Ryan, a Democrat from the 18th District, released a community survey with more than 1,800 participants earlier this month. In it, Optum patients and staff described a decline in the quality of care since the medical company began buying up practices in the Hudson Valley a few years ago. More than 36 percent of patients reported issues with customer service, nearly half had difficulty getting an appointment, and 25 percent saw inaccurate billing and unexplained fees.
Tuesday's meeting at the Poughkeepsie Senior Center turned into an airing of grievances. Kingston resident Barbara Scott says she saw two different Optum doctors about an undiagnosed mass and was left “bleeding on the table” following an unsuccessful biopsy in Poughkeepsie.
“As her nurse said to me, they ‘had to keep things moving,'" says Scott. "Both doctors had to be pressed to release my visit reports to me. Both reports contained inaccuracies. One stated that she had discussed with me the high probability of endometrial cancer, without ever doing that.”
Scott says it was her internist, an independent physician, who helped her seek care at Memorial Sloan Kettering in Manhattan. Scott says she is now cancer free, and no longer an Optum patient.
Optum is a subsidiary of UnitedHealth Group, the largest healthcare company in the world by revenue. The Department of Justice opened an antitrust investigation into the company last year. Ryan says he plans to submit his survey to the DOJ, the Department of Health and Human Services, and the Federal Trade Commission.
Hudson Valley medical practices changing hands and names is not new. Nurse Margaret Franks says she remembers when Vassar Brothers Medical Center in Poughkeepsie was an affiliate of Health Quest, before Health Quest merged with the Western Connecticut Health Network to form Nuvance Health. Now, Nuvance is preparing to merge with Northwell Health.
In 2022, Optum bought Franks’ first employer, CareMount Medical, which includes 2,100 providers serving roughly 1.6 million patients in the tristate area. It purchased Crystal Run Healthcare in 2023, adding another 400 providers in Orange County to its roster.
“Every time a merger happens, no matter what setting it’s in, you’re told it’s a ‘new era’ of healthcare," says Franks. "You’re told it’s an ‘exciting time to live in’ for a patient.”
Franks, who also serves as the treasurer of the New York State Nurses Association union, says these consolidations limit patients’ options for medical care. At the same time, she says consolidations can lead to staff cuts and longer wait times.
"We see patients who cannot afford their prescriptions. We tell them to follow up with a neurologist or a rheumatologist or another specialist knowing they cannot get that appointment for six months if they’re lucky," she says. "We see offices closing down. We’re on the phone for hours trying to get through to an actual person. That is not an ‘exciting time.’”
Actor Kim Elizabeth Kiernan says she’s had to put up with cancelled appointments, disputed insurance claims and high drug costs as an Optum patient on Medicare. She says the delayed care resulted in an ICU stay for diabetic keto acidosis.
“Had I been getting doctors appointments on time, my medication could have been adjusted, and I might not have almost died," she explains. "We are just numbers."
In a statement to WAMC, Optum Medical Care President and Chief Medical Officer Dr. Jonathan Nasser says Optum is working to recruit more physicians, improve its telephone system, increase available appointments, and more. He says Optum recently launched a digital portal for patients to manage their healthcare, and it has "dedicated teams responsible for scheduling and supporting medication refills and clinical questions."
"We understand the frustrations some of our patients have been experiencing and are working to make necessary improvements, as we value the long-standing relationships we have with our patients," he adds. "We look forward to continuing to work with Representative Ryan and policymakers at all levels of government to achieve our common goals."
Looming over Tuesday’s meeting were fears of potential cuts to Medicaid in the next federal budget. The Republican-led House passed a budget framework last week that calls for as much as $880 billion in spending cuts in the House Energy and Commerce Committee, which oversees Medicaid.
Ryan voted against the framework. He says Medicaid covers more than 240,000 residents in the 18th District.
"They want us — the Trump Administration, specifically — to feel that this is fait accompli, and that we don't have power to change it. That is not the case," he says. "I really, really believe that events like this happening across the country matter."
The budget is not finalized. Some Republicans, including 17th District Congressman Mike Lawler, have called fears over cuts to Medicaid and other social services a lie.
