Friday, September 07, 2007

Unitedhealth Gets Off Easy

I was going to comment on the ridiculously small sum ($20 million) UnitedHealth will have to pay the 36 states as part of a settlement to resolve problems with the insurer's claims-paying systems. Fortunately, Dr. Rich Fogaros over at The Covert Rationing Blog nails it on the head:
First, the insurance companies themselves are the only entities that fully understand their labyrinthine reimbursement schemes; they control the process. In this light it is telling that UnitedHealth Group and the regulators have been “negotiating” the “improved” reimbursement procedures for at least a couple of years. In a culture swimming in seamless electronic processing systems, the puzzle of simplifying claims processing should have been solvable in a couple of weeks.

Second, remember that the Wonkonians themselves, in the guise of Medicare and Medicaid, are also deeply engaged in purposefully mysterious reimbursement schemes. One suspects that there’s a limit to how far they’ll push the insurers toward transparency and simplicity, lest the expectation for similar processes is turned back on them.

Third, when was the last time any regulators have ever been able to simplify anything?
And when one figures that $6 million of that payout will go to New York alone (for their time and effort, I guess) and divides up the rest evenly among 35 states, we see that the other states get paid, on average, a little over $570,000 each.

Now compare that the top 25 CEO pay amounts (salary, bonus, exercised options and vested stock grants) for 2005 (the year the original suit was filed). We see that all twenty-five received over $35 million EACH in a single year.

Sorry, but when UnitedHealthcare CEO Kenneth Burdick says: “This new, forward-thinking approach focuses the regulatory process for the states and our company on a practical set of uniform performance standards, while providing clearer and more meaningful means of assessing how well we are serving customers.”

We get, it Ken. Crystal.

You won.

Guess we can look for those premiums to rise again next year to cover the cost of these "uniform performance standards," eh?


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