MHA5010_BantaLucresha_Assessment3-1

1 Directional Strategies Report for UHG Capella University Strategic Health Care Planning Lucresha Banta August 5, 2023

2 UnitedHealth Group is a health and well-being company with two distinct and complementary businesses working to help build a modern, high-performing health system. UHG employs approximately 300,000 employees worldwide and serves 150 million unique individuals. UHG has over $320 billion in total revenues. UHG serves consumers, employers, governments, care providers, patients, and health plans. UnitedHealth Group, located in Minneapolis, MN, is a health care and well-being company. UnitedHealth Group is a managed healthcare company that promotes evidence-based medicine, simplifies the administrative aspects of healthcare delivery, and provides actionable and relevant data to help physicians, consumers, employers, and healthcare professionals to make better and more informed healthcare decisions ( www.uhc.com ). Effective Directional Strategies A directional strategy will help an organization define what it stands for, wants to achieve, where it wants to focus its business efforts, its resources for growth, and where it wants to maintain its stability or look into cutbacks. Without a directional strategy, a company can quickly and easily lose focus on its goals and objectives. Effective directional strategies will help the company focus on its mission, vision, and values. UHG’s mission is to “help people live healthier lives and help make the health system work better for everyone” (uhg.com) . UHG is a healthcare and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone. UHG serves 150 million people, including Medicare beneficiaries, Medicaid recipients, employers,

4 healthy, as evidenced by a 75% report of a positive experience from a 2022 employee experience survey ( www.uhg.com ). UHG currently has five strategic growth priorities. The mission, values, and vision encompass these strategic growth priorities of value-based care, expanding health benefits, improving health technology, streamlining health financial services, and improving pharmacy services. There is, however, room for improvement, as will be discussed below. Gaps in Effective Directional Strategies Approximately 28 million uninsured Americans, or 8% of the population (McDonough, 2023). Approximately 40% of Americans report that they or a family member have delayed getting care due to the cost of care. UHG is the leader in covering Americans at 12.5% of the overall market; there continue to be gaps in coverage. With 40% of Americans or their families reporting delaying care due to the cost of deductibles, copays, or other factors, UHG has to work on closing the gaps in care for these at-risk patients. UHG needs to expand in-home assessments to low- income, rural communities to assist these members in receiving the care they need to continue to close gaps in care and build the value-based, high-quality health system UHG drives to attain. To provide the best possible care for members, UHG must also offer the best possible care for its employees. UHG needs to ensure its employees are equipped through its benefits package, training for advancement, and attracting a diverse, inclusive workforce to serve its varied member population.

5 Alignment between directional strategies and strategic goals Directional alignment is taking the directional strategy through the layers of the organization so that it can be developed and aligned appropriately. UnitedHealth Group’s directional strategies are in alignment with its strategic goals. UHG has plans for diversifying the workforce to support and address health disparities and advance health equity. UHG focuses on national public health trends such as behavioral and mental health, chronic condition management, and value-based care. UnitedHealth Group’s strategic growth priorities are most appropriate at this time. UHG has a short and long-term plan with goals to reach by 2025 and 2030. Their strategic growth priorities include value-based care, health benefits, health technology, health financial services, and pharmacy services. Changes to Directional Strategy Shrank et al. (2021) propose five policy priorities that should be expanded on to help with healthcare costs. These include transitioning to value-based care, increasing home-based care, improving the affordability of medications, expanding insurance coverage, and finally developing a high-value workplace. UHG must continue to close gaps in care for the members that need it most, those that cannot get services, and those that cannot afford them. In-home care visits need to be expanded to cover more members, allowing for more care coordination, identifying gaps in care, and improving patient outcomes. Even though UHG has the HouseCalls program in place, the company needs to expand this program to reach more members. There is also an opportunity here for UHG to become a leader in the

7 Table 1 TOWS Matrix Threats  Competition: increased pricing pressure, reducing margins of profits  Online identity theft and hacking  Fluctuations in market rates  Shortage of physicians and nurses Opportunities  Extend value-based care into patients’ homes.  Partnership with Health Net to expand behavioral health in Indiana  Expected growth in the insurance market.  Telemedicine.  Value-Based medicine. Strengths  Market presence: available in all 50 states and territories in the US. 7.1 million members in Medicare & Retirement.  Premium earnings of $324,162 million due to a surge in the number of clients served by Medicaid and MA and overall Optum business expansion and cost trends.  High employee satisfaction rates.  Branding with AARP and Optum  Obtaining LHC and possibly Amedisys Home Health companies ST  Even with a strong market presence, other insurance companies have the opportunity to come in and provide lower costs and increased benefits.  Fluctuations in interest rates can cause a decrease in revenue, thus relying on premium earnings to help carry the company.  Increase use of online platforms by providers and members can cause weaknesses in online security, leading to a risk of hacking and identity theft. SO  Being available in all 50 states allows UHC to extend services to more people.  With growth expected in the insurance market, the opportunity to increase revenue is high.  Expanding services, such as behavioral health, to other states besides Indiana is an opportunity that UHG could expand upon and develop into another benefit to its members to help set it apart.  Expanding value-based care into patients’ homes. Weaknesses  Decrease in investments and other income by 12.7% in FY2022  Dissatisfaction with platform use by providers  Poor customer service.  Prior Authorizations. WT  Decrease in investments and other incomes caused by market fluctuations can lead to decreased profits for the company.  Provider dissatisfaction can lead to loss of business, members, and profits.  Poor customer service can lead to loss of members, profits, STAR ratings, and CMS reimbursement. WO  Increasing patient satisfaction through better customer service can help drive revenue.  Increasing ease of use with technology, thus increasing provider satisfaction, can lead to increased provider relationships to provide in- home care and other community-based services such as Health Net in other states.

8 Table 2 1. Strategy: Value-based, comprehensive care delivery  Continue to expand services across all markets  Extend care into patients’ homes through the acquisition of LHC and Amedisys  Optimizing the site of service  Expand behavioral health services  Advance health equity by 2033 2. Strategy: Improve the patient (customer service) experience.  Improve customer service experience when members call in  Improve the use of applications for providers with prior authorization and claims processing  Improve ease of use of the application for members and make one app for all needs, including paying claims, requesting prescriptions, virtual visits, and accessing benefits.  Improve data sharing across payers and government programs 3. Strategy: Expand Virtual Health Capabilities  Provide 24/7 Virtual care/telehealth visits and no-cost to members.  Provide personalized health care to members on their time at the right time  Work to prevent the projected shortage of PCP by 2034 4. Strategy: Provide affordable health benefits  With the company having an annual growth of 12.7% in FY2022 and reports in 2023 already showing a profit, UnitedHealth Group appears to be showing affordability for its Medicare Advantage programs as it continues to grow and serve the population it serves.  continue to provide Medicaid services to the underprivileged through DSNP coverage .