HLTH: UnitedHealthcare Launches Virtual-First Health Plan

UnitedHealthcare made headlines at HLTH by announcing the launch of NavigateNOW, a virtual-first health plan that offers an integrated approach to providing care both virtually and in-person.

  • NavigateNOW is a collaborative effort between UnitedHealth’s payor arm and its Optum subsidiary that seeks to capitalize on the industry-wide shift towards hybrid care. The virtual-first health plan is designed to provide patients with a personalized virtual care team for medical and behavioral health services with a seamless hand-off to in-person treatment if needed.
  • Availability begins later this year in nine initial markets, with a goal of expanding to large employers and over 25 markets by the end of 2022. NavigateNOW offers members no copays for common services, unlimited 24/7 physician access, and reduces plan premiums by approximately 15%. 
  • The collaboration leverages Optum’s primary care and behavioral healthcare services, with UnitedHealthcare’s national provider network available for in-person visits. The integrated care model is designed to identify health issues earlier, encourage preventive care, and deliver services in the most appropriate setting.

The Takeaway

It’s a strategic priority for UnitedHealth to take advantage of the overlap between Optum and UnitedHealthcare, and NavigateNOW is the first major launch in that initiative. NavigateNOW is UnitedHealth’s first virtual-first primary care plan, and combining Optum’s digital resources with a large clinical footprint gives the service strong value proposition within the digital health market.

Optum Enters the Direct-to-Consumer Arena

Optum, a subsidiary of UnitedHealth, recently began selling prescription medications online directly to patients. The company also began offering telehealth services to provide prescriptions to treat depression, erectile dysfunction, and other common illnesses – directly challenging startups such as Ro and Hims that offer online access to drugs for many of the same ailments.

UnitedHealth is the most profitable US healthcare company, with net income totaling $15.8b in 2020, and Optum is its fastest growing business segment. The company has expanded far beyond its payer roots and now employs or contracts over 50k physicians.

Optum launched its online storefront in November 2020 before adding pharmacy and healthcare services in June. It’s recent redesign and cash payment options make it more friendly to digitally native consumers.

  • The Strategy – More Americans are paying directly for healthcare, and by offering cash services to either uninsured or budget-constrained patients, Optum is increasing access to healthcare.
  • The Real Strategy – Optum’s entrance into the direct-to-consumer world defends against rising competition from retail giants such as Amazon and Walmart, both of which have launched digital pharmacy options as membership incentives.

The Takeaway

UnitedHealth’s largest competitive advantage is its vertical integration. It operates the largest US commercial insurance provider, a substantial pharmacy benefits manager, and is one of the biggest employers of physicians in the country. It’s recent expansion deepens this integration, while keeping patient money in-house amid a sea of new competition.

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-- The Digital Health Wire team