As everyone is focused on this global pandemic of COVID-19 or SARS-CoV-2, I will go on ahead and keep writing about insurance monopolies quietly controlling the healthcare system in the US. In my last article, I hinted to insurance companies monopolizing healthcare: providing insurance to the people, managing doctor practices, urgent cares, and controlling the flow of patients. Now, who knew, a day after I wrote that article, I would see this one “An insurance titan is dropping hundreds of N.J. physicians to enrich itself, doctors and patients charge”.
This article circulated amongst physicians quiet often. It hits home because a family member of mine is one of the doctors who is being dropped by these monopolies. UnitedHealthcare, whose revenues are expected to eclipse $260 billion this year, is back at it again. They are dropping hundreds of physicians in central and northern NJ Medicaid physician networks and funneling those patients to the practices they control. They are shifting patients to its Riverside Medical Group, a 20-office physicians’ practice owned by Optum, a sister company of UnitedHealthcare, both of which are owned UnitedHealth Group. Mind blown?
Now, why would insurance companies go on ahead and do that? Well, the consolidation of physician practices and hospital systems has made it very difficult for insurers to negotiate and control cost and hence, they have started building their own groups to combat that. Don’t believe the power such groups have? Look up RWJBarnabas Health in New Jersey and see how much of the healthcare market it controls and note that no Insurance company has the ability to negotiate with it.
Unfortunately, moves such as these are bad news for the independent physicians and patients. The patient-physician relationship is severed. After all, these are Medicaid patients, who tend to be the most complex of all patients and the most difficult to be compliant. Physicians have already built trusting relationships with such patients and worked with them overtime to get them to be compliant and help improve their quality of life. One can only imagine the difficulty of being forced to see another physician and start from scratch.
Practices such as Salerno Medical Associates whose patient population is 40% Medicaid, have already lost 500 patients and the numbers are continuing to climb, though there is a lawsuit pending against UnitedHealthcare. Riverside Medical offered to buy his practice in 2018 and he refused. Perhaps, this is their way of running him out of business.
It’s business as usual, right?