“Evil empire:” UnitedHealthcare schemes to intentionally underpay healthcare providers, lawsuits claims —

It’s no secret that UnitedHealthcare is reducing provider networks across the nation while boosting its record-setting profits.  

And another company is fighting back: Envision Healthcare in Broward County, FL, filed a lawsuit against UnitedHealthcare in May, claiming UnitedHealthcare is scheming to underpay front-line healthcare providers and push them out-of-network.  An article in Becker’s Hospital Review says that Envision is seeking to recover millions of dollars in alleged underpayments for medical care it provided to UnitedHealth members.

Excerpts from the Envision lawsuit shine a light on how UnitedHealthcare allegedly operates:

United, the country's largest commercial health insurance company, engages in a nationwide pattern and practice of intentionally underpaying frontline healthcare providers to boost its profits. United's scheme is simple: issue drastically reduced "take it or leave it" reimbursement rates during contract negotiations to force providers out of its networks, rather than pay them fair and reasonable rates for their services, including saving lives during an unprecedented pandemic. 

Once United successfully forces a provider out of network, United then intentionally and significantly underpays the now "out-of-network" provider, often at rates even lower than the contract rates offered. United then lines its pockets with the money that providers have worked tirelessly to earn, money the providers deserve.”

This model is not limiited to United Health Group, nor is it a recent phenomenon.Every major health insurance plan has implemented this methodology against providers and institutions.It has been an ongoing model for two decades at the inception of preferred provider groups in the 1990s. At the same time health insurance premiums, deductibles, and copayments have increased.  The victims are the patients using providers as the weapon.  In Georgia it has reached the judicial level of adversarial contracting.

One lawsuit in one state may set a small precedent against the huge health insurance lobby.

“Evil empire:” UnitedHealthcare schemes to intentionally underpay healthcare providers, lawsuits claims

Health Care Industry, the effects of "Deskless Working"

Health Care Industry Consulting and Strategy | BCG

Massive changes—including breakthroughs in digital health, the emergence of novel therapies, the rise of personalized care, and value-based care—are transforming health care.

At the start of 2020, the global health care industry was already facing transformational changes driven by shifting consumer behaviors, the rise of disruptive competitors, changing regulations, and new alliances and mergers. To thrive in the face of such change—and in the postpandemic world—health care leaders need to reimagine their strategies, value propositions, and organizational capabilities.  Health care consulting teams help clients do so by adopting agile ways of working, accelerating innovation, advancing digital transformation, evolving go-to-market strategies, and driving growth and portfolio strategy through M&A. Across virtually every engagement, experts can help clients optimize capabilities through data, digital, and advanced analytics.

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Medicinal Cannabis, or Medical Marijuana,

Medicinal cannabis, or medical marijuana, has evolved from a controversial, misunderstood therapy, to a mainstream treatment option for a growing list of health challenges. As more states legalize marijuana for medical purposes—reducing pain, nausea and inflammation, decreasing anxiety, and aiding sleep, among other symptoms—interest in cannabis therapies has been growing among healthcare professionals.

In a past Sermo poll of 245 global physicians, 70% responded that they are interested in learning more about the power of cannabis medicine.

Despite a growing adoption and legalization movement—in the US alone, 37 states and Washington DC have legalized marijuana treatments—some in the medical field continue to question its efficacy, requesting more research and data before widely recommending treatment. In the same Sermo poll, only 22% of doctors said they have experience recommending cannabis to patients.

We want to hear from you and understand where you fall on the spectrum. Please fill out the poll below to give your thoughts on medical marijuana. We’d also love to hear about your patient cases and any additional thoughts in the comments section.

Iin addition to information about the herb, paraphernalia is a major source of contentment for users.  These include roll your own joints, e-dispensers (akin to e-cigarettes). ceramic pipes, vaporizers, bongs, grinders and other creative tools.

The plant.   

    The leaf  

THE MARIJUANA LEAF IS LIKE NONE OTHER

,1 OF 5

In the past six months, have your patients asked you about medicinal marijuana to treat specific illnesses or conditions?

The Paraphernalia. 

DeepDyve

57%

Yes47/83

43%

No36/83

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