this post was submitted on 05 Dec 2024
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Reporting Highlights

  • An Insurer Sanctioned: Three states found United’s algorithmic system to limit mental health coverage illegal; when they fought it, the insurer agreed to restrict it.
  • A Patchwork Problem: The company is policing mental health care with arbitrary thresholds and cost-driven targets, highlighting a key flaw in the U.S. regulatory structure.
  • United’s Playbook Revealed: The poorest and most vulnerable patients are now most at risk of losing mental health care coverage as United targets them for cost savings.

Around 2016, government officials began to pry open United’s black box. They found that the nation’s largest health insurance conglomerate had been using algorithms to identify providers it determined were giving too much therapy and patients it believed were receiving too much; then, the company scrutinized their cases and cut off reimbursements.

By the end of 2021, United’s algorithm program had been deemed illegal in three states.

But that has not stopped the company from continuing to police mental health care with arbitrary thresholds and cost-driven targets, ProPublica found, after reviewing what is effectively the company’s internal playbook for limiting and cutting therapy expenses. The insurer’s strategies are still very much alive, putting countless patients at risk of losing mental health care.

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[–] tiefling@lemmy.blahaj.zone 35 points 3 weeks ago (1 children)

Seems to have backfired for them

[–] errer@lemmy.world 3 points 3 weeks ago (1 children)
[–] Rezbit@lemmy.world 12 points 3 weeks ago

No, what's brutal is policing mental health care with arbitrary thresholds and cost-driven targets to limit help that people need

[–] ccunning@lemmy.world 19 points 3 weeks ago

Well it seems society has finally cracked how to bring attention to these things…

[–] Railcar8095@lemm.ee 14 points 3 weeks ago (1 children)

Man, I sure hope somebody does something about it.

[–] capt_wolf@lemmy.world 2 points 2 weeks ago* (last edited 2 weeks ago) (1 children)

Working in mental health, I'm liking that this is where the media spotlight is pointing because of what happened.

However, I don't have much faith it'll change anything.

[–] Sir_Kevin@lemmy.dbzer0.com 3 points 2 weeks ago

This one incident won't change anything, no. But if it were to become a trend..

[–] macaro@lemmy.blahaj.zone 11 points 3 weeks ago (1 children)

And they wonder why their executives are being targeted.

[–] VieuxQueb@lemmy.ca 5 points 2 weeks ago

Oh, they know, now they are surely on a meeting trying to figure out how much of personal Security details they need to keep going the way they always gone. It's much cheaper to get security following your CEO'S than to stop denying claims they should accept. It's all about $$$.