David Weinstock’s Post

I hope you don’t mind a viewpoint from the “other side”. I’m a clinician leader at an Optum owned multi specialty practice and I don’t feel complicit in any badness whatsoever. I’m grateful to be practicing in a much better resourced organization than most primary care clinicians in this country describe. Everyone I work with is super patient centered and works very hard to succeed in providing high quality care in the most affordable way. We test and spread amazing innovations to care regularly. We focus a lot on accurate diagnosis capture and risk adjustment in addition to care gap completion and patient experience improvement because margins in primary care are virtually nonexistent and those are the evidence based factors on which value based care payment formulas operate. Our clinician burnout rate has gone down since being acquired, and our organization’s ability to invest in both (a) capital improvements (read: better work environments for staff, better diagnostic equipment for our patients, more locations to serve patients in) and (b) staff recruitment/retention has improved substantially. I work as hard as you likely do, and my patients feel as cared for as yours likely do.

Fast Money had a short segment tonight with one of the authors. This is both criminal and inhumane.

Assuming Healthcare ( with its Delivery and Payment Systems) is a Business and with Employer-Sponsored Coverage established in the 1940s, and with the Patient and Family Doctor being the 1900 established strongist relationship in Healthcare in the 2000, 2010 and 2020s Model is Healthcare Delivery and Payment be PCP Driven. Of course Optum's Insured and Self -insured Employer Medical and Drug Expense Model is PCP driven and AdvancedPCP with Salaried and Capitated PCPs with Narrow In-network PPO referrals to SCP/ASCs and Rx Formulary based on Comparative Drug Effectiveness as well as Rx Price, per MPC; will be their model into the 2030s. Makes for good Business/Revenue Growth Strategy;eh? Not being an MD or DO, I am not qualified to opine on " are doctors complicit"; but since Economics and Finance are not mandatory courses in Medical College, it seems that they would be?

Not "complicit". They are part of the IPA wraparounds that frequently circle the integrated groups that Optum has acquired, but are corporately separate from Optum.

Only ones complicit are the lawmakers who allow this to happen while making private practice increasingly more difficult

Antitrust Division Katrina Rouse

Complicit