Investigation: UnitedHealth Allegedly Paid Nursing Homes Bonuses to Reduce

An investigation published by The Guardian in May 2025 alleged that UnitedHealth, through its subsidiary Optum, secretly paid bonuses to nearly 2,000 nursing homes across the United States for reducing hospital transfers among long-term care residents enrolled in the company’s Medicare Advantage plans. UnitedHealth disputed the findings, stating the program improved patient care and that the Department of Justice had investigated the allegations and found significant factual inaccuracies.

How the Program Worked

Optum embedded medical teams in participating nursing homes, which received bonuses through programs called “Premium Dividend” and “Shared Savings” for lowering hospitalization rates. The company’s internal metric - “admissions per thousand” (APK) - determined bonus eligibility: homes with lower hospital transfer rates qualified for payments; those with higher rates did not. Roughly 55,000 long-term care residents were enrolled in UnitedHealth’s Medicare Advantage plans, under which the company received lump-sum federal payments and stood to profit by minimizing services provided.

Whistleblower Allegations

Two whistleblowers submitted declarations to Congress through the legal nonprofit Whistleblower Aid. Maxwell Ollivant, a former Optum nurse practitioner, alleged that medical teams were pressured to avoid hospital transfers even when clinically warranted. His earlier False Claims Act lawsuit alleged the company billed Medicare while withholding services - a case the Department of Justice declined to pursue. UnitedHealth said Ollivant “lacks both the necessary data and expertise” to support his claims.

Multiple sources described specific cases to The Guardian, including a Washington state nursing home resident who displayed stroke symptoms - slurred speech and facial drooping - but was allegedly advised by a remote UnitedHealth nurse practitioner to wait four hours for bloodwork rather than be transferred to hospital. That resident later suffered permanent neurological damage. UnitedHealth declined to comment on individual cases, saying hospitalization decisions depend on clinical variables including patients’ goals of care.

Enrollment and Confidentiality Concerns

The investigation also found that nursing homes allegedly shared confidential patient records with UnitedHealth sales teams in exchange for enrollment-linked bonus payments. In a federal case filed in Georgia, families alleged their elderly relatives were enrolled in Medicare Advantage plans without informed consent, resulting in reduced hospital access. UnitedHealth did not directly address this allegation.

References: Revealed: UnitedHealth Secretly Paid Nursing Homes to Reduce Hospital Transfers | UnitedHealth Paid Nursing Homes to Reduce Hospital Transfers: Report | UnitedHealth Falls After Report It Secretly Paid Nursing Homes to Reduce Hospital Transfers