Optum saw 4 million less consumers in the fourth quarter of 2024 compared to the third quarter as the company focuses on a broad strategy centered on integrated, value-based care.
"One area that we have diminished in terms of emphasis is urgent care," UnitedHealth Group CFO John Rex told investors on Jan. 16. "There was a time when standalone urgent care was an important element here. As you start developing more geographic density, however, you can probably better serve those patients by just having one of your clinics have after-hours presence and focus on that."
He added that the drop in total consumers from 104 million to 100 million in one quarter largely reflects the company stepping away from "narrow offerings" that no longer align with its long-term goals.
In 2024, Optum closed urgent care clinics across several states or transferred ownership to health systems, along with closing some primary care clinics, infusion services facilities and medical groups. The company has also conducted workforce reductions multiple times in recent years, including at the Everett (Wash.) Clinic and the Polyclinic in Seattle; Morgantown, W.Va.-based MedExpress Urgent Care; and San Antonio-based WellMed. In August 2023, MedExpress clinics eliminated all registered nursing positions at nearly 150 facilities.
In its year-end earnings report, Optum reported $253 billion in total revenue in 2024, up 11.7% year over year. Optum Health's 2024 revenues were $105.4 billion, up 10.5%. The segment's operating margin decreased from 8.3% in Q3 to 7% in Q4.
Amar Desai, MD, president of Optum Health, noted short-term costs associated with the new strategy, along with investments in clinical quality and patient engagement.
"We took a number of planned actions, including restructuring and refining some of our legacy contracts, which had a one-time impact of the year," he said. "We had some membership mix changes, and we did make investments in the quarter around clinical quality and the Stars program, as well as onboarding for new membership coming on for 1/1."