The transition has begun and the former Blue Cross subsidiary who tried to hang on and the that members of Tri-Care wanted to keep is slowly going out of business as the loss was too big for them to sustain.  If you followed the couple of years of Tri-Care updates, and it was a long one, United wanted the south too until Humana protested the award and got it back so that only left the west and when they didn’t get it, the company sued DOD to get it.  This contract was worth around $20 billion so to the court they went to get their money to manage care.  I think they make more from all their subsidiaries be it their bank, wellness, analytics, EHR companies etc than they do selling policies. 

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?

UnitedHealth Loses Tri-Care Protest Again With Contract Awarded to Humana in the South-Now Protesting Contracts Awarded In Both the South and the Western States

Back when it looked like they were going to get the award for the Northeast before the Health Net issued a complaint and got it back, the loss that Health Net was going to incur caused the company to sell of patients and policies in a couple of states back there like Connecticut.  In July of last year Tri-West even took their campaign to the internet but they just could not compete with the business models, algorithms and math formulas that United produced.  That’s how the company makes a lot of money plus selling a lot of your data and if not from the main company, there’s ton of United subsidiaries that sell tons of data.  I wonder how much they make selling data as if Walgreens can make short of $800 million selling data alone in 2010, these folks have to be up around 2 or 3 billion in profits selling data and they were one of the first to make money selling data.  If you were to break down and really look at all the subsidiaries under the United corporate blanket they almost have a company that could handle everything from introducing a drug to the FDA all the way down to physician/hospital reimbursement.  You know they make their money with mathematical formulas and analytics as if you look at job ads at any given time they are always advertising for more “Quants”. If you don’t’ know what those jobs are watch the video on the left and you can learn what Quants do on Wall Street and it’s not much different with companies as they write model and the code. 


Tri-West Takes Their Campaign to the Internet Protesting Award of The Award of the Tri-Care Contract to United Healthcare––Final Decision Date Slated for July 5th


So in essence with the data selling and algorithms Blue Cross was pretty much under direct attack here with technology from United.  It’s interesting as to when you read the article, the DOD won’t say why or give a clear answer on why United has the contract. 

“The loss of the contract, which is renewed every five years, was announced last summer. As to why, Celley said the Department of Defense hasn’t given them a clear answer.”

The algorithms probably backed them into a corner somewhere along the line as that’s how they operate as you can remember for 15 years their formulas and algos enabled them to pay doctors and hospitals short for out of network services.  So far it says there won’t be any change in care and patients need not worry, but we didn’t and don’t have the same here in the OC with regular insurance policies since they bought up the large physicians groups.  Crying towels came out in the OC when that happened.  Only half of the employees will get to move over to Untied and the rest will be out of work.  I wonder if they will be bused to a hotel like they did here in the OC. 

UnitedHealthcare Lays Off 180 Employees In Orange County-Initial Notification Sent By Instant Message to Those Affected

April 1st is the actual cut over date and there are 80 locations in the west that are set to be closed down.  Is the word “divest” ever going to come up with this company as they are so big and even have subsidiaries in some areas that compete against themselves in the IT areas.  BD

TriWest Healthcare Alliance's
Tricare West medical clinics in Hawaii will transition to UnitedHealth Group after TriWest lost a $17 billion contract renewal with the Department of Defense last year.

“Beginning today, we switched over operations of our various locations on the Islands and also across the Western United States and we will operate on a dual-operations period from now until April 1, at which point UnitedHealth will take over,” TriWest spokesman Scott Celley said. “There are roughly 80 locations across the West today that we are closing down.”


Post a Comment

Google Analytics Alternative