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(Meeting ID: 541 907 772)
The Las Vegas trial between health insurance giant United and TeamHealth Nevada emergency room clinicians entered its third week yesterday, with Judge Nancy Allf presiding. John Haben, former head of United’s Shared Savings Program, returned for his third day of testimony.
Houston attorney John Zavitsanos asked Haben about a Shared Savings example, in which emergency providers billed $1,400, and United allowed payment of $300. United had claimed the $1,100 difference as “shared savings” and charged its employer client a fee of $385 for accomplishing the savings. When pressed on the matter, Haben responded that he was “proud of what we did for our clients.” He later testified that the program generated an annual profit of $830 million, which grew to more than $1 billion annually.
Zavitsanos also asked Haben about the Yale University study in which United is alleged to have colluded with Yale professor Zack Cooper and “target[ed] TeamHealth.” The Yale study has been used to promote the false view that TeamHealth engaged in massive and egregious balance billing, though Haben stated under oath yesterday that “in 2016, there was no balance billing.” Zavitsanos asked Haben about the role of Dan Rosenthal, then president of UnitedHealth Networks, in editing the study. To which Haben responded, “You’d have to ask Dan.”
United documents show the company’s expectation that the Yale University study would “bring up what’s been happening in the clinician world under a less than positive light.” To avoid revealing its influence on the research and its relationship with Zack Cooper, United acknowledged, “We’ll have to look into the possibility of further distancing ourselves from the piece and messaging in anticipation of media inquiries.”
Zavitsanos asked Haben whether “one of the things this Yale study was intended to do was go after [large emergency department physician practices like TeamHealth].” Haben denied that, though admitted later that United’s documents stated the company specifically planned “to provide Zack with TeamHealth, EmCare, and Sheridan Health as three big names in this space.” Based on United documents introduced in court yesterday, both Dan Rosenthal and United’s Chief Medical Officer Sam Ho, MD, approved of and guided the publicity campaign behind the United-backed Yale study.
According to documents introduced at trial, The New York Times, NBC Nightly News, The Wall Street Journal, The Washington Post, NPR, ABC World News, and other news outlets reported on the Yale study, in the belief that it was an unbiased presentation of evidence prepared within the norms of academic integrity, rather than a piece prepared under the influence of a large, publicly-traded company focused on driving profits.
Haben is expected to testify today and tomorrow, followed by United executive Rebecca Paradise, who now heads the Shared Savings Program. The trial is expected to continue into the week of Thanksgiving.
TeamHealth’s more than 15,000 clinicians continue to watch the trial closely. At stake is the very ability of heroic frontline healthcare providers to get necessary reimbursements from large profitable insurers to cover the cost of the lifesaving care they provide.
“Over 11 years at TeamHealth, I have seen a tremendous change in the healthcare landscape,” said David Levine, MD, Regional Medical Director, TeamHealth Northeast Group. “Many know that TeamHealth supports us individually; however, most never see how they support us nationally and as an industry. They have taken those challenges head-on, and I’m glad to have them on my team.”
At TeamHealth, our purpose is to perfect the practice of medicine, every day, in everything we do. We are proud to be the leading physician practice in the U.S., driven by our commitment to quality and safety and supported by our world-class operating team. To improve the experience of our physicians and advanced practice clinicians, we empower clinicians to act on what they believe is right, free clinicians from distractions so they can focus on patient care, invest in learning and development to promote growth in the clinical field and foster an environment where continuous improvement is a shared priority. Through our more than 15,000 affiliated healthcare professionals and advanced practice clinicians, TeamHealth offers emergency medicine, hospital medicine, critical care, anesthesiology, orthopedic surgery, general surgery, obstetrics, ambulatory care, post-acute care and medical call center solutions to approximately 2,900 acute and post-acute facilities and physician groups nationwide. Join our team; we value and empower clinicians. Partner with us; we deliver on our promises. Learn more at www.teamhealth.com.
The term “TeamHealth” as used throughout this release includes Team Health Holdings, Inc., its subsidiaries, affiliates, affiliated medical groups and providers, all of which are part of the TeamHealth organization. “Providers” are physicians, advanced practice clinicians and other healthcare providers who are employed by or contract with subsidiaries or affiliated entities of Team Health Holdings, Inc. All such providers exercise independent clinical judgment when providing patient care. Team Health Holdings, Inc., does not have any employees, does not contract with providers and does not practice medicine.
The collective term “United” as used throughout this release references defendants, UnitedHealthcare Insurance Company (“UHIC”), United HealthCare Services, Inc. (“UHS”), UMR, Inc. (“UMR”), Sierra Health and Life Insurance Co., Inc. (“SHL”), and Health Plan of Nevada, Inc. (“HPN”).
Case Name is Fremont Emergency Services (Mandavia), et al. vs. UnitedHealth Group, Inc et al. Case number is A-19-792978-B.