Dr. Margaret-Mary Wilson is UnitedHealth Group (UHG) ‘s Chief Medical Officer, and she recently told Fortune magazine that UHG’s acquisition of physician practices and surgery centers through its subsidiary Optum has allowed UnitedHealth Group to gather “a critical mass” of doctors, which helps the company improve care. She said that the practices that they’ve acquired are not a bunch of “flashy acquisitions” but rather each one “brings the pieces together to help drive value.”
It’s undeniable: more physician involvement in leadership and in business means that communities get higher-value health care. UHG, CVS, and the other eight health care companies that are among the top 25 U.S. companies for revenue all agree, too. They are all vertically integrating insurance plans, pharmacies, physicians’ offices, health care IT companies specializing in analytics and telehealth, and home health. And it is profitable. Both CVS and UHG earned 150 to 200 percent more revenue in 2023 than they did a decade ago (corrected for inflation). That’s $20.1 billion in profits and $4.1 billion in profits respectively.
Clearly employing more physicians and owning more practices is working for these huge corporations, and it may be working well for patients covered by their insurance plans who live in an area of the country with good access to primary care and their other menu of services. But is there an even better option out there than massive corporate control? Yes, and I think physician-led innovation will be the driver.
I want to see a critical mass of women physician innovators creating the companies and policy solutions that turn the tide to better serve patients. Karen Lynch is the CEO of CVS, and she told Fortune that CVS wants to “drive engagement, simplicity, and effectiveness.” I think that the tools to do that will be created by physician innovators.
If you are a physician with a heart for serving patients, but are disgusted with the disengagement, layers of complexity, and ineffectiveness in health care today, what can you do? What are the areas of opportunity for innovation?
Health care IT solutions that offer the simplicity of patient experience and integrate information across platforms and companies are one huge opportunity. Home-based primary care is another area – CMS authorized the Independence at Home Demonstration program in 2021-2023 in part to investigate the feasibility and set criteria for practices that offer at-home primary care. Private practices that are built around state-by-state Medicaid expansion and Medicare Advantage populations are another; UHG just acquired two such private practices. And, of course, figuring out how to incorporate wearable data into collaborative health care decision-making is another (if physicians don’t do it, employers surely will!). These are our opportunities.
Carrie Atcheson is an anesthesiologist.
