UnitedHealth Group Hints at Big Home-Based Care Plans

UnitedHealth Group (NYSE: UNH) was the first health care titan to report its 2021 year-end results, doing so Wednesday morning.

The Minnetonka, Minnesota-based company showed few signs of a pandemic-driven slowdown and hinted at big home-based care moves on the horizon.

“Our broad home-based clinical care initiatives at Optum and UnitedHealthcare are central to improving near- and longer-term health outcomes for people with medical, behavioral and social needs,” UnitedHealth Group COO Dirk McMahon said during the company’s earnings call.

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Overall, UnitedHealth Group’s full-year 2021 revenues were up 11.8% to $287.6 billion on a year-over-year basis, with substantial growth across the Optum and UnitedHealthcare businesses. Revenues climbed to about $73.7 billion during the fourth quarter of last year, a nearly 13% increase compared to the same three-month period in 2020.

Generally, growth in the UnitedHealthcare business was due to strong Medicare Advantage (MA) enrollment. Including Dual Special Needs Plans (D-SNPs), MA membership rose by about 900,000 individuals in 2021, with strong gains in both individual and group offerings.

Optum, meanwhile, was buoyed by a 33% increase in revenue per consumer in 2021 compared to the previous year. Optum Health served 100 million people at year end, compared to 98 million in 2020.

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“We focus relentlessly on the quadruple aim, including lowering total cost of care, and providing better outcomes and outstanding patient experiences,” Wyatt Decker, CEO of Optum Health, said on the call. “And we are relentless in monitoring specific data points that help deliver that out – those outcomes.”

Decker and other UnitedHealth Group executives on the call explained how the health care and health insurance giant plans to progressively build out its multi-modality care platform moving forward through a combination of in-home physician and digital offerings.

Optum HouseCalls clinicians, for example, conducted over 1 million in-home visits in 2020. They eclipsed that mark in just the first half of 2021 – with more growth anticipated in 2022 and beyond.

It’s also important to note that Optum acquired in-home medical group Landmark Health last year.

“We say within Optum Health or Optum Care [that] the build out of the home and community platform is one of the more important areas that Wyatt and his team are focused on,” McMahon said. “There has been lots of development there.”

Among strategic benefits, seniors served by UnitedHealth Group’s home and community platform have experienced a 14% lower rate of hospital admissions compared to national averages. They also have a 14% higher rate of physician encounters, according to the company.

“We expect, during 2022 and beyond, to further build on these opportunities to connect and integrate multiple channels of care,” McMahon continued. “Simplify the experience for patients and providers, and deliver quality care that is affordable and in the optimal setting.”

As far as potential headwinds to its home-based care goals, there’s the ongoing pandemic and a worsening labor crisis, though UnitedHealth Group believes it can capably navigate both fronts.

In the third quarter, the company saw approximately 60,000 COVID-19 hospitalizations, “meaningfully above” the second quarter, with the month of August peaking at nearly 30,000.

National health care employment increased slightly in 2021, ending the year up 0.4%, or about 63,000 jobs, compared to December 2020. In particular, there was a clear shift from institutional settings to ambulatory care settings – like the home.

“The U.S. health care market is very tight right now,” Decker said. “For us and our care delivery assets, we are seeing … good retention, engagement and recruitment of physicians and care providers.”

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