UnitedHealth Group​​'s
OptumInsight, LLC
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TAX ID NUMBER: 41-1858498
LOCATION: DE
TYPE: Other
SUBTYPE: Analytics
FUNCTION: Consulting
SECONDARY FUNCTION: Technology
DIRECTLY CONTROLLED BY: OPTUMINSIGHT HOLDINGS, LLC
DATE ESTABLISHED: 2010 or before
OptumInsight is one of the three major subsidiaries of Optum and leverages data analytics, artificial intelligence and predictive modeling with the stated objective of improving health care decision making. Clients include health care providers, payers, and life sciences companies.
The company has grown through notable acquisitions, including the Advisory Board’s health care business in 2017 for $1.3 billion. This transaction enabled the company to add significant experience in health care consulting and analytics and provided access to many Advisory Board clients, including major health care systems and insurance companies. It also acquired Change Healthcare, which provides data analytics and payment solutions for payers and providers in a 2022 deal valued at $13 billion.
The transaction was met with significant regulatory scrutiny over concerns about Optum’s ability to gain an unfair competitive advantage by servicing other health insurers and having access to their claims data. The Department of Justice sued to block the transaction in 2022, but a federal judge ruled in UnitedHealth’s favor and the transaction closed shortly thereafter, although UnitedHealth was required to make divestitures of its claims editing business.
OptumInsight’s revenues have grown rapidly over the past decade, nearing $20 billion in 2023, a 29.8% increase over the prior year. The portfolio is especially diverse, encompassing data and analytic solutions, revenue cycle management, payment integrity solutions, value-based care (which connects how much providers are paid to the results they deliver), consulting and advisory services, and provider tools such as electronic health integration and clinical decision support. The company says these offerings enable customers to identify operational inefficiencies and improve care delivery, but the sheer size of the portfolio and the vertical nature of UnitedHealth Group’s portfolio could introduce complexity and risks.
The U.S. Justice Department's lawsuit to block UnitedHealth Group’s acquisition of Change Healthcare.
These include data security and privacy risks and the potential use of information to optimize the performance of other company-owned or affiliated businesses (e.g., coding and documentation initiatives to affect Medicare Advantage risk scores and reimbursement, pre-payment reviews to reduce payment to providers, assigning providers to proprietary tiers based on expected costs, etc.).
Subsidiary
highlights
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