UnitedHealth Group's "Firing Squad"
Another round of layoffs leads to a surprising amount of original reporting in this newsletter.
When I started writing about UnitedHealthcare, I didn't think it would go like this. What you're reading today is breaking news fresh from insiders at UnitedHealthcare.
In the beginning, I imagined I was making fun of a behemoth… playfully. Like most other companies, particularly public companies, I imagined they had meaningful constraints on their behavior. When I started making TikTok videos about United Healthcare? I was reporting the news. I didn't imagine they would get over 1 million views. I was making videos, all of 15 seconds each. Next, sources started sending me information. Those messages were from insiders at United Healthcare. Some of them are still working at United Healthcare. A markedly different story has just started to emerge. I was not prepared for it.
I did not start as an investigative journalist. I'm a psychiatrist. I have close relationships with colleagues in industry. I don't want to offend them.
It's hard to avoid United Healthcare in America. I don't even avoid United. I still use ConnectCenter, which is part of Optum and, in turn, part of United. My employees have United Oxford as their health insurance, which I pay for. As a small company in New York City, I didn't have other options. This is the business model of a 1/2 trillion dollar empire:
“What else are you gonna do?”
United had a massive round of layoffs yesterday, and it's worth noting that they have never done a robust job of reporting things to the federal WARN Act database. The point of the act was to have a place in which mass layoffs had to be reported, among other things:
The Worker Adjustment and Retraining Notification (WARN) Act helps ensure advance notice in cases of qualified plant closings and mass layoffs. The U.S. Department of Labor has compliance assistance materials to help workers and employers understand their rights and responsibilities under the provisions of WARN.
Yesterday, hundreds of people were laid off in Texas and Florida. I still don't know if this would violate the WARN Act, but it almost doesn't matter. United Healthcare provides so much money to politicians in Congress! Enforcement actions against it will never ever make a change in behavior— or a dent in it’s remarkable profits.
I've spoken to former insiders at United Healthcare who described their interactions with the Department of Justice…in their attempts to blow the whistle. The following is paraphrased:
The DOJ? It wasn't interested. The Department of Justice brings in revenue to the federal government through its enforcement actions. When it comes to UnitedHealthcare, they have a cap. They can't do too much enforcement. Bring a case, get a settlement, get an admission of something or other, but don't cause real trouble.
Even settlements that might sound like unbelievable amounts of money? UnitedHealthcare’s quarterly revenue— announced two days ago—was $99 billion, with profits in the billions. Any fine, however large, is a rounding error.
They have every right to act in the fiduciary interest of their shareholders—that's a responsibility. Internally, United is doing everything right. For shareholders, it's returning value. Unfortunately, a massive vertically integrated healthcare company can make endlessly more money by doing things that have negative externalities.
This is a pattern we have seen before. We talk about big oil, we talk about big tobacco, we talk about Purdue Pharma, like they were really evil. The remarkable thing about United Healthcare? It gets away with behavior that is going to harm more of us—and more profoundly—than the opioid crisis. United’s damage is just too boring to follow back to the source. If that sounds extreme, remember 1/3 of American’s home addresses, bank information, medical conditions, prescription records, and more are all now the property of cyber criminals in the Change Cyber Attack. This is thanks to United’s wonton disregard for their own internal security standards.
More United Healthcare employees, both former and current, have now come forward. Let's start with what United said to to these employees. What follows is transcribed from a video of firings at United on the 18th of this month. The source is still an employee at UnitedHealthcare.
Setting the scene, yesterday, hundreds of employees got an invitation to a Microsoft Teams meeting, which they were instructed to join join from home. These were employees at clinics owned by United Healthcare or its Optum subdivision. I've gotten at least four different sources telling the same story. One provided video.
If you've ever wanted to know what it's like to die inside, imagine the calendar invite telling you to work from home, and I'm not kidding; the title is “RIF.”
RIF is an acronym for “reduction in force,” which is a layoff. The meeting was held on video…with the cameras off. The chat was turned off. The hand-raising was not enabled. The host muted attendee microphones. The firing squad began:
“Okay, hoping everyone can still hear us.”
From whence this hope? Of course, they have turned off their cameras at this point, and were deaf and blind to the individuals they were about to eliminate. The firing squad proceeded, undaunted.
“We're going to get started. We've got a lot of hands raised. Um, we're going to actually encourage everyone as we walk through the information that we're got to…[edit]/
So, first of all, we want to address the elephant in the room. Um, as we know, at this point in the morning, you've probably heard lots of rumor. Um, so we want to tell you that if you receive an invite to this 8. 30 AM, um, team huddle, That means that you are remaining a part of our organization.”
So they sent out two different sets of invitations. The 8 AM invitation was for those who would be fired, and the 8:30 invitation was for people who would not be fired, except it seems there was some mixup. They repeated the cycle throughout the day: 12 and 12:30, for the dead and the living:
“However, many employees' roles have been impacted, and we announced some closures of clinics. “
This is a verbatim transcript. I have edited only for transcription errors:
“So I do want to clarify, team members that received an 8 a. m. meeting invitation were those that were impacted. If you received an 8:30 a. m. invitation, you're remaining with the organization. We've had some, um, folks in some confusion with the meeting invites. If you're on this call and you received direct from the calendar an 8:30 meeting invitation, it means that you will remain a part of the organization. So, as part of our ongoing business evaluation, we talk about this all the time. We're constantly looking for ways, um, to ensure the sustainability of our organization. So, we've identified some major changes that must be made to sustainably grow our core business and continue providing extraordinary value based care to our Medicare patients.”
The clip I saw continued:
“Today, across all of South region. So this is all of Texas and all of Florida. Um, announcements will be made about consolidating our network of clinics and right sizing our clinician and non clinician workforce. So several of our colleagues have been notified earlier this morning that their roles within the organization have been eliminated.
These changes will impact employees across all levels of our clinics. Specifically here in our North Texas market, this means that we're consolidating our clinic footprint from 108 clinics to 77 clinics via consolidations, clinic closures, and right sizing our clinician and non clinician staff. So the consolidation process began in 2023.
As many of you all are aware with Project Monarch, we've completed 15 consolidations. To date, we have 12 additional consolidations remaining to be completed through early 2025.”
They gave this speech in order to rally the spirits of those who hadn't been laid off.
Let that sink in.
Here are some other details about these layoffs, as presented to me by individuals who represented themselves as working at United Healthcare. The subsequent information I have not been able to verify with video evidence, so consider these unverified reports:
“I'm going to need a psychiatrist after being laid off by Optum… I worked at the XXX clinic. They closed 17 clinics down. We all got laid off over a teams meeting after they told us how much they appreciate us. They shut down a lot lot of specialty [clinics as well]. They harass patients… They made us call patients—even if the patient told us not to…they are focusing on medicare advantage patients, UHC AARP and Humana Gold.”
At this point, I asked, “What was the point?” My source responded:
“When [patients] provide [their telephone] number to insurance, it gives [the number] to us [as providers]. [In the clinic] To have them come in and change their doctor, or have them come in [to the clinic]… [management] get bonuses for meeting metrics.”
I tried to clarify:
“Was there a time when the patients withdrew their consent to be called, and you were told to violate that?”
My sources’ response: “Yes. Multiple times.”
Me: “Was that in writing?”
Source: “No, but there were a lot of lies that are visible. I know why I was chosen [for firing]… because I won't lie on dates [of service] or anything. When someone does something that's not right I say something…”
In the process of writing this very article, I got another report, strikingly similar to the above:
I was layed off yesterday but we heard rumors for months. It is done via Teams, mic and camera disabled. Read a script. 18 large urban markets shut down. Almost the entire home and community based services division across several programs. Then they make you attend meetings TODAY and told us to “dust off” and provide patient care until July 31. Last day is August 15. Gulf Coast market. There was 600+ social workers on my Teams call today. 600+ social workers cut. My role was on the palliative care team and we are abandoning the most fragile and vulnerable seniors/ disabled. I’m disgusted with how this rolled out. My home bound patients will suffer.
The source continued:
UHC is buying up companies that provide home based services and gutting them because they don’t want to pay for home based models…. Just google ‘United Healthcare acquired’ and it’ll tell you exactly what they are up to.
These reports were not all allegations of corporate malfeasance. One former employee, who was laid off in the last round, explicitly stated that nothing inappropriate happened until the layoffs.
Other individuals have made additional allegations about the nature of the guidance they were given about managing Medicaid plan members. Honestly, these allegations are horrifying to me, and until I can verify those claims, I'm not even going to put them in print.
But I don't think it's hard to argue that corporate culture is Orwellian when the individuals who are not getting “Right Sized” are still getting this as their pep talk:
When I wrote my piece about the BlackCat Cyber Criminals getting a video-off call…
[A Dark Warehouse, somewhere in Eastern Europe, this transcript was—with some irony—leaked from BlackCat HQ]
Thank you so much for coming, we appreciate your attention.
I am going to request that all cameras be off for this, out of respect for the culture at Optum.
It was intended as satire.
One of the videos, for reference:
Excellent reporting! I especially appreciated your comment that United's behaviors cause more harm than Purdue Pharma; I'm sure that's true. Would you consider sharing your reporting with ProPublica?
This is terrible. Thank you for reporting.