Vertical Integration:
How UnitedHealth Group Uses and Abuses Our Health Data

In my series on vertical integration of health care, I’ve been looking at the staggering reach of health care behemoths like UnitedHealth Group (UHG). By buying up companies involved in every aspect of health care delivery, UHG controls whether we are eligible for care, what care we’ll get, where we get it, how much we’ll be charged, what information we’ll receive about our care, and how our data is shared.

UHG’s vertically integrated companies are rife with abuse. In 2025 alone, the American Economic Liberties Project identified 24 investigations and lawsuits pertaining to corrupt practices, denial of care, upcoding and overbilling, patient privacy violations, and anticompetitive steering of patients and providers. These egregious practices aren’t easy to spot. UHG has taken over more than 2700 entities, but retains their names and the appearance of separation.

This month, my focus is on how UHG uses and abuses our health data. Invariably, UHG describes its data practices as being in customers’ interests, using words like “personalized," “customized," and “efficient.” It’s certainly the case that we expect our health care providers to have ongoing access to our personal medical history. We value it. We want Dr. A to know what Dr. B has prescribed and why. We also value the smooth interface between medical care and insurance and payment processing.

But “personalization” has other implications, too. It limits the options you are offered; your data is sliced and diced to determine which goods and services to market to you. Every click you make provides UHG subsidiaries with information about your motivations and priorities. Your data is aggregated with that of other consumers and becomes a commodity to be bought and sold. You are monetized.

Your data is also routinely shared to process transactions, an area of considerable vulnerability. In 2020, one takeover was especially significant. At that time, UnitedHealth Group was considering purchasing Change Healthcare, a company that provided the interface between insurers and health care providers to process insurance transactions. UHG turned to McKinsey and Company for advice. Pro Publica reports that McKinsey provided a sweeping vision for harvesting data: “UnitedHealth could 'utilize transactions intelligence' from Change’s claims data to 'optimize benefit design' for United Healthcare.” Most important, UHG would have access to claims data from other insurers. It could integrate that information into designing and positioning its own insurance offerings. An antitrust suit against the proposed purchase didn’t bear fruit.

The presiding judge took the word of UHG that they wouldn’t use the data inappropriately: His 58-page opinion dismissed the McKinsey documents as “mere references to data and data rights” and concluded that United Health’s history of compliance with its own rules on maintaining data firewalls, along with the “convincing testimony from senior executives,” were persuasive.

But in February, 2024, due to its failure to secure data, Change Healthcare experienced a massive data breach, affecting 192 million people and 45% of US health care transactions. Hospitals and medical practices were unable to bill patients, receive reimbursements from insurers, get paid, or confirm patients’ coverage. Patients could not fill prescriptions for weeks. UHG then offered loans to providers who were unable to get paid for patient visits. It stated that loans would not need to be repaid until all claims processed during the time of the breach had been paid. A year later, UHG is demanding payment from providers who are still trying to recover.

Your data is also used to inform the predictive capability of artificial intelligence (AI). In 2023, UnitedHealth Group purchased NaviHealth, a company that utilizes artificial intelligence (AI) to deny medical care to seniors on Medicare Advantage. That didn’t go well. According to the American Economic Liberties Project, NaviHealth’s algorithm had a whopping 90% error rate in its denials.

RVO Health is a UHG subsidiary with a different orientation to data usage: digital media and marketing. The Sunlight Report, which reviews and analyzes UHG’s acquisitions, reports that RVO Health “reaches 300 million people each month and manages more than 100 news and information sites.” One of its sites, Health Markets, purports to provide unbiased insurance information, despite its inherent conflict of interest because UHG is an insurance purveyor.

Your data is also used for predictive analytics, in which your deidentified patient data is plugged into statistical models to identify what services and supports you might need. Yes, you

read that right. Your data is aggregated with that of others, with the intent of then identifying you, individually, as a potential consumer for specific services. Here’s how UHG spins it:

The new advocacy capability uses deidentified claims data from United Healthcare members to proactively identify who is most likely to need support with social determinants of health, such as access to nutritious food or aflordable housing. UnitedHealthcare call center advocates then use real-time interactions coupled with a curated database of community resources to help individuals dealing with challenging life events or circumstances.

That all sounds great, but UHG’s embrace of supports for vulnerable community members is belied by its fierce cost-cutting initiatives, like the WISeR program, whose profits are predicated on maximizing denials of service, or UHG’s incentivizing nursing homes to ignore requests for hospitalization for its patients on Medicare Advantage. Efforts to hold UHG to account haven’t yet yielded results. The Interfaith Center on Corporate Responsibility recently sued UHG after UHG quashed a shareholder resolution to force disclosure of the impacts of UHG’s acquisition strategy.

In January, Senators Warren (D-MA) and Wyden (D-OR) renewed their demands for UHG to produce data on the impacts of its acquisitions. Senator Warren and Senator Josh Hawley (R-MO) have introduced the Break Up Big Medicine Act to break up health care conglomerates.

The PSARA Education Fund will work to integrate into our educational forums and written materials information about the dangers of vertical integration and the need to pass the Act. PSARA will join with local allies to advocate that our WA Senators and Representatives co-sponsor the legislation and work with national allies to position the legislation for passage after the 2028 election. Additionally, PSARA will work with state legislators and allies to reverse corporate control of medicine at the state level.