UnitedHealth paid nursing homes to limit hospital care, risking elderly patient safety.
A recent investigation has raised serious concerns about how one of the country’s largest health companies, UnitedHealth, may be handling care for seniors in nursing homes. According to whistleblowers and leaked documents, the company paid nursing homes bonuses for keeping hospital visits to a minimum. On the surface, this might sound like a good way to cut back on unnecessary trips to the ER, but the details suggest something much more troubling. Several insiders claim that these bonuses led to real harm for elderly residents who needed emergency attention but, instead, received delayed care. In some cases, patients were left with permanent injuries because help was delayed while staff tried to avoid hospital transfers that could raise costs.
UnitedHealth reportedly placed its own medical teams inside thousands of nursing homes across the country. These teams were encouraged to lower hospital transfer rates for patients enrolled in Medicare Advantage, a plan where the company gets paid a fixed amount for each patient. If care costs less than that amount, the leftover money becomes profit. The more they saved, the more they made. This created a powerful reason to avoid sending residents to the hospital—even if that meant taking risks with their health with delayed care. One former employee even said that the company kept close watch over how many patients were being sent to the hospital and rewarded or penalized nursing homes based on how low they could keep those numbers.
Some whistleblowers also said they were told to push elderly residents to sign documents agreeing not to be resuscitated in an emergency, even when those wishes didn’t match what the patients or their families really wanted. These decisions can carry heavy consequences, especially if they lead to someone not receiving life-saving treatment. In some cases, staff were said to have asked for patient records without proper permission so they could sign up more people for UnitedHealth’s insurance programs. There are even reports of employees backdating paperwork or enrolling patients who didn’t have the mental ability to give proper consent.
The company has denied all of these claims. UnitedHealth says it is not preventing anyone from getting the care they need and that its programs are meant to bring more support to nursing homes. They claim that their teams help patients get better care where they live, so they don’t have to go to the hospital as often. But for the families of those who were harmed—or who believe their loved ones were pressured into making medical choices they didn’t understand—those promises feel empty. One nurse practitioner who came forward with concerns said plainly, “No one is truly investigating when a patient suffers harm. Absolutely no one.”
This situation has caught the attention of federal investigators. The U.S. Department of Justice has launched a civil fraud investigation into UnitedHealth’s practices, and public pressure is building. Some advocates believe this story highlights a deeper problem in how senior care is handled when money is involved. When companies get paid more for doing less, it can lead to decisions that don’t always put patients first. The question now is whether the government will take stronger steps to stop what critics say is a dangerous pattern of placing profits ahead of people.
Sources:
UnitedHealth secretly paid nursing homes to cut hospital care, Guardian reports
UnitedHealth falls on report it secretly paid nursing homes to reduce hospital transfers
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