UnitedHealth talks rebates, payment plans as employers struggle with costs

As companies weather economic shocks from COVID-19, UnitedHealth Group says it's taking steps to shore-up the U.S. market for employer-sponsored health plans, the type of coverage that's the single most common source of health insurance in the country.

Executives at the Minnetonka-based health care giant told investors Wednesday they expect a shift in coverage from employer health plans to government-financed programs such as Medicaid, although they didn't forecast the magnitude of the change.

To stem the tide, the company's UnitedHealthcare division is granting payment plans to more customers. Executives also are considering premium rebates because health plans right now are saving so much money from the shutdown of elective surgeries to conserve supplies for COVID-19 patients.

For now, the savings are covering the cost of treating patients who are sickened in the pandemic, said David Wichmann, the chief executive at UnitedHealth Group.

"Employers are having to furlough employees. They have no revenues today," Wichmann said. "They need and want to keep people in coverage."

"It very well could be that under the circumstances, deferrals of services outweigh COVID-19 costs," Wichmann said, adding: "We very well may find ourselves in a position where we could provide additional premium relief to those clients."

First quarter results released Wednesday show UnitedHealth Group has absorbed little immediate damage thus far from the economic effects of the outbreak. The company also announced that one of its top executives, Andrew Witty, will temporarily leave the firm to help the World Health Organization develop a vaccine against the coronavirus.

UnitedHealth Group is Minnesota's largest company by revenue and employs 18,000 people in the state. UnitedHealth said it is paying full wages to its workforce of 325,000 people, and has boosted pay for front-line caregivers.

The company's UnitedHealthcare division is the nation's largest health insurer, with coverage for 43 million people.

The health insurance division has increased the share of customers being granted payment plans to better handle their monthly premiums, said Dirk McMahon, the chief executive at UnitedHealthcare. It's grown from less than 1% of the premium base in a typical month, McMahon said, to about 3% in April.

The insurer expects there could be a shift of membership from employer group plans to enrollment in state Medicaid programs, for people with low incomes. More people could turn to individual policies, as well, such as coverage sold under the federal Affordable Care Act (ACA).

Citing financial losses a few years ago, UnitedHealthcare exited most of the government-run health exchanges where people buy ACA-compliant coverage. But on Wednesday, the company said it started considering a return to the health exchange market in more states even before COVID-19.

"With the current COVID crisis, we expect to be down for the year as businesses close and employers reduce payroll associated and driving group attrition," McMahon said. "We do expect to see increases in Medicaid and our individual products to ultimately offset some of the losses we experience in the commercial group business."

In addition to the health insurance business, UnitedHealth Group runs a collection of health care service companies called Optum, which includes a large network of clinics, surgery centers and urgent care facilities across 43 states.

The surgery centers have largely shut down with the delays in elective procedures, executives said Wednesday, but the division has expanded its use of "telehealth" technology so that caregivers and patients can communicate without meeting in clinics. Optum has cared for more than 10,000 COVID-19 patients, Wichmann said, while establishing more than 400 coronavirus testing sites across the country.

The COVID-19 crisis could inspire more physician groups to partner with the company, Wichman said, because "it will remind a number of them about how important it is to align with certain partners with a strong financial standing."

Optum runs a large IT and health care consulting business that's having trouble closing deals right now, executives said. Yet interest in Optum's services is growing, including from hospitals that are considering large outsourcing deals where the company takes over many back-office functions, said Witty, who is the chief executive at Optum.

Health care spending is being fundamentally altered by COVID-19, which impacts operations at UnitedHealthcare.

With the current halt in elective surgeries and procedures, the share of premium revenue spent on health care could be very low in the second quarter, said John Rex, the company's chief financial officer. But in the second half of the year, those surgeries and procedures could return in earnest, Rex said, with pent-up demand driving unusually high health care costs.

Yet there are many unknowns.

"Individuals with chronic conditions are among those for whom we have considerable concern in this environment," Rex said. "While we are mitigating the impact through other means, mistreatments can aggravate health status, resulting in initially more intense care needs as the system reopens."

Rex added: "The impact of testing and coverage expansion, such as serologic tests — these are just a few of the factors we must consider."

For the quarter ending March 31, the company saw a profit of $3.4 billion — off by about 3% from the same period last year — on revenue of $64.4 billion. On a per-share basis, earnings of $3.72 beat by 9 cents the profit expected by analysts surveyed by Refinitiv.

"It feels awkward to be talking about earnings outlooks at this moment," said Wichmann, the UnitedHealth Group chief executive. Maintaining the financial guidance is "the most reasonable baseline posture in these uncertain times as we continue to grow and operate our businesses while assessing the multitude of potentially offsetting factors."

Witty will spend the rest of the year co-leading the WHO effort, which is a partnership with other groups trying to speed vaccine development.

"We couldn't be more proud to see one of our own serve in this way," Wichmann said during a conference call with investors.

Before Witty joined the UnitedHealth Group board in 2017 and took the top position at Optum one year later, he was chief executive at the pharmaceutical giant GlaxoSmithKline. During that time, Witty "gained global recognition for his efforts to develop and expand access to critically needed vaccines," UnitedHealth Group said in a statement.

Christopher Snowbeck • 612-673-4744

Twitter: @chrissnowbeck