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Expand chart
Data: Company documents; Chart: Axios Visuals

UnitedHealth Group is mostly known as one of the country's largest health insurance carriers, but the massive conglomerate is increasingly making its money from things that have nothing to do with health insurance.

The bottom line: UnitedHealth doesn't just want to be your health insurer. It wants to be your doctor, your outpatient surgery center, your mail-order pharmacy and your drug price negotiator.

By the numbers: UnitedHealthcare is still UnitedHealth's most profitable unit, generating more than $10 billion in operating earnings in 2019 as a major carrier of employer and Medicare Advantage plans.

  • But UnitedHealth's Optum subsidiaries are close behind. Optum collected more profit in the fourth quarter of 2019 ($3 billion) than UnitedHealthcare ($2.1 billion). And that's not new: Optum has had a stronger Q4 than UnitedHealthcare in each of the past five years.
  • The last three months of the calendar year are usually the worst for health insurers. They pay out more for medical claims as more people reach their deductibles and out-of-pocket maximums.

Between the lines: The most profitable segment within Optum is OptumRx, which is part of the pharmacy benefit manager oligopoly that controls how drugs are paid for and which drugs are covered.

  • Rebates negotiated from drug companies, and other behind-the-scenes fees, have turned OptumRx into a cash cow — often at the expense of employers and their workers.
  • Optum's other units also are growing. They include a bank for health savings accounts, physician practices, urgent care clinics, surgery centers and almost any conceivable piece of technology and consulting used in health care.
Expand chart
Data: Company documents; Chart: Axios Visuals

Go deeper: UnitedHealth's political and financial heft just keeps growing

Go deeper

N.Y. Times faces culture clashes as business booms

Illustration: Sarah Grillo/Axios

New York Times columnist David Brooks' resignation from a paid gig at a think tank on Saturday is the latest in a flurry of scandals that America's biggest and most successful newspaper company has endured in the past year.

Driving the news: Brooks resigned from the Aspen Institute following a BuzzFeed News investigation that uncovered conflicts of interest between his reporting and money he accepted from corporate donors for a project called "Weave" that he worked on at the nonprofit.

America rebalances its post-Trump news diet

Illustration: Annelise Capossela/Axios

Nearly halfway through President Biden's first 100 days, data shows that Americans are learning to wean themselves off of news — and especially politics.

Why it matters: The departure of former President Trump's once-ubiquitous presence in the news cycle has reoriented the country's attention.

2021 sees a record number of bills targeting trans youth

Illustration: Annelise Capossela/Axios

Republicans in at least 25 states have introduced over 60 bills targeting transgender children — a legislative boom since January that has beaten 2020's total number of anti-trans bills.

Why it matters: LGBTQ advocates say the unprecedented push was catalyzed by backlash to Biden's election and the Supreme Court ruling that workers cannot be fired for being gay or transgender.

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