A UnitedHealthcare sign is displayed on its office building in Minnetonka, Minnesota, U.S., on Dec. 11, 2025.
Tim Evans | Reuters
UnitedHealth Group On Friday it published the first results of an extensive independent audit of its business practices and pledged to pursue a wide range of measures to track and implement improvements in three specific areas.
The healthcare giant said it has adopted 23 ongoing “action plans” to implement and monitor recommended improvements, with oversight from its internal audit and advisory services team. About 65% of those actions will be completed by the end of 2025, while 100% of those plans will be finished by the end of March next year.
The results come as private insurers try to rebuild the trust of the American public after a fierce backlash over their practices and the American healthcare system as a whole. Critics say insurers' marketing tactics have made it difficult for some patients to access and pay for care. The company owns UnitedHealthcare, the largest and most powerful insurer in the country.
While Friday's announcement is a step toward improving the business, it is unclear to what extent it will change public opinion of the company and the industry as a whole.
UnitedHealth announced in July that two independent consulting firms had initiated a third-party review of its business policies and performance metrics. That same day, UnitedHealth also confirmed that it faces Department of Justice investigations into its Medicare billing practices.
The independent audit marked one of Steve Hemsley's first steps as CEO after he took the reins in May following the abrupt departure of Andrew Witty.
“We hope you view these assessments as a commitment to setting a new standard of transparency for the healthcare marketplace, as we believe that you and every person who interacts with our healthcare system deserves to understand how we do our work,” Hemsley said in a letter Friday.
“We know that our actions and decisions have significant impacts on patients, care providers and the broader healthcare system, and we are determined to hold ourselves to the highest standard,” he added.
FTI Consulting reviewed UnitedHealthcare's approaches to underwriting operations within its Medicare Advantage programs, which refers to how the company rates the health status of members in those private plans. The firm also examined the company's care services management policies, procedures and processes.
Consulting firm Analysis Group also evaluated the policies and processes of Optum Rx, the company's pharmacy benefit manager, or PBM, to ensure that prescription discounts from drug makers “are accurately collected and distributed to customers.” PBMs are intermediaries that negotiate rebates with drug manufacturers on behalf of insurers, create lists of drugs covered by insurance, and reimburse pharmacies for prescriptions.
Hemsley said the firms determined that the company's policies and practices are “robust, rigorous and generally sound; and, in many respects, industry-leading.” But he noted that they also offered recommendations for improvement.
For example, a review by the Analysis Group found that OptumRx has “implemented a comprehensive and well-structured framework that governs all stages of manufacturer discount management.”
The assessment identified at least 25 different “controls” that together reduce the risk of miscalculating or delaying the distribution of discounts owed to customers and collecting incomplete discounts from drugmakers, Aaron Yeater, managing director of Analysis Group's Boston office, said in a filing Friday.
The review found “no deficiencies or need for corrective action,” but recommended ways to improve Optum Rx's practices. That includes strengthening Optum Rx's escalation processes to resolve cases of disputes and non-payment through communication with manufacturers. Among UnitedHealth's action plans is to develop a formal policy that supports procedures to address such cases.
Yeater noted that he looked at business processes and not the legal and regulatory issues the company faces with its PBM.
Meanwhile, FTI Consulting found that UnitedHealth outperformed its peers on several measures when it came to Medicaid and Medicare. But the firm pointed to slow decision-making on authorizations, documentation issues and the need to better address findings raised in regulatory audits.
Beyond these early results, UnitedHealth said it will share findings from a medical records review of diagnosis codes during the first quarter. The company will also report on its processes for developing what it calls “evidence-based medical policy” by mid-year.
Shares of UnitedHealth Group have fallen more than 35% for the year after it suspended its 2025 forecast amid skyrocketing medical costs, announced Witty's surprise departure and dealt with investigations into its Medicare Advantage business. This followed a difficult 2024 marked by a historic cyberattack and public backlash following the murder of UnitedHealthcare CEO Brian Thompson.
Correction: UnitedHealth Group had a tough 2024. An earlier version incorrectly stated the year.
