根据美国参议员查克·格拉斯利最新发布的调查报告，针对联合健康集团的深入调查显示，该医疗保健巨头存在通过操纵医疗保险风险调整机制获取超额利润的嫌疑。报告明确指出，联合健康似乎正在系统性滥用这套本应公平分配医疗资源的评估体系，将其转化为实现惊人利润增长的工具。
风险调整流程原是联邦医疗保险计划的核心设计，旨在根据参保人群的健康状况差异合理分配资金。然而调查发现，联合健康通过夸大患者病情严重程度、选择性申报高赔付疾病诊断等操作，人为抬高风险评分，从而获得远超实际医疗需求水平的政府拨款。这种操作模式不仅扭曲了医疗资源的配置效率，更可能最终推高全体纳税人的医保成本。
格拉斯利在报告中强调，当医疗巨头将精算技术转化为利润最大化工具时，受损的将是整个医疗体系的公平性。此次调查结果已引发监管机构高度关注，预计将对医疗保险风险调整机制启动全面审查。
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