UnitedHealth Group touts Optum effect on its corporate growth

UnitedHealth Group plans this month to open its 500th pharmacy that's focused on the behavioral health care needs of certain clinic patients.

The pharmacy is part of a business that UnitedHealth Group acquired last year and exemplifies how the Minnetonka-based health care giant has diversified beyond UnitedHealthcare, the core health insurance business that remains the largest carrier in the county.

During an investor conference Tuesday, UnitedHealth Group officials focused on growth prospects with the health services business, which is called Optum, as the company becomes more of a force in providing health care through pharmacies and clinics. Executives also stressed positive signs with the health insurance business, despite a few problems such as stagnant enrollment trends among commercial customers.

"UnitedHealth Group is a fundamentally different company than the commercial insurance company I joined 22 years ago," said David Wichmann, the company's chief executive. "With more than 50% of earnings coming from Optum in 2020, it's a good time to reflect on the accelerating impact diversification has had on the capacities of UnitedHealth Group, now a broad-based health care company."

UnitedHealth Group is Minnesota's largest company by revenue. It employs about 325,000 people, including about 18,000 in the company's home state.

The investor day presentation generally highlighted growth prospects, with Wichmann noting the company's track record of providing annual earnings growth in the range of 13 to 16%. Even so, he told investors there were three areas where "we should have performed better for you."

One was weak spot has been Brazil, where UnitedHealth Group in 2012 paid $4.9 billion to acquire a large health insurance company that also operates hospital and clinics in the country. UnitedHealthcare enrollment in health plans in South America fell by about 510,000 people between 2018 and 2019, according to data released Tuesday, but membership is expected to start growing again next year.

Financial performance also has been weak, Wichmann said, in the business that provides managed care plans to state Medicaid programs. In the past year or so, the company has dropped out of some state programs where UnitedHealthcare feels reimbursement rates are insufficient. Company officials on Tuesday noted several recent contract wins for the business, and prospects for the coming year.

And growth has been sluggish in health insurance enrollment from commercial customers — primarily employers buying group coverage. Figures released Tuesday suggest that commercial enrollment this year of 27.8 million people will either hold steady or decline slightly next year.

Bill Golden, UnitedHealthcare's chief executive for the employer health plan business, said that enrollment figures expected for January show "a bit of a divot in some large customers." But he added: "We feel good about our pipeline."

Even with those weak points, UnitedHealthcare next year projects revenue growth of 7 to 8% and operating earnings growth of between 9 and 13%. The growth rate for revenue and operating earnings are expected to be even higher at Optum, which includes divisions for health care delivery, pharmaceutical benefits management and health care/IT consulting.

At OptumHealth, revenue and operating earnings are projected to increase by more than 25% next year, according to figures released Tuesday. The division includes the company's fast-growing network of medical clinics, urgent care centers and surgery centers.

The OptumInsight division for IT and data consulting expects growth in revenue and operating earnings next year of more than 10%. The pharmaceutical benefits management (PBM) business expects revenue and operating earnings growth of more than 5%.

Traditionally, the PBM business has focused on negotiating drug prices with pharmaceutical manufacturers and then assembling a network of pharmacies where enrollees can fill their prescriptions. With deals like UnitedHealth Group's acquisition of Genoa last year, the company is augmenting the business with pharmacy care services that try to help patients keep taking their medicine.

At the time of the acquisition, Genoa operated more than 425 pharmacies in behavioral health centers, including 19 in Minnesota. The division is scheduled to open its 500th pharmacy this month, with the newest facility located in New York City.

"We're rapidly adding more," said Andrew Witty, the Optum chief executive. "Through these pharmacies and their connections with local health systems, we're driving more than 90% medication adherence — nearly double that achieved by most retail pharmacies."

In advance of Tuesday's investor conference, UnitedHealth Group said it now expects 2019 revenue of about $242 billion with adjusted net earnings of nearly $15 per share, which is at the higher end of the company's most recent earnings guidance. Adjusted earnings exclude certain expenses related to acquisitions.

For 2020, the company forecasts revenue of $260 billion to $262 billion and adjusted net earnings of $16.25 to $16.55 per share. Analysts surveyed by Refinitiv were expecting revenue in a range of $255.6 billion to $266.7 billion, and earnings per share between $16.25 and $16.75.

Christopher Snowbeck • 612-673-4744 Twitter: @chrissnowbeck