Physicians' academy critical of insurer's interventions in patient care
Officials originally confronted UHC leaders on the matter at a September annual meeting on patient care and insurance. When the American Academy of Family Physicians later heard from Texas members that UHC nurses had installed monitoring equipment for Medicare Advantage patients without their doctors’ knowledge, it referred to the issue as an example of communication problems.
The nurses in this instance are employed not by the physician but by the insurer. If the insurer authorizes any facet of treatment without informing the patient’s doctor, it potentially compromises his or her care team’s effectiveness and could pose a risk to the patient should the practitioner duplicate or change treatment.
AAFP sent UHC a follow-up letter in early December asking UHC to review its policy permitting nurses to give care without synchronizing communication with a primary care physician.
"The AAFP is concerned that UHC is [allowing] third parties to care for patients without coordinating the care with the patient's primary care physician," the letter said. "This type of care undermines the doctor-patient relationship, damages continuity of care and may put the patient at increased risk … Family physicians need to be kept informed of interventions so chronic disease management and care coordination can be optimized."
The Academy’s letter also referenced financial matters such as insurance payment models adapting to changes in care delivery. A UHC spokesperson responded in part by concurring that a nurse should send a care summary report to the primary care physician.