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United Health Group Overview of Business
1.
2. My daughter is seven. If she gets sick, I want to know that I
can get her the care she needs at a fair price. I want the
freedom and control to decide, together with my daughter’s
pediatrician, which course of treatment is most appropriate
for her and to have my health care company respect our
decision. And I want the whole process to be simpler.
I need help accessing quality care and using health care
resources effectively, but I want enough control and
flexibility to choose what’s best for our family. And because
our lives are so hectic, our benefits have to be easy to
understand and convenient to use.
It’s not too much to ask.
What’s right
UnitedHealthcare
We understand. That’s why four receiving care, assist them in Benefits and Services that drugs, which will cost them less.
simple principles shape understanding and complying Value Individual Choice In addition, UnitedHealthcare
UnitedHealthcare and, we with doctors’ instructions and and Control was a leader in aggressively
believe, will ultimately shape medication requirements, and UnitedHealthcare wants promoting open access, which
the marketplace for health care coordinate access to a broad people to be engaged and active allows individuals to schedule
services. set of resources and services. participants in managing their appointments directly with
UnitedHealthcare has pro- own health and well-being. The specialists without a referral
Simple, Convenient Access
grams that provide health edu- company designs options that from a primary care physician.
to Quality Care
cation, admission counseling let individuals choose what is
UnitedHealthcare is making it Improved Quality of Care
before a hospital stay, care best for themselves and their
easier for people to get the care Through Information
advocacy to help prevent families and offers incentives
they need, when they need it, To help physicians make
delays in accessing resources, that increase involvement in
with its comprehensive Care better treatment decisions,
help ensuring a safe transition treatment and buying decisions.
Coordination philosophy. Care UnitedHealthcare uses Clinical
from the hospital, support for UnitedHealthcare’s
Coordination helps make the Profiles — data that compares a
individuals at risk of needing multi-tiered pharmacy benefit
use of health care services physician’s actual practices to
intensive treatment, continuous program, for example, provides
more effective and efficient, nationally accepted benchmarks
coordination for people with access to a wide range of
while helping to preserve broad for the most successful care.
chronic conditions, and pre- generic and brand-name drugs.
access. Health care profession- UnitedHealthcare distrib-
scription drug management, Individuals can benefit by
als work with individuals to help utes profiles to physicians twice
which promotes safe and effec- accessing higher-priced brand-
identify and prevent delays in a year, and has added physi-
tive use of medications. name drugs, as well as generic
8
3. for my family
cians with each distribution. comes by avoiding complica-
More than 70,000 physicians tions and optimizing the use of
currently participate in this health care resources, which
leading-edge effort. ultimately lowers costs.
An enriched Web site Further, UnitedHealthcare
puts in-depth information arranges access to care
at consumers’ fingertips: a through more than 340,000
directory of physicians and physicians and 3,200 hospitals
hospitals, reports on thou- across the United States.
sands of health topics, and The consolidated purchasing
soon, a health profile tailored power represented by the
to individual interests. individuals we serve makes it
possible for UnitedHealthcare
Affordable Value
to contract cost-effectively,
UnitedHealthcare’s efforts to
passing on savings to con-
help improve quality also help
sumers and employers while
keep health care costs afford-
providing access to broad
able. Care Coordination, by
convenient networks of
helping connect people with the
care providers.
right care in a timely manner,
strives to improve health out-
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4. I have a great relationship with my physician, but I know she
may not be able to provide all of the services I need to
maintain my total health and well-being. I need vision care
and dental services. I believe many alternative therapies
provide valuable benefits, and I want affordable access to
services such as acupuncture and chiropractic care.
And though I feel healthy today, I want to know that if I ever
need special help, I will have access to quality specialized care
for things like heart or cancer treatment, transplantation,
behavioral health services or counseling support.
Specialized care
Specialized Care Services
Specialized Care Services was through the business-to-busi- United States. The company’s manage psychiatric medications
conceived and built to respond ness marketplace. For a wide focus on quality helps improve and, in turn, provide quality care
to people’s desire for affordable set of needs — whether as a outcomes — including survival at a reasonable cost in this
access to an ever broadening comprehensive package of rates — even as it lowers costs growing and sensitive area.
range of specialized health and specialty services or as access an average of 35 percent.
Health Information
well-being resources. Its portfo- to a specific, individual service
Behavioral Health Optum® helps individuals take
lio of businesses connects peo- — Specialized Care Services
United Behavioral Health charge of their health and well-
ple with leading care providers can organize services that can
provides mental health and being. For 10 years, Optum has
in more specialized fields, gives help. That translates into added
substance abuse services, been a leader in helping people
them access to valuable infor- convenience, simplicity and
employee assistance programs meet their personal health
mation and educational materi- value for its customers. SM
and PsychWorks , a unique needs in a confidential and pro-
als, and makes these services
Critical Care service that helps manage the tected manner. The company
increasingly affordable.
United Resource Networks is a impact of short-term disability provides information, education
Specialized Care Services
gateway to leading critical care due to mental illness. In 1999, and support in print, by phone,
offers access to the most com-
and chronic care programs at United Behavioral Health added on tape, face-to-face and over
prehensive array of specialized
more than 50 of the best med- specific programs that help the Internet. Optum Internet
and alternative care available
ical centers throughout the health care professionals services contain comprehensive
to the consumer directly or
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5. at my fingertips
information, including interac- create value for individual
tive features for personalized consumers or for health care
information. organizations.
Dental Care Life and Accident Benefits
Dental Benefit Providers offers Unimerica Life and Accident is
convenient access to afford- a single convenient source for
able dental care with the life and accident benefits that
broadest benefits portfolio, align with other health and spe-
demonstrated cost advantages cialty coverages and benefits.
and extensive networks that
allow maximum accessibility.
Vision Care
Coordinated Vision Care
facilitates each step in the
delivery of vision services and
products, helping to enhance
quality and control costs to
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6. I’m not a kid anymore, and I love it. I’ve worked hard all my
life, and now I have time to be myself, enjoy my grandkids,
travel with my wife and hit the bike trails.
I recognize my needs and opportunities are changing.
My health concerns are increasing. I need to understand
my health care choices, whether I have enough money, what
coverage Medicare will provide, and what supplemental
coverage I will need. I want information and services tailored
to my needs — family, health and fitness, travel and
recreation, home and work.
After all, I intend to enjoy the second half of my life, not
worry about it.
Services to meet my
Ovations
Ovations serves the needs Indemnity insurance to more that provides a hospital network Knowledge About Health
and aspirations of people in than 3.7 million AARP members. and 24-hour access to health and Well-Being
the second half of life, using Recently, Ovations introduced care information from nurses. Ovations Knowledge Group
UnitedHealth Group capabili- AARP Eye Health Services to provides useful information for
Healthy Lifestyles
ties and buying power to offer affordable eye exams, making health and lifestyle
In nearly every person’s life,
develop products and services complimentary glaucoma decisions. The Ovations Press
there comes a time when
around the distinct health and screenings and discounts on is developing books designed
thinking about where to live is
life-stage needs of people eyewear. Ovations’ Medicare to improve understanding of
influenced by health and family
age 50 and older. Supplement Pharmacy Service complex questions faced in life.
considerations. Ovations is
addresses one of the most sig- The first books provide guides
Affordable Health Care shaping a distinctive service
nificant cost problems facing to financial planning, caring
Americans are caught between that will respond to the
older Americans — prescription for your heart, forgetfulness,
the soaring cost of health care complex health, housing
drug costs. These services memory loss and Alzheimer’s
and pressure on Medicare to and well-being needs of older
saved AARP members nearly disease, and wills, trusts and
remain viable by reducing Americans. This integrated
$60 million in 1999. Ovations’ estate planning.
costs. Ovations is responding set of services will leverage
AARP Division also developed a
through a 10-year partnership Ovations’ and UnitedHealth
valuable offering with lower cost
with AARP, offering Medicare Group’s capabilities to serve
Medicare Supplement coverage
Supplement and Hospital the unique needs of this market.
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7. changing needs
Eldercare among the top reasons for
Through the EverCare® net- hospital admissions among
work, on-site nurse practition- elderly individuals. In its first
ers collaborate with physicians year, the pneumonia early
to enhance care to the elderly treatment and detection
through improved timeliness, program helped individuals
disciplined continuity and served by EverCare receive
coordination of care. EverCare timely access to services to
has innovative programs to treat their illnesses, helping
detect and treat common them avoid the trauma of
conditions — such as hospitalization, and lowering
pneumonia and other infec- hospital admissions for
tions, congestive heart failure, pneumonia by 10 percent.
hip fractures and medication
side effects — which are
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8. To run a world-class business, you need to recruit and retain
world-class employees. That’s why it’s so important to me to
be able to offer my employees and their families competitive
benefits that are distinctive in how they combine quality,
convenience and affordability.
I want to align with an organization that makes it easy for
my company to offer a set of employee services that delivers
maximum value to our people. And as my business needs
change, I want a technologically advanced, progressive
partner with the initiative to continually strive to develop
and deliver superior solutions.
Benefits that run as well as
Uniprise
Uniprise offers the most or diverse global enterprise, Consumer Focus applying advanced technology.
advanced and comprehensive or an insurance company, a Uniprise serves more than In this effort, Uniprise is looking
set of employee services and provider network or health care one-fourth of the Fortune 500 beyond the historic health care
technologies in the entire company seeking an outsourc- companies, including many of services industry and emulating
spectrum of health care ing solution, Uniprise can the most progressive compa- the best consumer services
benefits. Uniprise services fit respond with a set of services nies in the world. In 2000, companies, regardless of
seamlessly into any business appropriate for your needs. Uniprise will handle more than industry. In 2000, Uniprise will
environment and serve the Uniprise works with clients 350 million transactions with expand these investments
needs of employees and their to develop a strategic plan that industry-leading levels of and continue to advance its
families — from simplified takes them from where they are timeliness and quality. consumer-focused agenda.
benefits design with broad today to wherever they want to During the past 24 That is what the marketplace
network access to world-class go — and gets them there fast. months, Uniprise has invested desires, and it defines a great
Internet connectivity to That’s why, in 1998 and 1999, more than $100 million in infra- future for Uniprise.
consumer-friendly services Uniprise grew more than any structure enhancements aimed
Advanced Technology
and experiences. other enterprise in its market- at improving the consumer
Uniprise has aggressively
Whether you represent place, and has retained more experience by strengthening
expanded its Internet tech-
a large domestic company, than 98 percent of its customers service quality and accuracy,
nology. Already among the
university, government agency over the past three years. simplifying operations and
most connected, Internet-
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9. my business
capable companies in all of institutional outsourcing
health care, Uniprise has relationships with insurers,
invested heavily to enhance providers and other health
service features, speed and care industry participants.
functionality even further, so 2000 will be a defining
that ease of use and speed year for Uniprise as the
of service is optimized. company continues to apply
innovative solutions to its deep
Comprehensive Outsourcing
understanding of the needs
Through Uniprise, clients can
of large employers. What
seamlessly access all of the
will emerge is an ever more
services and features within
consumer-centered operating
the domain of UnitedHealth
environment that opens new
Group, as well as products
opportunities and enhances
and services from providers
service for clients and their
in any location outside of
employees or customers.
UnitedHealth Group, if that
works best for their situation.
Uniprise is rapidly expanding
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10. How are new technologies changing care protocols and costs?
Who provides the best care? What should I expect in terms of
duration, recovery and total costs for a given procedure?
Health care is too important for guesswork. I want information
I can use — evidence — to improve outcomes and help
control costs.
Knowing the cost of a single procedure or the result of one
patient’s experience with a treatment just isn’t enough. To
draw meaningful conclusions, I need information that helps
me understand broad trends, evaluate what works and doesn’t
work, consider results and costs over a longer period of time,
and learn from the experience of large populations.
Knowledge that
Ingenix
Whether you represent a corpo- improve health care operations With access to massive The Source for
ration trying to better under- and address critical issues, databases, Ingenix can identify Health Information
stand and shape health care such as rising medical costs, physicians with the necessary As a leader in health informa-
benefits for its employees, a quality of care and new experience for a certain study tion, Ingenix offers one-stop
pharmaceutical manufacturer therapies and compounds. and establish data sets for shopping to meet business-
seeking to bring a new product broad populations. As demon- to-business health care
The Source for
to market, a health insurer or strated in its work on clinical information needs.
Pharmaceutical Services
payer trying to understand trials, Ingenix’s ability to From the beginning,
Ingenix conducts clinical
costs, or a health care provider organize physician and patient UnitedHealth Group has used
research and studies to help
trying to improve coding and populations advances the information to study and make
develop new therapeutic
billing disciplines, Ingenix has search for better treatments advances in care, the reim-
agents, evaluate medical out-
the health care informatic data- and cures. Its access to bursement process, population
comes and consider economic
bases and expertise to help. UnitedHealth Group’s deep, risk management and cost
impacts. Ingenix helps devise
Ingenix combines the power of rich base of care and outcomes management. Now, with a
research protocols, identify and
information and technology to data aids in trial design and growing arsenal of advanced
train investigators, and assist
guide better clinical, technical enables Ingenix to identify information technologies,
with recruitment. The company
and financial decisions. Through treatment patterns and out- including increasingly sophisti-
also provides data manage-
its information, analysis, comes, as well as pinpoint cated analytic tools, Ingenix is
ment, biostatistics, regulatory
research and consulting servic- factors that contribute to poised to help solve the most
services and overall project
es, Ingenix can help customers adverse effects or other challenging operational issues
management services.
problems. and make breakthroughs in
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11. drives results
the treatment of today’s most conducted using Ingenix data
serious health problems. and software products.
• Data and Software • Publishing. Ingenix busi-
Products. Ingenix helps ness-to-business publications
companies streamline, inter- deal with coding and reim-
pret and manage activities by bursement information. These
providing data services and publications are used by virtu-
software to support bench- ally all providers and payers in
marking, pricing, cost manage- America to understand the use
ment, utilization, regulation, of health benefits more clearly.
reporting, coding, claim review • Consulting. In the United
and provider contracting. States and abroad, Ingenix
UnitedHealthcare’s Clinical advises providers, insurance
Profiling, which encourages companies and government
improvement in clinical programs on their health care
performance by comparing operations.
an individual physician’s
practices to local peer group
and national standards, is
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12. UnitedHealth Group At A Glance
Business Description Customer Base (as of Jan. 31, 2000) Market Opportunity
UnitedHealth Group Focused on forming and operating orderly, Not applicable $1.1 trillion in aggregate U.S.
efficient markets for the exchange of high health care spending, and further
quality health and well-being services through potential in worldwide activities
five distinct businesses operating in strategic in various markets.
alignment across separate market segments.
UnitedHealthcare 7.4 million individuals from small and Approximately $150 billion in
Network-based health and well-being services, •
mid-sized employers small and mid-sized employer
including commercial, Medicare and Medicaid
group, Medicare and Medicaid
products for locally based employers and 412,000 Medicare-eligible individuals
•
spending across the
individuals in six broad regional markets. 485,000 Medicaid-eligible individuals
•
UnitedHealthcare markets.
Ovations 3.7 million individuals served through About $20 billion of spending in
Health and well-being services for people in •
the AARP Division supplemental Medicare and
the second half of life and their families.
hospital indemnity products;
16,000 individuals served through
•
about $18 billion in eldercare
EverCare®
services; additional revenue
opportunity in emerging
businesses, such as health and
housing, and knowledge and
information services.
Uniprise Network-based health and well-being services, 218 large organizations, including More than $100 billion in
•
business-to-business transactional infrastructure 131 Fortune 500 companies, aggregate spending each year by
services, consumer connectivity and service, representing 6.3 million individuals U.S. employers with more than
and technology support for large employers, 5,000 employees through either
health plans, and other payers. fee-based or risk--sharing
business models; further
opportunity to manage
infrastructure for other payers in
the marketplace.
Specialized Care United Behavioral Health serves more More than $200 billion in total
Portfolio of specialized health and well-being •
Services than 15 million individuals payer, employer and consumer
companies, each serving a specialized market
spending across the spectrum of
need with a unique blend of benefits, provider United Resource Networks serves
•
specialized benefits and
networks, services and resources. 1,400 clients representing more than
products; purchases made on
41 million individuals
both a fee basis as well as on
Optum® services are available to more
•
partially or fully insured terms.
than 16 million individuals
Dental Benefit Providers serves more
•
than 2 million individuals
Ingenix More than 200,000 health care providers More than $40 billion in
Two primary business unit divisions — •
worldwide spending on
pharmaceutical services and health 2,000 payers
•
pharmaceutical research and
information — providing a comprehensive 100 Fortune 500 companies
•
development; an additional
line of health care knowledge and information
Most major pharmaceutical manufacturers
•
$13 billion in data, software
products and services to pharmaceutical
and health business information
companies, health insurers and payers, care
services.
providers, large employers and governments.
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13. Competitive Strengths 1999 Operating Highlights
• Strategically aligned, market-facing business model • Revenues increased nearly 13% to $19.6 billion
• Deep, talented and motivated management team • Earnings per share grew by 22%
• Entrepreneurial roots • More than 40% of operating income contributed from outside of our
health plan business
• Advanced technology capabilities
• Cash flows from operations well exceeded $1 billion for the
second consecutive year
• Return on equity rose to 14.1%
• Stock price increased 23%
Flexible, access-oriented products Revenues reached $13.9 billion, an increase of 16%
• •
Pro-consumer philosophy Introduced Care Coordination process to help enhance health outcomes
• •
SM
Local orientation What works for you? campaign and branding initiatives launched
• •
Simplicity, quality and affordability of services Added 160,000 net new fee-based commercial individuals
• •
Strong underwriting capabilities
•
Focus on health care providers as central participants in the system
•
Exclusive focus on needs of people 50 and older Revenues increased 1% to $3.6 billion
• •
Nation’s largest Medicare Supplement insurance offering with AARP, Enhanced the AARP Medicare Supplement product offerings for
• •
including unique services to address affordability and quality of health care individuals, improving membership trends
EverCare®, one of the nation’s largest eldercare Expanded EverCare® membership and revenues 47% with improving
• •
companies clinical and operational performance
EverCare’s award-winning nurse practitioner model Created total consumer savings of $60 million through Medicare
• •
Supplement Pharmacy Service offering
Depth of research and information through the Ovations Knowledge Group
•
New operational processes created medical savings of more than $50 million
•
Launched publishing enterprise
•
Focused commitment to this market segment Revenues increased 15% to $1.9 billion
• •
Consumer orientation Added 30 new major corporate employers as clients
• •
Advanced technology Processed 300 million transactions
• •
Scalable infrastructure serving 1.5 million members covered Achieved customer retention rate of 98.7%
• •
by other health insurers Electronic claim submission hit 46% and claim auto-adjudication
•
Comprehensive outsourcing for employee services rate exceeded 65%
•
Financial accuracy measured 99%
•
Developing new customer service solutions leveraging the Internet
•
Most complete offering of access to specialized health care services Revenues increased 17% to $726 million
• •
in America Added dental, vision, life and accident product capabilities
•
Premier behavioral health offering
• Enhanced behavioral health, catastrophic care and information-based
•
service offerings
Largest center of excellence critical care program in the nation
•
One of top consumer health information services
•
One of largest managed dental services companies
•
Vision care services that help improve quality and control costs
•
Unique, proprietary data sets Revenues reached $258 million, an increase of 40%
• •
Therapeutic clinical expertise Enrolled 13,000 physicians in clinical investigator network
• •
Commercialized medical cost and utilization knowledge and Increased clinical trials business sixfold
• •
information in business-to-business sector
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