A System Exploited
The Journal’s analysis also showed that insurers often added diagnoses to patients’ records using artificial intelligence and home visits from nurses. These “diagnoses” often contradicted what the patients’ doctors had recorded. Some insurers even incentivized patients to agree to home visits with gift cards and other perks. As a result, a staggering number of Medicare Advantage patients were diagnosed with conditions that traditional Medicare patients simply didn’t have. In fact, patients enrolled in Medicare Advantage were 15 times more likely to be diagnosed with diabetic cataracts than those in traditional Medicare.
UnitedHealth Group, one of the largest Medicare Advantage providers, pushed back against the findings, claiming the Journal’s report was “inaccurate and biased.” They argued that Medicare Advantage provides better outcomes and more affordable care for millions of seniors. However, the data paints a starkly different picture. The system has become more expensive than traditional Medicare, accounting for over $450 billion in taxpayer dollars annually.
