How UnitedHealth turned a questionable artery-screening program into a gold mine
UnitedHealth was perfectly positioned to invent a national screening program and profit from it. Over the last two decades it has assembled an unrivaled collection of physicians — some 90,000 doctors in all — and used this empire to pad its bottom line, as STAT previously reported. At the same time, it has cemented its lead as the largest Medicare Advantage insurer. The full story of the company’s sweeping vascular disease screening program, detailed here for the first time, reveals how UnitedHealth has used its growing dominance across the health care system to its own benefit — and to the detriment of doctors, patients, and taxpayers.
“The corporation views patients as entities that have money attached to their bodies,” said Michael Good, a retired physician who worked at a Connecticut practice where UnitedHealth tested older patients with the device, called QuantaFlo. “They want to use the clinicians to mine the money that lies within the bodies of the patient.”
Doctors whose practices were acquired by the company’s Optum subsidiary said they received hours of training on how to document patients’ illnesses and increase payments from Medicare. Some clinicians previously told STAT they were pushed to document conditions they didn’t believe applied to their patients. Part of their compensation was tied to the number of diagnoses they submitted for chronic conditions, including peripheral artery disease.
The Centers for Medicare and Medicaid Services began cracking down on the aggressive diagnosis of peripheral artery disease in 2024, removing a diagnostic code from its payment formula that allowed UnitedHealth and other insurers to get extra reimbursement for diagnosing patients even if they weren’t experiencing symptoms.
Several ProHealth doctors who STAT spoke with retired at least five years earlier than they planned, dismayed by the decisions UnitedHealth made to escalate profits at the expense of patients — the use of QuantaFlo among them.
“Patients were told these were things their doctors recommended,” Good said. “It was a betrayal of our patients’ trust.”
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UnitedHealth was perfectly positioned to invent a national screening program and profit from it. Over the last two decades it has assembled an unrivaled collection of physicians — some 90,000 doctors in all — and used this empire to pad its bottom line, as STAT previously reported. At the same time, it has cemented its lead as the largest Medicare Advantage insurer. The full story of the company’s sweeping vascular disease screening program, detailed here for the first time, reveals how UnitedHealth has used its growing dominance across the health care system to its own benefit — and to the detriment of doctors, patients, and taxpayers.
“The corporation views patients as entities that have money attached to their bodies,” said Michael Good, a retired physician who worked at a Connecticut practice where UnitedHealth tested older patients with the device, called QuantaFlo. “They want to use the clinicians to mine the money that lies within the bodies of the patient.”
Doctors whose practices were acquired by the company’s Optum subsidiary said they received hours of training on how to document patients’ illnesses and increase payments from Medicare. Some clinicians previously told STAT they were pushed to document conditions they didn’t believe applied to their patients. Part of their compensation was tied to the number of diagnoses they submitted for chronic conditions, including peripheral artery disease.
The Centers for Medicare and Medicaid Services began cracking down on the aggressive diagnosis of peripheral artery disease in 2024, removing a diagnostic code from its payment formula that allowed UnitedHealth and other insurers to get extra reimbursement for diagnosing patients even if they weren’t experiencing symptoms.
Several ProHealth doctors who STAT spoke with retired at least five years earlier than they planned, dismayed by the decisions UnitedHealth made to escalate profits at the expense of patients — the use of QuantaFlo among them.
“Patients were told these were things their doctors recommended,” Good said. “It was a betrayal of our patients’ trust.”
How UnitedHealth turned a questionable artery-screening program into a gold mine
This is the second in a periodic series from STAT about how UnitedHealth Group wields its unrivaled physician empire to boost profits and expand its influence.
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