UnitedHealth Group

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UnitedHealth Group

UnitedHealth Group is an American for-profit managed health care company based in Minnetonka, Minnesota. It offers health care products and insurance services. In 2019, it was the second-largest healthcare company (behind CVS Health) by revenue with $242.2 billion, and the largest insurance company by Net Premiums. UnitedHealthcare revenues comprise 80% of the Group's overall revenue.[1]

Racial bias controversy

UnitedHealth Group used technology accused that they may have kept sick black patients from receiving high-quality care in October 2019. The state’s Department of Financial Services said it sent a letter Friday to UnitedHealth Chief Executive David Wichmann asking for the company to either show the algorithm isn’t racially discriminatory or stop using it. The New York Department of Health joined in sending the letter. A UnitedHealth spokesman didn’t comment about the letter or a New York state investigation, but said the algorithm was only one part of a far broader tool it offers to help analyze patients’ health needs.[2]

The algorithm in question, Impact Pro, identifies which patients would benefit from complex health procedures favored treating white patients than sicker black ones between 2013 and 2015, according to a study published in the prestigious journal Science.[3]

The algorithm predicted black patients would cost less, which signaled to medical providers that their illnesses must not be that bad. But, in reality, black patients cost less because they don't purchase healthcare services as much as white people on average.

Rich Caruana, a Microsoft Corp. senior researcher who studies machine learning in health care, says he was “not at all surprised” to learn that researchers uncovered hidden bias in a predictive algorithm.

“Most of what machine learning is doing is right, but in addition to these things it’s doing really right, roughly 5% of what it’s learning are these sort of silly, wrong things,” he continues. “These are known as treatment effects — we’re seeing patients’ risk as more or less based on the treatment that they receive.”[4]

Support to Black community

On a message from Ken Ehlert, Chief Scientific Officer, UnitedHeath Group, he mentioned that systemic racism and inequities are also present in healthcare. COVID-19 has shown the world the rates of disease, hospitalizations, complications and death are higher for Black Americans. But that isn’t new. We’ve known for a long time that diabetes, hypertension, maternal mortality, cancer and other diseases impact Black, Hispanic and Native Americans at higher rates. It would be easy to say this is due to genetic differences or social determinants of health. But that isn’t true. The reality is people of color are underrepresented in genetic databases, clinical trials and the medical profession…and as a result, they often receive different, sub-standard care.[5]

Therefore, UnitedHealth are trying to make a difference in the healthcare system. For example, they are currently studying the effect of sickle cell trait, which is prevalent in 8-10% of African Americans, on COVID-19 with Herman Taylor, MD (Morehouse School of Medicine and former director of the Jackson Heart Study) as a co-principal investigator. Dr. Taylor is also working with UnitedHealth to help recruit patients into our ACE inhibitor clinical trial to ensure adequate representation from the African American community in that important work.[5]

UnitedHealth Group also announced a $10 million commitment to support George Floyd's children, and Minnesota businesses impacted by civil unrest. UnitedHealth is giving $5 million to the YMCA Equity Innovation Center of Excellence. UnitedHealth employs 20,000 people in Minnesota and is headquartered outside of Minneapolis, where Floyd was killed.[6]

References

  1. McFarlane, Greg. How UnitedHealth Group Makes its Money: Premiums, Fees and Health Service Sales. investopedia.com. Retrieved Feb 1, 2021.
  2. Evans, Melanie. New York Regulator Probes UnitedHealth Algorithm for Racial Bias. Oct 26, 2019. The Wall Street Journal. Retrieved Feb 1, 2021.
  3. Akhtar, Allana. New York is investigating UnitedHealth's use of a medical algorithm that steered black patients away from getting higher-quality care. Oct 28, 2020. businessinsider.com. Retrieved Feb 1, 2021.
  4. Perspectives on Racial Bias in Optum Risk-Prediction Algorithm. Nov 28, 2019. mmitnetwork.com. Retrieved Feb 1, 2021.
  5. 5.0 5.1 Building An Equitable Health System Together, UnitedHealth Group. Retrieved Feb 1, 2021.
  6. Livingston, Mercey. These are the major brands donating to the Black Lives Matter movement. June 16, 2020. cnet.com. Retrieved February 1, 2021.