Revealed: UnitedHealth secretly paid nursing homes to reduce hospital transfers

[WhiskeyGrinder]

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

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.’”

[yardwork]

1. Class action lawsuit is needed.

NC is pushing all retired state employees to go on Medicare Advantage. They are making it more expensive to stay on traditional Medicare. And it's very difficult to figure out how to get on traditional Medicare as secondary insurance.

It's a big racket.

[k_buddy762]

2. Live well, die fast

My family has very clear instructions: I will never be placed in a long-term care facility, under any circumstance, at any age, ever.

[dalton99a]

3. .

[bif]

4. DUPE

https://www.democraticunderground.com/100220332211

[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/