Profile: UnitedHealth Group Inc (UNH)
23 Mar 2018
UnitedHealth Group Incorporated, incorporated on July 1, 2015, is a health and well-being company. The Company operates through four segments: UnitedHealthcare, OptumHealth, OptumInsight and OptumRx. The Company conducts its operations through two business platforms: health benefits operating under UnitedHealthcare and health services operating under Optum. UnitedHealthcare provides healthcare benefits to an array of customers and markets, and includes UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement, UnitedHealthcare Community & State, and UnitedHealthcare Global businesses. Optum is a health services business serving the healthcare marketplace, including payers, care providers, employers, governments, life sciences companies and consumers, through its OptumHealth, OptumInsight and OptumRx businesses.
The Company's UnitedHealthcare Employer & Individual offers a range of consumer-oriented health benefit plans and services for national employers, public sector employers, mid-sized employers, small businesses and individuals across the nation and active and retired military and their families through the TRICARE program. UnitedHealthcare Global is a global health services business with a range of offerings, including international commercial health and dental benefits.
As of December 31, 2016, UnitedHealthcare Employer & Individual provided access to medical services for over 30 million people on behalf of its customers and alliance partners. Through its risk-based product offerings, UnitedHealthcare Employer & Individual assumes the risk of both medical and administrative costs for its customers in return for a monthly premium, which is a fixed rate per individual served for a one-year period. When providing administrative and other management services to customers that elect to self-fund the healthcare costs of their employees and employees' dependents, UnitedHealthcare Employer & Individual receives a fixed monthly service fee per individual served. These customers retain the risk of financing medical benefits for their employees and employees' dependents, while UnitedHealthcare Employer & Individual provides services, such as coordination and facilitation of medical and related services to customers, consumers and healthcare professionals, administration of transaction processing and access to a contracted network of physicians, hospitals and other healthcare professionals, including dental and vision.
UnitedHealthcare Employer & Individual has relationships with network care providers that integrate data and analytics, implement value-based payments and care management programs. UnitedHealthcare Employer & Individual offers its products through affiliates that are licensed as insurance companies, health maintenance organizations (HMOs) or third-party administrators (TPAs). UnitedHealthcare Employer & Individual's product families include traditional products, which include a range of medical benefits and network options from managed plans, such as choice and options preferred provider organization (PPO), to traditional indemnity products; consumer engagement products, which couple plan design with financial accounts to increase individuals' responsibility for their health and well-being, and clinical and pharmacy products, which offers a suite of clinical and pharmacy care services products. Traditional products also offer a range of covered services, including preventive care, direct access to specialists and catastrophic protection. Consumer engagement products include consumer-driven benefit plans, which include health reimbursement accounts (HRAs), health savings accounts (HSAs) and consumer engagement services, such as personalized behavioral incentive programs and consumer education.
UnitedHealthcare Employer & Individual's clinical programs include wellness programs, decision support, utilization management, case and disease management, complex condition management, onsite programs, incentives to reinforce positive behavior change, mental health/substance use disorder management, and employee assistance programs. As of December 31, 2016, UnitedHealthcare Employer & Individual also delivered dental, vision, life and disability product offerings through an integrated approach, including a network of over 20,000 vision offices and over 80,000 dental offices, in private and retail settings. As of December 31, 2016, UnitedHealthcare Military & Veterans provided healthcare services for over three million active duty and retired military service members and their families in 21 states under the Department of Defense's (DoD) TRICARE Managed Care Support contract.
UnitedHealthcare Medicare & Retirement provides healthcare coverage and health and well-being services to individuals age 50 and older, addressing their needs for preventive and acute healthcare services, as well as services dealing with chronic disease and other specialized issues for older individuals. UnitedHealthcare Medicare & Retirement offers a selection of products that allow people to obtain the health coverage and services they need as their circumstances change. For those preferring traditional fee-for-service Medicare, UnitedHealthcare Medicare & Retirement offers both Medicare Supplement and Medicare Prescription Drug Benefit (Medicare Part D) prescription drug programs that supplement their government-sponsored Medicare by providing additional benefits and coverage options. Beneficiaries with special needs are served through UnitedHealthcare Medicare & Retirement Dual, Chronic and Institutional Special Needs Plans (SNPs) in various markets. UnitedHealthcare Medicare & Retirement services include care management and clinical management programs, a nurse health line service, around the clock access to healthcare information, access to discounted health services from a network of care providers and administrative services.
UnitedHealthcare Medicare & Retirement's product categories include Medicare Advantage, Medicare Part D and Medicare Supplement. UnitedHealthcare Medicare & Retirement provides healthcare coverage for seniors and other eligible Medicare beneficiaries primarily through the Medicare Advantage program administered by Centers for Medicare & Medicaid Services (CMS), including Medicare Advantage HMO plans, PPO plans, Point-of-Service plans, Private-Fee-for-Service plans and SNPs. Under the Medicare Advantage program, UnitedHealthcare Medicare & Retirement provides health insurance coverage in exchange for a fixed monthly premium per member from CMS plus, in some cases, monthly consumer premiums. UnitedHealthcare Medicare & Retirement provides Medicare Part D benefits to beneficiaries throughout the United States and its territories through its Medicare Advantage and stand-alone Medicare Part D plans. UnitedHealthcare Medicare & Retirement offers a range of supplemental products, which cover the various levels of coinsurance and deductible gaps that seniors are exposed to in the traditional Medicare program.
UnitedHealthcare Community & State's customers oversee Medicaid plans, Children's Health Insurance Programs (CHIP), SNPs, integrated Medicare-Medicaid plans (MMP), and other federal, state and community healthcare programs. As of December 31, 2016, UnitedHealthcare Community & State participated in programs in 24 states and the District of Columbia, and served 5.9 million beneficiaries. As of December 31, 2016, UnitedHealthcare Community & State served over a million people through Medicaid expansion programs in 15 states. It offers health plans and care programs, which are designed to address the needs of the populations they serve, including the chronically ill, those with disabilities and people with a risk of medical, behavioral and social conditions. UnitedHealthcare Community & State coordinates resources among family, physicians, other healthcare providers, and government and community-based agencies and organizations to facilitate continuous care.
UnitedHealthcare Global participates in international markets through national in country and cross-border strategic approaches. UnitedHealthcare Global's cross-border healthcare business provides health benefits, care management and care delivery for multinational employers, governments and individuals around the world. As of December 31, 2016, UnitedHealthcare Global provided medical benefits to 4.2 million people, principally in Brazil, but also residing in over 125 other countries. UnitedHealthcare Brazil offers a product portfolio with a range of product offerings, benefit designs, price points and value, including indemnity products. UnitedHealthcare Brazil's products include various administrative services, such as network access and administration, care management and personal health services and claims processing. UnitedHealthcare Global includes other global health services operations with a range of offerings for international customers, including network access and care coordination in the United States and overseas; TPA products and services for health plans and TPAs; brokerage services; practice management services for care providers; government and corporate consulting services, and global expatriate insurance solutions.
The Company's OptumHealth is engaged in health and wellness business. As of December 31, 2016, OptumHealth served the physical, emotional and health-related financial needs of 83 million individuals. OptumHealth sells its products primarily through its direct sales force, collaborations and external producers in three markets: employers, payers and government entities. OptumHealth's mobile care delivery business delivers occupational health and medical services to government customers, with a particular focus on the United States military. OptumHealth serves people through population health management services that meet both the preventative care and health intervention needs of consumers across the care continuum-physical health and wellness, mental health, complex medical conditions, disease management, hospitalization and post-acute care. This includes offering access to networks of provider specialists in various clinical specialties, including behavioral health, organ transplant, chiropractic and physical therapy. As of December 31, 2016, Optum Financial Services, through Optum Bank, a subsidiary, served consumers through over 4.6 million health savings and other accounts.
OptumInsight provides services, technology and healthcare solutions to participants in the healthcare industry. OptumInsight's solutions are focused on data and analytics, technology and information. Hospital systems, physicians, health plans, governments, life sciences companies and other organizations that comprise the healthcare industry depend on OptumInsight to meet the needs of the health system. OptumInsight's products and services are sold primarily through a direct sales force. OptumInsight's products are also supported and distributed through an array of alliances and business partnerships with other technology vendors, integrating and interfacing OptumInsight's products with their applications. As of December 31, 2016, OptumInsight served approximately 300 health plans through technology-enabled solutions. OptumInsight provides services, including data and analytics technology, claims management and payment accuracy services, and strategic consulting. OptumInsight also provides services to global life sciences companies.
As of December 31, 2016, OptumRx provided a spectrum of pharmacy care services to over 65 million people in the United States through its network of over 67,000 retail pharmacies and multiple home delivery facilities throughout the country. OptumRx provides retail network contracting, purchasing and clinical solutions and works with customers to develop an optimal set of programs in areas, such as step therapy, formulary management, drug adherence and disease/drug therapy management. OptumRx's whole-person approach to pharmacy care services integrates demographic, medical, laboratory, pharmaceutical and other clinical data and applies analytics to drive clinical care insight to support care treatments and compliance, benefiting clients and individuals through enhanced services and cost trend management.
OptumRx provides pharmacy care services to non-affiliated clients, including a number of health plans, national employer plans, unions and trusts and government entities; as well as a substantial majority of UnitedHealthcare members. Additionally, OptumRx manages specialty pharmacy care services, including patient support and clinical programs. OptumRx's distribution system consists primarily of health insurance brokers and other healthcare consultants and direct sales.
OptumRx's pharmacy care services deliver pharmacy benefit through retail network contracting, including rebate management and clinical programs, such as step therapy, formulary management, drug adherence and disease/drug therapy management programs. OptumRx's whole-person approach integrates demographic, medical, pharmaceutical and other clinical data and then applies analytics to drive clinical care insight to support care treatments and compliance, benefiting clients and individuals through services and cost trend management. OptumRx provides pharmacy care services to a majority of UnitedHealthcare members. Additionally, OptumRx manages specialty pharmacy benefits across all of UnitedHealthcare's businesses with services, including patient support and clinical programs. OptumRx also provides pharmacy care services to non-affiliated external clients, including a number of health plans, national employer plans, unions and trusts and government entities.
The Company competes with Aetna Inc., Anthem, Inc., Centene Corporation, Cigna Corporation, Humana Inc., Kaiser Permanente, CVS Health Corporation, Express Scripts, Inc. and Prime Therapeutics LLC.
UnitedHealth Group Inc
9900 Bren Rd E
HOPKINS MN 55343-9664
Company Web Links
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