From announcing plans to eliminate 20 percent of its current prior authorizations, to closing its acquisition of LHC Group, here 10 UnitedHealth Group updates to know from the first six months of 2023:
1. UnitedHealthcare is seeing rising utilization as more older adults seek out services they delayed during the COVID-19 pandemic, Tim Noel, CEO of Medicare and retirement, said June 14 at the Goldman Sachs Global Healthcare Conference.
2. A federal judge in North Carolina certified class-action status June 5 in a lawsuit alleging Aetna and UnitedHealth Group's OptumHealth Care Solutions conspired to use "dummy code" to make administrative fees appear to be billable medical charges.
3. UnitedHealthcare rolled back plans to implement a gastroenterology endoscopy prior authorization policy set to take effect June 1 and instead set up an advance notification process for non-screening GI procedures. The change came following pushback from GI societies and other medical organizations.
4. The Senate Permanent Subcommittee on Investigations sent letters to CVS Health, Humana and UnitedHealth Group on May 17 seeking internal documents on Medicare Advantage claims denials.
5. Arbitrators sided with physician services company Envision Healthcare in its dispute with UnitedHealthcare over allegations the payer breached their contract by reducing reimbursement rates. The arbitrators ruled that UnitedHealthcare must pay $91 million in damages.
6. Optum purchased Middletown, N.Y.-based Crystal Run Healthcare, a multispecialty physician group with over 400 providers across more than 30 locations. The deal was made official Feb. 22. The purchase was not publicly announced by Optum or Crystal Run.
7. UnitedHealthcare announced March 29 it is moving forward with a plan to eliminate 20 percent of its current prior authorizations and implement a national gold-card program. Code reductions will begin this summer and continue through the rest of the year for most commercial, Medicare Advantage and Medicaid plans. The national gold-card program will be implemented in early 2024.
8. UnitedHealth Group closed on its $5.4 billion acquisition of home health firm LHC Group on Feb. 22.
9. The largest employer of physicians in the United States is UnitedHealth Group's Optum. With 70,000 employed or aligned physicians across more than 2,200 locations in 2023, Optum has cemented itself at the forefront of the changing healthcare delivery landscape.
10. UnitedHealth Group is planning to integrate more behavioral and home health services into its care delivery strategy as the company continues to expand its value-based care offerings, CEO Andrew Witty told investors during a fourth-quarter earnings call Jan. 13.