potentially avoidable inpatient hospitalizations.

The Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents, which ran from 2012 to 2020, focused on long-stay LTC facility residents, primarily those enrolled in the Medicare and Medicaid programs. The Initiative supported organizations that partner with LTC facilities to implement evidence-based interventions that both improve care and lower costs.

Background
LTC facility residents often experience potentially avoidable hospital transfers. Unnecessary hospitalizations are expensive, disruptive, and disorienting for frail elders and people with disabilities. LTC facility residents are especially vulnerable to the risks that accompany hospital stays and transitions between nursing facilities and hospitals, including medication errors and hospital-acquired infections.

Many LTC facility residents are enrolled in both the Medicare and Medicaid programs (Medicare-Medicaid enrollees). CMS research on this population has repeatedly found that a large number of hospital admissions could have been avoided. More information can be found at the links below:

https://www.cms.gov/medicaid-chip/medicare-coordination/avoidable-hospitalizations


Here's another--

"Policy Points.
Misaligned incentives between Medicare and Medicaid may result in avoidable hospitalizations among long‐stay nursing home residents.

"Providing nursing homes with clinical staff, such as nurse practitioners, was more effective in reducing resident hospitalizations than providing Medicare incentive payments alone.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9836234/

[erronis]

9. There's no question that hospitalization can be harmful to patients especially if they are just "warehoused."

But there is frequently not a good alternative that offers the "clinical staff such as nurse practitioners". It is so expensive to stay in a decent LTC facility - most of us couldn't afford a month there.

[malaise]

6. Brian Thompson clearly knew this as did other top brass

Did Luigi Mangione?

[nitpicked]

10. Health Insurance UnitedHealth falls after report it secretly paid nursing homes to reduce hospital transfers

https://www.cnbc.com/2025/05/21/unitedhealth-reportedly-paid-nursing-homes-to-reduce-hospital-transfers.html
'
UnitedHealth shares fell in premarket trading after a Guardian report that the company made secret payments to nursing homes to reduce hospital transfers added to the troubles of the healthcare conglomerate.

The alleged action, part of a series of cost-cutting tactics, has saved the company millions, but at times risked residents’ health, the Guardian reported, citing an investigation.
(snip)

The company’s stock has taken a beating after the Wall Street Journal recently reported that the U.S. Department of Justice had begun a criminal investigation into the company for potential Medicare fraud, which followed CEO Andrew Witty’s abrupt departure and the withdrawal of its 2025 forecast last week.

On Wednesday, UnitedHealth shares fell more than 8% before paring losses and were last down 3% at $311.59.
(snip)