Optum expects to treat 4M in fully accountable, value-based models this year

Optum Health expects to treat 4 million people in fully accountable care models this year, executives said Friday.

UnitedHealth Group CEO Andrew Witty said on the company's fourth-quarter earnings call that this represents an increase of 1.8 million people year-over-year. This includes care provided across a number of settings, including in-clinic or in the home, supported by the company's data capabilities.

This patient pool represents people both in UnitedHealthcare plans as well as those covered by other payers, Witty said.

"We're achieving this by connecting benefits, care and other services to support our patients," he said.

Optum Health CEO Wyatt Decker, M.D., said on the call that the provider sees significant opportunity in harnessing home health to further its value-based care ambitions. Integrating home health into the clinic-based model allows Optum Health to differentiate itself in the market, he said.

Optum views behavioral health similarly. Integrating behavioral health services into its primary and virtual care models makes Optum Health appealing to patients, Decker said.

"We view home health as one of the new frontiers of providing value-based healthcare because of the convenience it provides and the ability to access people, like dual special needs patients that often have very difficulty leaving their home to get care," Decker said

The insurer beat the Street yet again in the fourth quarter, posting $4.8 billion in profit, according to its earnings report released Friday morning.

The healthcare giant's $82.8 billion in fourth-quarter revenue also surpassed Wall Street's expectations, according to analysts at Zacks Investment Research. Both figures were up from the prior-year quarter, where UnitedHealth reported $73.7 billion in revenue and $4.1 billion in profit.

For the full year 2022, UnitedHealth Group brought in $324.2 billion in revenue and $20.1 billion in profit. By comparison, the company reported $287.6 billion in revenue and $17.3 billion in profit for full-year 2021.

Witty said in the release that the company is aiming for "balanced growth" as it looks ahead to 2023. Its performance in the fourth quarter as well as in full-year 2022 represent growth at both Optum and UnitedHealthcare, the company said.

“We expect the efforts by the people of our company that led to strong performance in 2022 will define 2023 as well, especially delivering balanced growth enterprise-wide, improving support for consumers and care providers, and investing to make high-quality care simpler, more accessible and affordable for everyone,” Witty said.

UnitedHealthcare, the company's health insurance arm, brought in $63 billion in revenue for the quarter and $249.7 billion for the full year 2022, according to the report. Full-year revenues grew 12%, UnitedHealth said.

Its domestic membership grew by 1.2 million people over the course of 2022, led by community-based and senior plans. UnitedHealth's commercial book added 275,000 new members in the past nine months. 

Total medical membership as of Dec. 31 was about 51.7 million, according to the report.

At Optum, revenues for the quarter were $47.9 billion and and $182.8 billion for the year. Optum Health, which houses its providers, grew its revenue per patient by 29% over the course of the year, according to the report, thanks to the expansion of value-based care arrangements as well as growth in multiple care delivery services areas.

Optum Insight, which offers data analytics services, is "advancing its investment initiatives" to drive faster improvement in system performance as it continues to integrate Change Healthcare. Change joined Optum in October following a lengthy legal battle.

And revenue at Optum Rx, the company's pharmacy benefit manager, was up 9% year over year, UnitedHealth said.

UnitedHealth Group also reaffirmed its guidance for 2023. The company expects to bring in between $357 billion and $360 billion in revenue and $24.40 to $24.90 in earnings per share for the year.