A United Healthcare sign is displayed on an office building in Minnetonka, Minnesota, USA on December 11, 2025.
Tim Evans Reuter
united health group announced on Friday the first results from a wide-ranging independent audit of its business practices and committed to taking wide-ranging steps to track and implement improvements in three specific areas.
The healthcare giant said it has adopted a 23-point ongoing “action plan” to implement and monitor recommended improvements, with oversight from its internal audit and advisory services team. Approximately 65% of these efforts will be completed by the end of 2025, and 100% of the plan will be completed by the end of March next year.
The results come as private insurers seek to rebuild trust with the American public following intense and mounting backlash against their practices and the nation’s broader health care system. Critics say insurers’ business strategies make it difficult for some patients to access and pay for treatment. The company owns United Healthcare, the nation’s largest and most powerful insurance company.
Friday’s announcement is a step toward improving its performance, but it’s unclear how much it will change public perception of the company or the industry as a whole.
In July, UnitedHealth announced that two independent consulting firms had begun an independent review of the company’s business policies and performance metrics. On the same day, UnitedHealth also acknowledged that it was under investigation by the Department of Justice over its Medicare billing practices.
The independent audit was one of Steve Hemsley’s early steps as CEO after he took over in May following the sudden resignation of Andrew Whitty.
“We hope you will view these evaluations as an effort to set a new standard for transparency in health care markets, because we believe you and everyone in our health care system have a right to understand how we do our work,” Hemsley said in a letter Friday.
“We recognize that our actions and decisions have a significant impact on patients, healthcare providers and the broader healthcare system, and we are determined to uphold the highest standards,” he added.
FTI Consulting reviewed UnitedHealthcare’s approach to risk assessment activities in its Medicare Advantage program. This refers to how the company evaluates the health status of members of privately managed plans. The company also examined its care services management policies, procedures and processes.
The consulting firm’s analytics group also evaluated the policies and processes of Optum Rx, the company’s pharmacy benefit manager (PBM), for ensuring that prescription discounts from pharmaceutical companies are “accurately collected and distributed to customers.” A PBM is an intermediary that negotiates rebates with drug companies on behalf of insurance companies, compiles a list of covered drugs, and reimburses pharmacies for prescriptions.
Hemsley said the companies have determined that the company’s policies and practices are “robust, rigorous, generally sound, and industry-leading in many respects.” However, he noted that they also provide recommendations for improvement.
For example, a review by our analytics group found that OptumRx “implements a comprehensive and well-structured framework that manages all stages of manufacturer discount management.”
The assessment identified at least 25 different “controls” in place that collectively reduce the risk of miscalculating discounts to customers, delays in allocating them, and recovering incomplete discounts from drug companies, Aaron Eater, a managing principal in Analysis Group’s Boston office, said in a statement Friday.
The review found “no deficiencies or need for corrective action,” but recommended ways to strengthen Optum Rx practices. This includes enhancing Optum Rx’s escalation process to resolve non-payment and dispute cases through communication with manufacturers. Part of UnitedHealth’s action plan is to develop a formal policy to support procedures for dealing with these cases.
Eater noted that the company looked at business processes, not the legal and regulatory issues faced by PBMs.
Meanwhile, FTI Consulting found that UnitedHealth scores better than its peers on several measures when it comes to Medicaid and Medicare. However, the company cited delays in licensing decisions, documentation issues, and the need to respond appropriately to regulatory audit findings.
In addition to these initial results, UnitedHealth said it will share the results of a review of medical records for diagnosis codes during the first quarter. The company also plans to report by mid-year on its process for developing what it calls “evidence-based health policy.”
UnitedHealth Group stock has fallen more than 35% in the year since the company suspended its 2025 forecast amid rising health care costs, announced Witty’s sudden exit and faced an investigation into its Medicare Advantage business. It followed a difficult 2024 marked by historic cyberattacks and public backlash after the killing of UnitedHealthcare CEO Brian Thompson.
Correction: UnitedHealth Group had a difficult year in 2024. Previous versions listed the year incorrectly.
