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Kristen Bell in Podcasts

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Kristen Bell, a nurse practitioner who worked for UnitedHealth.

healthcare professional person
12 mentions

Mentions in Podcasts

The Journal.
Medicare, Inc. Part 1: How Insurers Make Billions From Medicare

If the quanta flow showed decreased blood flow, Kristen was supposed to conclude that the patient had peripheral artery disease. But she says she was uncomfortable making such a definitive diagnosis just based on the device, especially since elderly people often have decreased blood flow.

The Journal.
Medicare, Inc. Part 1: How Insurers Make Billions From Medicare

Like peripheral artery disease. It's a serious condition where blood vessels get narrower, and in some cases, it can lead to amputations. A House Calls training manual reviewed by the investigations team advised nurse practitioners like Kristen to diagnose peripheral artery disease based on results from a device called the Quantiflow.

The Journal.
Medicare, Inc. Part 1: How Insurers Make Billions From Medicare

According to the data seen by the journal team, UnitedHealth Medicare Advantage members were about 15 times as likely to have a diagnosis of diabetic cataracts compared to the average patient in traditional Medicare. It was this unusual condition that Kristen, the nurse practitioner with House Calls, says she was encouraged to put down on patient charts.

The Journal.
Medicare, Inc. Part 1: How Insurers Make Billions From Medicare

UnitedHealth told us that their nurse practitioners are not, quote, Chris looked at a three-year period where Medicare Advantage insurers sent out nurse practitioners like Kristen to run tests and add diagnoses to patient records, including diagnoses of the kinds of conditions that trigger those extra payments. The extra payments added up to about $15 billion during that time.

The Journal.
Medicare, Inc. Part 1: How Insurers Make Billions From Medicare

After working at the House Calls program for about a year, Kristen told us that she eventually began doing the tests she was asked to do. And after that, she got a raise.

The Journal.
Medicare, Inc. Part 1: How Insurers Make Billions From Medicare

But what you really need to work on is, you know, the testing that we're trying to deliver to the patients. And I said, look, you know, if somebody is asymptomatic. You know, you don't test somebody for everything if they come into the hospital. You test them for what they're having difficulties with. She said to me, Kristen, we're not billing for any of this. Just do the testing. Just do it.

The Journal.
Medicare, Inc. Part 1: How Insurers Make Billions From Medicare

Kristen also started getting the message from a manager that she should do more testing on her patients.