Becker's ASC Review

13 ASC MANAGEMENT Anesthesiologists ask feds to investigate UnitedHealth for alleged anticompetitive conduct By Alan Condon T he American Society of Anesthesiologists has urged the Justice Department to look into the behavior of UnitedHealth Group, which the society claims is stifling competition by ending partici- pating provider agreements with anesthesia practices across the country. Terminating participating provider agreements with ASA member anesthesia practices is hampering competition by "forcing willing anesthesia practices out of network," ASA President Beverly Philip, MD, said in an Oct. 7 news release. Dr. Philip said this leads to "higher out-of-pocket costs and reduced numbers of in-network anesthesiologists for patients, especially where UnitedHealth Group can do this to favor its own employed anesthesiologists." UnitedHealth Group, as a vertically integrated com- pany, has an incentive to leverage its UnitedHealth- care subsidiary's status as a health insurer, including to favor UnitedHealth Group's healthcare provider subsidiary, Optum, and its employed anesthesiologists unfairly, Dr. Philip said in an Oct. 7 letter to the Justice Department's acting assistant attorney general. e letter also claims that UnitedHealth Group, which acts as a third-party administrator for employer-spon- sored health plans, has the incentive through a shared savings program to reduce the number of in-network anesthesiologists to boost its profits, while upping the fees and overall costs for employers. According to the ASA, anesthesiologists have felt the pinch by being denied access to UnitedHealth Group's members, especially in areas where its members represent a significant portion of commercially insured patients. "e participating provider agreements that have been terminated were negotiated at arm's length and mutu- ally beneficial," Dr. Philip said. "It is regrettable that [UnitedHealth Group] is taking steps to reduce access to in-network anesthesiologists and harming patients, employers and anesthesiologists in the process." n Los Angeles-area hospital building ASC as part of $125M project By Marcus Robertson C ovina, Calif.-based health network Emanate Health is build- ing an ASC with four operating rooms at its Queen of the Valley Hospital campus, according to the Los Angeles Busi- ness Journal. The ASC is part of a $125 million expansion that will add two 60,000-square-foot buildings. In the first year of operation, the facility will be equipped for up to 1,700 outpatient programs, ac- cording to Emanate Health. Builders broke ground on the project Aug. 27, and completion of the first building is set for late next year. n 8 largest health insurers by revenue — UnitedHealthcare No. 1 at $257B By Alan Condon H ealth insurance companies generate revenue through the premiums they charge, the number of policies they write, the services they sell and the number of businesses in which they operate. UnitedHealthcare is the largest health insurer in the U.S. by revenue, generating $257 billion in 2020, according to an August 2021 Val- uePenguin report. With 70 million members, UnitedHealthcare also leads the pack in terms of covered lives. Here are the eight largest health insurance companies by revenue: 1. UnitedHealthcare — $257 billion 2. Anthem — $122 billion 3. Centene — $111 billion 4. Kaiser Permanente — $89 billion 5. Humana — $77 billion 6. CVS Health — $75 billion 7. HCSC — $47 billion 8. Molina Healthcare — $19 billion n

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