Doctors speak: Inside our meeting with UnitedHealth Group

EDEN PRAIRIE, MINNESOTA - APRIL 16: Protesters with People's Action target health insurance giant UnitedHealth Group due to exorbitant health insurance costs and insurance claims denials on April 16, 2024 in Eden Prairie, Minnesota. Photo by Adam Bettcher/Getty Images.

In June, a delegation of medical professionals, patients, community, and labor leaders met with the chief medical officers of UnitedHealth Group and UnitedHealthcare, and the CEO of OptumRx, to discuss the systemic issue of care delays and denials by UnitedHealthcare and demand change. UnitedHealth Group, which owns UnitedHealthcare and OptumRx, is one of the largest corporations globally and is headquartered in Minnesota.

As local physicians, we felt it was important to join the meeting with the executives, each of whom are fellow doctors. The 90-minute meeting, organized by People Action Institute’s national Care Over Cost campaign, included UnitedHealthcare policyholders who took to public petitions, social media, and interventions from their U.S. senators in order to get prior authorizations approved and care covered.

Despite having trained for years to provide excellent, evidence-based medical care, nothing could have prepared us for the burnout and stress we face from fighting health insurance companies. UnitedHealthcare, which has increased its insurance footprint in Minnesota since a ban on for-profit HMOs was lifted, is often the insurer we are dealing with.

At the meeting, we shared our experience with UnitedHealthcare’s practice of prior authorization requirements, denials, and appeals, which most importantly harm people’s health but also contribute to physician burnout.

We shared that our health systems’ prior authorization departments are growing as denying care becomes the status quo. Providers spend countless hours writing letters justifying medically necessary care and communicating with patients about denials and how to cope in the meantime. People may go months with untreated or poorly treated heart disease, lung disease or diabetes while we wait for prior authorizations: It is horrific for people and not the way we practice medicine. And most terrifying at all, this is not the exception but the rule.

We hoped that the chief medical officers who share our professional background would empathize with our experience and commit to making concrete changes, or at least acknowledge there is a systemic problem. They did not.

Dealing with prior authorizations is part of our daily existence as physicians. Yet leaders from UnitedHealth Group, UnitedHealthcare and OptumRx stated that only 2% of care requires extra hoops. The chief medical officers told us they care about preventing physician burnout and believe that the relationship between doctors and patients is “sacred,” but also claimed all of their prior authorization practices are rooted in “evidence-based medicine,” as though we wouldn’t practice evidence-based medicine if it were not for insurance companies.

Meanwhile, their profits grow by the minute.

While it was an empowering experience to confront UnitedHealthcare about the impact of care delays and denials alongside affected policyholders, far more accountability is needed. At the end of the meeting, our group asked UnitedHealthcare to stop blocking prescribed care, to provide transparency and data around care delays and denials, and to meet with policyholders as they do shareholders.

UnitedHealthcare refused to change any of their practices, but they did stick to their promise of looking into people’s cases on the call. Since then, several claims have been resolved. While this is great news for a few people, a case-by-case approach to get care covered is not a solution.

Still, we left the meeting with hope.

First, the Care Over Cost campaign is showing that there is strength in numbers. Americans care about their health care and having good access. Delays and denials of care hurt millions of people every year and result in ongoing sickness, injury, medical debt, bankruptcy, worsened health outcomes and even premature death. We all pay for this convoluted system, whether it is in our health insurance premiums or in our public programs. UnitedHealth Group is making billions of dollars in profit by denying people care, including in privatized Medicare and Medicaid plans, to the point that it has prompted a federal investigation .

Second, the change that is needed is not impossible: It is a matter of holding corporations like UnitedHealth Group accountable for greed and a business model built on denying care. Billions of dollars that could be going to care for people is being spent on stock buybacks, shareholder dividends , lobbying, political contributions and executive pay. If corporations will not change their practices, the public has the right to demand policy change and governments have a responsibility to take action. Here are the demands we sent UnitedHealth Group to address our concerns.

Third, there is hope in Minnesota. The state is examining the role of health insurance companies in public health care programs, and exploring more efficient models for health care delivery. The big change we need will take time, but if there is a will, and we keep organizing, there is a way.

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