US health firm handed £7million to help NHS identify most ‘expensive’ patients
A US healthcare firm praised by Donald Trump has been handed £7million to help the NHS identify its most “expensive” patients.
It is running a nine-month programme to train managers to rank people according to their risk of illness.
The move has sparked fears more could be turned down for ops because of factors like age or weight.
And it raises fears the NHS could be on the table in a trade deal despite PM Boris Johnson’s claims it is not for sale.
The contract was agreed between NHS England and Optum – which assesses patients for America’s privatised insurance-led system.
It divides NHS patients into high, medium and low risk groups and identifies “rising risk groups” such as those at risk of Type 2 diabetes.
The training has been rolled out all over the country including Dorset, Berkshire, Lancashire, Cumbria and Leeds.
Managers say it helps them allocate resources more efficiently as they try to save cash amid a historic Tory funding squeeze.
But half of local care groups are already restricting who can have once-routine procedures such as cataract surgery and hip and knee replacements.
Anti-privatisation campaigner Ellen Lees, of We Own It, said: “These revelations are the latest in a long list of toxic private sector involvement and a classic example of eroding our NHS bit by bit.
“The prospect of people being shut out of treatment flies in the face of a service based on the principle that everyone’s needs must be met. What’s frankly terrifying is the idea that this training could be rolled out more widely. It should be stamped out.”
NHS England – including chairman Lord Prior – has held a string of meetings with Optum in recent years.
The US firm has already done NHS advisory work in Dorset, Harrow and other areas but this is the first time the company has trained managers how to identify high-cost patients.
Former boss Larry Renfro boasted to investors in 2016: “We’ve been planting seeds and I’d say that we’re strong with the NHS. We’re strong with [the regulator] NHS improvement. We are getting stronger with the Minister of Health, as well as the Secretary of Health.”
Optum is one of the biggest health insurers in the US and has had regular meetings with President Trump.
The outgoing chief of its parent firm UnitedHealth Group was once America’s highest-paid boss – on £50million a year.
Stephen Hemsley held a series of talks with NHS chiefs in 2016 and 2017 and was praised by Donald Trump after a meeting at the White House in 2017.
NHS England chief executive Simon Stevens used to be an executive at UnitedHealth Group but we understand he was not involved in the Optum deal.
NHS England said: “The NHS works with organisations for the sole purpose of offering better care to our patients.”
The Department of Health and Social Care said: “The NHS is not and never will be for sale. No one will be excluded from treatment because of the cost.”
Optum said: “We use our extensive experience to train the NHS in analytics, so the NHS can identify groups of patients who already have chronic illness and provide treatments which keep patients as well as they can be.”
UnitedHealth Group is the biggest health insurance company in the world when measured by revenue, making £184billion
last year with profits of more than £10billion.
It employs more than 300,000 and already gives the NHS contract negotiation and medication management services. in 2018, it won dismissal of a case alleging that it had defrauded the US government’s Medicare insurance scheme of more than £771million.
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