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Specifically, most ratings are determined from multivariate logistic regressions of medical outcomes at a given healthcare provider to risk-adjust the patients and 1-, 3- and 5-star awards are given to providers whose negative outcomes are worse than expected, near predicted levels, and better than expected, respectively.
Optum was formed as a subsidiary of UnitedHealth Group in 2011 by merging UnitedHealth Group’s existing pharmacy and care delivery services into the single Optum brand, comprising three main businesses: OptumHealth, OptumInsight and OptumRx. [2] In 2017, Optum accounted for 44 percent of UnitedHealth Group's profits. [3]
Also in 2003, UnitedHealth Group acquired Golden Rule Financial, a provider of health savings accounts. [15] On July 21, 2003, Exante Bank started operating in Salt Lake City, Utah, as a Utah state-chartered industrial loan corporation. It changed its name to OptumHealth Bank in 2008 [16] and to Optum Bank in 2012.
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Lumenos was the pioneer and market leader in consumer-driven health plans. In December, WellPoint acquired WellChoice, a New York City-based Blue Cross Blue Shield provider, for approximately $6.5 billion, [45] making New York the 14th state in which WellPoint is a Blue Cross Blue Shield licensee.
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As of 2023, PBMs managed pharmacy benefits for 275 million Americans and the three largest PBMs in the US, CVS Caremark, Cigna Express Scripts, and UnitedHealth Group’s Optum Rx, make up about 80% of the market share covering about 270 million people [4] [5] with a market of almost $600 billion in 2024. [6]
HealthCare.gov is a health insurance exchange website operated by the United States federal government under the provisions of the Affordable Care Act (ACA), informally referred to as "Obamacare", which currently serves the residents of the U.S. states which have opted not to create their own state exchanges.