UnitedHealth Group has released the first results from an extensive independent audit of its business practices.
The health-care conglomerate also announced a series of action plans aimed at implementing recommended improvements across multiple areas of its operations.
The move comes as private insurers face growing public scrutiny over access to care and rising costs.
Action Plans and Implementation Timeline
UnitedHealth said it has adopted 23 ongoing action plans based on audit findings.
The company expects approximately 65% of those measures to be completed by the end of 2025.
All remaining actions are scheduled for completion by the end of March next year.
Oversight of the plans will be handled by UnitedHealth’s internal audit and advisory services team.
Leadership Transition and Regulatory Pressure
The independent review represents one of the earliest initiatives under CEO Steve Hemsley, who assumed the role in May.
Hemsley took over following the abrupt departure of former CEO Andrew Witty.
UnitedHealth announced the third-party review in July, alongside confirmation that it is facing Department of Justice investigations related to Medicare billing practices.
Commitment to Transparency
“We hope that you see these assessments as a commitment to setting a new standard of transparency for the health care marketplace, as we believe that you and every person who engages with our health system deserves to understand how we go about our work,” Hemsley said.
“We know that our actions and decisions have significant impacts on patients, care providers and the broader health system, and we are determined to hold ourselves to the highest standard,” he added.
Findings Across Insurance and Pharmacy Operations
FTI Consulting reviewed UnitedHealthcare’s risk assessment operations within Medicare Advantage programs.
The firm also examined care services management policies and procedures.
Separately, the Analysis Group evaluated Optum Rx, UnitedHealth’s pharmacy benefit manager, focusing on how prescription discounts from drug manufacturers are collected and distributed.
Hemsley said both firms found the company’s policies to be “robust, rigorous and generally sound; and, in many respects, industry leading.”
Recommendations for Further Improvement
The Analysis Group concluded that Optum Rx operates a comprehensive framework governing manufacturer discount administration.
It identified at least 25 controls designed to reduce the risk of miscalculating or delaying discounts owed to clients.
While no deficiencies were found, the firm recommended enhancements, including stronger escalation procedures for nonpayment disputes.
UnitedHealth said one of its action plans includes developing a formal policy to address those cases.
Additional Reviews and Market Impact
FTI Consulting noted that UnitedHealth performed better than peers across several Medicaid and Medicare metrics.
However, it also cited slow authorization decisions, documentation challenges, and the need to better address regulatory audit findings.
UnitedHealth said it will release further findings on medical record reviews in the first quarter.
The company also plans to report on its evidence-based medical policy processes by mid-year.
UnitedHealth shares remain down more than 35% for the year after the company suspended its 2025 forecast and faced multiple operational and regulatory challenges.
