UnitedHealth’s dominant growth forges ahead amid intensifying antitrust scrutiny

Editor's Note

In addition to the uptick in acquiring outpatient facilities since 2023, UnitedHealth Group quietly acquired or created more than 250 subsidiaries last year, expanding its already vast network of services comprising a major health insurer, physician practices, a pharmacy benefit manager, and various other healthcare ventures, STAT March 7 reports. According to recent financial documents, many of these unannounced deals continued to be in the lucrative realm of outpatient surgery centers, extending the group’s years-long buying spree and vertical integration strategy.

Over 100 ambulatory surgery centers (ASCs) were added in 2024 alone, many focused on profitable specialties such as cardiology, orthopedics, ophthalmology, and gastroenterology. Notable among these acquisitions are ASCs affiliated with Texas Health Resources, a nonprofit hospital system in the Dallas-Fort Worth area, where commercial and Medicare Advantage plans—often controlled by UnitedHealth—are prevalent. By directing its insured members to facilities it owns, the company effectively pays itself, enjoying both the premium and procedural revenue. Critics worry this approach could squeeze out independent doctors and insurers who must negotiate with a giant that sets both the coverage terms and the care venues.

In addition to ASCs, UnitedHealth purchased specialty pharmacies, including CPS Solutions and PharmScript, broadening its influence in hospitals and long-term care facilities, the article noted. These deals enable the group to manage prescription drug sales, tap federal discount drug programs, and control distribution chains. The creation of Nuvaila, UnitedHealth’s own generics and biosimilars unit, highlights further expansion into pharmaceutical manufacturing and distribution—mirroring similar moves by CVS Health and Cigna.

While these initiatives helped boost UnitedHealth’s annual revenue by 8% to more than $400 billion, growing regulatory pressure is mounting. The Department of Justice has sued to block UnitedHealth’s attempted takeover of home health provider Amedisys, and lawmakers have expressed concerns about the potential for anticompetitive behavior. Industry experts argue such extensive vertical integration could limit patient choice and inflate costs if competing providers and payers are locked out or underpaid.

Despite these legal challenges, UnitedHealth aims to increase revenues by at least 12.5% this year to roughly $450 billion. As the group’s business interests become increasingly intertwined, experts say federal regulators must keep a close eye on how UnitedHealth’s broad reach may affect competition and patient outcomes—particularly in markets where its dominance is already substantial.