We talk a lot about Optum in terms of its place in the UnitedHealth Group family tree, and how it fuels its parent company United’s growth. But a recent piece in Fierce Healthcare reminds us that Optum merits a closer look on its own terms, particularly considering that it employs more physicians than the largest hospital system in the United States.
First, though, let’s review where Optum falls in the complex United conglomerate. UnitedHealth Group sits at the top, as a massive managed healthcare and insurance company. Under that is UnitedHealthcare, the gigantic health insurance company, which owns Optum. Optum is the rapidly expanding health services business that quietly influences healthcare delivery (OptumHealth), data analytics and technology (OptumInsight), and pharmacy benefits (OptumRx). While Optum may look like it’s in the shadow of United, it’s actually got a presence in practically every aspect of the industry.
In the Fierce Healthcare piece, Andrew Witty, who is the CEO of both Optum and UnitedHealth Group, muses about Optum’s “untapped potential.” We have to wonder what could possibly be left to tap, considering that Optum’s 2020 revenue topped $136 billion. As it turns out, Witty has some ideas. One is growing Optum’s focus on value-based care (VBC), which puts doctors in contracts where they’re allocated set amounts of funds to care for their patients. Optum now uses VBC with about 90 insurers, which represents a reach that extends far beyond United’s sizeable member base.
Witty also names new technology as an avenue of expansion, such as tech-driven capabilities for decision making at the point of care, among other things. Are you hearing alarm bells? To us, the upshot is that doctors’ jobs, their frameworks for decision making about patient care, and the tools they use that influence care could all be under Optum’s control.
We’re accustomed to calling out United’s growth and maneuvers to boost its massive bottom line. But as Optum’s presence seeps into so many aspects of the care environment, and as its CEO projects still more expansion, we question where it’s all headed—and whether it’s actually going to be any good for patients.