Image courtesy John D. & Catherine T. MacArthur FoundationJeffrey C. Brenner, M.D.
One of the nation’s most innovative physicians is leaving UnitedHealth Group to start a primary care practice in New Jersey. Jeffrey Brenner, M.D, is returning to primary care after more than three years as a senior vice president at the nation’s largest health insurer, where he launched programs in some 14 cities to provide housing and other services for UHC’s neediest members.
Many of us have covered the work Brenner has done in pioneering new models of care for patients known as high utilizers, super users or frequent fliers. They are the 5 percent of patients who account for at least 50 percent or more of all health care spending. Included in this cohort was the top 1 percent of Americans whose health care costs accounted for about 22 percent of total health care spending nationwide. Continue reading →
To Stevens’ way of thinking, there is one group positioned to overcome those barriers and push the system forward: Health plans. UnitedHealth and its competitors have the data, platforms and connections to become major change agents in the field of health care delivery, as well as the incentive to put it all to work improving outcomes and decreasing costs.
In addition to limiting and maybe even eliminating the proposed “public option,” insurers, led by UnitedHealth, have deftly steered legislators toward universally mandated coverage with little or no cost controls. After identifying the insurance behemoth with impressive influence in Washington as the ringleader of the effort, the reporters proceed to dig deeper into UnitedHealth’s closet, chronicling dirty laundry like rate hikes, sketchy databases and dubious plans for seniors.
Terhune and Epstein also point out that the Lewin Group – whose work (especially that showing how government-run care would harm the insurance industry) is often cited by legislators opposing a public option – is ultimately owned by none other than UnitedHealth. But Lewin isn’t the only arm of UnitedHealth making a cameo appearance in the reform debate, the number crunchers at its Ingenix wing and its chronic care OptumHealth subsidiary both stand to reap substantial windfalls from the proposed reforms.