Optum, the country's largest employer of physicians and parent company of ASC chain SCA Health, is focusing on a different type of growth: hiring employees instead of building facilities.
The company has seen soaring growth in the last year, adding nearly 20,000 physicians in 2023 and inking deals with physician groups, hospitals and even Uber.
Optum is not focusing on ownership of inpatient facilities. Instead, it is looking to health system partnerships that outsource administrative functions to Optum. These deals add affiliated employees to Optum's ranks while it manages macro-level functions such as revenue cycle management, information technology, informatics, analytics and inpatient care management. The company has inked at least nine health system partnerships as of 2024.
This wider-lens outlook correlates to its ASC strategy as well. SCA Health has a portfolio of 320 ASCs, second only to Tenet Healthcare's ASC giant, United Surgical Partners International, which has more than 480.
In May 2022, Optum's ASC arm, previously known as Surgical Care Affiliates, rebranded to SCA Health, with intentions to expand beyond ASC management.
Then-SCA Health CEO Caitlin Zulla told Becker's at the time the rebranding represents the company's transition to "support physician specialists more holistically across the specialty care continuum," rather than an ASC company "singularly focused on partnering with surgeons in their ASCs.
Optum has doubled down on value-based care and its physician strategy while SCA Health is expanding its focus to the larger care continuum, rather than just ASCs.
"Value-based care for us is a proven way of overcoming many of the widely recognized shortcomings of a fee-for-service-based health system such as fragmented consumer experiences and incentives, that can emphasize volume over quality," UnitedHealth Group CEO Andrew Witty said in a Jan. 12 earnings call transcribed by Seeking Alpha. "Our value-based offerings empower physicians to provide more connected, coordinated and comprehensive care, align incentives among consumers, care providers and health plans, deliver better health outcomes and improve costs."
While hospital acquisitions are not a part of Optum's game plan, the company is looking to physician groups. The company is looking to acquire Baton Rouge, La.-based home health provider Amedisys, and it acquired Middletown, N.Y.-based multispecialty physician group Crystal Run and home health company LHC Group last year. The company is also eyeing the acquisition of the physician-owned Corvallis (Ore.) Clinic, which operates 11 locations and an ASC.
Many leaders, however, are concerned about the company's rapid growth.
"The trend that currently concerns me most is the vertical integration sweeping the healthcare industry. Physician practices are being bought out or acquired in a trend that is sweeping across this nation (now 90,000 strong) with Optum," Udaya Bhaskar Padakandla, MD, president of the Texas Society of Anesthesiologists, told Becker's. "Two things about it bother me more than any other: This increasingly leads to loss of independence in the decision-making ability of physicians in patients' best interest, and second, government watchdogs (like the FTC) are passive onlookers to this dominance of the physician workforce by a monopolizing entity. But at the same time, much smaller physician groups (with 3,000 to 5,000 physicians) get sued by the same entity for 'monopolizing' the marketplace."