UnitedHealth Group

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About the Company

UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota. Offering insurance services under UnitedHealthcare and healthcare products under Optum, it is the world’s eleventh-largest company by revenue and the largest healthcare company by revenue, and the largest insurance company by net premiums. Optum and UnitedHealthcare had roughly equal earnings from operations in 2022.

The company is ranked 10th on the 2023 Fortune Global 500. UnitedHealth Group had a market capitalization of $477.4 billion as of August 7, 2023.

  • Solutions are designed to ensure the more than 26,000 community and independent pharmacies in our network can support expanded access to care, improve outcomes for the patients they serve and remain competitive.
  • Nearly 46 million Americans live in rural areas in the United States, and many rely on local pharmacies for high quality medical care and services that might otherwise be harder to reach. Optum Rx, a pharmacy care company, is introducing new programs and services to support independent and community pharmacies, enabling them to spend more time caring for their patients.
  • Driven by a commitment to deliver solutions for our pharmacy partners and the Pharmacy Services Administrative Organizations (PSAOs) that work with them, the new initiatives aim to empower pharmacists to deliver care, improve the pharmacy experience and help make prescription drugs more affordable for patients.
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  • Maximizing pharmacy resources through greater efficiency
  • Optum Rx is providing community and independent pharmacies with access to tools and data aimed at reducing administrative burdens, improving patient outcomes and ensuring pharmacists are paid fairly. These include:
  • Improved analytics and reporting, including access to more detailed claims information (available now).
  • An enhanced provider portal that will reduce time pharmacists spend on administrative tasks (launching this summer).
  • Greater payment and cash flow predictability and value-based reimbursement opportunities focused on patient support, advancing care for underserved and rural populations, and disease management (launching this summer).
  • Supporting pharmacies in achieving better health outcomes for underserved and rural communities
  • New programs have already been introduced in select geographic regions to support community pharmacies as they work to improve health outcomes for underserved and rural patients. Initial efforts focus on areas such as maternal and fetal health and helping to bridge care gaps for patients who do not live near health care providers.
  • New, innovative partnerships between Optum Rx and community pharmacies aim to expand access to care, preventive services, and medication adherence and improve health outcomes in underserved communities.

The pharmacy is the most used touchpoint in health care. For the most vulnerable populations, especially those in rural and underserved communities, community and independent pharmacies are a vital part of providing patients with access to the care they need. These pharmacies – and the pharmacists who have built trusted relationships with their patients – serve as a critical touch point on the front lines of care to drive better health outcomes and identify unmet medical and social needs.

To support their efforts, Optum Rx is launching initiatives that will support pharmacists in connecting their patients to services that address basic needs such as food, nutrition, transportation, housing, and baby supplies.

The initiatives will focus in three critical areas:

  • Connecting underserved patients to community resources, beginning with pregnant women and patients with diabetes;
  • Improving maternal and fetal health through increased preventative prenatal vitamin use, access to community diaper bank resources and baby supplies; and
  • Providing increased access to health care resources through community pharmacies in health care deserts.

Launching in select states starting in June, the programs will be offered nationwide to all pharmacies later this year. Participating pharmacies will receive appropriate reimbursement for supporting patients in accessing medically necessary services that improve their health outcomes.

These programs kick off Optum Rx’s broader, industry-leading commitment to bridge resource gaps in the community, including strategies to care for underserved and rural populations and supporting community and independent pharmacies with solutions that simplify processes, promote payment predictability, enhanced reporting, and offer appropriate compensation for services that improve health outcomes.

Connecting patients to care to address unmet social needs

Many people lack access to necessities such as housing, transportation, and food, and Optum Rx is partnering with pharmacies to help address the needs of their patient population. The program, launching June 1, will support community pharmacies serving Optum Rx members in underserved and rural communities by helping them connect members to the Unite Us site, a nationwide technology platform that identifies social care needs to connect people with community services and resources at a local level.

The program will initially launch in North Carolina, Nebraska, New Jersey, New Mexico, New York, Texas, and Louisiana, and will focus on people with diabetes and pregnant women. In the Fall of 2023, these programs will roll out nationally.

New offerings build on our history of bringing innovation to employers, unions, health plans and consumers to help improve affordability and transparency in pharmacy benefits.


Optum Rx is working to empower consumer and provider choice and make prescription drugs more affordable. Each of our customers is unique and we believe they are best positioned to determine the affordability and transparency solutions that meet their pharmacy benefit needs.

Increasing transparency and choice

In January, Optum Rx began offering expanded payment options that enable choice and drive transparency and affordability in pharmacy benefits to the employer, union and health plan customers we serve. In addition to traditional and pass-through payment solutions we offer today, we now offer additional solutions including:

  • Cost Clarity, a model that bases costs on independent costs baselines, such as the National Average Drug Acquisition Cost (NADAC) and wholesale costs.
  • Cost Advantage, a flexible, pass-through model using average ingredient costs and reflecting real-time network price improvements.

These models continue to align incentives across the supply chain, while providing even greater transparency, choice and customizable pharmacy benefit solutions and maintaining our continued drive for lowest net cost for clients. Clients who choose the new models will also receive member care, formulary design and consultation and additional client support services for an administrative fee.
 

Enhancing choice and competition to improve affordability

Optum Rx continues to promote choice and competition to make prescription drugs more affordable. We were first in market to announce a plan to cover biosimilars for Humira, which gives patients and their doctors the ability to make decisions based on each individual’s needs, while ensuring access to a broader set of effective therapies and lowering costs to payers.


We also offer greater choice in pharmacy benefit services for clients and clearer benefit navigation and support tools. Earlier this year, we launched Price Edge, a consumer solution that identifies the best available price for prescription drugs. Price Edge seamlessly and in real time compares available direct-to-consumer pricing for traditional generic drugs with insurance pricing to ensure Optum Rx members always get the lowest available prescription drug price – on or off benefit and applied to their deductible. Just over 1 million members have enrolled since the January launch, resulting in more than $4 million in savings on their medications.

Priorities for advancing a modern health system

UnitedHealth Group, Optum and UnitedHealthcare team members are working to advance our mission to help people live healthier lives and help make the health system work better for everyone by focusing on five strategic growth priorities.

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