United Health's Cancer Payment Experiment = Patient Danger?

[AllenChicago]

It seems to me that United Health is playing right into the ObamaCare flawed methodology by lumping all cancer patients into catagories and then paying the physicians & hospitals only enough for standard treatment regimes. There's no incentive for the physician to individualize treatment to a patient's specific needs. Since every patient's needs are unique, grouping treatments in this manner is not good medicine, IMO. This United Health experiment reminds me of how the "scheduled benefit" type of insurance plans pay a fixed dollar amount for specific surgeries, illnesses, etc. If United Health customers knew about this, they wouldn't be happy.

Excerpt:
"Health insurer UnitedHealth said Tuesday that it will test a new way payment method for cancer doctors. The program pays doctors a lump sum payment for providing care during an entire course of care for the disease instead of how it's done now — with a fee for each service a doctor provides."


List of News Stories on this Subject:
UnitedHealth Says It Will Test Lump Sum Payments For Some Cancer Care - Kaiser Health News


In addition, it appears to me that the patient is in serious trouble if the lump-sum payment isn't enough to cover their full treatment regime. What if United Health only pays $90,000, but your total treatments run up to $140,000? Does the hospital simply stop the cancer treatments when your tab reaches $90,000? It seems that UnitedHealth is breaking the new law by capping payments in this manner. But, since it's a way to reduce the upward cost curve, HHS will probably give UnitedHealth a big hug and encourage other companies to follow their example. The fact that patients could suffer financially, and/or die un-necessarily, is just a price to pay for achieving the goals of ObamaScare.

-AC

 

[somarco]

I fail to see how this differs from the ACO model that is being adopted by Medicare.

 

[Post Quartermaster]

Capitation with a new twist!

In addition, it appears to me that the patient is in serious trouble if the lump-sum payment isn't enough to cover their full treatment regime. What if United Health only pays $90,000, but your total treatments run up to $140,000?

Obviously, as long as the provider was contracted/in-net with UHC, one would assume that the 90k is the contracted amount for the "bundle" of procedures/treatment......providers will get efficient or providers will leave the network......


It'll be like the 90's all over again!!!

 

[Crabcake Johnny]

I was reading another article about a week ago (will try to find it) going over the ethics of the final days of cancer patients and medication that costs thousands a day that's only purpose is to keep them alive about a week longer.

These medications do not offer any hope of a cure or reversal but the drug companies maintain they're important for the further research of medications.

In the mean time, health carriers are paying in some cases $50K to keep a patient alive for literally days more and families - since they don't pay for it - are all on board with anything that gives them hours/days/weeks more.

 

[AllenChicago]

I guess the end result of this lump-sum "take it or leave it" will be to terminate a cancer patient, if he/she needs more treatment than what United Healthcare sees as usual and customary.