A new, first-of-its-kind report details the corporate structure and acquisition history of the world’s largest healthcare company, UnitedHealth Group.
The “Sunlight Report” was published on July 16 by the Center for Health & Democracy and funded by Arnold Ventures. AV has awarded more than $358 million to research and initiatives focused on healthcare, including grants to study hospital consolidation and fund litigation against health systems. While the report information was obtained and compiled from publicly-available sources, the report notes that it is not intended to be relied upon as definitive.
The information about UnitedHealth’s subsidiaries was gathered from Schedule Y filings, which are public records required by state regulators. The report examined Schedule Ys for each year from 2010 to 2024.
10 notes:
1. As of the third quarter of 2024, UnitedHealth Group was composed of 2,694 subsidiaries across a broad range of sectors and categories. This number has likely changed since then, with Bloomberg reporting that the company sold stakes in some of its business units near the end of 2024.
2. According to the Sunlight report, many of UnitedHealth’s subsidiaries appear to have no assets, operations, or employees, instead serving as holding companies that can facilitate M&A or manage international services. The company also has many international entities, making it difficult for U.S. regulators and consumers to see a full picture of the company’s structure and finances. UnitedHealth has entities headquartered in 17 countries, including in the United Kingdom, India, China, Chile, Peru, the Netherlands and Canada.
3. UnitedHealth Group is composed of two core entities: UnitedHealthcare (insurance) and Optum (health services). At the end of 2024, the company had more than 400,000 employees globally, and reported revenue of more than $400 billion.
4. Most of UnitedHealth’s acquisitions have occurred since 2010, with the majority being in the clinical category.
Subsidiaries by type:
- Clinical: 2,050+
- Insurance: 200+
- International: 150+
- Pharmacy: 100+
- Other: 100+
5. Most notable acquisitions:
- $2.3 billion acquisition of SCA Health in 2017
- $3.4 billion acquisition of DaVita Medical Group in 2019
- $3.2 billion acquisition of Equian in 2019
- $3.5 billion acquisition of Landmark Health in 2021
- $8 billion acquisition of Change Healthcare in 2023
- $5.4 billion acquisition of LHC Group in 2023
6. UnitedHealth now employs or has contractual ties with more than 90,000 physicians, or about 10% of the U.S. physician workforce. Its provider subsidiaries span many industries and specialties, and include at least 880 homecare companies, 423 ASCs, and 335 administrative entities.
7. UnitedHealthcare is the world’s largest insurance company, with more than 50 million members across commercial, ACA, Medicare Advantage and Medicaid. The company controls 15% of the U.S. health insurance market.
Insurance subsidiaries breakdown:
- Health: 49%
- Administration: 28%
- Specialty: 21%
- Unknown: 0.9%
8. In the pharmacy space, UnitedHealth owns 36 infusion-focused subsidiaries, 24 PBMs, and 9 technology entities. In total, it controls 21% of the U.S. PBM market.
9. The company also owns many non-healthcare entities, including in consulting, media, real estate and venture capital. Those include 21 real estate subsidiaries, 11 venture capital subsidiaries, and 7 government-focused entities.
10. In a statement about the report, a spokesperson for UnitedHealth told Becker’s:
“UnitedHealth Group comprises a small fraction of the U.S. health system. Through our diversified business, we’re helping to accelerate the transition of the U.S. health care system from volume to value; moving beyond a transaction-based health system to a model that is designed to be proactive to help keep people healthy over the course of their lifetimes; and incentivizing care delivery organizations the right way.”
The full report is here.
