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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

Updated 1 hour ago - Energy & Environment

Bomb cyclone prompts blizzard warnings from Virginia to Maine

Computer model projection showing the intense storm off of Cape Cod on Jan 29, 2022, with heavy snow and strong winds lashing the coastline. (Weatherbell.com)

Blizzard warnings are in effect for 11 million people from coastal Virginia to eastern Maine as a powerful and potentially historic winter storm is set to slam the Mid-Atlantic and Northeast beginning Friday.

Why it matters: The storm will bring an array of hazards, from zero visibility amid hurricane force wind gusts and heavy snow to coastal flooding that will erode vulnerable beaches and threaten coastal property from the Jersey shore to coastal Massachusetts.

Republican-led Pennsylvania court deems mail-in voting law unconstitutional

Workers count ballots for the 2020 Presidential election at the Philadelphia Convention Center in Philadelphia, Pennsylvania, U.S., on Nov. 3, 2020. Photo: Hannah Yoon/Bloomberg via Getty Images

A Republican-led Pennsylvania court on Friday ruled that the state's mail-in voting law is unconstitutional.

Driving the news: Three Republican judges sided with Republican challengers and ruled that no-excuse mail-in voting is prohibited under the state's constitution. Two Democrats on the panel dissented.

2 hours ago - World

China's ambassador warns Taiwan could spark "military conflict" with U.S.

Photo: Liu Jie/Xinhua via Getty Images

China's ambassador to the U.S. warned in a rare interview with NPR that if Taiwanese authorities "keep going down the road for independence," it would "most likely" lead to a "military conflict" between the U.S. and China.

Why it matters: Chinese officials rarely speak in such blunt terms, but veteran diplomat Qin Gang was unequivocal: "The Taiwan issue is the biggest tinderbox between China and the United States."

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