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Insurer Now Has Ties to 10% of Doctors

— UnitedHealth's Optum division added 20,000 doctors this year alone


by Kristina Fiore, Director of Enterprise & Investigative Reporting, MedPage Today November 30, 2023


Optum Health now counts 90,000 doctors -- some 10% of the physician workforce -- as employees or affiliates, company leadership announced.


The company, which is a part of UnitedHealth Group, said during an investor conference on Wednesday that it acquired or hired nearly 20,000 doctors in 2023 alone, according to reports. It also counts an additional 40,000 advanced practice clinicians among its ranks.


The figures, reported by Amar Desai, MD, CEO of UnitedHealth's Optum Health division, make Optum Health the largest employer of physicians in the U.S., and UnitedHealth is the country's largest private health insurer.


UnitedHealth has spent $5 billion on acquisitions this year, including on Crystal Run Healthcare, a large medical practice in New York, according to STAT. However, the company declined to tell STAT which physician practices it has acquired this year, or how much of that $5 billion went toward physician deals.


The company hasn't shied away from spending large sums on physician practices. In September 2022, Optum Health said it would buy Houston-based physician group Kelsey-Seybold for about $2 billion.


Optum Health's physician network far outpaces physician employment figures reported earlier this year by Definitive Healthcare, which are focused on physician groups connected to health systems, contract management groups, and small practices owned directly by doctors.


In this year's data, Southern California Permanente Medical Group took the top spot with about 13,700 doctors, followed by the Permanente Medical Group (Northern California) at 11,570 doctors.


Over the past several decades, physicians have increasingly become employees rather than owners of independent practices. Physicians have cited corporate consolidation, financial pressures, changing generational perspectives, and the COVID pandemic as reasons behind the continued push toward employment.


The American Medical Association reported in 2021 that for the first time ever, one of its key surveys revealed that fewer than half of U.S. physicians (49.1%) worked in private practice, down from 54% just 2 years prior. It was the largest 2-year change since the AMA had started the survey in 2012.


Those employers can include private equity, contract management groups, hospitals, and health systems, and in the case of Optum Health, health insurers.


Glenn Melnick, PhD, a healthcare economist at the University of Southern California, previously told MedPage Today that investing in medical services can give insurers more control over their financial outlays.


However, the "worry" is that if they "get control of a local market's physician supply, are they going to use that to disadvantage competing health plans," Melnick said. "I control all the docs in the county -- I give myself a good price and I charge all the other plans 30% more. [Then], within a couple years, their premiums are going to be way above mine, and I'm going to control the insurance market."


On the other hand, if an insurer "runs medical groups efficiently, then it gives them a low-cost benchmark," Melnick said. "And if they run most of their patients through there, it keeps their premiums low, and that's good for everybody."


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