UnitedHealth Group releases results of independent audit

UnitedHealth Group Releases Results of Independent Audit

UnitedHealth Group, the parent company of UnitedHealthcare, the nation’s largest health insurer, has released the results of an independent audit of its business practices. The audit, which was conducted by two separate consultancies, FTI Consulting and the Analysis Group, examined various aspects of the company’s operations, including its Medicare Advantage programs and pharmacy benefit management services.

The audit was commissioned by UnitedHealth Group’s new CEO, Steve Hemsley, who took the reins in May following the abrupt departure of his predecessor, Andrew Witty. The move is seen as an effort to rebuild trust with the American public, which has been critical of the company’s practices and the broader US healthcare system. Critics have accused private insurers, including UnitedHealthcare, of making it harder for patients to access and pay for care.

Audit Findings and Recommendations

The audit found that UnitedHealth Group’s policies and practices are “robust, rigorous, and generally sound,” but also identified areas for improvement. The Analysis Group, which reviewed the company’s pharmacy benefit management services, found that Optum Rx, the company’s PBM, has a “comprehensive and well-structured framework” in place for managing manufacturer discounts. However, the firm recommended strengthening Optum Rx’s escalation processes for resolving nonpayment and dispute cases with manufacturers.

FTI Consulting, which reviewed UnitedHealthcare’s Medicare Advantage programs, found that the company scored better than its peers in several areas, but noted slow decision-making on authorizations, documentation issues, and the need to better address findings raised in regulatory audits. The firm also recommended that UnitedHealthcare develop a formal policy to support procedures for addressing these issues.

Commitment to Transparency and Improvement

UnitedHealth Group has committed to implementing the recommendations made by the audit, with 65% of the actions to be completed by the end of 2025 and 100% by the end of March next year. The company has also pledged to share the findings of future reviews, including an examination of its medical records and diagnosis codes, which is expected to be released in the first quarter of next year.

CEO Steve Hemsley stated that the company is “determined to hold ourselves to the highest standard” and that the audit is a “commitment to setting a new standard of transparency for the healthcare marketplace.” The move is seen as a step towards rebuilding trust with the public, but it remains to be seen how much it will change the public’s perception of the company and the broader industry.