- UnitedHealth Group has staked much of its future growth on delivering care directly to patients.
- It’s been busy moving patients into arrangements where doctors are on the hook for the cost of care.
- UnitedHealth President Dirk McMahon revealed three key investments to make that transition work.
Healthcare juggernaut UnitedHealth Group, best known as the parent of the country’s biggest insurer, is staking much of its future growth on delivering care directly to patients.
The company is hoping to build its business unit OptumHealth, which includes roughly 60,000 doctors and more than 1,600 OptumCare clinics, into its next $100 billion business.
To get there, it’s been moving more of its 20 million OptumCare patients into arrangements where doctors are paid fixed fees to provide all of their care, instead of billing health plans for every single patient visit or lab test.
In 2021, Optum was fully accountable for the costs of about 2 million patients. This year, it’s moving another 500,000 patients into those arrangements — double the number it moved over last year, Dirk McMahon, UnitedHealth’s president and chief operating officer, said Wednesday during the company’s fourth-quarter earnings call.
That should drive an increase in Optum’s revenue per consumer of over 25%, he said. Optum collected $155.6 billion in revenue in 2021, the company reported Wednesday. UnitedHealth recorded net income of $17.3 billion on revenue of $287.6 billion.
Getting Optum ready to take full responsibility for the new patients took a lot of planning and money: the company spent more than $100 million in 2021 to prepare, McMahon said. During the call, he laid out the three key areas where it focused its investments, including educating doctors, equipping them with technology and data, and laying the groundwork to coordinate care for patients.
“These foundational preparations and investments have been critical in creating strong results across the variety of geographies and practices we have transitioned,” McMahon said.
Here are the 3 key investments UnitedHealth made to prepare its clinics.
McMahon said Optum begins training its doctors to care for patients differently more than a year before they’re on the hook for the cost and quality of care.
Doctors are educated and given resources on how to care for patients’ whole health, he said. That can be a complicated change for doctors coming from practices paid in traditional ways, he said.
Optum also makes sure it has enough doctors, nurses and other clinicians to care for patients, he said.
Equipping care teams with technology and data
The company also invests in technology and data that clinicians need to care for patients.
That includes patient portals and systems that care teams need to report on patients and manage their use of healthcare, McMahon said.
Coordinating care for complex patients
Optum also invests in its doctors’ ability to coordinate care for patients beyond primary care and get them set up with “high-touch” clinical services they need to improve their health, McMahon said.
Patients with complex needs are paired with a personal care navigator who can help them with medication and schedule appointments.