5 ms·

UnitedHealth pays its own physician groups 17% more than outside ones

65 points by brandonb 1y ago

broswell 1y ago
My experience with United Health Care has been terrible.
daft_pink 1y ago
I found it’s terrible too. Especially with dental insurance they negotiate terrible rates so you end up paying a lot more than if you went with the local Blue Cross Blue Shield or Delta dental.
cebert 1y ago
Does anyone have something positive to share about UnitedHealth?
- pluto_modadic 1y ago
  if you don't have anything nice to say... :3
- mystraline 1y ago
  [flagged]
  - kshacker 1y ago
    I am also not advocating anything but ... wasn't the famous Spock line "needs of the many outweigh the needs of the one". The question is of empirically proving it and that's the challenge. The jury may not be co-opted but the judiciary is. I wonder how do we go about proving this.
    - anonym29 1y ago
      Utilitarianism is a dangerous mistress when it comes to justifying moral and ethical transgressions. Sounds great until TPTB decide that the half dozen lives that can be saved with your organs matter more than your one life.
      - kshacker 1y ago
        If we followed the rules strictly, and not different rules for the rich, why's that a problem?
        anonym29 1y ago
        You don't see a problem with involuntary organ donations from living people?
  - JumpCrisscross 1y ago
    > Shooting their CEO caused more people to get claims approved One, it was a middle manager with a CEO title. Two, genuine question, can you point out how UnitedHealth’s profits relative to peers changed after the shooting versus before?
- tombert 1y ago
  I don't. I have their "platinum" insurance, and they still seem to fight any claim we file. For example, my wife got knee surgery recently, and the doctor recommended we rent a CPM machine to help her knee avoid atrophying. Renting the machine is $200 a week. Insurance said it was "optional" and refused to cover any of it. We ended up buying a used one on eBay for about $900, which is a lot but not insurmountable for us. It kind of annoys me though, because not all their clients are yuppie software people who have disposable income. A lot of people can't afford to rent a machine for $200 a week or buy one for $900 on eBay, but they do make it much easier for the leg to heal better. Isn't "stuff that most people can't afford but would help with healing" the stated purpose for health insurance? It seems more than a little unfair that my wife's leg is more likely to heal better purely because she's married to a software engineer. I really have no fucking idea what the difference between the cheap and expensive UHC plans. It sure seems like I'm paying many thousands of dollars more for medical stuff than I was for equivalent services with Anthem. Oh, well, at least my premiums are higher too, so that's fun. Hopefully obviously I don't advise shooting a CEO for several reasons (both ethical and legal), but I have to say that I was unable to cry many tears when I heard it happened.
  - gruez 1y ago
    >Isn't "stuff that most people can't afford but would help with healing" the stated purpose for health insurance? I thought the operative term was "medically necessary"? "would help with healing" can theoretically cover everything from protein shakes for knee injuries, to iPads to help with stroke recovery. A CPM machine is on the far end of this, closer to "medically necessary" than the other examples, but you have to draw the line somewhere, so some reasonable-but-theoretically-optional equipment gets excluded.
    - tombert 1y ago
      Sure. I guess I would draw the line in a different place. There are plenty of things that aren't strictly "necessary" but are still provided by insurance. My wife's painkiller medication isn't strictly necessary, she wouldn't die without it and the leg would probably heal the same way, but they covered that because obviously they should cover that. I feel like a piece of medical equipment like a CPM machine is more necessary than painkillers.
- droopyEyelids 1y ago
  Here's a point about all the insurance companies: UHC administers the medical plan on behalf of your employer. For all practical purposes, they are a whipping boy for the real 'man behind the curtain' (your employer). Your company (for self-funded plans) actually decides what’s covered and what isn’t, sets copays and deductibles, and ultimately saves or spends money on healthcare costs. UHC’s role is to apply those rules, maintain the provider network, and handle the billing and customer service. If your company offers insurance, there is someone who can tell the "insurance company" to cover the service they are not covering. Usually the HR Benefits Administrator, or 'plan sponsor'. And they do it all the time! If you have a sad story and the budget is ok for the quarter, they will help! If you are a company officer, you can also have whatever your company can afford.
  - kiratp 1y ago
    This only applies to large employers. Smaller ones are just presentef a limited list of plans to pick from, and the plans change every year. Most of the time, as a startup, you can’t buy a Mag7 equivalent health plan for any amount of money off the marketplace
    - tombert 1y ago
      Yeah, I work for a smaller company. I'm not sure which options they omitted but I don't think have the same bargaining power as a BigCo.
    - droopyEyelids 1y ago
      It depends. If your employer is part of a self-funded group of other employers, then there is a group of trustees from all the employers that can approve. If it's a 'fully insured' group plan then the insurance company is technically in charge, but your company can do an Employer-paid exception (aka carve-out reimbursement) to cover something thats getting rejected. They also have the option to purchase add-on policies to add coverage for upper class stuff like fertility treatments, weight loss drugs, or gender-affirming care.
    - meetingthrower 1y ago
- jawiggins 1y ago
  Yeah I really like their rewards program: https://e-i.uhc.com/uhcrewards https://e-i.uhc.com/uhcrewards Each year they pay me $1,000 (in the form of HSA deposits, which I can invest) to do basic things like get a checkup, get a flu shot, and get a blood test. I sync my wear-able data and they pay me $1-2 each time I exercise or get enough sleep. It's great!
  - krackers 1y ago
    >I sync my wear-able data and they pay me $1-2 each time I exercise or get enough sleep I wonder if the data is sold off and if so whether it's properly anonymized...
    - Tadpole9181 1y ago
      Where do you think the $1-2 comes from? Insurance company is double dipping to optimize those profits!
- rayiner 1y ago
  We have a UHC choice plan at work and it’s been completely invisible, both for me and coworkers I know. Health insurers are like Congressmen. Most people hate the institution, but are satisfied with their own insurer. https://www.kff.org/affordable-care-act/kff-survey-of-consumer-experiences-with-health-insurance/ https://www.kff.org/affordable-care-act/kff-survey-of-consum...
  - Larrikin 1y ago
    [flagged]
    - efs98 1y ago
      [flagged]
      - tomhow 1y ago
        Please don't reply to a bad comment with a worse one, it just drags the whole place down. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
    - tomhow 1y ago
      > I think you're a bad person. It's not acceptable to comment like this on HN, no matter who it is or what it's in reply to. The guidelines ask us to "assume good faith", "edit out swipes" and "be kind". That applies equally to all of us and in replies to anyone else on HN. If someone posts a comment that's egregious, just flag it, don't abuse the commenter, as it just makes the place worse for everyone. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
      - Larrikin 1y ago
        [flagged]
        tomhow 1y ago
- jmspring 1y ago
  No, but working at a company that was founded by a bunch of former gov employees, the coverage is mostly ok and some having to manage the refusal bs. What was new to me - a gap that went employed -> consulting -> employed - (same company family) - how damn expensive top tier coverage for a family of three really is - $3700/mo. Insane.
- shrubble 1y ago
  I had them via a previous employer and had serious surgery; they asked me to go through the “get a second opinion” process which was getting all the records to their system and then a virtual/video call, but after that, they paid for everything.
bronco21016 1y ago
It’s terrible that this is an area that is caught up in political ideology. Somehow, healthcare MUST be decoupled from capitalistic incentives. I don’t pretend to have the answer but continuing on this path will lead to worsening patient outcomes. We cannot have corporations expecting to make a dollar off human life.
- tiahura 1y ago
  United Healthcare isn’t the reason healthcare is unaffordable any more than Geico causes car repairs to be expensive. American demand for healthcare is insatiable, and doctors are a scarce and greedy bunch. That there is a middle man trying to get his 5% isn’t the problem.
  - PaulDavisThe1st 1y ago
    > any more than Geico causes car repairs to be expensive Given how much cheaper things like body shop repairs are if you do not have insurance, is it really clear that Geico does not cause car repairs to be expensive? And for that matter, get emergency health care without insurance and then fight the cost to get a massive reduction, and you'll wonder whether it actually is UHC and their ilk that help make healthcare unaffordable ...
  - stephenitis 1y ago
    What is the problem breakdown by % in your eatimate?
  - mystraline 1y ago
    Wrong. 'Medical insurance companies' do absolutely nothing in terms of health care, drain massive amounts of money in what amounts to a Brazil-style (movie) system, corporate death panels, and a drain on all of our resources. And its not even a product we want. We dont buy it. The companies we work for do, and never have to dogfood any of it. But for the rest of us, its a take it or leave it proposition. > doctors are a scarce and greedy bunch. Speaking of that, an MD is the ONLY profession who is solely controlled how many can apply is controlled by Congress. Get rid of that, and that would fix a facet. But getting rid of insurance companies would also work a great deal. Or at least, decoupling work/med insurance would be a start. Even going full competitive capitalism OR full socialism would be better than the garbage we have now.
vjvjvjvjghv 1y ago
I am close to retirement but far away from Medicare age. The health care situation alone makes me want to leave this country. It’s such a mess. And I don’t see any movement to improve things. It’s just getting worse every year.
- nine_zeros 1y ago
  [dead]
- deleted 1y ago
  [deleted]
- SoftTalker 1y ago
  I’ve basically opted out. I can’t see that the healthcare system has any incentives to keep me healthy. In fact all the incentives are to keep me medicated indefinitely. No thanks. I have a plan for catastrophic coverage but I stay as far away from hospitals and doctors as I can otherwise.
  - danans 1y ago
    > No thanks. I have a plan for catastrophic coverage but I stay as far away from hospitals and doctors as I can otherwise. This is pretty much the Republican plan for healthcare.
    - seizethecheese 1y ago
      [flagged]
      - danans 1y ago
        This is what the current Republican administration recently posted to the website of the Centers for Medicare & Medicaid Services: "Expanding Access to Health Insurance: Consumers to Gain Access to “Catastrophic” Health Insurance Plans in 2026 Plan Year" https://www.cms.gov/newsroom/fact-sheets/expanding-access-health-insurance-consumers-gain-access-catastrophic-health-insurance-plans-2026 https://www.cms.gov/newsroom/fact-sheets/expanding-access-he...
JCM9 1y ago
United is a disaster of a company. Physicians hate them. Patients hate them. I feel bad for anyone forced to deal with their BS. Their reputation is so bad I wouldn’t be surprised if they rename the company at some point in hoping people forget that they’re United Healthcare.
- tombert 1y ago
  I really hope my employer changes to pretty much any of the other ones eventually. I really hate having to argue on the phone with with a poor representative over everything. Anthem BCBS and Aetna never gave as much trouble. I know they both have their scandals and it's not like I love any American health insurance company, but I definitely rank UHC lower.
- vjvjvjvjghv 1y ago
  My girlfriend is nurse practitioner and she says United is the worst to deal with. They deny everything and it sucks up enormous amounts of time to appeal.
estearum 1y ago
For-profit pay-viders (payer-provider mergers) should be illegal. In theory they can drive greater efficiencies that pass down to consumers, but in practice pay-vider integration makes available a lot more levers to screw consumers. All of those levers are easier to pull than increasing efficiency of care delivery. If you want to act as both insurer and provider, then you should have to be a non-profit and have thorough performance monitoring in place to ensure you're passing what's possible back to consumers.
silexia 1y ago
The law of supply and demand controls the high prices we see in healthcare. Doctors have the most powerful trade union on earth and have lobbies for strict limits on the number of new doctors per year by limiting residencies. Shrink the federal government and its overbearing regulations in healthcare and allow many more people to go through residency to become doctors.

65 points by brandonb 1y ago

My experience with United Health Care has been terrible.

I found it’s terrible too. Especially with dental insurance they negotiate terrible rates so you end up paying a lot more than if you went with the local Blue Cross Blue Shield or Delta dental.

cebert 1y ago

Does anyone have something positive to share about UnitedHealth?

pluto_modadic 1y ago
if you don't have anything nice to say... :3
mystraline 1y ago
[flagged]
- kshacker 1y ago
  I am also not advocating anything but ... wasn't the famous Spock line "needs of the many outweigh the needs of the one". The question is of empirically proving it and that's the challenge. The jury may not be co-opted but the judiciary is. I wonder how do we go about proving this.
  - anonym29 1y ago
    Utilitarianism is a dangerous mistress when it comes to justifying moral and ethical transgressions. Sounds great until TPTB decide that the half dozen lives that can be saved with your organs matter more than your one life.
    - kshacker 1y ago
      If we followed the rules strictly, and not different rules for the rich, why's that a problem?
      - anonym29 1y ago
        You don't see a problem with involuntary organ donations from living people?
- JumpCrisscross 1y ago
  > Shooting their CEO caused more people to get claims approved One, it was a middle manager with a CEO title. Two, genuine question, can you point out how UnitedHealth’s profits relative to peers changed after the shooting versus before?
tombert 1y ago
I don't. I have their "platinum" insurance, and they still seem to fight any claim we file. For example, my wife got knee surgery recently, and the doctor recommended we rent a CPM machine to help her knee avoid atrophying. Renting the machine is $200 a week. Insurance said it was "optional" and refused to cover any of it. We ended up buying a used one on eBay for about $900, which is a lot but not insurmountable for us. It kind of annoys me though, because not all their clients are yuppie software people who have disposable income. A lot of people can't afford to rent a machine for $200 a week or buy one for $900 on eBay, but they do make it much easier for the leg to heal better. Isn't "stuff that most people can't afford but would help with healing" the stated purpose for health insurance? It seems more than a little unfair that my wife's leg is more likely to heal better purely because she's married to a software engineer. I really have no fucking idea what the difference between the cheap and expensive UHC plans. It sure seems like I'm paying many thousands of dollars more for medical stuff than I was for equivalent services with Anthem. Oh, well, at least my premiums are higher too, so that's fun. Hopefully obviously I don't advise shooting a CEO for several reasons (both ethical and legal), but I have to say that I was unable to cry many tears when I heard it happened.
- gruez 1y ago
  >Isn't "stuff that most people can't afford but would help with healing" the stated purpose for health insurance? I thought the operative term was "medically necessary"? "would help with healing" can theoretically cover everything from protein shakes for knee injuries, to iPads to help with stroke recovery. A CPM machine is on the far end of this, closer to "medically necessary" than the other examples, but you have to draw the line somewhere, so some reasonable-but-theoretically-optional equipment gets excluded.
  - tombert 1y ago
    Sure. I guess I would draw the line in a different place. There are plenty of things that aren't strictly "necessary" but are still provided by insurance. My wife's painkiller medication isn't strictly necessary, she wouldn't die without it and the leg would probably heal the same way, but they covered that because obviously they should cover that. I feel like a piece of medical equipment like a CPM machine is more necessary than painkillers.
droopyEyelids 1y ago
Here's a point about all the insurance companies: UHC administers the medical plan on behalf of your employer. For all practical purposes, they are a whipping boy for the real 'man behind the curtain' (your employer). Your company (for self-funded plans) actually decides what’s covered and what isn’t, sets copays and deductibles, and ultimately saves or spends money on healthcare costs. UHC’s role is to apply those rules, maintain the provider network, and handle the billing and customer service. If your company offers insurance, there is someone who can tell the "insurance company" to cover the service they are not covering. Usually the HR Benefits Administrator, or 'plan sponsor'. And they do it all the time! If you have a sad story and the budget is ok for the quarter, they will help! If you are a company officer, you can also have whatever your company can afford.
- kiratp 1y ago
  This only applies to large employers. Smaller ones are just presentef a limited list of plans to pick from, and the plans change every year. Most of the time, as a startup, you can’t buy a Mag7 equivalent health plan for any amount of money off the marketplace
  - tombert 1y ago
    Yeah, I work for a smaller company. I'm not sure which options they omitted but I don't think have the same bargaining power as a BigCo.
  - droopyEyelids 1y ago
    It depends. If your employer is part of a self-funded group of other employers, then there is a group of trustees from all the employers that can approve. If it's a 'fully insured' group plan then the insurance company is technically in charge, but your company can do an Employer-paid exception (aka carve-out reimbursement) to cover something thats getting rejected. They also have the option to purchase add-on policies to add coverage for upper class stuff like fertility treatments, weight loss drugs, or gender-affirming care.
  - meetingthrower 1y ago
jawiggins 1y ago
Yeah I really like their rewards program: https://e-i.uhc.com/uhcrewards https://e-i.uhc.com/uhcrewards Each year they pay me $1,000 (in the form of HSA deposits, which I can invest) to do basic things like get a checkup, get a flu shot, and get a blood test. I sync my wear-able data and they pay me $1-2 each time I exercise or get enough sleep. It's great!
- krackers 1y ago
  >I sync my wear-able data and they pay me $1-2 each time I exercise or get enough sleep I wonder if the data is sold off and if so whether it's properly anonymized...
  - Tadpole9181 1y ago
    Where do you think the $1-2 comes from? Insurance company is double dipping to optimize those profits!
rayiner 1y ago
We have a UHC choice plan at work and it’s been completely invisible, both for me and coworkers I know. Health insurers are like Congressmen. Most people hate the institution, but are satisfied with their own insurer. https://www.kff.org/affordable-care-act/kff-survey-of-consumer-experiences-with-health-insurance/ https://www.kff.org/affordable-care-act/kff-survey-of-consum...
- Larrikin 1y ago
  [flagged]
  - efs98 1y ago
    [flagged]
    - tomhow 1y ago
      Please don't reply to a bad comment with a worse one, it just drags the whole place down. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
  - tomhow 1y ago
    > I think you're a bad person. It's not acceptable to comment like this on HN, no matter who it is or what it's in reply to. The guidelines ask us to "assume good faith", "edit out swipes" and "be kind". That applies equally to all of us and in replies to anyone else on HN. If someone posts a comment that's egregious, just flag it, don't abuse the commenter, as it just makes the place worse for everyone. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
    - Larrikin 1y ago
      [flagged]
      - tomhow 1y ago
jmspring 1y ago
No, but working at a company that was founded by a bunch of former gov employees, the coverage is mostly ok and some having to manage the refusal bs. What was new to me - a gap that went employed -> consulting -> employed - (same company family) - how damn expensive top tier coverage for a family of three really is - $3700/mo. Insane.
shrubble 1y ago
I had them via a previous employer and had serious surgery; they asked me to go through the “get a second opinion” process which was getting all the records to their system and then a virtual/video call, but after that, they paid for everything.

bronco21016 1y ago

It’s terrible that this is an area that is caught up in political ideology. Somehow, healthcare MUST be decoupled from capitalistic incentives. I don’t pretend to have the answer but continuing on this path will lead to worsening patient outcomes. We cannot have corporations expecting to make a dollar off human life.

tiahura 1y ago
United Healthcare isn’t the reason healthcare is unaffordable any more than Geico causes car repairs to be expensive. American demand for healthcare is insatiable, and doctors are a scarce and greedy bunch. That there is a middle man trying to get his 5% isn’t the problem.
- PaulDavisThe1st 1y ago
  > any more than Geico causes car repairs to be expensive Given how much cheaper things like body shop repairs are if you do not have insurance, is it really clear that Geico does not cause car repairs to be expensive? And for that matter, get emergency health care without insurance and then fight the cost to get a massive reduction, and you'll wonder whether it actually is UHC and their ilk that help make healthcare unaffordable ...
- stephenitis 1y ago
  What is the problem breakdown by % in your eatimate?
- mystraline 1y ago
  Wrong. 'Medical insurance companies' do absolutely nothing in terms of health care, drain massive amounts of money in what amounts to a Brazil-style (movie) system, corporate death panels, and a drain on all of our resources. And its not even a product we want. We dont buy it. The companies we work for do, and never have to dogfood any of it. But for the rest of us, its a take it or leave it proposition. > doctors are a scarce and greedy bunch. Speaking of that, an MD is the ONLY profession who is solely controlled how many can apply is controlled by Congress. Get rid of that, and that would fix a facet. But getting rid of insurance companies would also work a great deal. Or at least, decoupling work/med insurance would be a start. Even going full competitive capitalism OR full socialism would be better than the garbage we have now.

vjvjvjvjghv 1y ago

I am close to retirement but far away from Medicare age. The health care situation alone makes me want to leave this country. It’s such a mess. And I don’t see any movement to improve things. It’s just getting worse every year.

nine_zeros 1y ago
[dead]
deleted 1y ago
[deleted]
SoftTalker 1y ago
I’ve basically opted out. I can’t see that the healthcare system has any incentives to keep me healthy. In fact all the incentives are to keep me medicated indefinitely. No thanks. I have a plan for catastrophic coverage but I stay as far away from hospitals and doctors as I can otherwise.
- danans 1y ago
  > No thanks. I have a plan for catastrophic coverage but I stay as far away from hospitals and doctors as I can otherwise. This is pretty much the Republican plan for healthcare.
  - seizethecheese 1y ago
    [flagged]
    - danans 1y ago
      This is what the current Republican administration recently posted to the website of the Centers for Medicare & Medicaid Services: "Expanding Access to Health Insurance: Consumers to Gain Access to “Catastrophic” Health Insurance Plans in 2026 Plan Year" https://www.cms.gov/newsroom/fact-sheets/expanding-access-health-insurance-consumers-gain-access-catastrophic-health-insurance-plans-2026 https://www.cms.gov/newsroom/fact-sheets/expanding-access-he...

JCM9 1y ago

United is a disaster of a company. Physicians hate them. Patients hate them. I feel bad for anyone forced to deal with their BS. Their reputation is so bad I wouldn’t be surprised if they rename the company at some point in hoping people forget that they’re United Healthcare.

tombert 1y ago
I really hope my employer changes to pretty much any of the other ones eventually. I really hate having to argue on the phone with with a poor representative over everything. Anthem BCBS and Aetna never gave as much trouble. I know they both have their scandals and it's not like I love any American health insurance company, but I definitely rank UHC lower.
vjvjvjvjghv 1y ago
My girlfriend is nurse practitioner and she says United is the worst to deal with. They deny everything and it sucks up enormous amounts of time to appeal.

estearum 1y ago

For-profit pay-viders (payer-provider mergers) should be illegal. In theory they can drive greater efficiencies that pass down to consumers, but in practice pay-vider integration makes available a lot more levers to screw consumers. All of those levers are easier to pull than increasing efficiency of care delivery. If you want to act as both insurer and provider, then you should have to be a non-profit and have thorough performance monitoring in place to ensure you're passing what's possible back to consumers.

silexia 1y ago

The law of supply and demand controls the high prices we see in healthcare. Doctors have the most powerful trade union on earth and have lobbies for strict limits on the number of new doctors per year by limiting residencies. Shrink the federal government and its overbearing regulations in healthcare and allow many more people to go through residency to become doctors.