If it isn’t a government contract to manage care it’s a dispute imagewith a hospital.  It is getting worse and more cumbersome all the time.  This contract seems to evolve around out of network charges an area United Healthcare knows a lot about if you go back to the Ingenix lawsuit settlement to where doctors and hospitals were short paid for 15 years with lowballing the customary fees last year.  Everybody wants patients to take a greater role with their care and education today, but this stuff acts as somewhat of a deterrent as it makes it difficult.  Has anyone said that yet? 

Here’s an example below of Aetna and several other contract disputes and there’s a bunch of United links mentioned there as well relative to other contracts across the US.  If you read the entire source here it states that United just sent a letter cancelling the contract and didn’t even come to the table to negotiate…the algorithm did it more than likely with an automated letter that cancelled the contract as it did not meet the parameters of the query ran and probably done via business intelligence software.  They kick out and you deal with it, a lot of that going on today. 

Aren’t These Health Insurance Contracts a Bitch! Aetna Suing City of Jacksonville Over Decision to Award Contract to Florida Blue- Battle of the Algorithms

It is interesting today with the multi faceted insurers to see where a stall with a contract one one end is working, but on the other hand with all the subsidiaries owned today another one of their companies might give them a grant, give them a big break on pricing for Health IT, or even give them a break on cheap hearing aids, but yet the major contract for reimbursement gets left on the table all the time.  I try to keep up with this so consumers and businesses know the bottom line of the big conglomerate they are feeding with money as it helps.  It’s all about those algorithms that create business models today and some so complex that CEOs have no clue on how they work within their own company.  Algorithms move money and create profits. 

Subsidiary Watch-Corporate Conglomerate Insurers Reduce Compensation Contracts Using One Subsidiary Then Market Same MDs With Another Subsidiary in Health IT

So in summary all these contracts do make it a lot more difficult to get consumers involved in their healthcare as they have to look at dollars first and where they can go, so with all of this we have a Catch 22 situation as insurers will offer you all kinds of tools to use, but gee, are you a party of a big contract to where they will benefit you?  Of course too many of the insurer subsidiaries sell your data too and make millions doing there as well with the “data for nothing and profits for free business model they and all other big conglomerates use to include banks.  Taxing data sellers could really help fund the NIH and FDA too for a portion of the money collected.  If you read in the news each week you can’t help but see to where someone quotes that corporate profit levels are at an all time high, why?  Because they all sell data and profit immensely.  BD   

One More Good Reason to Tax the Data Sellers– Create Additional Funding for the NIH and FDA From Sources That Otherwise Are Too Greedy to Share & Contribute

Hartford Hospital and UnitedHealth Group, the nation's largest health insurer, are in a hard-fought contract negotiation that could leave thousands of customers facing higher out-of-pocket expenses if the current agreement expires Oct. 28.

"Hartford Hospital wants consumers to pay 30 percent more over the next three years for services received at their facilities," said Daryl Richard, spokesman for UnitedHealth Group.

"In practical terms, that means the average cost for a two-day hospital stay after delivering a baby would increase by as much as $650, and the average cost of outpatient surgery, such as arthroscopic knee surgery, would increase by almost $300."

"Back in March of this year we received a termination notice from United," Hartford Hospital CEO and President Jeffrey Flaks wrote to patients in a letter dated Sept. 27. "In fact, United ended our relationship without ever exchanging proposals or trying to reach a new agreement. If United had come to the table and negotiated with us prior to terminating the agreement, we are confident a new agreement would have already been reached."


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