Optum, the health services arm of UnitedHealth Group, is a major player in the healthcare industry, offering services in pharmacy, primary care, and revenue cycle management. With divisions like Optum Health, Optum Insight, and OptumRx, the company has experienced significant growth, surpassing $100 billion in annual revenue. Optum’s leadership, extensive acquisitions of provider groups, and partnerships with health systems demonstrate its influence on healthcare delivery. Competing with industry giants and making headlines, Optum continues to expand its reach and innovate in the ever-evolving healthcare landscape.
Here are 50 key facts about Optum, the health services arm of UnitedHealth Group, which operates in various sectors of the healthcare industry such as pharmacy, primary care, and revenue cycle management.
1. Optum was established by UnitedHealth Group in 2011.
2. Optum consists of three main divisions: Optum Health, Optum Insight, and OptumRx.
3. The company is headquartered in Eden Prairie, Minnesota.
4. With 165,000 employees worldwide, Optum is a significant player in the industry.
5. Optum has international operations in countries like India, Brazil, Ireland, and the U.K., managed by its international arm, Optum Global Advantage.
6. In collaboration with the Mayo Clinic in Rochester, Optum created the research initiative Optum Labs in 2013.
7. Optum surpassed $100 billion in annual revenue in 2018.
By the numbers:
8. In the second quarter of 2023, Optum generated $56.3 billion in revenue, marking a 25 percent year-over-year increase from 2022.
9. Optum Health experienced a 33 percent year-over-year growth in revenue per customer in Q2 2023, with 900,000 patients added to value-based care arrangements.
10. In the second quarter of 2023, Optum Rx filled 381 million prescriptions.
11. Optum Health served 103 million consumers in Q2 2023.
12. Optum Insight’s revenue backlog increased by $8 billion year over year in Q2 2023, driven in part by the acquisition of Change Healthcare.
13. In the second quarter of 2023, Optum Rx was the highest-earning segment, generating $28.6 billion in revenue.
14. Optum Health generated $23.9 billion in revenue in Q2 2023, while Optum Insight generated $4.7 billion.
15. Optum Rx holds the position of the third-largest pharmacy benefits manager (PBM) in the U.S., with a 22 percent market share.
16. In 2022, approximately 77 percent of Optum’s revenue came from UnitedHealthcare, with the remaining quarter attributed to Optum.
17. UnitedHealth Group expects Optum to generate between $212 and $214 billion in revenue in 2023.
Leadership:
18. Larry Renfro served as the first CEO of Optum from 2011 to 2017. He currently acts as a managing partner of Optum’s venture arm.
19. Andrew Witty, the current CEO of UnitedHealth Group, assumed the role of Optum’s CEO in 2018 and later took over the leadership of the parent company in 2021.
20. While Optum has not appointed a CEO since Witty’s promotion, each of its three divisions has its chief executive.
21. Heather Cianfrocco became the CEO of OptumRx in 2021, having previously served as the chief executive of Optum Health Services.
22. Wyatt Decker, MD, serves as the CEO of Optum Health, joining the company in 2019 after holding positions such as chief medical information officer for Mayo Clinic and CEO of Mayo Clinic in Arizona.
23. Neil de Crescenzco, who was the CEO of Change Healthcare before its acquisition by Optum, currently holds the position of CEO of Optum Insight.
24. Jeff Grosklags has been the CFO of Optum since 2022.
Healthcare delivery:
25. Optum is the largest employer of physicians in the U.S., with a workforce that includes at least 70,000 employed or aligned physicians.
26. The company operates 2,200 primary and specialty care offices in 16 states.
27. Dr. Decker stated in 2022 that Optum’s unique strength lies in bringing together patients, providers (especially doctors), payers, and data under one organization, which is rare in the U.S. healthcare system.
28. Optum acquired Crystal Run Healthcare, a multispecialty physician group with over 400 providers across more than 30 locations, earlier in the year.
29. In 2022, Optum acquired Refresh Mental Health, which has over 300 outpatient sites in 37 states and employs more than 1,500 individuals.
30. Houston-based medical group Kelsey-Seybold Clinic was acquired by Optum in 2022. The group currently operates 32 locations in Houston and plans to expand to over 50 by 2026.
31. Optum acquired Atrius Health in 2022, which has 30 locations in Massachusetts.
32. Other notable acquisitions of provider groups include MedExpress for $1.5 billion in 2015, Surgical Care Affiliates for $2.3 billion in 2017, the healthcare arm of the Advisory Board for $1.3 billion in 2017, and DaVita Medical Group for $4.3 billion in 2019.
Revenue cycle:
33. Numerous health systems have outsourced revenue cycle, IT, and other functions to Optum Insight.
34. Examples of hospitals outsourcing to Optum include Bassett Healthcare Network (Cooperstown, NY), SSM Health (St. Louis, MO), MarinHealth (Greenbrae, CA), John Muir Health (Walnut Creek, CA), Northern Light Health (Brewer, ME), Owensboro Health (Owensboro, KY), and Virginia Mason Franciscan Health (Tacoma, WA).
35. Mike Valli, president of Optum’s Northeast Region, hinted at the possibility of additional health system partnerships in 2023.
36. Bassett Healthcare, led by Tommy Ibrahim, MD, expects to save $25 million annually through its partnership with Optum.
More acquisitions:
37. In February, UnitedHealth Group acquired LHC Group, a home health provider, for $5.4 billion.
38. In October 2022, UnitedHealth Group completed a $7.8 billion acquisition of Change Healthcare, a data and analytics giant.
39. UnitedHealth Group spent $100 million to integrate Change Healthcare with Optum.
40. UnitedHealth Group announced plans to acquire hospice care provider Amedisys in June 2023, with an all-cash deal valued at $101 per share, subject to shareholder and regulatory approvals.
41. UnitedHealth Group’s CEO, Andrew Witty, emphasized the importance of home health capabilities in delivering value-based care, leading to the decision to acquire Amedisys.
Competitors:
42. Optum, HCA, and Tenet Healthcare are engaged in competition for market share in the ambulatory surgical center space.
43. Amazon has also become a competitor to Optum by expanding its presence in direct-to-employer health services through the acquisition of One Medical for $3.9 billion in 2022.
44. Optum owns more clinics than competing companies such as CVS Health, Walgreens, Amazon, and Walmart.
45. Some CIOs predict that Optum will be the primary disruptor in primary care in 2023.
In the headlines:
46. In June, a federal judge certified class-action status in a lawsuit alleging Aetna and OptumHealth Care Solutions conspired to use “dummy code” to make administrative fees appear as billable medical charges.
47. Virginia Mason Franciscan Health partnered with Optum Washington, designating Virginia Mason Medical Center in Seattle as the primary acute care referral center for the physician group. The Polyclinic, a 200-physician group acquired by Optum five years ago, will refer patients to Virginia Mason Medical Center for inpatient treatment.
48. Optum experienced several leadership shake-ups in 2023.
49. Optum now offers financing to healthcare organizations in need of advanced funds. Optum Pay Advance provides loans from Optum Bank to healthcare providers who have been Optum Pay customers for at least two years.
50. In July 2022, Optum Health and Red Ventures collaborated to launch RVO Health, a comprehensive consumer healthcare platform.
