Presto Chango, Can a Leopard Change His Spots?
UnitedHealth cured the Ingenix stigma by simply changing its name to OptumInsight. It’s as though they made a deal with a witness protection program. Like other large medical insurers, over the years, they sustain fines for federal racketeering, skirt state laws by systematically reducing, denying and delaying payments owed to doctors for medical care and pay fines in the billions and still they continue on!
Who dispenses Medicare and ACA money? Who controls the prices that the exchanges charge? And who is operating the very workings of the exchanges? That would be the leaders of the pack, UnitedHealth and Optum.
Santa Fe, New Mexico, 18 June 2015
by TAMMM Staff
The infamous Ingenix, a wholly-owned subsidiary of UnitedHealthGroup, decided to have a baby: OptumInsight.
It’s touching, really. A new baby with a new name… and an even bigger game!
The baby was born on April 11, 2011, as reported in this article by Emily Berry for American Medical News, “Ingenix name retired as United re-brands subsidiaries”. The baby is now a budding 4-year-old and heading for industry domination.
United HealthGroup’s health data subsidiary Ingenix, once known for its role in setting out-of-network physician payments, now will be known as OptumInsight.
Ingenix was forced to shutter that business after an investigation by and subsequent settlement with the New York attorney general’s office.
At the time, Andrew Cuomo, then New York’s attorney general and now governor, said the databases were skewed to produce lower payment rates for physicians and patients for out-of-network care. Cuomo ordered Ingenix to stop producing the database as soon as a new, independently derived and operated database could be created. That new database, FAIR Health, is now operational and has replaced the PHCS and MDR products.
Company spokeswoman Christine Farazi said the decision to re-brand was not driven by negative publicity linked to the Ingenix brand.
Right. Farazi saw things differently. She says the decision to “unify our brand presence under the Optum master brand was absolutely driven by what our clients told us they need.” How convenient.
To put the Ingenix fraud into perspective, Governor Cuomo described a typical scenario. An out-of-network doctor who charges $200 for an office visit is told that the “going rate” is only $77. The insurer would then normally pay only 80 percent of that figure, leaving the patient responsible for the difference of about $138. At the heart of New York’s lawsuit is how that $77 rate was set in the first place. Come to find out, the number is derived from a database of claims data created and maintained by Ingenix and then sold to other insurers.
Don’t take our word for it. Cuomo’s Attorney General described Ingenix and UnitedHealth’s use of data as “deception, manipulation of data and outright fraud.”
The following analysis of the earnings and structure of Optum clearly reveals that these boys are in it for the really big bucks.
Please pay special attention to Larry Renfro, now head of Optum, but formerly the president of AARP Financial.
Previously, we have discussed the cozy relationship between AARP and UnitedHealth who are together being sued in a class action suit brought by several parties for insurance fraud. So the acorn does not fall far from the tree!
If this were not so tragic with respect to the American public’s best interests, it could be the basis of a sitcom series.
Optum is well down the track in establishing a giant conglomerate which incorporates their version of two incredible, unproven and self-serving premises in healthcare: Evidence-Based Medicine and Value-Based Pricing. (TAMMM has discussed EBM previously in the article, “The Evidence-Based Medicine Lie Exposed” and will be delving into Value-Based Pricing very soon.)
Concurrently, the big insurance players are eating each other up through mergers, now underway, that will likely result in two-to-three major medical insurance behemoths. These are likely to be led by UnitedHealth and Optum, their keeper of the sacred data, which justifies fixing prices to fuel the American medical money machine.
When these boys play, they play for keeps. Ingenix may be history, but Optum, the son of Frankenstein, has special powers and a giant war chest which only legislation and very tight regulations can control. The government is unlikely to intervene.
And wouldn’t you know it? This insurance industry domination arrangement plays right into the hands of the Affordable Care Act. No wonder Obama has a big grin on his face. His relationship with AARP/United has never been stronger. The likelihood that he will personally benefit once he leaves the hallowed halls of the White House is extremely high.
Here is a direct quote from our Dear Leader in February of this year. It’s truly poetic.
Remarks by the President at the AARP
THE PRESIDENT: Thank you. (Applause.) It is great to be back here—not just to pick up my AARP card. (Laughter.) I want to thank Jo Ann and everybody at AARP for the work you do every single day on behalf of seniors. I am especially grateful to all of you for the work you’re doing to help us prepare for the White House Conference on Aging, which will be coming up later this year and will cover a whole host of issues, including protecting one of the most critical components of middle-class life, and that’s a secure and dignified retirement. And that’s what we’re here to talk about today.
You see, ladies and gentlemen, what has happened to medicine in America has happened across the board in so many industries. The public knows it and the ratings show it. Every major poll indicates that more than half of the population of the country disapproves of Obama’s performance. Our contention is that as Obamacare settles in (pending the outcome of the Supreme Court Case King v. Burwell) these stats of disapproval will continue to plummet.
Don’t Forget the Stupidity of the American Voter
The most recent revelation as reported by Forbes is that Jonathan Gruber of MIT, one of the chief architects of Obamacare, who mocked “the stupidity of the American voter” for not perceiving the ways in which the controversial health law concealed its true costs, was in no way an independent expert.
At the time, President Obama and others went through great lengths to deny Gruber’s centrality to Obamacare. But 20,000 pages of new emails, obtained from MIT by the House Oversight Committee, appear to prove Gruber’s critical role. And Gruber’s role may help decide the King v. Burwell case that is now before the Supreme Court, the one that will shape Obamacare’s implementation for years to come.
Well, America: Belly up to the bar. You’re buying drinks for the house!
In other words, the architects knew very well that Obamacare was not going to save you and me money. They knew it would be quite the opposite. They pulled a fast one on the public and some members of Congress. But now the bill is coming due. Americans are beginning to realize that they may have insurance, but that they are not covered for real medical care because it’s too expensive.
So who do you think dispenses Medicare and ACA money? Who controls the prices that the exchanges charge? And who is operating the very workings of the exchanges? It’s UnitedHealth and Optum that stand to make a killing through Obamacare. A killing which they played a key role in arranging and pushing through Congress with four healthcare lobbyists for every one Representative and Senator in the country when Obamacare was being debated.
In fact, UnitedHealth has made a cottage industry out of the ACA through Optum, which has become the go-to fix-it company for troubled insurance exchanges. Yes, it was our very own Optum that was on the team ordered to swoop in and help the disastrous rollout of healthcare.gov get back on track.
Forget not the famous words of Nancy Pelosi, that pillar of wisdom, which you can hear again for posterity: “We have to pass the bill so that you can find out what’s in it away from the fog of the controversy.”
Well folks, you’re about to find out what’s in it…what’s in it for United and Optum. They are standing in the wings to bag billions as the top dog of the biggest, most powerful insurance cartel ever.
Optum, Inc.: Your Worst Nightmare
UnitedHealth Group (with 350 Incorporated Affiliates) has two operating businesses:
- UnitedHealthcare, a health benefits business that serves more than 70 million individuals nationwide, and
- Optum, a health services business with three operating divisions:
- OptumInsight (previously Ingenix)
- OptumRx (previously Prescription Solutions)
Keep in mind all of these Optum companies are wholly-owned subsidiaries of UnitedHealth Group. And just look how well they are performing for their parent:
Optumhealth, Inc. Reports Earnings Results for the Third Quarter Ended September 30, 2014
For the period, the company reported revenues of $2.8 billion grew 14 percent year-over-year, led by expansion and growth in integrated care delivery services. Earnings from operations were up 16 percent year-over-year. These results were led by Collaborative Care businesses.
Who is the face of the Optum baby? That would be Larry C. Renfro, Vice Chairman and Chief Executive Officer of Optum. His total calculated compensation for 2014 was a tad more than $12 million. His base salary is only $900,000. The rest of the cash showers down in bonuses and stock options and other perks of the trade.
And wouldn’t you know it. Mr. Renfro was formerly the president of AARP Financial. In fact, he lead the team that created AARP Financial and the AARP Funds!
Let’s look at Optum’s ever-growing empire Mr. Renfro orchestrates:
- Optum, Inc
- Optum Health Financial
- Optum Bank
- Optum Palliative and Hospice Care
- Optum RX
- Optum Medical Network
- Optum CarePlus Care Management
- Optum Clinic + Urgent Care
- Optum Health Allies
- Optum Coding
- Optum Labs
- Optum 360
- Apple Care Medical Group Urgent Care Centers
- Monarch HealthCare
- Southwest Medical Associates
- Hi Health Innovations
Of course, these 16 are just a drop in the bucket for Optum’s Godfather UnitedHealth! Please take a look at the 350 Incorporated Affiliates to check how close they are operating in your neck of the woods.
- 310 Canyon Medical, LLC
- ACN Group IPA of New York, Inc.
- ACN Group of California, Inc.
- AHJV MSO, Inc.
- AHJV, Inc.
- A-Life Medical, LLC
- All Savers Insurance Company
- All Savers Life Insurance Company of California
- AmeriChoice Corporation
- AmeriChoice Health Services, Inc.
- AmeriChoice of Connecticut, Inc.
- AmeriChoice of Georgia, Inc.
- AmeriChoice of New Jersey, Inc.
- Amico Saúde Ltda.
- Amil Assistência Médica Internacional S.A.
- Amil Clinical Research Participações Ltda.
- AMIL International S.á.r.l.
- Amil Lifesciences Participações Ltda.
- Aperture Credentialing, Inc.
- Arizona Physicians IPA, Inc.
- ASI Global, LLC
- Aveta Arizona, Inc.
- Aveta Colorado, Inc.
- Aveta Health Solutions Inc.
- Aveta Inc.
- Aveta Kansas City, Inc.
- Aveta Tennessee, Inc.
- Connected Software, Inc.
- Behavioral Healthcare Options, Inc.
- Bosque Medical Center S.A.
- CanReg (Europe) Limited
- Care Improvement Plus Group Management, LLC
- Care Improvement Plus of Maryland, Inc.
- Care Improvement Plus of Texas Insurance Company
- Care Improvement Plus Practitioners, LLC
- Care Improvement Plus South Central Insurance Company
- Care Improvement Plus Wisconsin Insurance Company
- CareMedic Systems, LLC.
- Carlton Life – Residências e Serviços S.A.
- Catalyst360, LLC
- Cemed Care Empressa de Atendimento Clínico Geral Ltda.
- ChinaGate (Hong Kong) Limited
- ChinaGate Company Limited
- Citrus Health Care, Inc.
- Coachella Valley Physicians of PrimeCare, Inc
- Collaborative Care Holdings, LLC
- Collaborative Care Services, Inc.
- Collaborative Care Solutions, LLC
- Comfort Care Transportation, LLC
- Commonwealth Administrators, LLC
- Connextions HCI NM, LLC
- Connextions HCI, LLC
- Connextions, Inc.
- DBP Services of New York IPA, Inc.
- Dental Benefit Providers of California, Inc.
- Dental Benefit Providers of Illinois, Inc.
- Dental Benefit Providers, Inc.
- Distance Learning Network, Inc.
- Duncan Printing Services, LLC
- Electronic Network Systems, Inc.
- ELG FZE
- Esho – Empresa de Serviços Hospitalares S.A.
- Etho – Empresa de Tecnologia Hospitalar Ltda.
- Evercare Collaborative Solutions, Inc.
- Evercare Hospice, Inc.
- Evercare of Arizona, Inc.
- Excellion Serviços Biomédicos S.A.
- Executive Health Resources, Inc.
- Exploration for Mine Clearance LLC
- Exploration Logistics B.C. Ltd.
- Exploration Logistics Group for Medical Services PLC LTD
- Exploration Logistics Nova Scotia Limited
- Family Health Care Services
- Family Home Hospice, Inc.
- FMG Holdings, LLC
- FOR HEALTH OF ARIZONA, INC.
- For Health, Inc.
- Frontier Medex Tanzania Limited
- FrontierMEDEX (RMS), Inc.
- FrontierMEDEX Canada Holdings Ltd.
- FrontierMEDEX Canada Limited
- FrontierMEDEX Government Services, LLC
- FrontierMedex Kenya Limited
- FrontierMEDEX Limited
- FrontierMEDEX US, Inc.
- FrontierMEDEX, Inc.
- Golden Rule Financial Corporation
- Golden Rule Insurance Company
- H&W Indemnity (SPC), Ltd.
- Health Net Insurance of New York, Inc.
- Health Net Services (Bermuda) Ltd.
- Health Plan of Nevada, Inc.
- Health Technology Analysts Pty Limited
- HealthAllies, Inc.
- Hospice Inspiris Holdings, Inc.
- Hospice Inspiris of Pennsylvania, Inc.
- Hospice Inspiris of Texas, Inc.
- Hospital Alvorada de Taguatinga Ltda.
- Hospital Monte Klinikum S/S Ltda.
- HPP – Hospitais Privados de Portugal, SGPS, S.A.
- HPP A.C.E.
- HPP Algarve, S.A.
- HPP Boavista, S.A.
- HPP Lusiadas, S.A.
- HPP Saúde – Parcerias Cascais, S.A.
- HPP Viseu, S.A.
- Humedica, Inc.
- Hygeia Corporation
- Hygeia Corporation (Ontario)
- Imed Star Serviços Médicos e Odontológicos Ltda
- Information Network Corporation
- Informed Choice HealthCare Alliance, Inc.
- Ingenix Innovus (Netherlands) B.V.
- Ingram & Associates, LLC
- INSPIRIS of New York IPA, Inc.
- INSPIRIS of New York Management, Inc.
- Inspiris of Tennessee, Inc.
- INSPIRIS of Texas Physician Group
- Inspiris Services Company
- Inspiris, Inc.
- International Psychological Services Pty Limited
- Lifeprint Accountable Care Organization, LLC
- Lifeprint East, Inc.
- LifePrint Health, Inc.
- Logistics Health, Inc.
- Lynx Medical Systems, LLC
- K. Diagnóstico por Imagem Ltda
- MAMSI Insurance Resources, LLC
- MAMSI Life and Health Insurance Company
- Managed Physical Network, Inc.
- MD Ops, Inc.
- MD-Individual Practice Association, Inc.
- MEDEX Insurance Services, Inc.
- Medica Health Plans of Florida, Inc.
- Medica HealthCare Plans, Inc.
- Medical Preparatory School of Allied Health, LLC
- Medical Transportation Services, LLC
- MHC Real Estate Holdings, LLC
- Midwest Security Life Insurance Company
- Monarch Financial Services, LLC
- Monarch Management Services, Inc.
- Monte Klinikum Diagnóstico por Imagem Ltda.
- NAMM Holdings, Inc.
- NAMM West, Inc.
- National Pacific Dental, Inc.
- Neighborhood Health Partnership, Inc.
- Netwerkes, LLC
- Nevada Medical Services LLC
- Nevada Pacific Dental
- North American Medical Management – Illinois, Inc.
- North American Medical Management California, Inc.
- Northern Nevada Health Network, Inc.
- OneNet PPO, LLC
- Optimum Choice, Inc.
- Optum (Argentina) SRL
- Optum (France) SAS
- Optum (Spain), S.A.U.
- Optum Bank, Inc.
- Optum Clinical Services, Inc.
- Optum Government Solutions, Inc.
- Optum Health & Technology Limited
- Optum Health & Technology Serviços Do Brasil Ltda.
- Optum Labs Dimensions, Inc.
- Optum Labs, Inc.
- Optum Nevada Accountable Care Organization LLC
- Optum Public Sector Solutions, Inc.
- Optum Rocket, Inc.
- Optum Services, Inc.
- Optum Solutions & Services Limited
- Optum Solutions UK Holdings Limited
- Optum UK Solutions Group Limited
- Optum, Inc.
- Optum360 Services, Inc.
- Optum360, LLC
- OptumHealth Care Solutions, Inc.
- OptumHealth Financial Services, Inc.
- OptumHealth Holdings, LLC
- OptumHealth International B.V.
- OptumInsight (Canada) Inc.
- OptumInsight (Deutschland) GmbH
- OptumInsight (Singapore) Pte. Ltd.
- OptumInsight (Sweden) AB
- OptumInsight Holdings, LLC
- OptumInsight Italy S.r.l
- OptumInsight Korea LLC
- OptumInsight Life Sciences, Inc.
- OptumInsight Poland sp. z.o.o.
- OptumInsight, Inc.
- OptumRx Holdings, LLC
- OptumRx NY IPA, Inc.
- OptumRx, Inc.
- Ovations, Inc.
- Oxford Benefit Management, Inc.
- Oxford Health Insurance, Inc.
- Oxford Health Plans (CT), Inc.
- Oxford Health Plans (NJ), Inc.
- Oxford Health Plans (NY), Inc.
- Oxford Health Plans LLC
- PacifiCare Life and Health Insurance Company
- PacifiCare Life Assurance Company
- PacifiCare of Arizona, Inc.
- PacifiCare of Colorado, Inc.
- PacifiCare of Nevada, Inc.
- Payment Resolution Services, LLC
- PCCCV, Inc.
- Personal Performance Consultants India Private Limited
- Personal Performance Consultants UK Limited
- PHC Holdings of Florida, Inc.
- PHC Subsidiary Holdings, LLC
- Physician Care Partners, Inc.
- Physicians Choice Insurance Service, LLC
- Physicians Health Choice of Texas, LLC
- Physicians Health Plan of Maryland, Inc.
- Picis, Inc.
- Picis, Ltd.
- Plus One Health Management Inc. Puerto Rico
- Plus One Holdings, Inc.
- Polar II Fundo de Investimento em Participações
- Positive People Company
- PPC International II, LLC
- PPC International, L.L.C.
- PPC Worldwide Canada EAP Services Ltd.
- PPC Worldwide Pte. Ltd.
- PPC Worldwide Pty Ltd
- ppoONE, Inc
- Preferred Care Partners Holding, Corp.
- Preferred Care Partners Medical Group, Inc.
- Preferred Care Partners, Inc.
- Premier Choice ACO, Inc.
- Prime Health, Inc.
- PrimeCare Medical Network, Inc.
- PrimeCare of Citrus Valley, Inc.
- PrimeCare of Corona, Inc.
- PrimeCare of Hemet Valley, Inc.
- PrimeCare of Inland Valley, Inc.
- PrimeCare of Moreno Valley, Inc.
- PrimeCare of Redlands, Inc.
- PrimeCare of Riverside, Inc.
- PrimeCare of San Bernardino, Inc.
- PrimeCare of Sun City, Inc.
- PrimeCare of Temecula, Inc.
- Promarket Propaganda e Marketing Ltda.
- QSSI Technologies India Private Limited
- Quality Software Services, Inc.
- R&H Family Fitness Unlimited LLC
- ScriptSwitch Limited
- Senior Care Partners, Inc.
- Sierra Health and Life Insurance Company, Inc.
- Sierra Health Services, Inc.
- Sierra Health-Care Options, Inc.
- Sierra Home Medical Products, Inc.
- Sierra Nevada Administrators, Inc.
- Southwest Medical Associates, Inc.
- Southwest Michigan Health Network Inc.
- Specialty Benefits, LLC
- Spectera of New York, IPA, Inc.
- Spectera, Inc.
- The Lewin Group, Inc.
- Three Rivers Holdings, Inc.
- Travel Express Incorporated
- S. Behavioral Health Plan, California
- UHC International Services, Inc.
- UHC of California
- UHG Brasil Participações S.A.
- UHG Global Services, Inc.
- UHIC Holdings, Inc.
- Ultima Rx, LLC
- UMR, Inc.
- Unimerica Insurance Company
- Unimerica Life Insurance Company of New York
- Unison Administrative Services, LLC
- Unison Health Plan of Delaware, Inc.
- Unison Health Plan of the Capital Area, Inc.
- United Behavioral Health
- United Behavioral Health of New York, I.P.A., Inc.
- United Health Foundation
- United HealthCare Services, Inc.
- United Resource Networks IPA of New York, Inc.
- UnitedHealth Advisors, LLC
- UnitedHealth Group Global Healthcare Services Limited
- UnitedHealth Group Global Services, Inc.
- UnitedHealth Group Incorporated
- UnitedHealth Group Information Services Private Limited
- UnitedHealth Group International B.V.
- UnitedHealth Group International GP
- UnitedHealth Group International L.P.
- UnitedHealth Group Ventures, LLC
- UnitedHealth International, Inc.
- UnitedHealth Military & Veterans Services, LLC
- UnitedHealth UK Limited
- UnitedHealthcare Benefits of Texas, Inc
- UnitedHealthcare Community Plan of California, Inc
- UnitedHealthcare Community Plan of Ohio, Inc
- UnitedHealthcare Community Plan of Texas, LLC
- UnitedHealthcare Community Plan, Inc
- UnitedHealthcare India Private Limited
- UnitedHealthcare Insurance Company
- UnitedHealthcare Insurance Company of Illinois
- UnitedHealthcare Insurance Company of New York
- UnitedHealthcare Insurance Company of the River Valley
- UnitedHealthcare International Asia, LLC
- UnitedHealthcare International I B.V
- UnitedHealthcare International I S.á.r.
- UnitedHealthcare International II B.V.
- UnitedHealthcare International II S.á.r.l
- UnitedHealthcare International III S.á.r.l
- UnitedHealthcare International IV S.á.r.l.
- UnitedHealthcare Life insurance Company
- UnitedHealthcare of Alabama, Inc.
- UnitedHealthcare of Arizona, Inc.
- UnitedHealthcare of Arkansas, Inc.
- UnitedHealthcare of Colorado, Inc.
- UnitedHealthcare of Florida, Inc.
- UnitedHealthcare of Georgia, Inc.
- UnitedHealthcare of Illinois, Inc.
- UnitedHealthcare of Kentucky, Ltd.
- UnitedHealthcare of Louisiana, Inc.
- UnitedHealthcare of Mississippi, Inc.
- UnitedHealthcare of New England, Inc.
- UnitedHealthcare of New Mexico, Inc.
- UnitedHealthcare of New York, Inc.
- UnitedHealthcare of North Carolina, Inc.
- UnitedHealthcare of Ohio, Inc.
- UnitedHealthcare of Oklahoma, Inc.
- UnitedHealthcare of Oregon, Inc.
- UnitedHealthcare of Pennsylvania, Inc.
- UnitedHealthcare of Texas, Inc.
- UnitedHealthcare of the Mid-Atlantic, Inc.
- UnitedHealthcare of the Midlands, Inc.
- UnitedHealthcare of the Midwest, Inc.
- UnitedHealthcare of Utah, Inc.
- UnitedHealthcare of Washington, Inc.
- UnitedHealthcare of Wisconsin, Inc.
- UnitedHealthcare Plan of the River Valley, Inc.
- UnitedHealthcare Service LLC
- UnitedHealthcare Services Company of the River Valley, Inc.
- UnitedHealthcare Specialty Benefits, LLC
- UnitedHealthcare, Inc.
- UnitedHealthOne Agency, Inc.
- Valley Physicians Network, Inc.
- WellMed Medical Management of Florida, Inc.
- WellMed Medical Management, Inc.
- Wellness, Inc.
- XLHealth Corporation
- XLHealth Corporation India Private Limited
- Your Health Options Insurance Services, Inc.
- Your Partner in Health Services, Inc.310 Canyon Medical, LLC
[If you can find out what Optum Rocket, Inc. is, we’d love to know!]
Before We Forget
Let’s add Optum Clinics Holdings, a new subsidiary that was formed in 2015, but the company’s business is not disclosed. There’s something strange about them. They raised more than $36 million in an exchange of shares from unknown investors. Hmmm…
Yep, United changed the name of their failed Ingenix bomb. But, the baby monster is back, smarter than ever. And the public is in their crosshairs.
We’ll have more to say soon about what Optum is up to. This is just the opening pitch!