When we first started going to SMA @ Nellis care seemed good, I got a great referral to have my knees replaced etc. AND THEN Optumcare took over which has led to not being able to see our primary Dr. for three months unless we wanted a group appointment where they put 15 patients in a conference room & the Dr. goes from patient to patient in his comfy chair to discuss what's ailing them for all to hear! At our last group visit at least six of us needed qqrefills for pain meds at which time Dr. Orr informed us he was not refilling our pain meds, that the DEA was zeroing on doctors for prescribing too many narcotics, that Europe uses far less narcotic drugs as the U.S., & here is the best one: elderly people are selling their drugs! Mind you, my husband has degenerative disc disease in his cervical & thoratic spine & has taken Vicodin for this condition for 8 years & Dr. Orr cut him off immediately, with no tapering off. The effects were disastrous & he has been suffering immeasurable pain. Thankfully we have found other doctors at private clinics in the area who aren't brainwashed by Optumcare and we are getting far better care. It truly seems that care has been over-standardized to the point that the individual conditions are lumped into one big category and everyone is treated the same. It sure seems like socialized medicine. My Medicare dollars are being squandered by SMA & quality of care is declining. If I were a doctor there I would be embarrassed to say I worked for SMA because individual thought is being replaced by brainwashed rhetoric and patients are suffering needlessly. Optumcare isn't improving patient care but I bet it has improved the bottom line, that's what it is really all about!