10 Things to Know About UnitedHealth Group

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UnitedHealth Group, based in Minneapolis, is one of the nation’s largest companies based on revenue and has introduced health insurance innovations including drug formularies, hospital admission pre-certification processes and physician office software to manage and control costs. Here are 10 things to know about UnitedHealth.

1. UnitedHealth serves clients and consumers through two platforms: UnitedHealthcare, which provides health insurance coverage and benefits services, and Optum, which focuses on information and technology-enabled health services.

2. Overall, UnitedHealth provides health benefits and services to more than 85 million people around the world. UnitedHealthcare and Optum have members in every state and more than 126 countries.

3. Stephen J. Hemsley has served as UnitedHealth’s president and CEO since November 2006. He has been with the company since 1997 and previously held the position of president and COO.

4. For the entire 2013 fiscal year, UnitedHealth brought in $122.5 billion in revenue, up 10.7 percent from 2012, while earnings rose 1.8 percent to $5.63 billion. However, during the first quarter of 2014, the company’s financial growth was “offset by headwinds from new [PPACA] taxes and Medicare Advantage funding deficiencies,” Mr. Hemsley said in a news release. UnitedHealth’s net earnings in the first quarter of fiscal year 2014 fell 7.8 percent, from approximately $1.2 billion in 2013 to $1.1 billion this year. Medicare Advantage cuts due to the healthcare reform law and sequestration led UnitedHealth Group to exit markets, adjust networks and reduce product offerings and benefits this year. Additionally, the company’s first-quarter income tax rate increased more than five percentage points year-over-year to 42 percent because of nondeductible health insurance taxes and reinsurance fees under the PPACA.

5. UnitedHealth was the top ranked company in the insurance and managed care sector in Fortune magazine’s “World’s Most Admired Companies” list in 2014, the fourth straight year it earned the top spot. Additionally, the company — which has 133,000 employees in 21 countries — earned a top rating of 100 percent for four straight years on the Corporate Equality Index from the Human Rights Campaign Foundation. The insurer was also recognized by Becker’s Hospital Review as one of 150 Great Places to Work in Healthcare in 2014.

6. However, it seems that UnitedHealth isn’t as well-regarded by hospital and health system leaders as it is by its employees. ReviveHealth’s eighth annual National Payor Survey, which polled 203 hospital and health system executives about their feelings toward several health insurers, found about 42 percent of hospital leaders said UnitedHealthcare was the worst at dealing with hospitals. The executives identified Humana as the second-worst payer and Blue Cross Blue Shield as the best overall payer.

7. The insurer has taken issue with the survey’s findings. UnitedHealthcare spokeswoman Cheryl Randolph released the following statement in response: “UnitedHealthcare contracts with 6,000 hospitals and more than 800,000 physicians and care professionals across the country. This very selective (only 203 hospital and health system executives were interviewed for 2014), non-scientific, web-based survey misrepresents the positive relationships that UnitedHealthcare has with most hospitals. Productive, collaborative relationships between hospitals and payers are important if we are going to make progress together to improve our nation’s healthcare system, and UnitedHealthcare has taken a number of steps to improve how it works with healthcare providers.”

8. UnitedHealthcare is undertaking projects to promote higher-quality care at a lower cost. In May, the insurer and Arizona Care Network (formed through collaboration between San Francisco-based Dignity Health and Phoenix-bassed Abrazo Health) announced they are forming an accountable care organization.

9. The insurer also recently launched two text message-based wellness programs to promote healthy behavior among beneficiaries of its Medicaid benefits plans. The programs, Txt4health and Text4kids, send personalized reminders to users’ cell phones to help them manage their health.

10. UnitedHealthcare is dealing with legal issues surrounding its coverage for mental health and substance abuse treatment. Last month, a class action lawsuit was filed against the insurer alleging the company is acting in violation of the federal mental health parity law by improperly denying mental health and substance-abuse related claims. The lawsuit was filed by three UnitedHealthcare members who had been denied coverage.