March 05, 2024
On February 27, 2024 the Wall Street Journal (WSJ) reported that the U.S. Department of Justice (DOJ) is investigating UnitedHealth Group (UHG) regarding potentially anti-competitive actions and corporate arrangements. As WSJ reports, “the Biden administration’s antitrust enforcers have stepped up investigations of some of the biggest U.S. companies… [and] has pushed to revive enforcement of laws that restrain monopolies in the U.S. The department has had mixed results on merger enforcement, but its challenges to monopolies are continuing.” Although scant on details at this time, WSJ suggested that the UHG inquiry appears to focus on “certain relationships between the company’s UnitedHealthcare insurance unit and its Optum health-services arm” and the “possible effects of the company’s doctor-group acquisitions on rivals and consumers.”
While the initiation of an investigation does not itself signal wrongdoing by the involved companies, and the conclusion of the action and/or resulting legal proceedings (if any) are likely months or years away, employers and their plans may have questions about any interim direct or indirect impacts for UHG services and for health care services and coverage more broadly. We expect employers plan sponsors to continue their long-standing promotion and pursuit of competition in health care plan design/offerings to attract and retain talent, as well as to drive innovation and to mitigate cost increases.
Why Your CEO May Care
Beyond health plan sponsorship, leaders of large US employers are generally broadly aware of market dynamics, compliance requirements and ensuring competitive practices in their own industry. Anytime the DOJ inquires into or pursues a company for potentially anti-competitive actions it can be informative for compliance and review purposes more broadly, even across industries. Here, UHG is a well-known company (ranked 5th in the 2023 Fortune rankings) and provides diverse services across the health care ecosystem. Whether your company is in the health care sector or not, your CEO likely is familiar with UHG as a company and maybe as a service provider to your plan, employees and families. This may raise your CEO’s interest in the inquiry both for how it may inform your own company’s business practices and how it may or may not affect current and future coverage and services for your population(s).
What Does this Investigation Mean for Employer Plans, and Covered Employees and Families?
In the short-term, employer plans, employees and families are unlikely to experience significant disruption or changes based solely on the DOJ’s investigation. Longer-term any changes will depend on how the investigation unfolds, any resulting action or agreements between the DOJ and UHG, and the broader market dynamics at that time.
As we describe in the Business Group on Health’s Promoting Competition and Innovation in Health Care Policy Position Statement, employers and the Business Group recognize innovation, competition, and differentiation are the building blocks for employer sponsored plans to deliver meaningful coverage and services. The Business Group and its members value and promote policies and business practices that enhance and encourage innovation and competition in health care. In order to ensure appropriate market dynamics, certain appropriate government review and involvement may be justified to address anti-competitive concerns. But employer plans recognize that there is a balance, and while certain consolidation activity may warrant review or action, others will enhance the plan and employee experience by integrating care, increasing interoperability, improving communication and navigation, and driving cost savings through efficiency and innovation.
What’s Next?
Business Group on Health will continue to monitor developments related to the investigation and will provide additional information to members. In the near term, we will cover new information (if any) at our next Public Policy: Regulatory & Compliance Update webinar on Thursday, March 21, 2024 at 12:00 p.m. ET. Members can register here.
We provide this material for informational purposes only; it is not a substitute for legal advice.
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