Last month, Andrew Witty led UnitedHealth Group’s first earnings call since the tragic murder of Brian Thompson, the CEO of its insurance division, UnitedHealthcare. The killing shocked the industry, drawing renewed attention to the nation’s largest health insurer at a time when public frustration over healthcare costs and coverage denials has reached a boiling point.
On the call, Witty addressed the elephant in the room: why America healthcare is unaffordable.
“Fundamentally, healthcare costs more in the U.S. because the price of a single procedure, visit or prescription is higher here than it is in other countries.”
Witty is right. Americans pay twice as much as their global counterparts for the same drugs, hospital stays and clinical services. Worse, insurers have little control over pricing: a broken patent system, restrictions on drug price negotiations and unchecked hospital consolidation make it extremely difficult to rein in the nation’s $5 trillion annual healthcare bill.
But does that mean nothing can be done? UnitedHealth Group isn’t just any insurer, after all. It is the largest and most powerful healthcare company in the world, insuring 50 million Americans, employing 90,000 physicians and generating the fourth highest revenue among U.S. corporations.
Part of the challenge is that insurers have, historically, tackled rising costs by restricting care: rejecting prior authorization requests, denying claims and limiting patient access. This approach has made them a target for congressional scrutiny, media criticism and public outrage.
But the story doesn’t have to end there. Witty has an opportunity to seize this moment and shift strategy.
The Next Era For UHG: Competing On Health, Not Denials
For decades, UnitedHealthcare has stayed ahead of its competitors by consolidating market power, expanding into lucrative areas like pharmacy benefit management and maximizing profits within a dysfunctional system.
It’s a strategy reminiscent of a classic story. Two hikers encounter a charging bear in the woods. One quickly laces up his shoes. The other scoffs, “Why bother? You can’t outrun a bear!” The first hiker responds, “I don’t have to outrun the bear. I just have to outrun you.”
Likewise, UHG has long focused on outrunning its competitors by cutting costs, tightening prior authorization rules and restricting access to care.
Now, Witty has an opportunity to stop running and start leading. Instead of relying on prior authorization requirements and claims denials, UHG could lower costs by keeping people healthier in the first place.
That would mean shifting from short-term cost-cutting measures to long-term investments in the prevention and effective management of chronic diseases: the biggest drivers of medical spending and the reason U.S. life expectancy has stagnated over the past 15 years.
Witty’s Chance To Fix The Real Problem
According to the CDC, 6 in 10 American adults have at least one chronic illness. Conditions like diabetes, heart failure and hypertension are major contributors to serious medical complications, including heart attacks, strokes, cancers and kidney failure—leading causes of death and disability that account for at least 70% of all healthcare expenditures.
But these complications of chronic disease aren’t inevitable. CDC data suggests that prevention and more effective control of chronic diseases would reduce these expensive and life-threatening medical problems by 30-50%. In other words, the problem isn’t just the prevalence of chronic disease. It’s how well (or poorly) the healthcare system controls them.
Currently, the U.S. does a poor job of managing chronic disease.
- Hypertension, which contributes to 40% of strokes, is controlled only 60% of the time in the U.S. Yet high-performing healthcare systems achieve control rates that are 30% higher, according to HEDIS data.
- Diabetes, the leading cause of heart disease, kidney failure and amputations, is successfully controlled in less than half of patients nationwide, despite the availability of proven interventions.
The problem is this: we know how to prevent these complications, but our healthcare system fails to value and fund the solution. As a result, the U.S. spends the vast majority of its healthcare dollars treating costly, preventable conditions after they become life-threatening. This is where
Witty and UnitedHealth Group have an unprecedented opportunity to address our current failures and lead the transformation of American medicine.
UHG has the resources, data and provider network to implement smarter strategies at scale. By shifting away from a system that waits for life-threatening disease to develop, UHG could not only improve patient health but also significantly lower long-term healthcare costs.
Three Ways UHG Can Lead The Future Of Healthcare
Witty’s recent public comments suggest he understands the problem. The question is: Will he take the bold action required?
For over a decade, policymakers and healthcare leaders have talked about shifting America’s healthcare model from fee-for-service medicine (which rewards volume) to value-based care (which rewards better health outcomes). But despite the rhetoric, little has changed. The financial incentives for doctors and hospitals remain misaligned, technology is underutilized in managing chronic disease and insurers continue to focus on restricting care rather than preventing illness. Witty has an opportunity to redefine what a health insurer can be. Here are three bold moves to kickstart the process of transformation:
1. Pilot A Capitated Care Model
Instead of paying providers per test, procedure or hospitalization, United should pilot test a system in multiple communities where doctors and hospitals receive a fixed, risk-adjusted payment per patient. This model, called “capitation,” incentivizes prevention, early intervention and better disease management rather than unnecessary treatments.
- Make a five-year funding commitment to the participants to allow enough time for better chronic disease management to lower hospitalizations and emergency visits.
- Pay participating doctors at the level they would earn under fee-for-service but promise to share half of the cost savings with them as patients become healthier and require fewer ED visits, hospitalizations and complex procedures.
2. Invest In Primary Care And Preventive Health
The U.S. underinvests in primary care, favoring expensive specialty care and hospital interventions. UHG should shift incentives to prioritize prevention, ensuring chronic diseases are managed before they escalate.
- Increase the number of primary care doctors who participate in the pilot projects to ensure they have time to focus on prevention and effective management of chronic diseases when they arise.
- Leverage Optum’s data to help clinicians proactively manage patient health. Provide monthly reports highlighting patient progress on chronic disease management, identifying those at risk of complications and flagging individuals who need early intervention to prevent costly health crises.
3. Use Generative AI For Excellent Chronic Disease Management
Instead of patients relying on infrequent doctor visits for help managing their chronic diseases, AI-powered health monitoring could track daily patient data—such as blood pressure, glucose levels and early signs of heart failure—allowing for real-time intervention. By analyzing patterns and detecting warning signs early, AI can alert physicians when a patient’s condition is deteriorating, thus preventing costly complications and emergency hospitalizations.
- Use AI-driven predictive analytics to personalize care plans and recommend medication changes quickly, long before scheduled office visits.
- Use new, open-source AI models like DeepSeek to create disease-specific clinical tools that empower patients to both prevent and more effectively control their chronic conditions.
A Defining Moment For Witty, UnitedHealth
This is Witty’s chance to redefine the role of health insurance in America. With the cost of coverage becoming unaffordable for tens of millions of Americans and congressional scrutiny mounting, UHG has a choice: continue the status quo of cost-cutting and utilization restrictions and face potentially huge consequences or lead a transformation that lowers costs by improving health.
For the health of our nation, let’s hope he chooses the latter.
UnitedHealth Group was contacted regarding this story on Friday, February 7. The company had not responded by the time of this article’s publication.
