UnitedHealth Group Inc is a US-managed health and well-being company. Optum is one of its subsidaries and is its most active component in the UK healthcare market and NHS contracts.
Unitedhealth Group inc was founded in 1974, originally under the name Charter Med Incorporated, by a group of physicians and other healthcare professionals. In 1998 it became the UnitedHealth Group inc and reorganised its structure into a group of linked businesses. It created Optum in 2009; which is now also split into a range of companies from healthcare commissioning, to pharmacy services, to IT.
UnitedHealth Group inc is an American healthcare company, ranked 6th on the fortune 500. Although based in the USA, its subsidiary companies operate globally; in the UK its affiliate Optum provides commissioning support to the NHS, an opportunity first seized after the 2012 NHS reforms. Optum has been involved in many contracts since; of particular note is its position on the Lead Provider Framework for commissioning support. It has connections to multiple Commissioning Support Units (CSUs) including the South, West, and Central CSU and a previous contract worth £150 million in Thames Valley and Wessex, providing commissioning support to 18 CCGS.
Unitedhealth Group is divided into two platforms: UnitedHealthCare - for health benefits - and Optum - for health services. Put simply the first deals with physical health care, primarily in the USA and not currently in the UK. Meanwhile the latter is extremely active in the UK and deals with services such as commissioning and employment and locum workers.
There is much interest over the links between Unitedhealth Group and multiple British politicians and prominent figures in the NHS.
The most notable link concerns the current Chief Executive of the NHS: Simon Stevens. Stevens, who was appointed to this role in 2013, is British, but from 2004-2013 was vice-president of UnitedHealth. In that role he became a founder member of a US lobby group - the "Alliance for Health Care Competitiveness" - explicitly trying to use TTIP to force state-run health systems, including the NHS, to employ private health firms from the US.
Another figure with ties to both the UK public and American private sectors is Nick Seddon, who was Special Adviser for Health from 2013-2016. Only 4 months after leaving the government role he became Executive Vice President of Optum. A policy change made by David Cameron’s government in 2014 meant Mr Seddon’s move to the private sector did not need to be vetted for conflicts of interest by a semi-independent advisory committee, as was previously the case.
David Sharpe was NHS England’s director of commissioning operation for the central midlands sub-region until in 2015 he left to join Optum as Senior Vice President for Growth Strategy in the UK. He still works at Optum to this day, most recently speaking at the Health+Care Commissioning Show about Accountable Care. United Health Group already operates 26 Accountable Care Organisations (ACOs) in the US.
Former GP Martin McShane, director for long term conditions and mental health for a three-year contract between 2012 and 2015, left his career within the NHS at the end of 2015. He then joined Optum as chief medical officer for clinical delivery.
Optum has a large number of contracts for commissioning support with CCGs and other NHS organisations, gained thorugh its presence on the NHS England's Procurement Framework. Large contracts include the following:
Under this contract Optum will provide: contract management, forecasting and capacity management for eighteen CCGs within Wessex and the Thames Valley. This will be over the duration of three years.
The new contract, which covers approximately £50m per annum of acute activity, was gained through a formal tender process when the initial contract ended.
The first contract awarded through the NHS England Procurement Framework was awarded in September 2015. The £9m contract will last three years and requires Optum to provide the full range of support services for two CCGs: South Lincolnshire and South West Lincolnshire. The value of the deal is less than half the budget allocated to the CCGs.
Another concern is VAT. If unrecoverable it could push up costs for CCGs by 20%. Tax is currently not charged when the CSU is a public body.