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UnitedHealth gives MDs final say
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11-15-99 Minneapolis. UnitedHealth Group will allow health providers to have the final say on what treatments are medically necessary for their patients, the company announced Nov. 9. The company's decision has created a stir nationwide. The move eliminates certain programs associated with traditional managed care organizations, such as pre-authorization for in-patient hospital procedures. "Millions of dollars are spent every year on reviewing the treatment decisions made by physicians. Over the last decade we have seen the value to patients and employers of these efforts diminish as runaway healthcare costs have been slowed and services expanded," said Archelle Georgiou, MD, chief medical officer of UnitedHealth, in a statement. UnitedHealth officials say the decision will allow them to focus their energies in other areas. "The vast majority of reviews support the clinical decision, so it makes sense to focus on other programs and efforts," Georgiou said. The move will likely attract patients who are disillusioned with the idea of plan administrators making care decisions, according to Ed Howard, executive vice president of the Alliance for Health Reform, a nonprofit group based in Washington, D.C. It should also attract physicians who like the idea of having final say on treatment, he said. Industry experts expect other managed care plans to follow UnitedHealth's lead. "This is the overall direction the field was moving in, and it will likely give momentum to others," said Susan Pisano, vice president for communications for the American Association of Health Plans. Plans that choose to operate this way "will achieve the same goals, just in different ways."
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