UnitedHealth pays Optum physicians 17% more than outside providers

Tara Bannow covers hospitals, providers, and insurers. You can reach Tara on Signal at tarabannow.70.

UnitedHealth Group pays its own physician practices much more than it pays competing practices, a new study finds, reinforcing STAT’s own analysis on the subject and presenting fresh evidence that the conglomerate may be skirting a rule designed to curb health insurer profits. 

UnitedHealth’s insurance arm, UnitedHealthcare, pays practices under its UnitedHealth-owned Optum umbrella 17% more on average for common services than it pays non-Optum practices in the same region, according to the study, published today in Health Affairs. In areas where its insurance arm has a large market share, it pays Optum practices 61% more. 

The study’s lead author, Daniel Arnold, said his research was inspired in part by STAT’s reporting from last year, which found that UnitedHealthcare paid 13 of 16 Optum practices more than others in the same market, ranging from as little as 3% more to 111% more. UnitedHealth paid the other 3 practices less than the market average. UnitedHealth paid roughly two times the market average for some common services, STAT found.