As I keep saying there’s money in those algorithms and insurers use Quants as well to help design their business models.  Scroll down for more on that topic.  You can watch the video below and maybe ask what kind of business model they have going here as the one patient in the video says she can’t go to her hospitals anymore as United owes them $11 million dollars.  These are Medicare patients that have United Part D plans.  In 2013 United patients will only have emergency access.  United didn’t even tell them but the hospital put a big ad in the newspaper.  This affects 10 hospitals in Florida, so that’s maybe how they do it. 

I guess it also helps to have the former HHS executive credited with writing the Healthcare Reform Law on the payroll too?  I wonder how many of their shareholders are insured by United?  Just a question. 

US Health Insurance Regulator Leaving to Take a Job at UnitedHealth Care As Vice President of the Optum Division – Moving to the “For Profit Side” With Business Intelligence Algorithm Dollars To Review

Remember earlier this year they bought a couple HMOS in Florida and sued the DOD for the Tri-Care contract in the west…

United Healthcare Buys Two HMOs in Florida–More Cheap or Free Hearing Aids for Seniors Perhaps–Subsidiary Watch

Update: UnitedHealthcare Sues Department of Defense Over Tri-Care Contracts–They Said They Would Do This – Is This A Case Of My Algorithms Are Better Than Yours?

It even gets real touchy here with what I call an all out technology war with Blue Cross as that subsidiary of Blue Cross looks like it will close and United is buying  up or giving contracts to the subsidiaries/partners of TriWest that will remain.  TriWest is owned by 11 Blue Cross and Blue Shield plans and two University Hospital systems so this gets even more interesting and do they use software that was created by United’s Optum division?

Is this a matter of a contract with the hospitals or did they not meet their goals that United set forward on existing contracts?  United’s Optum division, the formulas and algorithm side is really kicking in a big part of their profits these days and you can usually see that noted on every quarterly report they file. 

United Healthcare Preparing to Roll Out New Contracts To Pay Doctors& Hospitals For Meeting Goals and Keeping Costs Down– Plenty of Subsidiaries to Provide Some of the Technology And/Or Products & Generate Income–Subsidiary Watch

So what are these business models that CEOs can’t explain (i.e. Jamie Dimon) and others?  Nobody asks and nobody is accountable for their math and formulas with business models today and again insurers all have them along with their Quants.  Now here’s a great documentary that I have used many times here and it’s still be read daily about the Quants Being the Alchemists of Wall Street…nobody checks their math or formulas but that’s what makes the money…business models so complex that CEOs struggle to make sense out of them, but they don’t touch as the algorithms move money and bring profits to banks and corporations and society gets Algo Duped and sometimes fed a lot of flawed data. 

So whether it’s United or Banks or other companies think about these complex business models to where nobody is held accountable for formulas that could contain fiction and come from the somewhat fantasy world of some Quants…the video is a Quant telling you exactly that. I  kind of assume the other person in this video was a former Lehman tech but he’s paying $60k to go to Quant school now.  These are the corporate profits gained by the  Attacks of the Killer Algorithms.    BD

The nation's largest health insurer, UnitedHealth Group Inc., reported a 23% increase in third-quarter profit on the strength of continued growth in its Medicare and Medicaid businesses.

The Minnetonka, Minn., company raised its full-year earnings forecast and said overall medical costs among its customers remained largely in check. UnitedHealth is the first major health insurer to report third-quarter results, and it often sets the tone for the industry.

But UnitedHealth is also looking beyond the U.S. market for new customers. Last week, it agreed to acquire 90% of Amil Participacoes SA, Brazil's largest healthcare company, for about $4.3 billion, after certain tax benefits.,0,4753192.story


Post a Comment

Google Analytics Alternative