About Optumhealth Holdings, LLC
UnitedHealth Group is a leading US health insurer offering a variety of plans and services to group and individual customers nationwide. Its UnitedHealthcare health benefits segment manages health maintenance organization (HMO), preferred provider organization (PPO), and point-of-service (POS) plans, as well as Medicare, Medicaid, state-funded, and supplemental vision and dental options. In addition, UnitedHealth's Optum health services units — OptumHealth, OptumInsight, and OptumRx — provide wellness and care management programs, financial services, information technology solutions, and pharmacy benefit management (PBM) services to individuals and the health care industry.
UnitedHealth operates through four reportable segments — UnitedHealthcare, OptumRx, OptumHealth, and OptumInsight.
UnitedHealthcare, the core health benefits segment, accounts for about 65% of annual revenue. Its largest business is the Employer & Individual unit, which serves more than 27.8 million members through its plans for students, families, individuals, and businesses (ranging from sole proprietorships to multinational enterprises). The Medicare & Retirement senior services unit is the second-largest business serving about 5.3 million people through its Medicare Advantage products. A smaller division, Community & State, manages public Medicaid programs for disabled and disadvantaged citizens. Military & Veterans provides medical plans for about two million people through a government TRICARE contract. The Global unit serves international markets and includes Amil, which provides health and dental benefits to some six eight million people in Brazil.
The Optum health services segments are OptumRx (about 25% of total revenue), OptumHealth (another 10%), and OptumInsight (about 5%). OptumRx provides a full spectrum of pharmacy care services to 56 million people in the US through its network of more than 67,000 retail pharmacies, multiple home delivery, specialty and community-health pharmacies, and through the provision of home infusion services. OptumHealth serves as the health and wellness arm, serving more than 96 million individuals, while OptumInsight provides technology and consulting services to the health care industry.
UnitedHealth's plans have a combined provider network of more than 6,500 hospitals and other facilities nationwide. Its health plan units and other divisions serve customers throughout the US, as well as in 130 international countries including Brazil, Chile, Colombia, and Peru.
Sales and Marketing
UnitedHealth's insurance products are largely sold through independent brokers and consultants, as well as through a direct sales force, strategic collaborations, and external producers in three markets: employers, including the sub-markets of large, mid-sized, and small employers; payers, such as health plans, third-party administrators, underwriter/stop-loss carriers, and individual market intermediaries; and government entities (states, Centers for Medicare and Medicaid Services, the Department of Defense, the Veterans Administration, and other federal procurement agencies). Optum Rx's network includes more than 67,000 retail pharmacies and a number of home delivery facilities throughout the US.
UnitedHealth's revenues have been steadily rising for the past five years, increasing by 54% since 2015.
In 2019 revenue increased 7% to $242.2 billion compared with $226.2 in 2018. Growth was attributed to the increased number of people served through Medicare Advantage; pricing trends; and organic and acquisition growth in the Optum business, specifically expansion in care delivery, pharmacy care services, partially offset by the moratorium of Health Industry Tax 2019.
Net income has also been rising, and in 2019, the company posted profits of $14.2 billion, a 13% increase over 2018. This increase was largely due to higher revenues, offset by the return of the Health Insurance Industry Tax (under the Affordable Care Act) for 2019. The federal budget included a one-year moratorium on the industry tax in 2018. The moratorium will be repeated for the 2019 fiscal year.
Cash at the end of fiscal 2019 was $11 billion, a decrease of $119 million from the prior year. Cash from operations contributed $18.5 billion to the coffers, while investing activities used $12.7 billion, mainly for investment purchases and acquisitions. Financing activities used another $5.6 billion for loan payments, dividends to stockholders, and the company's stock repurchase program.
UnitedHealth Group is focused on improving outcomes for patients, lowering healthcare costs, and offering a better health care experience for patients and care providers. To this end, the company is increasingly incorporating data analytics and other technologies in the delivery of health care.
UnitedHealth believes offering both providers and patients with portable, electronic Individual Health Records (IHRs) facilitates better healthcare outcomes. The company is working to provide free IHRs for all people it serves in North and South America. It is also pairing nurses with customer service reps to navigate care, including physical therapy, medical equipment, and transportation services, throughout a patient's sickness or injury.
The company has partnered with government agencies to identify ways to control increasing costs of prescription drugs.
To battle the challenge of low engagement in patients managing their own health, the company's OptumHealth division has developed its new Rally consumer digital platform that provides personalized online tools to help people maintain their health. It encourages changes in daily routines and offers monetary incentives to set goals and track progress.
Mergers and Acquisitions
In 2019, UnitedHealth Group agreed to buy healthcare payments firm Equian LLC from its private equity owner for about $3.2 billion. Indianapolis-based Equian offers payment-processing services for healthcare companies, specializing in reducing overpayment mistakes. UnitedHealth may merge Equian into its fast-growiing Optum health services division.
In the same year, UnitedHealth purchased online patient community portal PatientsLikeMe, which became part of UnitedHealth Group's research arm that focuses on healthcare improvements and innovation.
UnitedHealth Group traces its roots back to Dr. Paul Ellwood, the health-policy guru who coined the term "health maintenance organization," or HMO, in the 1960s and helped entrepreneur Richard Burke found the company in 1977. Then United HealthCare Corporation, the company acquired Charter Med Incorporated, a company formed by a group of physicians and other health care professionals who wanted to expand health coverage options for consumers. In 1984, United HealthCare Corporation became a publicly-traded company and in 1998, was renamed UnitedHealth Group.
13625 Technology Dr
Eden Prairie, MN 55344-2252
Phone: 1 (763) 595-3200
Employer Type: Privately Owned
Senior Apps Devpr: Brian Malicki
SENIOR MARKETING SPECIALIST: Therese Manzer
Pres: Dawn Owens
Employees (This Location): 1,500
Employees (All Locations): 24,000
Eden Prairie, MN