July 10, 2024

UnitedHealth has ‘quietly’ bought several outpatient surgery centers

Editor's Note

UnitedHealth Group acquired dozens of outpatient facilities, particularly surgery centers, in 2023, often without public announcements, STAT March 11 reports. This builds on their network of about 90,000 physicians. Many new centers are in areas where UnitedHealth dominates the Medicare Advantage market.

A major acquisition was National Cardiovascular Partners, bought from Fresenius Medical Care, and now listed as NCP Investment Holdings, Inc in UnitedHealth’s annual report. UnitedHealth’s strategy of vertical integration, which combines owning insurance and healthcare providers, has reportedly making way for the giant to capture more profit, raising federal antitrust concerns.

Filings reveal UnitedHealth acquired more than 50 companies in 2023, including over 35 surgery centers and physician practices. They also bought technology company Episource, which helps document patient health conditions for Medicare Advantage risk adjustment.

Chris Whaley of Brown University and Michael Richards of Cornell University, who have studied “surgery centers and UnitedHealth’s acquisition patterns for the past few years,” noted in the article that UnitedHealth “buying a chain as large as SCA [Surgical Care Affiliates] was a quick way to get into the surgery center market.” They also observed that UnitedHealth’s acquisition strategy has been focusing on regions with strong Medicare Advantage presence, effectively creating a referral network for outpatient care, which started with their $2.3 billion purchase of SCA in 2017.

UnitedHealth's approach involves directing patients to its own facilities, often offering low or no out-of-pocket costs. While this could benefit patients through coordinated care and lower prices, there are concerns it could also lead to higher prices and restricted care options if facilities are taken out of rival insurers' networks.

Per the article, Whaley and Richards warned that UnitedHealth’s opaque acquisition process raises red flags, with many transactions not publicly disclosed. This lack of transparency could indicate attempts to obscure ownership details.

Live chat by BoldChat