As the world’s largest healthcare company, UnitedHealth Group, the parent company of Optum and ASC chain SCA Health, continues to shape the U.S. healthcare landscape.
A newly published report, titled the “Sunlight Report,” offers a look into UnitedHealth’s corporate structure and acquisition strategy. Released on July 16 by the Center for Health & Democracy and funded by Arnold Ventures, the report compiles and analyzes public records to reveal how UnitedHealth has expanded across sectors over the last 15 years.
The Sunlight Report’s findings are based on Schedule Y filings. Researchers reviewed UnitedHealth’s filings from 2010 to 2024, mapping the company’s acquisitions and subsidiaries across clinical care, insurance, pharmacy and beyond. While the report draws solely from publicly available data, its authors note that it should not be interpreted as a complete or final accounting.
Read the full report here.
Here are five key notes for ASC leaders and physicians:
1. UnitedHealth’s 90,000 physicians
UnitedHealth now directly employs or contracts with over 90,000 physicians, representing approximately 10% of the U.S. physician workforce.
2. A massive and multi-sector portfolio
Through its Optum arm and related subsidiaries, UnitedHealth has built a vast portfolio that spans care delivery, home health, ambulatory surgery and back-end administration. This is part of a broader network of at least 2,694 subsidiaries, although some of those assets were reportedly divested toward the end of 2024.
As of late 2024, the company’s provider subsidiaries span:
- 423 ASCs
- 880+ home health companies
- 335 administrative/support entities
3. Clinical acquisition strategy
UnitedHealth’s most aggressive acquisition efforts began in 2010, focusing on clinical services. Today, the breakdown of its subsidiaries by category includes:
- 2,050+ clinical entities
- 200+ insurance-related businesses
- 150+ international assets
- 100+ pharmacy companies
- 100+ other support services
4. Key acquisitions shaping the ASC and physician landscape
Several high-profile deals have cemented UnitedHealth’s reach into physician services and outpatient care:
- Surgical Care Affiliates (SCA Health): Acquired for $2.3 billion in 2017
- DaVita Medical Group: $3.4 billion in 2019
- Equian (payment integrity firm): $3.2 billion in 2019
- Landmark Health (home-based medical care): $3.5 billion in 2021
- Change Healthcare (claims, data): $8 billion in 2023
- LHC Group (home health/hospice): $5.4 billion in 2023
5. Insurance dominance
UnitedHealthcare, the insurance arm of UnitedHealth Group, covers more than 50 million members across commercial, ACA marketplace, Medicare Advantage and Medicaid plans. The company holds roughly 15% of the national health insurance market.
Its insurance operations include:
- 49% health plans
- 28% administrative services
- 21% specialty insurance
- <1% other/unknown
In a statement about the report, a spokesperson for UnitedHealth told Becker’s:
“UnitedHealth Group comprises a small fraction of the U.S. health system. Through our diversified business, we’re helping to accelerate the transition of the U.S. health care system from volume to value; moving beyond a transaction-based health system to a model that is designed to be proactive to help keep people healthy over the course of their lifetimes; and incentivizing care delivery organizations the right way.”
