Optum's 90,000 physicians: What consolidation could mean for medicine 

UnitedHealth Group, parent company of Optum, now employs, contracts or aligns with roughly 90,000  physicians in the country, according to a Dec. 14 report from Medscape

The group added 20,000 physicians in 2023 and inked three major physician group acquisitions. The group's rapid growth is "raising antitrust and noncompete concerns as more payers and private equity firms pursue medical practice acquisitions," according to the report. 

Physician consolidation and mergers have become increasingly common as reimbursements decline and costs soar. Payers like UnitedHealthcare are one of the many new forces in the battle to employ physicians as they look to value-based care. 

Payer-led consolidation hasn't been widely studied, Yashaswini Singh, PhD, healthcare economist and assistant professor of health services, policy and practice at Providence, R.I.-based Brown University, told Medscape. She predicts it could improve care coordination and outcomes. 

The increase in consolidation could also raise antitrust concerns, according to the report. The Biden administration has doubled down on healthcare antitrust enforcement. And in October, a Justice Department antitrust division leader said payers should expect close scrutiny of any acquisitions moving forward.

Dr. Singh told Medscape that Optum's acquisitions could bypass antitrust statutes because most prospective mergers and acquisitions are reviewed only if they exceed a specific monetary value. Additionally, when physicians are hired instead of acquired, they are not subject to antitrust laws. 

But Optum has faced antitrust suits in smaller markets. Emanate Health filed a suit against Optum in November, alleging the company steered patients away from physicians who left Optum to join the Covina, Calif.-based health system. 

Many leaders are worried about how this increasing consolidation will affect patient care. 

"Companies such as Optum are rapidly taking over with the guise that they can provide better care," Ramy Elias, MD, medical director for the Center for Advanced Orthopedics & Sports Medicine at Cerritos (Calif.) Surgery Center, told Becker's. "The only path to success is for physicians to band together and stand up to the insurance companies. The divide-and-conquer model has worked well for insurance companies, and we must put an end to this. We need to realize that we are not in competition with our colleagues and we are much stronger together."

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