Optum

Optum, Inc.
TypeSubsidiary
IndustryHealthcare
Founded2011 (15 years ago) (2011)
Headquarters
Eden Prairie, Minnesota
,
U.S.
Key people
ServicesPharmacy benefit manager, Healthcare provider
RevenueUS$270.6 billion (2025)
ParentUnitedHealth Group
SubsidiariesOptumInsight
OptumRx
OptumHealth
Optum Financial
Websiteoptum.com

Optum, Inc. is an American healthcare company that provides technology services, pharmacy-care services (including a pharmacy benefit manager) and various direct healthcare services, headquartered in Eden Prairie, Minnesota, United States.

Optum was formed as a subsidiary of UnitedHealth Group in 2011 by merging UnitedHealth's existing pharmacy and care delivery services into the single Optum brand, comprising three main businesses: OptumHealth, OptumInsight and OptumRx.

From the late 2010s through the early 2020s, Optum expanded significantly through a series of mergers and acquisitions. In 2017, the company accounted for 44 percent of UnitedHealth Group's profits. In 2019, Optum's revenues surpassed $100 billion for the first time, growing by 11.1 percent year over year, making it UnitedHealth's fastest-growing unit at the time.

History

Organization

Optum's three businesses, OptumRx, OptumHealth and OptumInsight focus on five core capabilities: data and analytics, pharmacy care services, population health, healthcare delivery and healthcare operations. Optum serves employers, government agencies, health plans, life science companies, care providers and individuals and families, offering products in data and analytics, pharmacy care services, healthcare operations and delivery, population health management and advisory services. The Optum Serve division provides health-related services to U.S. government agencies. In January 2013, Optum, in partnership with the Mayo Clinic, unveiled Optum Labs, a health-data initiative. In October 2013, Optum, in partnership with Dignity Health, launched Optum 360, a revenue-cycle management venture.

Major acquisitions

Since Optum's founding in 2011, the company has acquired various healthcare technology services to build out its pharmacy-benefit manager and care services offerings.

This Optum-UnitedHealth model of vertical integration is pointed to as having sparked a pattern of acquisition activity in the healthcare industry; most notably, mega-mergers between CVS-Aetna, Cigna-Express Scripts and Humana-Kindred.

"Vertical integration" has met with considerable pushback and claims of antitrust law violations. The Federal Trade Commission (FTC) has accused major pharmacy benefit managers (PBMs), including CVS Caremark and OptumRx, of engaging in anticompetitive practices that harm competition and raise drug prices, citing conflicts of interest and exclusivity provisions.

Similarly, the American Medical Association (AMA) has criticized the CVS-Aetna merger, arguing it undermines competition in pharmacy benefit management services, health insurance, and retail pharmacy markets, leading to higher consumer costs and fewer choices. Ana Gupte, managing director of healthcare services at Leerink, said Optum's approach to acquisitions inspired the Aetna-CVS deal in an interview with Healthcare Dive.

ScriptSwitch Ltd, a software provider acquired by UnitedHealth UK for a reported £50m in 2009, was branded as "ScriptSwitch, provided by Optum" as of 2026.

Leadership timeline

Controversies

Haven lawsuit

In early 2019, UnitedHealth Group filed a lawsuit asking a U.S. district judge to stop former Optum executive, David William Smith, from working at Haven (the Amazon, JP Morgan and Berkshire-Hathaway joint-healthcare venture). Optum argued that Haven is in direct competition with its business and as such, Smith's employment would be in violation of a noncompete agreement that he signed while with Optum. Smith, meanwhile, asked the judge to send the parties into closed-door arbitration. Wolf rejected Optum's request and allowed Smith's, putting court proceedings on hold until the arbitration process is complete.

The case garnered media attention as setting a precedent in trade secret litigation ahead of an anticipated wave of vertical integration in the healthcare industry and for uncovering previously unknown details about Haven. The case has also been referred to as having shed light on the threat that pharmacy benefit managers feel to bottom lines amid mounting bipartisan pressure to control rising healthcare costs. Testimony brought by Haven chief operating officer Jack Stoddard was unsealed after a motion brought by the parent companies of Stat News and The Wall Street Journal.

Alleged racial bias

A 2019 study published in Science, alleges the "algorithm used to manage the healthcare of millions of Americans shows dramatic biases against black patients". Said algorithm, applied to over 200 million individuals yearly, "significantly underestimates the amount of care black patients need compared with white patients". In fact, "less money is spent on black patients with the same level of need as white patients, causing the algorithm to conclude that black patients were less sick". Optum claims "its system helps 'clinicians provide more effective patient care every day'".

References

  1. ↑ Mathews, Anna Wilde (May 13, 2025). "UnitedHealth Places New Bet on Old CEO Who Made It a Giant". The Wall Street Journal. Archived from the original on June 1, 2025. Retrieved June 1, 2025.
  2. ↑ "United Health Group 2025 10k". United States Securities and Exchange Commission.
  3. ↑ "UnitedHealth Group Announces "Optum" Master Brand for its Health Services Businesses - UnitedHealth Group". United Health Group. Archived from the original on April 10, 2021.
  4. 1 2 3 4 5 "Optum a step ahead in vertical integration frenzy". Healthcare Dive. Archived from the original on February 4, 2023. Retrieved January 22, 2019.
  5. ↑ "UnitedHealth's Optum revenues surpass $100B for 1st time". Beckers Hospital Review. January 15, 2019. Archived from the original on November 12, 2019. Retrieved April 21, 2020.
  6. ↑ Japsen, Bruce (January 15, 2019). "UnitedHealth's Optum Sales Hit $100B for First Time". Forbes. Archived from the original on April 11, 2025. Retrieved May 27, 2025.
  7. ↑ "Optum Products & Services". United Health Group. Archived from the original on August 7, 2023.
  8. ↑ "Optum Serve". Optum. Retrieved May 27, 2025.
  9. ↑ "Optum, Mayo Clinic Partner to Launch Optum Labs: An Open, Collaborative Research and Innovation Facility Focused on Better Care for Patients" (Press release). Mayo Clinic. January 15, 2013. Retrieved July 21, 2025.
  10. ↑ "Dignity Health and Optum Launch New Company" (Press release). Dignity Health. October 14, 2013. Archived from the original on October 9, 2025. Retrieved October 3, 2025.
  11. ↑ Rosenbaum, Eric (February 17, 2022). "Where One of UnitedHealth's First Tech Start-Up Acquisitions Is T0today". CNBC. Retrieved December 15, 2025.
  12. ↑ Herman, Bob (April 9, 2015). "Optum Acquires Urgent-Care Company MedExpress". Modern Healthcare. Crain Communications. Archived from the original on November 11, 2024. Retrieved September 20, 2024.
  13. ↑ "Secret Weapon: UnitedHealth's Optum Business Is Laying Waste to Old Notions about How Payers Make Money". Healthcare Finance News. Retrieved March 11, 2019.
  14. ↑ Japsen, Bruce (March 7, 2019). "Anthem Won't Mimic UnitedHealth's Doctor Buying Binge". Forbes. Archived from the original on March 8, 2019. Retrieved March 11, 2019.
  15. ↑ "OptumCare officially purchases Reliant for $28M". Worcester Business Journal. Archived from the original on October 18, 2025. Retrieved September 27, 2025.
  16. ↑ Sweeney, Evan (September 28, 2018). "Genoa Healthcare Bought by UnitedHealth, Adding 400+ Pharmacies to PBM | Fierce Healthcare". www.fiercehealthcare.com.
  17. ↑ Snowbeck, Christopher (September 13, 2019). "UnitedHealth Group Acquires 'Payment Integrity' Firm". StarTribune.
  18. ↑ "hCentive – Company profile". CB Insights. Retrieved September 20, 2025.
  19. ↑ "Subsidiaries of UnitedHealth Group Incorporated (Exhibit 21.1)". U.S. Securities and Exchange Commission. December 31, 2022. Archived from the original on February 12, 2025. Retrieved September 20, 2025.
  20. ↑ "Subsidiaries of UnitedHealth Group Incorporated (Exhibit 21.1)". U.S. Securities and Exchange Commission. December 31, 2024. Retrieved September 20, 2025.
  21. ↑ "National Company Law Tribunal (Hyderabad Bench) — Order CA (CAA) 4/2022" (PDF). National Company Law Tribunal. April 21, 2022. Retrieved September 20, 2025.
  22. ↑ "Change Healthcare acquired for $13 billion by UnitedHealth Group's OptumInsight". dotmed.com.
  23. ↑ "Supplemental Benefits for Members". business.optum.com.
  24. ↑ "News & Media | Atrius Health Joins Optum". AtriusHealth.org. Archived from the original on August 20, 2022.
  25. ↑ "UnitedHealth Unit to Buy UK Health-Tech Firm EMIS for $1.5 Billion". Bloomberg. June 17, 2022. Retrieved June 17, 2022.
  26. ↑ Barbarino, Al (June 26, 2023). "Optum to Buy Amedisys For $3.3B, Derailing Option Care Deal". Law360. Archived from the original on June 27, 2023. Retrieved June 27, 2023.
  27. ↑ Sego, Alyxandra (June 26, 2023). "Amedisys Dumps Option Care for UnitedHealth's Optum". American City Business Journals.
  28. ↑ Teague, Slater (August 11, 2025). "Holston Medical Group now part of Optum". WJHL.
  29. ↑ "UnitedHealth to Buy Chile's Banmedica for $2.8 Billion". Reuters. December 22, 2017. Archived from the original on February 10, 2019. Retrieved February 15, 2019.
  30. ↑ Japsen, Bruce. "Buoyed By Optum, UnitedHealth Group Remains on a Roll". Forbes. Retrieved January 22, 2019.
  31. ↑ "Middlemen Have Outsized Influence on US Drug Prices Due to Market Consolidation, FTC Says". Reuters. July 9, 2024. Retrieved December 5, 2024.
  32. ↑ "Feds Poised to Sue Pharmacy Gatekeepers over High Insulin Prices as Part of Broader Probe into Drug Costs". Politico. July 10, 2024. Retrieved December 5, 2024.
  33. ↑ "CVS-Aetna Merger Would Reduce Competition, AMA Says". American Medical Association. 2018. Archived from the original on December 13, 2024. Retrieved December 5, 2024.
  34. ↑ "UnitedHealth buys ScriptSwitch for £50m". e-health-insider.com. November 19, 2009.
  35. ↑ "ScriptSwitch" (PDF). optum.co.uk.
  36. ↑ "G-Cloud - Optum Health Solutions (UK) Limited - ScriptSwitch Prescribing". Retrieved October 5, 2026 – via digitalmarketplace.service.gov.uk. Optum offers a range of Medicine related products/services, including ScriptSwitch
  37. ↑ "Larry Renfro Named CEO of Optum" (Press release). Minnetonka, Minnesota: UnitedHealth Group. BusinessWire.com. July 6, 2011. Archived from the original on January 19, 2024.
  38. ↑ "UnitedHealth Group Announces Leadership Actions" (Press release). Minneapolis: UnitedHealth Group. BusinessWire.com. March 13, 2018. Archived from the original on January 19, 2024.
  39. ↑ "UnitedHealth Group Announces Executive Leadership Actions" (Press release). Minnetonka, Minnesota: UnitedHealth Group. BusinessWire.com. February 4, 2021. Archived from the original on January 14, 2025. Retrieved May 27, 2025.
  40. ↑ Snowbeck, Christopher (April 7, 2021). "UnitedHealth CEO makes first changes to leadership team". Star Tribune. Retrieved August 18, 2026.
  41. ↑ Mitchell, Hannah (June 23, 2021). "Who leads Optum? 14 execs to know". Becker's Hospital Review. Retrieved August 18, 2026.
  42. ↑ Emerson, Jakob (August 4, 2023). "Optum reshuffles leadership, names president". Becker's Hospital Review. Retrieved August 18, 2026.
  43. ↑ "UnitedHealth Group Executive Management Team". UnitedHealth Group. Retrieved July 3, 2024.
  44. ↑ "UnitedHealth Names Insider Patrick Conway as Optum CEO". April 2025. Archived from the original on April 30, 2025. Retrieved July 2, 2025.
  45. ↑ "Amazon-Backed Healthcare Venture Gets Much-Needed Name: Haven". Health Leaders. Archived from the original on March 7, 2019. Retrieved March 11, 2019.
  46. ↑ Abelson, Reed (February 1, 2019). "Clash of Giants: UnitedHealth Takes On Amazon, Berkshire Hathaway and JPMorgan Chase". The New York Times. ISSN 0362-4331. Archived from the original on March 9, 2019. Retrieved March 11, 2019.
  47. ↑ "Judge Allows Ex-Optum Exec to Work for Amazon Healthcare Venture". Health Leaders. Retrieved March 11, 2019.
  48. ↑ Coombs, Bertha (January 23, 2019). "UnitedHealth sues ex-executive for taking trade secrets to Amazon health venture". CNBC. Retrieved March 11, 2019.
  49. ↑ Japsen, Bruce. "Buying Binge for UnitedHealth's Optum Is Only Just Beginning". Forbes. Archived from the original on April 18, 2018. Retrieved March 11, 2019.
  50. ↑ Ramsey, Lydia. "A Lawsuit Is Giving Us the First Hints of How Amazon, Berkshire Hathaway, and JPMorgan Are Planning to Upend the US Healthcare System". Business Insider. Archived from the original on March 14, 2019. Retrieved March 11, 2019.(access to article is restricted)
  51. ↑ Paul, Kari (October 25, 2019). "Healthcare algorithm used across America has dramatic racial biases". The Guardian. Retrieved October 29, 2019.
  52. ↑ Obermeyer, Ziad; Powers, Brian; Vogeli, Christine; Mullainathan, Sendhil (2019). "Dissecting Racial Bias in an Algorithm Used to Manage the Health of Populations". Science. 366 (6464): 447–453. Bibcode:2019Sci...366..447O. doi:10.1126/science.aax2342. ISSN 0036-8075. PMID 31649194. S2CID 204881868. Archived from the original on June 28, 2020. Retrieved August 29, 2020.

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