A Guardian investigation finds insurer quietly paid facilities that helped it gain Medicare enrollees and reduce hospitalizations. Whistleblowers allege harm to residents
It matters because they control both groups involved in this decision and are financially incentivizing not calling a hospital. They aren’t solving how to make a more efficient determination, they’re pushing people away from getting potentially much needed care. They are functionally paying people to not act when lives are on the line. Train them. Teach them. Don’t literally reward them for rolling the dice with lives.
That is a terrible way to incentivize someone to change their behavior when they could be very well determining who lives or dies. And as we gleaned from the article, there have been totally avoidable casualties from this program.
“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.’”
It’s not complicated. The problem is complicated, but the solution is simple and cruel.
It matters because they control both groups involved in this decision and are financially incentivizing not calling a hospital. They aren’t solving how to make a more efficient determination, they’re pushing people away from getting potentially much needed care. They are functionally paying people to not act when lives are on the line. Train them. Teach them. Don’t literally reward them for rolling the dice with lives.
That is a terrible way to incentivize someone to change their behavior when they could be very well determining who lives or dies. And as we gleaned from the article, there have been totally avoidable casualties from this program.
It’s not complicated. The problem is complicated, but the solution is simple and cruel.