Terminating participating provider agreements with ASA member anesthesia practices is hampering competition by “forcing willing anesthesia practices out of network,” ASA President Beverly Philip, MD, said in an Oct. 7 news release. Dr. Philip said this leads to “higher out-of-pocket costs and reduced numbers of in-network anesthesiologists for patients, especially where UnitedHealth Group can do this to favor its own employed anesthesiologists.”
UnitedHealth Group, as a vertically integrated company, has an incentive to leverage its UnitedHealthcare subsidiary’s status as a health insurer, including to favor UnitedHealth Group’s healthcare provider subsidiary, Optum, and its employed anesthesiologists unfairly, Dr. Philip said in an Oct. 7 letter to the Justice Department’s acting assistant attorney general.
The letter also claims that UnitedHealth Group, which acts as a third-party administrator for employer-sponsored health plans, has the incentive through a shared savings program to reduce the number of in-network anesthesiologists to boost its profits, while upping the fees and overall costs for employers.
According to the ASA, anesthesiologists have felt the pinch by being denied access to UnitedHealth Group’s members, especially in areas where its members represent a significant portion of commercially insured patients.
“The participating provider agreements that have been terminated were negotiated at arm’s length and mutually beneficial,” Dr. Philip said. “It is regrettable that [UnitedHealth Group] is taking steps to reduce access to in-network anesthesiologists and harming patients, employers and anesthesiologists in the process.”
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