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The tragic assassination of Brian Thompson, CEO of UnitedHealthcare and a prominent leader in the health insurance industry, has left an indelible void in both the professional community and the lives of those who knew him personally. Brian was not just a figurehead in the health insurance world; he was a visionary whose work focused on ensuring access, equity and innovation in health care. His untimely death, under such tragic and violent circumstances, has shaken the industry to its core and ignited a collective call for justice and remembrance.
I got to know Brian personally in what would best be described as a wartime situation. I started working directly with him in March 2020 just as the COVID-19 lockdown shut down the entire health care industry. I worked in the White House at the time as an economist advising the Trump administration. I was suddenly called on to recommend how to distribute the first $100 billion of CARE Act financial relief to health providers who were struggling financially and no longer able to complete elective procedures. To put it bluntly, federal government Medicare contractors failed to find easy ways to distribute the money through normal channels. That is where Brian responded through a personal connection to a federal official to map out a novel, unorthodox mechanism using resources of UnitedHealth Group and, in particular, using their Optum bank to move the first tranche of $30 billion to over 300,000 physicians and hospitals throughout the United States to keep them financially afloat during the first month of the pandemic.
Most people need to learn about this effort. When we think back on COVID, people focus on the success of Operation Warp Speed to get the economy fully reopened. In many ways, there was no template to rescue an entire health care economy. It’s a tribute to Brian and his courageous and ingenious way of getting all of the key components of UnitedHealth Group to come together to complete a mission that the Medicare contractors said would not be possible until July 2020 with two months of planning and another one month of execution.
Why did this relief matter? Many hospitals had seven to 10 days of cash on hand at the time because they were running very lean supply chains, as they had been trained to do for 20 years. During the lockdown, there were no elective procedures. These services keep many hospitals and physicians operational. Without revenue, providers could not pay their staff at the worst possible time during the COVID pandemic when some cities such as New York and Detroit were surging with hospitalizations. These hospitals needed to have money flowing into their health systems in order to stay operational.
UnitedHealth Group was in a unique position because they are not just an insurance company but have Optum Bank. This bank’s purpose is to hold health savings accounts and have people use them to pay for medical services. Because United had a bank, they could wire money directly to hospitals and physicians who did not know they would be getting assistance until it showed up on April 9, 2020. All of Minnesota’s major hospital systems received at least $20 million of relief that day. Several New York City hospitals quickly spent over $100 million to stay operational. While these sums may sound very large, they are only about two weeks of operating expenses for those large hospital systems.
At the time, those working on this project were encouraged by the notes we received back two weeks after the first tranche was deposited. Here are some examples: