© Am Ang Zhang 2009
The company is a huge force within US healthcare, with 70 million Americans on its books, employing 400,000 doctors in 4,000 hospitals. UnitedHealth is America's biggest health insurer. And it's growing in influence in Britain.
It already runs two GP practices in Derbyshire and now the government has given the green light to 14 companies, including United, to bid for potentially much bigger contracts from the primary care trusts that run hospitals. They would be paid for providing data analysis and research, giving trusts a clearer idea of how to manage patients with chronic conditions such as diabetes.
But their role may be bigger than that. Companies may also be invited in to act as middlemen, negotiating with hospitals on the trusts' behalf to reduce costs, ushering in the prospect that some patients may find their care plan managed not by a doctor but by an American insurance company.
Allowing UnitedHealth and others into the NHS fills the unions and many health workers with horror. That dismay will be amplified when they watch Michael Moore's latest film, Sicko, which alleges that United and other big US insurers routinely deny care for patients who may be critically ill.
In the WSJ there was a report:
“……UnitedHealth Group Inc. (UNH) agreed to pay $912
million to settle two class-action lawsuits regarding its stock-options
practices……”
Rewind to last year in the New York Times:
“In one of the largest corporate pay give-backs ever, William W.
McGuire,
the former chief executive of UnitedHealth Group, has agreed to forfeit at least $418 million to settle claims
related to back-dated stock options.”
How
very sad! $418 million is a lot of money!
“The payback is on top of roughly $198 million that Mr.
McGuire, an entrepreneur who built UnitedHealth, had previously
agreed to return to his former employer.”
An entrepreneur! This reminded me of Dr Crippen’s blog about
NHS entrepreneurs, and I duly alerted him. UnitedHealth is said to cover the
Health Insurance of 70 million US
Citizens.
“As part of the settlement with the S.E.C., Mr. McGuire
will pay a $7 million fine and will be barred from serving as a director of a
public company for 10 years.”
Oh,
no, another $7 million and 10 years! You must feel sorry for him.
“He will, however, be allowed to keep stock options
valued at more than $800 million, including many that have been sharply
criticized.”
Jul 20, 2010
UnitedHealth Profit Jumps as
Medicare, Medicaid Grow
UnitedHealth
Group Inc., the biggest U.S.
health insurer by sales, raised its full-year profit forecast after increased
enrollments and lower-than-projected medical costs lifted second-quarter
earnings 30 percent.
The
insurer forecast 2010 profit of $3.40 to $3.60 a share compared with a previous
projection of $3.15 to $3.35, citing growth in sales or membership for all
business units. Net income rose to $1.12 billion, or 99 cents a share, for the
quarter, from $859 million, or 73 cents, a year earlier, the company said
today. The earnings and forecast topped estimates.
Chief
Executive Officer Stephen Hemsley boosted enrollment in Medicare Advantage, the
U.S.-backed program for the elderly. Weakness in the economic recovery in the U.S. also helped, by keeping people away from
doctors and hospitals, said Jason Gurda, a Leerink Swann & Co. analyst in New York. UnitedHealth
did better than expected for commercial enrollment, taking business from rival
insurers, he said.
October
18, 2006
UnitedHealth's Options Scandal Shows
Familiar Symptoms
Stephen
Hemsley, who upon being hired in June 1997 was presented with 400,000 stock
options with an issue date of five months earlier. Hemsley told the Wilmer Hale
lawyers that he "didn't recall focusing at the time" on the $2.9
million gimme he'd just been handed as a result of the backdating.
You
might say that Hemsley comes honestly to his lack of focus and ethical
sensitivity. Before coming to UnitedHealth -- I'm not making this up -- he'd
spent the previous 23 years at Arthur Andersen, rising to chief financial
officer. That's the same accounting firm that helped bring you Enron, WorldCom
and Freddie Mac. And, you'll be shocked to learn, it's the same Arthur Andersen
that served as a consultant to Spears and other members of UnitedHealth's
compensation committee.
Hemsley
was rewarded for his lack of focus by being named to succeed McGuire as chief executive.
He was also directed to root out the senior executives in the legal, accounting
and personnel departments who provided the bad advice on which the board and
chief executive now say they have relied. Hemsley, too, has volunteered to
reprice his options.
The reward:
Chief
executive Stephen Hemsley pulled in $102 million in 2009, with $98.6 million
coming from exercised stock options, according to a filing with the Securities
and Exchange Commission Wednesday. Star Tribune
Friday
16 July 2010
The
Minnesota-based firm beat Bupa and Humana to win the contract from the health
department to advise PCTs
The Minnesota-based UnitedHealth has already become a key
adviser to primary care trusts (PCTs) on commissioning health services and
operating bids to run GP practices. Earlier this month it beat Bupa and Humana,
another US
health insurer, to win the contract from the health department to advise PCTs.
The decision follows successful bids to run two GP
practices in Derbyshire in 2006 and three practices in central London in 2008, taking over from the
Brunswick Group. In April the company announced a 21% increase in profits for
the first three months of the year to $1.2bn (£784m).
United said it brought high level management expertise and
efficient provision of services to the UK health service but it has faced
accusations of overcharging and malpractice in a series of legal suits.
New
York Settlement:
January 15, 2009
UnitedHealth
Group Inc., the biggest U.S.
health insurer, said it will spend $400 million to settle allegations it has
manipulated payments to doctors and patients for the last 15 years.
The company agreed to put $350 million into a class-action
restitution fund to pay physicians and policyholders for services provided by
out-of-network providers, the company said in a statement today. On Jan. 13,
the Minnetonka, Minnesota-based insurer settled allegations from New York
Attorney General Andrew Cuomo by paying $50 million and transferring to a
nonprofit group its database that set the amount to be reimbursed when patients
used doctors outside their network.
UnitedHealth has been battling the largest physician group,
the American Medical Association, over out-of-network costs since 2000. The
settlement affects less than 10 percent of health benefits because most
policyholders use their health plan’s network providers to minimize
out-of-pocket expenses. Still, the AMA said it stopped rampant cheating Its California subsidiary
was fined a record $3.5m in the same year for mishandled claims against
patients and doctors. In 2006 The UnitedHealth chief executive William McGuire
resigned after an investigation "concluded he had received stock option
grants 'likely backdated' to allow insiders to maximise financial gains."
During his tenure as chief executive, McGuire was granted more than $1.6bn in
stock options. In 2007, McGuire avoided trial after he agreed to repay $468m.
In one example, Cuomo’s office said that when $200 was a
fair-market rate for a 15-minute doctor’s visit for a common illness, Ingenix
said it was $77. UnitedHealth would pay $62 when it should have paid $160,
leaving the consumer with a $138 bill.
The British Medical Association may now have a new role.
The future is here now:
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