How insurers use doctors to profit off medical codes

Insurers like UnitedHealth are profiting off of the Medicare Advantage system, and it’s causing problems for both doctors and patients.

Traditional Medicare is run by the federal government, while Medicare Advantage health insurance plans are operated by private companies like UnitedHealth. These privately run plans are still subsidized by government funds. Medicare Advantage insurers are paid a set monthly amount for each of their members regardless of whether they received care that month or not. That amount is based on each patient’s personal risk score. The sicker the patient is, the higher their risk score, and the bigger the check insurers receive from the government.

This system is intended to prevent insurers from favoring healthier people over those who have illnesses, but it also leaves room for insurers to make more money by making their patients appear as sick as possible.

This video is part of Health Care's Colossus, a STAT Investigation by Tara Bannow, Bob Herman, Casey Ross, and Lizzy Lawrence. Read it here:

Part 1: How UnitedHealth harnesses its physician empire to squeeze profits out of patients https://tinyurl.com/Colossuspart1
Part 2: How UnitedHealth turned a questionable artery-screening program into a gold mine https://tinyurl.com/Colossuspart2
Part 3: UnitedHealth pledged a hands-off approach after buying a Connecticut medical group. Then it upended how doctors practice https://tinyurl.com/Colossuspart3

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