I have take the comment left by anonymous reader here and it’s worth a read and looking at.  If all of this contained here is in fact right to the point and imagefactual then it’s a new “low” on the part of insurers.  I can’t imagine a teenager getting this type of a letter without first notifying their doctor.  Did they jump the gun before the patient had a chance to meet with their doctor and send this letter out?  No matter how it happened, we have a huge break down with ethics here and the doctor/patient relationship and in this case add the parents in here too as they were not notified. 

When you read further here you can see there’s an admittance of a blood test for Lyme disease and that is whole different test than testing for glucose and blood sugar levels.   With a glucose test there’s usually a “fasting” period required, depending on the type of the test and a Lyme test would not require this as they would be looking for antibodies and not sugar.

I don’t know if I will hear back on this or not but I wrote a post about a year ago on the more aggressive analytics the company was implementing and this is where the comment was made today.  Below is a quote from the press release last year as well. 

United Healthcare Expanding Diabetes Prevention & Predictive Algorithm Program With Walgreens And Pay for Performance Incentives In Atlanta

“The prevention arm will use UnitedHealth claims data and other demographic information to flag people at risk of developing diabetes and invite them to a free, 16-session exercise and nutrition class at a local YMCA. They’ll have monthly follow-up after the class is over, and instructors will be paid bonuses if participants meet certain modest weight-loss goals.”

The company is convinced that pay for performance is the answer to almost all healthcare woes as today there was a press release talking about a new imageCancer Payment Model paying physicians for health outcomes.  I don’t know about you but when I read the press release it almost sounds like they think the cures for cancer are here today and are somewhat implicating patient survival rates in here somewhere as reducing cost is right in there too.  They talk about the “buy and bill” to where oncologist buy the more expensive drugs and keep them on hand and bill for them. 

Many of the MDs I know don’t do much in office chemo any longer as they were cut a few years ago with reimbursement and now can’t afford the wait time for claims to be paid and some were not getting reimbursed at all if the analytics of the insurance company decided later not to pay.  It may be different in other states but so many in California couldn’t afford it anymore.  Let’s also not forget we have a chemo drug shortage going on too which doesn’t affect all cancer treatments but enough to be declared a shortage as patients are not getting their treatments on time or all the time. 

Back on track, this is a good read here and let’s hope someone is working on fixing this so the “letter algorithms” don’t start kicking out cold crappy letters like this and again you wonder as the parent of the teenager makes note of, how much privacy is here?  I really do hope to hear back for an update here to see if it really is diabetes, pre-diabetes and how the blood test algorithm kicked out this letter without first getting in touch with the patient’s doctors.  This is a brand new low from insurers. 

Aetna too has been having problems with their algorithms keeping track of who and who is not in network with mailing 8000 folks in California that their doctor was no longer in network and they admitted it was an error, but all the while 150 doctors in Texas found out there were getting cut out, so insurers and their algorithms. 


When you hear stuff like this it’s one more Attack of the Killer Algorithms, below is the reader comment….BD 


“Our teenage daughter just received a letter from UHC saying she had imageDiabetes!    None of her healthcare providers have ever mentioned this!
The United Healthcare letter has this at top:
"you have diabetes. You know it. And that means you can control it."

The letter then says Dear so and so, Our medical records indicate you may have diabetes, and that puts you in a perfect position to do something about it...".....Enroll in the Diabetes Control Program.

Can you imagine receiving a letter from your insurance company stating that you or a loved one has a disease that you have never worried about before?
Ironically, this will provoke me into getting my daughter a Doctor's appt and tested asap.

What a mean and inappropriate way to scare people. If there IS any evidence that my daughter has diabetes, why didn't UHC send us a personal note with the evidence?

Why have none of the providers who have seen our daughter and that UHC reimbursed and paid never mentioned this to any of us? Never. Are they randomly sampling blood given for other tests? Our daughter had a Lyme disease test in March, not a glucose test.

It raises some serious questions, don't you think? How private is your blood? How safe is your insurance company regarding data mining and manipulation of unnecessary tests.

I hope our daughter doesn't have diabetes, but if God forbid she does, what a hell of a way to find out about it.
If she's fine, then I have a lot more questions and comments about UHC sending us this letter.


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