The government’s Medicare Advantage system, which uses private insurers to provide health benefits to seniors and disabled people, pays companies based on how sick patients are, to cover the higher costs of sicker patients. Medicare calculates sickness scores from information supplied by doctors and submitted by the insurers. In the case of UnitedHealth, many of those doctors work directly for UnitedHealth. 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.
Read the full article: UnitedHealth’s Army of Doctors Helped It Collect Billions More from Medicare //
Source: https://www.wsj.com/health/healthcare/unitedhealth-medicare-payments-doctors-c2a343db