Modernizing Health Care
UnitedHealth Group Center
9900 Bren Road East
Minnetonka, Minnesota 55343
unitedhealthgroup.com
2009 Summary Annual Report
100-9409 4/10
Table of contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Letter to Shareholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Responsive, Efficient Service . . . . . . . . . . . . . . . . . . . . . . . . 6
Increasing Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Containing Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Personalizing the Experience . . . . . . . . . . . . . . . . . . . . . . . 16
Strengthening the
Physician-Patient Relationship . . . . . . . . . . . . . . . . . . . . . 18
Improving Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Transformative Technology . . . . . . . . . . . . . . . . . . . . . . . . 22
Business Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Foundations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
2009 Financial Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Officers and Board Members . . . . . . . . . . . . . . . . . . . . . . . 38
Forward-Looking Statements . . . . . . . . . . . . . . . . . . . . . . . 39
Investor Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Mission and Values . . . . . . . . . . . . . . . . inside back cover
The names and health information for individuals included in this report
have been used with their express permission.
Our mission is to help people live healthier lives.
Mission statement
We seek to enhance the performance of the health system and improve the
overall health and well-being of the people we serve and their communities.
We work with health care professionals and other key partners to expand access
to quality health care so people get the care they need at an affordable price.
We support the physician/patient relationship and empower people with the
information, guidance and tools they need to make personal health choices
and decisions.
Our values
We serve people through a value and performance culture based on integrity,
quality, innovation, diversity and social responsibility. The best way we can satisfy
the millions of people we serve — our customers and members, employees,
shareholders and partners — is to execute on the fundamentals of our business
to the very best of our abilities, each and every day. That means as an organization,
we are accountable for adding value to the health care system.
For more information on how our 80,000 people work to fulfill our mission every
day, please see our Social Responsibility Report at
www.unitedhealthgroup.com/2009-social-responsibility-report
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BV-COC-940655
BV-COC-940655
This annual report is printed on recycled
papers certified by Bureau Veritas per FSC
(Forest Stewardship Council) standards for
Chain of Custody ensuring environmentally
responsible, socially beneficial and
economically viable forest management,
and also uses reduced VOC (Volatile
Organic Compounds) vegetable-based inks.
UnitedHealth Group 2009 Summary Annual Report
UnitedHealth Group is a leading health care company, serving
more than 70 million people. Our family of companies touches nearly
every aspect of health care, helping people live healthier lives.
We help people find and receive the best care possible. We work to provide them
with access to the quality care they need at an affordable cost. And we provide
information, guidance and tools to help people make more informed decisions about
their health, health care and well-being. These decisions have lifelong, sometimes
life-defining, consequences. We embrace this position of trust and the critical social
responsibility we have to serve people’s health care needs in the United States
and worldwide. UnitedHealth Group plays a unique role in modernizing the health
care system and making it work better for everyone, through innovation, advanced
technology and careful stewardship of our unparalleled resources and capabilities.
UnitedHealthcare provides comprehensive commercial health benefits for individuals,
small- and medium-sized businesses and large national and international companies.
In partnership with AARP, Ovations delivers health care services tailored to the needs
of people over 50, serving one in five Medicare beneficiaries nationwide. AmeriChoice
is the largest U.S. company serving low-income families through programs like
Medicaid and the Children’s Health Insurance Program (CHIP). OptumHealth works
with health plans, employers and the public sector to bring together information, inter-
ventions and holistic solutions that help people make better decisions, achieve their
health and well-being goals and finance their health care needs. Ingenix develops health
information and technology that improve health system performance and stream line
administration. Through Prescription Solutions we are a leader in the management
of pharmacy benefits.
UnitedHealth Group 2009 Summary Annual Report
1
Letter to Shareholders
Dear shareholders:
In 2009, the people of UnitedHealth Group delivered a strong
As a result, we entered 2010 a much
performance while advancing our mission to help people live
stronger enterprise. We are positioned
for the next generation of growth, in
healthier lives, despite a very difficult economy. We demonstrated
both health benefits and health services.
consistency in effectively managing medical costs and continued
While we cannot predict what changes
ultimately will be introduced to the health
to reduce our own operating costs. Our businesses again steadily
care system, we understand that in any
delivered in service and practical innovation. We continued to
combine national scale with local responsiveness and further
diversified our products, services and markets. We built stronger
relationships with the people we serve across the health care
setting we must combine consistent
fundamental execution with our proven
ability to adapt to core market demands
and continuously innovate in practical
ways across the health care experience.
The extraordinary, national debate over
community. Our balance sheet grew stronger — our investments
the future of health care in the United
performed well and our leverage decreased.
States serves to shine a spotlight on a
key challenge: How do we modernize
the health care system, in a fiscally
responsible manner, to make quality
health care accessible and affordable
for all Americans?
Finding innovative, practical and
financially responsible answers to that
question has been our objective for
more than two decades. This annual
2
For online access: www.unitedhealthgroup.com/2009-annual-report
Quite simply, we are helping to create the
infrastructure and capabilities that will enable
a modernized American health care system
to take root and function more effectively for
all participants.
The changes we envision include:
• Americans will become better
• Common administrative standards and
informed consumers of health services,
enabling technology will connect and
unify patients, health care providers,
because there will be personalized
motivations to be engaged, including
health benefit plans and the entire
financial incentives.
health care sector. Actionable informa-
• Better management of care, driven
tion will be available electronically to
by education, adherence to evidence-
help physicians and patients make
based medicine and aligned incentives
better decisions together.
for patients and health care providers,
• Evidence-based medicine will become
widely accepted and consistently
practiced, improving care quality and
helping to control costs.
• Transparency, performance account-
ability and comparative effectiveness
along with supporting information and
technologies, will become ubiquitous
to health care, built right into the
core of how medicine is practiced
rather than existing as a parallel
“administrative” function as it is today.
will be adopted across all care services,
• Health care will adopt a culture of
just as they are in other sectors of
the economy.
prevention that promotes good health
rather than simply treating illnesses
as they are presented in the doctor’s
office or the emergency room.
report highlights just a handful of the
many ways we are helping create a
more modern and effective health care
system. We continue to make it easier
for people to get the care they need,
to personalize and simplify their health
care experience, to strengthen the bonds
between patients and their physicians,
to foster the introduction of modern
technology and to find new ways to
control the rising costs of health care.
These advances are critically important.
As we move into the next decade, we
believe positive, competitive pressures
and ever-growing demands from
individuals and employers, physicians
and medical facilities and state and
federal govern ments will open the health
care system to even greater change …
change that will accelerate the evolution
of new products and services and cost-
effective new technologies, spurring
even more rapid modernization of our
health care system.
UnitedHealth Group 2009 Summary Annual Report
3
Letter to Shareholders
• There will be a new focus on the
range of capabilities, market positions,
As we have for a decade, we continue
challenges of helping people cope
capital strength and experience of
to develop and enrich our three core
with chronic disease, as well as the
UnitedHealth Group. Our business
competencies, which are the building
importance of health and wellness
model and philosophy are designed to
blocks of a better health care system:
programs that can prevent the onset
align with and help enable this national
of those conditions for many years
path into a better health care future.
• Information — to guide and lead;
• Technology — to enable, simplify
or a lifetime.
• Health care will be purchased based
on the effectiveness of achieving
health outcomes, not the volume of
services rendered.
We are already delivering many of
and modernize; and
these modernizations to the marketplace.
• Expertise in clinical access and
We have developed and invested in
management — to consistently
innovative technologies that bring the
deliver higher quality, lower cost and
health care sector into the 21st century.
consumer affordability in health care.
• All health care transactions will follow
We pioneered the financial services
the lead of the financial industry and
market for health care. We are a leader
become totally electronic.
in the introduction of consumer-focused
• Public health plans, like Medicare
benefits and services, and we have
and Medicaid, will be modernized to
more integrated and performance-based
become more economically viable for
care delivery payment relationships than
the long term and enable better care.
anyone else in health care.
We leverage these competencies to
help the health care system perform
to its potential. Quite simply, we are
helping to create the infrastructure and
capabilities that will enable a modernized
American health care system to take
root and function more effectively for
all participants.
We will remain focused on executing on the
fundamentals, prepared to further elevate
our performance in medical and operating
cost management and deliver an even better
experience and value to the markets we serve.
The modernization of Medicare is per-
haps the greatest area of opportunity
to positively influence health care
nationally, as well as to improve our
financial outlook as a nation.
These changes to our health care
system will promote a positive health
agenda for our nation and a positive
growth agenda for a company with the
4
UnitedHealth Group is ready to help make
health care more accessible and affordable,
and take a leading role in our nation’s efforts
to modernize health care.
Over the next year, you will see our
The U.S. health care market will move
benefits businesses become even more
forward and grow, driven by the need
integrated within a more streamlined
of our society for sustainable care, for
organization with razor-sharp cost and
even more effective cost controls and
price sensitivities. Our benefits offerings
for better overall system performance.
will become more tightly aligned behind
UnitedHealth Group is ready to help
And as we help lead and adapt to
change, we are meaningfully deepening
our culture as a company to better
serve the vital social needs of health
care. This is apparent in externally
measured satisfaction levels among
key stakeholders and in the trust we
continue to build with those we touch
in the health care community.
Engagement among our employees
the strong UnitedHealthcare brand name,
make health care more accessible and
increased significantly in 2009, on top
while the businesses themselves remain
affordable, and take a leading role in
of substantial gains in 2008. Set against
distinct, market-facing organizations,
our nation’s efforts to modernize health
the challenging business and political
dedicated to the differing needs of the
care. In the years to come, it will be
climate this year, this is a testament to
benefit markets we serve — commercial,
our progressive adaptability that will
the spirit and commitment of our people
senior and public benefits.
translate into high performance and
to our mission.
In 2010 we plan to further strengthen
concentrate on helping the whole health
Our health services businesses will fully
distinctive value for our customers and
our shareholders.
and diversify our competitive capabilities
system modernize and perform better.
Sincerely,
to deliver more consistent organic growth
These businesses have been expanding
and further market expansion across our
to address the needs of the care delivery
businesses. We will remain focused on
side over the past two years. We expect
executing on the fundamentals, prepared
the pace of this expansion will accelerate.
Stephen J. Hemsley
President and Chief Executive Officer
to further elevate our performance in
medical and operating cost management
and deliver an even better experience
and value to the markets we serve.
UnitedHealth Group 2009 Summary Annual Report
5
Responsive, Efficient Service
Service you can trust – transplant
patient says, “One call … and I never
worried again”
For virtually his entire life,
Afterward, his doctors told him his heart
David Reoch suffered from
problems were primarily caused by
diabetes. Diagnosed at age 7
complications of diabetes, and referred
after he fell into a coma, David
him for pancreatic transplant surgery to
has been through more medical
eliminate the diabetes and halt further
procedures than he can remember.
progression of the many complications
His friends jokingly call him the
he was already experiencing. Because
“Bionic Man.”
Several years ago he visited the doctor
because he was feeling increasingly
fatigued. David says that his physician
had him take a cardiac treadmill test.
After about 30 seconds the doctor
asked if David carried nitroglycerin.
David said, “No, why?” The doctor
of the seriousness of his condition, he
moved quickly through the preparations
for possible transplant surgery. But then
David switched jobs and his health care
coverage changed to UnitedHealthcare.
David worried that this change might
slow his progress toward, or perhaps
even block, the transplant.
replied, “Well, get off the treadmill and
He called UnitedHealthcare’s toll-free
put this pill under your tongue, because
number to review his coverage with
you’re about to have a heart attack.”
an employee who assists customers
Subsequent tests showed that David
had recently suffered a mild heart attack,
and he had more blockages in his heart.
He required immediate bypass surgery.
with questions about benefits and
health coverage. Within a day, he
received a call from a registered nurse
at UnitedHealthcare who conducted
Within a day, he received a call from
a registered nurse at UnitedHealthcare
who conducted an interview. She told
him everything would be taken care of.
6
Melissa and David Reoch
UnitedHealth Group 2009 Summary Annual Report
7
Responsive, Efficient Service
an interview. She told him everything
As David recovered, the next year
Consumer call centers continued to
would be taken care of. Confused,
was perhaps the most difficult in
deliver excellent results. Call center accu-
David sheepishly asked, “I’m not sure I
his life, but his nurse specialist from
racy remains strong. All UnitedHealthcare
understand you correctly. Am I going to
UnitedHealthcare was in constant
customer service call sites are located in
have coverage with UnitedHealthcare?”
contact with him, asking what she could
the United States. With 14 service sites
“Yes,” he was assured. “It’ll be fine.”
do to help address his health care needs.
across the nation, employees can easily
David jokes that UnitedHealthcare was
support unexpected surges in call volume
“I thought for sure I’d have a stack of
checking on his progress almost as
or site outages. Satisfaction scores in
papers in the mail the next day to fill out,
frequently as the transplant team.
2009 rose to 92.7 percent with the
but it was pretty much one phone call, a
return phone call from UnitedHealthcare
and I was done, and I never worried
about it again,” said David.
When people ask David how he got
through major transplant surgery, he
has a simple answer, “I’ve had a great
insurance company that took care of
When a new pancreas became available,
me. It might sound silly for a guy to say,
David traveled to a hospital with a
‘Oh, my health care company is a huge
average time to answer calls remaining
below 30 seconds. Employees at call
centers can immediately transfer complex
benefit questions to experts who have
the information and authority to resolve
them on the phone.
program specializing in the procedure
part of my life,’ and it might sound
UnitedHealthcare also offers its health
and underwent surgery. It was a “life-
like some advertisement that nobody
advisor service. Health advisors serve as
changing experience,” according to
believes when you see it on TV, but
a person’s advocate and single point of
David. “Every moment is different
it’s categorically true.”
contact in helping them understand their
now because with a new, functioning
pancreas I’m not planning my life
around diabetes.”
UnitedHealth Group works hard to earn
this kind of trust in the dependability of
our service with everyone we touch and
who touches us. In 2009, the company
continued to enhance service by making
it even easier, simpler and more personal.
“ Every moment is different now because with
a new, functioning pancreas I’m not planning
my life around diabetes.” — David Reoch
health care options and resolve issues
across medical, pharmacy and financial
products. Each health advisor is respon-
sible for full resolution of a patient’s issue
and will follow up with that person once
resolution is complete. When appropriate,
advisors help educate consumers about
relevant programs to help them use their
benefits most effectively and will even
help them in setting up appointments
with care providers or with a billing
dispute. Health advisors have the highest
customer satisfaction rating within
UnitedHealthcare at 94.8 percent.
8
www.uhc.com
Consumer call centers continued to deliver excellent
results. Call center accuracy remains strong.
Call center supervisor Shirlee Brown,
UnitedHealthcare
Claims processing accuracy climbed
to 99.6 percent in 2009 with the
great majority of claims processed
automatically and 96.6 percent of
all claims processed within 10 days.
UnitedHealthcare also supplies
physicians with real-time processing
of claims in their offices, delivering
accurate results in seconds that provide
patients with details of claim benefits
and their financial responsibility.
A 2009 survey of health benefit plan
consultants who work with large U.S.
employers found that their satisfaction
with UnitedHealthcare’s sales force
and client management staff continued
to increase. Health and wellness
and consumer engagement products
directly impacting customers, and the
breadth and quality of UnitedHealthcare’s
network, claims processing and
customer service were positively noted
by those consultants.
UnitedHealthcare is also making service
to brokers, consultants and employer
2009 call center scores
groups easier to access, simpler and
more personal with its Service Hotline,
United eServices® and Employer
eServices® Web sites, and dedicated
client service managers who track
94%
first call resolution
92.7%
satisfaction scores
issues end-to-end, providing updates on
progress and ensuring client agreement
99.6%
claims dollar accuracy
with resolutions.
82.2%
claims automatically processed
97.9% CALL ACCURACY
96.6%
claims processed within 10 days
Under 30 seconds
average time to answer consumer
calls remains below 30 seconds
UnitedHealth Group 2009 Summary Annual Report
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10
Increasing Access
“21st century house call” delivers
care to communities in need
One of the most fundamental
telecommunications and medical
ways to increase access to the
technology to deliver a virtual doctor’s
health care system is making
visit to patients wherever they are —
sure people simply have the
through mobile units that travel to
opportunity to see a doctor
patients, on-site units in the workplace
when they need to.
and in retail locations, and eventually
Today, millions of people in rural and
through home-based devices.
underserved urban communities do
Linked via high-definition video confer-
not have adequate access to primary
encing, the doctor “sees” patients in a
physicians, much less to medical
soundproof office with assistance from
specialists. The nearest doctor may be
an on-site nurse. Physicians can then
many hours away and a trip to consult
perform examination procedures
a medical specialist could require a
remotely, such as taking blood pressure
plane flight. The Association of American
and checking a patient’s ears, nose and
Medical Colleges estimates that the
throat, and treat a wide variety of acute
United States is facing a shortage of
159,000 primary care physicians by 2025,
which will compound the problem.
UnitedHealth Group has partnered with
Cisco to build the first national telehealth
network, which will give patients access
to physicians when in-person visits are
159,000
pOtentiAL sHORtAge OF
pRiMARY CARe pHYsiCiAns
not possible. This program uses modern
BY 2025
Today, millions of people in rural and
underserved urban communities do not
have adequate access to physicians …
UnitedHealth Group 2009 Summary Annual Report
11
Increasing Access
UnitedHealth Group’s collaboration with
Project HOPE will provide underserved
communities in rural New Mexico access
to much needed health services.
and chronic conditions. This advanced
Forty-five percent of New Mexico’s
telehealth program can provide specialist
population is of Hispanic origin — a
consultations and checkups for more
group that is highly predisposed toward
complicated condi tions like diabetes,
type 2 diabetes, according to the Centers
hypertension and heart disease. Through
for Disease Control and Prevention.
telehealth technology, doctors are
The mobile clinic will provide health
able to consult with their colleagues
screenings and treatment for diabetes,
about specific cases and share critical
pre-diabetes and other chronic
information and expertise.
conditions, such as high blood pressure
UnitedHealth Group launched its first
mobile telehealth clinic in 2009 in an
18-wheel tractor trailer, showcasing the
technology and connectivity available
through the network.
Collaboration with project HOpe
in new Mexico
One of the first telehealth initiatives
is an ongoing collaboration with Project
HOPE — the world-renowned health
education and assistance organization —
using UnitedHealth Group’s mobile clinic
to provide underserved communities in
rural New Mexico access to much needed
health services and to educate residents
about the risks of chronic diseases.
and heart disease.
Collaboration with Meharry
Medical College in tennessee
AmeriChoice, UnitedHealth Group’s
business dedicated to state Medicaid
and other programs for the underserved,
is collaborating with Meharry Medical
College in Nashville to provide people
in rural and underserved areas of
Tennessee access to Meharry Medical
Group physicians by using telehealth
technology. Individuals seeking adult
specialty medical services will be
able to consult specialists located in
Meharry’s Nashville offices, such as a
dermatologist or neurologist, through
UnitedHealth Group’s mobile telehealth
clinic uses modern technology to deliver a
virtual doctor’s visit to patients wherever
they are located.
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www.connectedcareamerica.com
Dr. Wayne J. Riley, president and CEO,
Meharry Medical College, Nashville, Tenn.
telehealth technology by visiting one
of the approximately 80 community
health centers across the state.
Meharry Medical Group is composed
of physicians who serve on the faculty
of Meharry Medical College, the nation’s
largest private, independent, historically
black academic health education and
research center. Dr. Wayne J. Riley,
president and CEO of the college, said,
“Meharry Medical College has a rich
tradition — stretching back over a
hundred years — of delivering quality
health care to people in poor, minority
communities and underserved
communities. UnitedHealth Group’s
telehealth technology will help Meharry
physicians provide care to even more
who are in need. We take great pride
in being on the cutting edge, providing
opportunities to people of color and
individuals from disadvantaged back-
grounds, regardless of race or ethnicity;
delivering high quality health services;
and conducting research that fosters the
elimination of health disparities. Through
this innovative telehealth program, we
can extend the benefits of our research
and medical expertise to more people,
more effectively.”
“ Through this innovative telehealth program,
we can extend the benefits of our research and
medical expertise to more people, more effectively.”
— Dr. Wayne J. Riley
UnitedHealth Group 2009 Summary Annual Report
13
Containing Costs
Changing lives and saving money
in the fight against diabetes
in 2009, the United states spent
UnitedHealth Group is focused on
$2.5 trillion on health care, which
finding new and innovative ways to
is approximately 17 percent of our
promote better health while controlling
nation’s gross domestic product.
costs — saving lives and saving money.
By 2019, that number may surpass
Modernizing health care by embedding
$4.5 trillion and is expected to
preventive medicine in the system is
continue to rise. these costs
an important key to this effort.
According to Dr. Deneen Vojta, senior
vice president, UnitedHealth Group
and a leader in the development of the
Diabetes Health Plan, “The design of
UnitedHealthcare’s Diabetes Health Plan
meaningfully engages people based
on their individual health needs. We’re
finding that once people have the tools,
support and incentives to make simple
changes, the response is phenomenal.
There is a massive, untapped opportunity
have real world effects: forcing
businesses to reduce coverage
and placing unneeded hardship
on families that lose access to
care, while diminishing our
nation’s global competitiveness
in challenging economic times.
UnitedHealthcare studies show
the average annual cost for treating
individuals with diabetes and
pre-diabetes as:
pre-diabetes
Undiagnosed diabetes
Diabetes without
complications
$ 5,000
$12,000
$10,000
The company is currently using this
for millions of Americans to slow the
approach to combat diabetes, a
progression of diabetes and avoid life-
devastating chronic disease that afflicts
threatening complications. The added
an estimated 24 million adults in the
bonus is that progress in combating
United States alone. Another 57 million
diabetes could save U.S. employers
people are considered pre-diabetic.
billions of dollars in health care costs.”
Though diabetes can often be controlled
with effective care, research from
the Centers for Disease Control and
Prevention shows that 60 percent of
people with diabetes do not follow their
physicians’ advice on how to manage
the disease.
The plan was piloted with General
Electric, Hewlett-Packard and Affinia in
2009. All three companies have renewed
or expanded their participation in the
program and a number of other groups,
including the city of New Orleans and
the American Postal Workers Union
In UnitedHealthcare’s Diabetes Health
Health Plan, will offer the plan in 2010.
Plan, those suffering from diabetes or
pre-diabetes, along with their family
members, are guided toward physicians
Diabetes with complications
$30,000
who have documented success in treating
$174B
2007 COst OF DiABetes
the disease. Participants are educated
about chronic disease, how to manage
it and the importance of routine care.
Out-of-pocket expenses for individuals
are reduced and enhanced benefits
tO tHe U.s. eCOnOMY
are offered in exchange for compliance
with preventive care guidelines.
14
Dr. Robert S. Galvin’s work as General
Electric’s executive director of Health
Services and chief medical officer, is
focused on keeping 300,000 employees
healthy. He is one of the nation’s leading
proponents of innovation in health
care management. Dr. Galvin says
that General Electric was interested in
participating in the Diabetes Health Plan
pilot because it is one of the few new
Dr. Deneen Vojta, senior vice president, UnitedHealth Group
and a leader in the development of the Diabetes Health Plan
programs that combines innovation,
company’s investment in the program.
treatment. And health care providers
incentives and accountability. As he
To get enhanced benefits, employees
must agree to follow evidence-based
puts it, the Diabetes Health Plan “really
have to go see their doctors regularly,
medicine to receive a performance
connects the dots.
make sure they get their lab tests and
bonus and an increased volume of
“Everybody participating in this
program has to do something differently.
Everybody has to take their share of
the responsibility for making it work
successfully,” says Dr. Galvin. “The
employer has to be willing to waive or
lower the copay as incentive for their
employees and take the risk on the
follow their physicians’ plans for their
patients directed to their practices.”
“ We’re finding that once people have the tools,
support and incentives to make simple changes,
the response is phenomenal.” — Dr. Deneen Vojta
www.uhc.com
UnitedHealth Group 2009 Summary Annual Report
15
Personalizing the Experience
One-on-one: guiding a cancer patient
to better care and a brighter future
Cancer is the second most com-
OptumHealth works with cancer centers
mon cause of death in the United
clinically proven to provide exceptional
states, exceeded only by heart
care for patients with complex cancers.
disease. A cancer diagnosis is
Treatment at these Centers of Excellence
frightening and the decisions that
can result in a more consistently
“Patty spent a lot of time with me,
explaining all the different kinds of
breast cancers and what each kind of
diagnosis meant,” said Nancy. “When
I received my pathology reports, Patty
reviewed them with me, line by line,
to make sure that I understood exactly
what I was dealing with.”
must be made can seem over-
accurate diagnosis; care that is planned,
After undergoing her first round of tests,
whelming. UnitedHealth group
coordinated and provided by a multi-
Nancy was told the cancer had spread —
offers a program that provides
disciplinary team of experts who specialize
and she was facing a terminal diagnosis.
a unique service to customers
in the patient’s specific kind of cancer;
Despite the grim news, Patty encouraged
and their families who are facing
appropriate therapy; fewer complications
her to stay positive and get a second
cancer: the OptumHealth Cancer
and higher survival rates; and shorter
opinion. She arranged for Nancy to see a
support program, a highly per-
hospitalizations and lower costs.
cancer specialist at one of the program’s
sonalized source of information
and support.
Patty Migler, RN, BSN, OCN, case manager,
Cancer Support Program, OptumHealth
In addition, experienced nurse advocates
Cancer Centers of Excellence.
help patients make informed decisions
The second opinion disputed the first
about their cancer care and navigate
diagnosis and Nancy began treatment,
the health care system. They help pre-
which included surgery, radiation and
vent and manage symptoms and side
chemotherapy. Patty was there to
effects to reduce inpatient admissions
support Nancy throughout each step,
and emergency room visits. They also
explaining symptoms or often just
collaborate with treating physicians, help
placing a friendly phone call to see
manage pharmacy costs and educate
how Nancy was feeling.
patients regarding hospice services and
palliative care.
Today, Nancy is cancer-free for more
than three years and she credits Patty
Nancy Mack is a director of project
for getting her through the experience.
management in UnitedHealth Group’s
Information Technology department.
When she was diagnosed with breast
cancer, the news made her and her
family fearful and uncertain about the
future. She turned to OptumHealth’s
Cancer Support Program. Nancy was
connected to Patty Migler, one of
59 clinicians who staff the program.
“Without Patty, I don’t think I would
be here today. She was the one who
encouraged me to get the second
opinion. She helped me take control
of the situation and fight for my life,
so that I’ll be around for a long time.
I think that she’s a great gift to this
company and this community.”
16
www.optumhealth.com
Today, Nancy is cancer-free for more than
three years and she credits Patty for getting
her through the experience.
Nancy Mack
UnitedHealth Group 2009 Summary Annual Report
17
Strengthening the
Physician-Patient Relationship
Welcome to the
Patient Centered Medical Home
in a modernized health care
The Patient Centered Medical Home
system, everyone should have
offers a holistic and well-integrated
a strong relationship with his
approach to providing patients with safe,
or her primary care physician
effective, comprehensive care — an
— a “medical home” where the
antidote to what is too often fragmented
patient and doctor work together
and episodic care from various health
to coordinate comprehensive
care providers and facilities.
care with an emphasis on overall
wellness and preventing disease,
improving the care of chronic
conditions, behavioral health
support and patient education.
“The medical home model goes beyond
simply the diagnosis and treatment of
injury and illness,” said Dr. Sam Ho,
chief medical officer, UnitedHealthcare.
“The Patient Centered Medical Home
In 2009, UnitedHealthcare launched
provides an overarching context for care,
Patient Centered Medical Home (PCMH)
strengthening the bond between doctor
projects in collaboration with select
and patient because the doctor has a
primary care physician practices in
better understanding of each patient’s
Arizona, Colorado, Ohio, Rhode Island
needs and preferences. We believe that
and New York.
moving to this model for the delivery of
Dr. Jeffrey I. Selwyn, internist and
president of New Pueblo Medicine in
Tucson is an enthusiastic participant.
“To try to be on the cutting edge of
primary care will result in higher quality,
more effective care, while improving
medical outcomes and reducing health
care costs.”
patient-centered awareness and practice
Dr. Selwyn explained, “It is truly a
is a tough task, but it’s something that
team-based model where there’s a very
has been a passion of mine,” he said.
significant bond between the patient and
“I’m very pleased to see this passion
the physician. It’s a 50-50 partnership.
finally coming to fruition.”
We engage our patients to really be
Dr. Sam Ho, chief medical officer,
UnitedHealthcare
29% FeWeR eMeRgenCY ROOM Visits
Early results from the
Patient Centered Medical Home
project are promising
29% fewer emergency room
visits, 11% fewer preventable
hospitalizations and 6% fewer
visits to the doctor’s office
“ The Patient Centered Medical Home will result in
higher quality, more effective care …” — Dr. Sam Ho
involved in their own care.”
UnitedHealthcare provides the technology
and infrastructure support to improve
information systems and adherence to
18
evidence-based medicine. Furthermore,
physicians also stand to receive enhanced
reimbursement in recognition of superior
care coordination, improved access,
better patient communications, delivery
of preventive and chronic care and
improvements in patient experience
and satisfaction. Increased compensation
can be funded by the medical cost
savings from improved health outcomes
resulting in fewer hospitalizations, better
coordination with specialists, fewer
emergency room visits and more cost-
effective medication use.
“What UnitedHealthcare is doing allows
benefits for the private physician, the
patient and plan sponsors,” Dr. Selwyn
said. “Better health care, better outcomes
for patients and less expenditure.”
The PCMH model was developed by
primary care physicians in the United
States, including the American Academy
of Family Physicians, the American
College of Physicians, the American
Osteopathic Association and the
American Academy of Pediatricians.
UnitedHealthcare’s pilot program in
Arizona is available to customers in
employer-sponsored benefit plans and
Medicare Advantage and Medicaid
health plan customers.
“ It is truly a team-based model where there’s
a very significant bond between the patient
and the physician.” — Dr. Jeffrey I. Selwyn
Dr. Jeffrey I. Selwyn, internist and president,
New Pueblo Medicine, Tucson, Ariz.
www.uhc.com
UnitedHealth Group 2009 Summary Annual Report
19
tracking prescriptions for
dangerous interactions
Many people see more than one
doctor or fill prescriptions at more
than one pharmacy for a broad range
of medical conditions. This is true
particularly for patients with multiple
medical challenges and the elderly who
often are facing a number of common
chronic conditions. This can mean that
physicians and pharmacists are unaware
of all the medications a patient has
been prescribed, which may lead to
dangerous drug interactions that are
harmful to patients, costly for the health
care system and largely avoidable.
Prescription Solutions, UnitedHealth
Group’s pharmacy benefit management
business, has developed the Drug
Interaction Alert Program (DIAP), an
innovative program to specifically identify
potentially dangerous drug interactions.
Heidi Lew, Pharm. D., Prescription
Safety and support for the most
vulnerable in a complex health system
the U.s. health care system’s complexity and often fragmented delivery
Solutions vice president, Clinical Programs,
of care can negatively impact quality. UnitedHealth group uses technology
explained, “First, we collaborated with
to help organize care and make it safer; and the company provides expert
an advisory group of physicians to
guidance to help individuals navigate a confusing and sometimes
identify drug interactions most likely to
contradictory system. Here are two examples of how UnitedHealth group
result in serious harm to patients. The
is modernizing health care to improve quality.
The Drug Interaction Alert Program is an
innovative program that specifically identifies
potentially dangerous drug interactions.
drug interaction alert system monitors
the millions of prescriptions filled by
pharmacies for customers every month
to identify instances where a person
may be receiving multiple medications
that could cause them harm. When
possible drug interactions are identified,
20
www.prescriptionsolutions.com
Improving Quality
patient-specific notifications that set
out the potentially clinically significant
guiding a caregiver
through the health care maze
and challenging time. It was great to
have the opportunity to help make a
drug-to-drug interactions are sent to
Rhonda Burcham, RN, is a care manager
difference in their lives.”
alert prescribing physicians promptly,
in SecureHorizon’s Post Acute Transition
often within 24 hours.”
Physicians report that the drug interaction
alert system helps them take better
care of their patients. Dr. Alan Nili runs
a family practice in Irvine, California. His
patients range from 12 to over 90 years
of age, with geriatric patients now
comprising more than 50 percent of
the patients he sees.
Team, a clinical program offered by
Ovations to Medicare recipients. She
first contacted Richard Radlinger
when his wife Mary Jane had just been
admitted to an acute care facility after
suffering a stroke. Rhonda said that
Richard was full of questions and very
worried: What did their insurance cover?
How would he find the treatments his
wife needed? How could he ever take
Dr. Nili stated, “Some seniors are
care of her on his own?
taking 10 to 12 different medications,
so it can be very difficult to keep track
of the interactions. My patients could
be receiving prescriptions from other
specialists, such as cardiologists and
orthopedists, without my knowledge.
As Richard explained, “You walk into
that situation and you just don’t know
where to turn, and that’s where I was.
I’m the only caregiver. We’ve been
married 48 years and I’m 73.”
Receiving a notification from Prescription
Rhonda went to work immediately,
Solutions alerts me to either switch
helping to arrange proper speech,
medications to a different group or to
occupational and physical therapy in
let the patient know there might be
preparation for discharge from the
side effects with specific combinations
facility. She recommended home care
of medications.”
Research shows that the drug interaction
alert system not only reduces the risk
of adverse drug reactions and harm to
patients, it provides significant savings
to the health care system. Depending on
the type and severity of drug interaction,
the drug interaction alert system can
potentially reduce medical costs up to
$13,000 for treatment of a patient at risk.
for a time and helped expedite out-
patient speech therapy. Rhonda found
answers to all their questions related to
their insurance. She said, “I spent a lot
of time with both of them throughout
Ms. Radlinger’s stay, and at discharge
he was comfortable with taking her
home.” Rhonda admired their courage.
“They are a really awesome couple
who have been through a very difficult
The admiration was mutual, as Richard
stated, “I think the world of Rhonda.
I’m not trying to unduly put a burden
on anybody, but I can’t do all the stuff
myself. The mental health of the
caregiver is important, because it’s
such a dramatic change in our lifestyles.
Rhonda was a blessing to us. That’s all
I can tell you.”
Rhonda Burcham, RN, care manager,
SecureHorizon’s Post Acute Transition Team,
helps guide customers through a sometimes
confusing health system.
315MpResCRiptiOns
pROCesseD AnnUALLY BY
pResCRiptiOn sOLUtiOns
www.ovationshealth.com
UnitedHealth Group 2009 Summary Annual Report
21
Transformative Technology
Information: the lifeblood of health care
information technology has
Those kinds of records, combined with
the power to transform health
information on the activities of other
care. UnitedHealth group built
health consumers, allows Ingenix to
a $2 billion business, ingenix,
make important observations about how
around that idea. ingenix is
doctors practice medicine; what happens
committed to using the power
to the patients in their practice; why
of health information and
some patients get better and some don’t;
analytics to help save lives,
and the correlation of health outcomes
improve care and modernize
to how often physicians and other health
the health care system.
care professionals do or do not follow
To begin to address the inefficiencies
evidence-based guidelines for care.
plaguing the health care system, Ingenix
Ingenix organizes these vast data
starts with large and robust resources of
resources, analyzes the information and
health care data, including 32 terabytes
puts the results into action throughout
of information covering more than
the health care system — all while
90 million people, and the performance
ensuring that the privacy and security
of 600,000 physicians and other health
of patient information is protected.
care providers.
Health care information is abundant.
Every time a person goes to a doctor’s
office or a hospital, gets a lab result,
orders a prescription or interacts with
the health care system in any way, a
record is created.
ingenix’s natural History
of Disease solution
Ingenix’s Natural History of Disease
solution and its application to the
analyses of diabetes provides one
example of how this works. Ingenix
looked at data — which had been
Ingenix organizes these vast data resources,
analyzes the information and puts the results
into action throughout the health care system.
22
www.ingenix.com
UnitedHealth Group 2009 Summary Annual Report
23
Transformative Technology
Based on a person’s health profile,
UnitedHealth Group can create a
personalized blueprint for healthy living and
customized outreach, including by telephone,
direct mail, online and mobile device.
de-identified to protect individual
their diagnosis. For example, Ingenix
With the insights gained from this work,
privacy — related to people suffering
discovered that many of these patients
Ingenix moves from being able to identify
from diabetes. The company studied
suffered either from insomnia or sleep
and suggest treatment for patients with
treatments that are successful and the
apnea. The company found patients with
pre-diabetes to helping treat people who
results of non-treatment. Ingenix also
these symptoms are 30 percent more
are at risk for developing pre-diabetes.
closely considered the factors leading
likely to become diabetic in the future,
Patients can be educated about potential
up to the diagnosis of diabetes: What
if nothing changes. Additionally,
risks to their health much earlier, and
characteristics did these people share?
their chances of developing diabetes
helped to take measures to protect
What early warning signs might there be
increases in the presence of obesity
themselves, potentially reducing or
that would enable health interventions
or certain other signals. Ingenix looked
avoiding the life-changing impacts of
that would help patients in the future
at patients from this group who went
chronic disease.
to avoid diabetes altogether?
on to suffer from diabetes and those
Research indicated an array of symptoms
diabetes patients experience long before
who did not — and the difference in
how these two groups were treated.
Understanding these potential links and
consequences is a powerful way to help improve
health and dramatically reduce costs.
24
Ingenix can also compare the difference
in the cost of caring for these patients.
Because untreated diabetes is linked
to cardiovascular disease, the cost
difference between patients who follow
their treatment plan and those who do
not can be staggering. Understanding
these potential links and consequences
is a powerful way to help improve health
e-mail, personal Web portals, fax and
of actionable, high-priority steps that can
and dramatically reduce costs.
mobile device.
be taken to help a patient manage his or
Based on average costs, the difference
The eSync Platform constantly reviews
in the cost of care for treated and
data to identify opportunities to engage
untreated patients for the group Ingenix
with patients and care providers to help
studied was more than $340 million per
improve health. eSync concentrates
year. Applied across the U.S. population,
on four key areas: choosing the right
that bill adds up to billions of dollars.
provider, making decisions about the
right care, taking the right medication
her health. And at critical junctures in a
patient’s care or in medical emergencies,
eSync’s care provider and patient alerts
and the integrated personal health
information eSync has available online
can make a crucial difference in a
patient’s care.
the esync platformsM
To apply information and analytics
capabilities and make them more relevant
for individual patients and their care
providers, as well as for UnitedHealth
Group’s clinical engagement teams,
OptumHealth worked with Ingenix to
launch the eSync Platform.
eSync helps create a holistic view of a
patient’s medical history by organizing an
individual’s appropriate health care data,
such as laboratory and claims information,
prescription drug use and recent medical
procedures and behavioral health, plus
the information each person wishes to
add about himself or herself and basic
demographic information.
Then, using each individual’s health
profile, the eSync Platform creates a
practical blueprint for healthy living that
allows UnitedHealth Group to offer
recommendations, opportunities to
improve health and tips for healthy living.
Outreach methods can be customized
to fit patients’ and care providers’ needs,
including telephone, direct mail, secure
and engaging in the right lifestyle.
Today, OptumHealth is using eSync
If needed, eSync also informs an
OptumHealth personal care consultant
to help deliver personalized health
management programs to approximately
22 million consumers.
Information matters
37%
CHAngeD
pHYsiCiAns
Better Decisions: 37 percent of consumers in the
treatment decision support program changed
to a quality-rated physician best suited for their
health needs.
Better Health: Quality-designated surgeons have a 23 percent lower
rate of medical complications and a nearly 20 percent lower cost.
64%
ReDUCtiOn in
ReADMissiOn RAtes
One specific example: UnitedHealth group
has seen a 64 percent reduction in readmission
rates when high-risk pregnant moms deliver
at a Center of excellence.
Better Economics: transplant Centers
of excellence produce a 57 percent lower
average cost per transplant.
57%
LOWeR AVeRAge COst
peR tRAnspLAnt
www.optumhealth.com/eSync
UnitedHealth Group 2009 Summary Annual Report
25
Business Summary
UnitedHealth Group focuses on improving the nation’s health
UnitedHealth Group has achieved
care system, helping to make quality care more accessible
market leadership by providing value
to our customers through:
and affordable for all Americans. Our family of businesses
• A sustained focus on advancing
today provides more than 70 million individuals with a highly
diversified and comprehensive array of health and well-being
health and well-being;
• A commitment to operational
excellence;
products and services. We are dedicated to helping people
• Product and service innovation;
live healthier lives.
By developing innovative solutions to the
care landscape and make important
challenges of health care and harnessing
health and lifestyle decisions.
• Advancement of practical technology
applications to engage consumers and
simplify the health care experience;
• The analytic use of information to
enhance service, quality and patient
the power of modern technology, we
create new health care options for
customers. Our products and services
expand consumer choice, engage people
more directly in their own health care and
strengthen patient-physician relationships.
Through our extensive network of health
safety;
care providers and facilities, we purchase
more than $120 billion in health care
per year for our customers from roughly
700,000 physicians and other care
providers, 5,200 hospitals and all major
• Support of science as the cornerstone
of optimum health care delivery; and
• Diversification of businesses and
product offerings.
We offer health benefits in the
drug and device companies. We process
At UnitedHealth Group, we value the
commercial market for employer and
more than 800 million claims, respond to
personal nature of our relationship with
individual customers, and hold market
more than 80 million phone calls, execute
our customers, understanding that
leading positions in the public and senior
more than three quarters of a billion
individuals and families often rely on our
sectors. We provide health services
Internet transactions and support more
services at crucial moments in their lives.
to the participants in the health care
than 24 million electronic personal health
system itself, ranging from employers
records. We maintain the only major
and health plans, to physicians and life
chartered health care bank, manage
sciences companies.
We are a valuable partner in supporting
the health and financial needs of our
customers, and we serve as a trusted
source of information for patients as
they navigate today’s complex health
almost $1 billion in assets, service nearly
2 million consumer health care accounts,
and process $36 billion in electronic pay-
ments to providers annually. Our health
care data assets are some of the most
robust in the nation.
Because health care is delivered and
accessed locally by the people we serve,
UnitedHealth Group closely aligns our
businesses with local communities
and markets. This focus, combined
with the company’s national scale and
breadth of resources, provides effective,
responsive health care service, greater
access and higher quality coast-to-coast.
Fast facts
$120B
in HeALtH CARe
pURCHAseD peR YeAR
26
www.unitedhealthgroup.com
700,000
pHYsiCiAns & CARe pROViDeRs
in netWORk
5,200
HOspitALs in netWORk
Our strong capital structure and asset
base enable us to invest in research
and development activities, which in
turn stimulate business innovation and
opportunity while providing stability
and security for customers, business
partners and our investors.
UnitedHealth Group performed well
in 2009 with just over $87 billion in
revenues — 7 percent year-over-year
growth — and earnings of $3.24 per
share. Satisfaction levels improved for
every key constituency — consumers,
physicians and other care providers;
employers and benefit sponsors; and
brokers and consultants.
We managed through many unforeseen
obstacles to achieve these results,
including significantly higher unemploy-
ment, anemic short-term investment
yields, the H1N1 outbreak, slower
buying behaviors in the market for health
Health Benefits
in 2009, revenues in Health Benefits increased $5.5 billion, or 7 percent, to
$81.3 billion, driven by the addition of nearly 1.1 million customers across
the public and senior markets, as well as rate increases reflecting underlying
medical cost trends. this growth was offset by a decrease of 1.7 million people
served in the commercial benefits market, reflecting the significant decline
in U.s. employment in 2009. Health Benefits earnings from operations for the
full year were $4.8 billion.
• Services that empower consumers
to take active control of their health
care needs and drive down costs; and
• Meaningful economic discounts and
innovative clinical advocacy programs
that promote quality care.
In 2009, UnitedHealthcare posted
a gain of 115,000 people participating
in consumer-driven health plans,
strengthening its position as the leader
in the consumer-driven health plan
services, COBRA benefit extensions,
More than 24 million customers
market segment.
unexpected state tax actions on
insurance premiums and more.
While cautious about the expected
economic recovery and the uncertainty
surrounding health reform, we are
well positioned to capture the growth
opportunities that are likely to accompany
receive a comprehensive array of
consumer-oriented health benefit plans
and services from UnitedHealthcare,
which serves the full spectrum of the
commercial benefits market, from
individual consumers to Fortune 500
companies.
the continuing modernization of the U.S.
UnitedHealthcare’s national scale allows
Initiatives like UnitedHealthcare’s
Premium® designation program drive
better and more efficient health decisions
by encouraging use of physicians who
meet quality and efficiency standards
through benefit design incentives.
health care system.
We also continue to expand internationally
in select markets as other industrialized
nations confront challenges similar to
those UnitedHealth Group helps resolve
for Americans.
it to provide employers and consumers
innovative, personalized and cost-effective
solutions geared toward their changing
health care needs. These include:
• Consumer-driven health plans;
• Flexible benefit plans, like the
Multi-Choice suite of offerings tailored
to meet the needs of small businesses;
Delivering a comprehensive
array of consumer-oriented
health benefit plans and
services to more than
24 million customers.
www.uhc.com
UnitedHealth Group 2009 Summary Annual Report
27
Business Summary
SimplyEngaged ® is a product for mid-
sized employers who are seeking to
engage employees in their own health
care and promote personal accountability.
It includes a national biometric screening
network and reinforces the value of
healthy actions and outcomes through
financial incentives and increased
consumer awareness.
Ovations is the largest business in
UnitedHealthcare leverages consumer-
America dedicated to the health and
centric innovations to integrate clinical,
well-being of individuals over the age
behavioral, financial, administrative and
of 50 — the fastest growing segment
claims data in practical ways.
of the health care market.
on customers and affordability. The
company has a deep understanding of
its customers’ needs, and offers health
benefit products that ensure predictability,
stability and financial protection. Ovations
offers its customers access to a broad
network of doctors, individualized health
and wellness programs, care coordination
services and products explained in
“plain language” that promote informed
decision-making. The business has
expanded its retail presence, improved
relationships with brokers and bolstered
its direct-sales channels. Ovations’
In 2009, UnitedHealthcare introduced
Through a diversified range of products
relationship with AARP is built not only on
two new programs that illustrate the
and services, the company makes it
providing affordable, quality products, but
company’s focus on personalized and
easier for more than 8 million seniors —
also on driving innovation and advances
cost-effective care. The Diabetes Health
or one in five Medicare beneficiaries —
in the delivery of senior health services.
Plan is a first-of-its-kind benefit program
to manage their health care needs.
that gives people with diabetes and pre-
diabetes tools designed to help them
avoid the complications of the disease.
The plan focuses on early identification
of diabetes and provides incentives for
patients to follow a health care plan that
lessens its effects.
Ovations is a market leader in delivering
Medicare Advantage health benefits
products, serving nearly 1.8 million people
across the United States. In association
with AARP, the company serves nearly
4 million people with specialized pro-
ducts for the senior health care market,
Making it easier for more
than 8 million seniors —
or one in five Medicare
beneficiaries — to manage
their health care needs.
The second new program is Patient
including operating the nation’s largest
Centered Medical Home, which creates
Medicare Supplement business. It also
a close partnership between patients
is the nation’s largest Medicare Part D
and physicians to improve con sumer
pre scription drug plan provider, serving
access and quality at lower cost.
4.3 million individuals on a stand-alone
Patient Centered Medical Homes use
basis and another 1.6 million through
Ovations delivers affordability through
a combination of effective medical man-
agement and administrative discipline.
It has a 20-year track record of proficient
adaptability to market and competitive
the latest health-information technology
Medicare Advantage Part D plans.
challenges.
to ensure people receive comprehensive,
In addition, the business is a national
coordinated and information-based
leader in providing health care planning,
care from their primary care physicians,
coordination and benefits to individuals
rather than fragmented care from a
residing in skilled-nursing facilities.
• Revenues grew $4.1 billion, or
15 percent, to $32.1 billion in 2009.
This strong growth included revenue
advances in the Medicare Advantage,
range of providers.
Ovations’ success in the senior
market is defined by an intense focus
28
www.ovationshealth.com
Medicare Supplement and Part D
AmeriChoice programs are specially
chronic or end-of-life diseases, including
prescription drug businesses.
designed to address the complex
the disabled and those living in a long-
Medicare Advantage enrollment
set of medical and social needs that
term care setting.
increased 20 percent, or nearly
confront this population, going beyond
300,000 seniors, while the number
the immediate medical issues to focus
of seniors served by Medicare
on the social, behavioral and economic
Supplement products grew by
barriers that impede healthier living.
In 2009, AmeriChoice revenues of
$8.4 billion increased $2.4 billion, or
40 percent from 2008, driven by strong
organic growth as well as the full
6 percent or 140,000 individuals. At
December 31, 2009, approximately
4.3 million people participated in
the company’s stand-alone Part D
prescription drug plans, including
growth of 240,000 people in 2009.
Working with states, municipalities
and other government agencies,
AmeriChoice provides assistance
to those Americans in greatest need
— the economically disadvantaged,
the medically underserved and those
who lack access to employer-funded
health care coverage.
This business is focused on supporting
and managing the health care needs
for nearly 3 million Americans who turn
to Medicaid and other public health
programs for care.
The cornerstone of the company’s
year benefit of a mid-2008 acquisition.
efforts is the AmeriChoice Personal
Growth highlights in 2009 included
Care Model™. This Personal Care Model
expanding to Hawaii and completing
program creates an ongoing relationship
program implementations in Connecticut,
between health care professionals and
Tennessee and New Mexico.
Focusing on supporting and
managing the health care
needs for nearly 3 million
Americans who turn to
Medicaid and other public
health programs for care.
individuals with serious and chronic
illnesses, including asthma, diabetes,
congestive heart failure, HIV/AIDS,
hypertension and high-risk pregnancies.
The Personal Care Model provides
outreach and education programs to
help patients and their families manage
these conditions. Other long-term
care programs focus on dementia,
depression, coronary disease and
functional deficiencies.
The company also offers government
agencies a broad array of management
tools designed to help them effectively
administer their distinctive health care
delivery systems. These include clinical-
care management and consulting,
disease and conditions management, and
administrative and technological services.
AmeriChoice expanded beyond its
traditional focus on mothers and children
by differentiating its programs across
three other primary groups: low-income
families, childless adults and people with
www.americhoice.com
UnitedHealth Group 2009 Summary Annual Report
29
Business Summary
Health Services
in 2009, Health services combined revenues increased $2.5 billion, or 13 percent,
to $21.8 billion. the revenue advance was driven by strong growth in consumers
served, particularly through pharmaceutical benefit management programs,
as well as higher revenues from public sector specialty benefit offerings and
health care technology software and services. Health services earnings from
operations for the full year were $1.6 billion.
• Complex condition management;
synchronized approach that allows
OptumHealth to leverage many different
types of outreach, including telephonic,
fax, text messaging, mail, e-mail and
personal Web portals.
OptumHealth Financial Services
operates the only major bank dedicated
exclusively to the health care industry.
OptumHealth is also a leader in the
promotion of paperless payment and
statement solutions. The company
• Physical health networks;
connects almost 500,000 health care
• Mental health and substance abuse
management; and
• Employee assistance programs.
Through myoptumhealth.com, as well
as more than 1,500 private health portals
(serving 36 million consumers), the
company is also a leading provider of
consumer health information. Every
day, thousands of calls are received
by OptumHealth’s NurseLineSM and
employee assistance programs, which
provide customers with personalized
health and wellness information.
OptumHealth’s innovative eSync
PlatformSM is a cutting-edge clinical tech-
nology capability. It provides a holistic
view of a patient’s medical history by
combining all pertinent data, such as
providers and electronically transmits
more than $3 billion of claim payments
per month.
Providing health
information and services
through four businesses —
Care Solutions, Financial
Services, Behavioral Solutions
and Specialty Benefits.
In 2009, OptumHealth continued to
identify new ways to integrate its robust
product offerings, while creating a more
personal ized patient experience and
closely partnering with care providers.
The result is a meaningful and powerful
lab and claims information, prescription
consumer franchise that is serving health
drug use, recent medical procedures,
needs for one out of every five Americans.
OptumHealth provides essential
health information and services to
nearly 58 million Americans.
Through its four businesses — Care
Solutions, Financial Services, Behavioral
Solutions and Specialty Benefits —
OptumHealth helps Americans more
effectively navigate the health care
system, make better informed health
decisions, finance their health care needs
and access the best health services.
OptumHealth is a recognized leader in:
• Wellness, disease and care
management programs;
• Care advocacy and decision support
behavioral information and self-reported
information. eSync’s analytic software
pores through this data and proactively
sends out care recommendations,
reminders to schedule annual exams
and information about upcoming
medical procedures. It’s an integrated,
In 2009, OptumHealth revenues
increased $303 million, or 6 percent,
to $5.5 billion. The year marked
OptumHealth’s best overall external
growth year in its history.
services;
1.9M
COnsUMeR ACCOUnts
seRVeD in 2009
30
www.optumhealth.com
OptumHealth’s public sector business
advanced analytics to strengthen clinical
350 federal and state agencies and
continued to grow strongly in 2009,
decision support, expand the use of health
135 United Kingdom government payers.
with significant new sales for services,
information technology, improve health
including five state programs serving
care administration — and ultimately help
a total of nearly 1 million people.
to improve health outcomes.
Over the past decade, revenue growth
for Ingenix has averaged approximately
20 percent annually. Market demand
OptumHealth Financial Services ended
the year serving 1.9 million consumer
accounts, up 10 percent from 2008.
Assets under management grew
31 percent to $860 million in 2009.
In 2009, Ingenix brought its ability to
for many of Ingenix services is on the
innovate and its commitment to health
rise with innovation driving growth. The
privacy and security to an array of
American Recovery and Reinvestment
opportunities to address major health
Act of 2009 is already accelerating
care outcomes and economics issues for
demand for industry-leading health care
clients. With more than 10,000 knowledge
technology like Ingenix CareTracker,
workers in more than 50 countries, Ingenix
Ingenix’s Web-based solution that
made an impact in some important
modernizes and integrates all the
arenas, including:
• Administrative simplification;
functions of a physician practice,
including electronic health records.
• Electronic health records and health
information exchanges;
• Clinical decision support and analytics;
• Performance management and
consumer transparency;
• Risk management, trend forecasting
and underwriting;
• Comparative effectiveness research;
As one of the largest global
health information technology and
consulting companies in the world,
Ingenix is a leading supplier of
information-based solutions to the
• Public health policy analysis; and
• Clinical and information services for life
sciences companies, improving clinical
effectiveness, safety and outcomes.
CareTracker modernizes
and integrates all the
functions of a physician
practice, including electronic
health records.
In collaboration with Intuit, a leader
in financial software, Ingenix helped
develop the Quicken Health Expense
TrackerSM, combining Intuit’s experience
building consumer-friendly financial
health care market.
Included are those who diagnose and
treat patients (doctors and hospitals),
those who develop cures for disease
(the life sciences industry) and those
who pay for care (governments, com-
mercial health plans and employers).
Relying on vast and robust health
information resources, including
32 terabytes of information covering
the health experiences of more than
90 million people, Ingenix uses the
power of health information and
Ingenix offers clients software, services,
consulting and outsourcing solutions.
These solutions are provided to nearly
management tools with innovative
Ingenix health care technology and
experience. This Web-based tool
every major participant in the U.S. health
guides consumers through the process
care system and a growing number of
international systems. Clients include
of understanding and managing their
health care finances. Quicken Health
approximately 6,000 hospitals, 245,000
Expense Tracker will be widely available
physicians, 2,000 health care payers and
to UnitedHealthcare customers in 2010
other intermediaries, 200 Fortune 500
through their personalized myuhc.com
companies, 655 life sciences companies,
Web portals.
www.ingenix.com
UnitedHealth Group 2009 Summary Annual Report
31
Business Summary
In 2009, The Lewin Group® launched its
comparative effectiveness research,
and Associates for its mail-pharmacy
Center for Comparative Effectiveness
international markets and electronic
service, and is the only PBM to receive
Research, formed to meet the growing
health records.
Continuing pressure to reduce health
care costs and improve care quality
is expected to create new demand for
Ingenix’s solutions.
need for fact-based, comparative
effectiveness research (CER) for use by
policymakers, researchers, health care
providers and others to improve patient
care and optimize health care resources.
Ingenix’s i3 business launched i3Cube™
in March 2009, an award-winning,
integrated solution for managing all drug
study activities in a centralized location
on a single, user-friendly Adobe® platform.
i3Cube brought a unique capability to
the marketplace and has attracted the
attention of clients embarking on projects
across all phases of the drug develop-
ment research cycle.
17% 2009 ingenix
ReVenUe inCReAse
A new consumer Web site was launched
Prescription Solutions is one of the
in 2009 to offer customers enhanced
largest pharmacy Benefit Managers
functionality, simplified navigation and
(pBMs) in the United states
up-to-date information on medications,
offering a comprehensive suite of
as well as a real-time pricing tool for the
pharmaceutical programs and
growing Medicare Part D population.
consumer health products including
retail, mail order, specialty pharmacy
and clinical services.
all four accreditations from URAC
(a leading health care accreditation and
education organization): Pharmacy
Benefit Management, Drug Therapy
Management, Mail Service Pharmacy
and Specialty Pharmacy.
Prescription Solutions’ mail order
facilities provide customers with
significant discounts versus typical
retail drug stores. Its purchasing scale
also allows it to supply customers with
cost-effective brand name and generic
drugs. Prescription Solutions generic
penetration rate is nearly 70 percent,
the highest among major PBMs.
In 2009, Prescription Solutions revenues
of $14.5 billion grew $1.9 billion, or
15 percent, driven by strong growth
in consumers served, script volume
growth and steady gains in mail service
drug fulfillment.
Over the past three years, revenue
has increased from $13.2 billion to
$14.5 billion and the number of custom-
ers served grew from 10.3 million to
11 million during the same period.
15% 2009 ReVenUe gROWtH
In 2009, Ingenix also made several
strategic acquisitions. In June, Ingenix
acquired AIM Healthcare Services, Inc., a
leading provider of health care payment
solutions in all 50 states. In November,
Ingenix acquired CareMedic Services,
Inc., a company known for its innovation
in hospital revenue cycle management.
Serving 11 million people
nationwide and processing
approximately 315 million
adjusted prescriptions
annually.
Ingenix increased revenues by
Prescription Solutions serves 11 million
$271 million, or 17 percent, to $1.8 billion
people nationwide and processes
in 2009. The year included significant
approximately 315 million adjusted
investments in new solutions related to
prescriptions annually. The company has
payment and revenue cycle management,
twice been recognized by J. D. Power
32
www.prescriptionsolutions.com
Foundations
To increase access to health care
for underserved communities, the
Foundation’s Community Health
Centers of Excellence initiative
supports community clinics that are part
of our nation’s health care safety net.
Five health centers, in New Orleans,
Miami, New York City and Washington,
D.C., provide care equal to or better than
care available by private-sector health
care facilities, despite challenges unique
to their locations.
The goal of the Foundation’s Diverse
Scholars Initiative is to increase
the number of qualified, yet under-
represented, college graduates entering
the health workforce. Scholarships
support hundreds of low-income
minority students pursuing degrees
in the health field. The development
of health professionals from diverse,
multicultural backgrounds will help
The United Health Foundation is a not for
profit, private foundation that provides
actionable information to support deci-
sions that lead to better health outcomes
and healthier communities. Established
by UnitedHealth Group in 1999, the
Foundation has committed more than
$170 million to improve health and health
care. Following are examples of its
program initiatives:
The United Health Foundation’s
improve the quality of culturally
Children who have medical needs are
sometimes not insured comprehensively
for all of their medical treatments. There
are few places for families who have
gaps in their commercial health benefit
plan coverage to turn to for funding
medically necessary services for their
children. As a result, children may go
without necessary treatment, or they
receive needed care while their families
assume large financial obligations.
America’s Health Rankings ® is an
competent health care and help close
That’s where the UnitedHealthcare
annual state-by-state assessment of
the health disparities gap.
the nation’s health. In collaboration with
the American Public Health Association
and Partnership for Prevention, for nearly
two decades America’s Health Rankings
has provided communities and individuals
with data that has spurred innovative
thinking and action to strengthen our
nation’s health.
Pictured above: Daughters of Charity
Health Center at St. Cecilia (New Orleans,
La.) participates in the United Health
Foundation’s Community Health Centers
of Excellence initiative.
(Photo taken as part of a documentary book
project on community health centers sponsored
by the United Health Foundation.)
The Foundation collaborates with health
research agencies, medical specialty
societies and others to translate science
into practice and helps make reliable
Children’s Foundation (UHCCF) helps fill
the gap. Established in 1999, UHCCF has
provided grants to hundreds of children
and their families to offset the cost of
medical care.
medical evidence available to physicians
UHCCF is funded by contributions from
and other care providers. Through
Advancing Clinical Excellence,
the United Health Foundation helps
UnitedHealth Group and its employees,
as well as the generosity of individuals
and corporations. To learn more about
physi cians and other health professionals
the UnitedHealthcare Children’s
achieve the best possible health out-
Foundation, visit www.uhccf.org.
comes for their patients.
To learn more about the
United Health Foundation, go to
www.unitedhealthfoundation.org.
Pictured above: UnitedHealthcare
Children’s Foundation grant recipient
Liam Wolf and his dad.
www.unitedhealthfoundation.org
www.uhccf.org
UnitedHealth Group 2009 Summary Annual Report
33
2009 Financial Results
UnitedHealth Group Highlights
• UnitedHealth Group achieved business growth across each of its reporting segments and generated
earnings from operations of $6.4 billion.
• Diluted net earnings per common share were $3.24.
• Revenues were $87.1 billion.
• Cash flows from operations reached $5.6 billion, representing 147 percent of 2009 net earnings.
• The challenging economic environment in the United States during 2009 exerted pressure on growth,
product pricing and margins for UnitedHealth Group.
The 2009 financial results on pages 34 through 37 should be read together with the consolidated financial statements
and notes in the 2009 Annual Report on Form 10-K. The 2009 Annual Report on Form 10-K is an integral part of this
summary annual report.
(dollars in millions, except per share data)
Year ended December 31
Consolidated Operating Results
Revenues
Earnings from operations
Net earnings
Return on shareholders’ equity
Basic net earnings per common share
Diluted net earnings per common share
Common stock dividends per share
Consolidated Cash Flows From (Used For)
Operating activities
Investing activities
Financing activities
Consolidated Financial Condition
As of December 31
Cash and investments
Total assets
Total commercial paper and long-term debt
Shareholders’ equity
Debt-to-total-capital ratio
2009
2008
2007
2006
2005
$87,138
$ 6,359
$ 3,822
$81,186
$ 5,263
$ 2,977
$75,431
$ 7,849
$ 4,654
$71,542
$ 6,984
$ 4,159
$46,425
$ 5,080
$ 3,083
17.3%
14.9%
22.4%
22.2%
25.2%
$ 3.27
$ 3.24
$ .030
$ 2.45
$ 2.40
$ .030
$ 3.55
$ 3.42
$ .030
$ 3.09
$ 2.97
$ .030
$ 2.44
$ 2.31
$ .015
$ 5,625
$ (976)
$ (2,275)
$ 4,238
$ (5,072)
$ (605)
$ 5,877
$ (4,147)
$ (3,185)
$ 6,526
$ (2,101)
$ 474
$ 4,083
$ (3,489)
$ 836
$24,350
$59,045
$11,173
$23,606
$21,575
$55,815
$12,794
$20,780
$22,286
$50,899
$11,009
$20,063
$20,582
$48,320
$ 7,456
$20,810
$14,982
$41,288
$ 7,095
$17,815
32.1%
38.1%
35.4%
26.4%
28.5%
34
Revenues
(in millions)
$87,138
$81,186
$75,431
$71,542
$46,425
05
06
07
08
09
Earnings From Operations
(in millions)
$7,849
$6,984
$6,359
$5,080
$5,263
Operating Margin
10.9%
10.4%
9.8%
7.3%
6.5%
05
06
07
08
09
05
06
07
08
09
Cash Flows From Operations
(in millions)
Diluted Earnings Per Share
$6,526
$5,877
$5,625
$4,083
$4,238
$3.42
$2.97
$3.24
$2.31
$2.40
05
06
07
08
09
05
06
07
08
09
UnitedHealth Group 2009 Summary Annual Report
35
2009 Financial Results
Health Benefits
(includes UnitedHealthcare, Ovations and AmeriChoice)
• UnitedHealthcare revenues of $40.8 billion decreased by 2 percent in 2009 primarily due to a 7 percent year-over-year
decrease in total people served, partially offset by premium rate increases. Employment attrition at continuing clients
contributed 55 percent of the total decrease in people served during the year.
• Ovations revenues were $32.1 billion, an increase of $4.1 billion, or 15 percent, compared to 2008 driven by an increase
in individuals served across each major senior health care product category including Medicare Advantage, standardized
Medicare Supplement offerings and Medicare Part D, as well as premium rate increases. In total, Ovations brought services
to an additional 675,000 seniors in 2009.
• AmeriChoice revenues of $8.4 billion in 2009 increased by $2.4 billion, or 40 percent, year-over-year primarily due to organic
growth in individuals served. Risk-based Medicaid programs organically grew by 24 percent or 565,000 individuals during
the year to 2.9 million people.
Health Services
OptumHealth
• OptumHealth revenues of $5.5 billion increased $303 million, or 6 percent, over 2008 primarily due to new business
development in large-scale public sector care management and behavioral health programs for state clients, partially offset
by a decline in people served in commercial products.
• Growth in public sector business included new sales for services commencing in 2009 or 2010 to five state programs
serving a total of nearly 1 million people.
• OptumHealth Financial Services grew its connectivity network to more than 500,000 physicians and care providers in 2009
and electronically transmitted $36 billion in medical payments to them, a year-over-year increase of 36 percent. Assets under
management in health-linked savings and investment accounts reached $860 million, an increase of 31 percent over 2008.
Ingenix
• Ingenix provides services in more than 50 countries and serves virtually every category of participant in the U.S. health system.
• Revenues for Ingenix increased $271 million, or 17 percent, during 2009 to $1.8 billion primarily due to organic growth in new
payer business and new internal service offerings.
• The Ingenix contract revenue backlog grew $380 million, or 21 percent, during 2009 to $2.2 billion, led by growth in the
government and payer sectors.
Prescription Solutions
• Prescription Solutions 2009 revenues of $14.5 billion grew $1.9 billion, or 15 percent, year-over-year due to strong growth
in consumers served through Medicare Part D prescription drug plans.
• During the year, Prescription Solutions processed approximately 315 million adjusted scripts for 11 million individuals.
• Generic prescriptions reached nearly 70 percent of all scripts filled by Prescription Solutions by the fourth quarter 2009,
an increase of 160 basis points year-over-year. The expanded use of generics increases the affordability of health care and
also increases earnings from operations at Prescription Solutions.
36
Revenues
(in millions)
earnings From Operations
(in millions)
Operating Margin
Health Benefits
$81,341
$75,857
$67,817
$71,199
$44,119
$6,595
$5,860
$4,376
$5,068
$4,788
9.9%
9.3%
8.6%
6.7%
5.9%
05
06
07
08
09
05
06
07
08
09
05
06
07
08
09
OptumHealth
$5,225
$4,921
$5,528
$4,342
$3,127
$895
$809
$718
$636
$574
18.4% 18.6% 18.2%
13.7%
11.5%
05
06
07
08
09
05
06
07
08
09
05
06
07
08
09
Ingenix
$1,823
$1,552
$1,304
$956
$796
$266
$246
$229
$176
$130
20.4%
18.4%
16.3%
14.8%
13.5%
05
06
07
08
09
05
06
07
08
09
05
06
07
08
09
Prescription Solutions
$14,452
$13,249
$12,573
$689
4.8%
$4,084
$78
05
06
07
08
09
$363
$269
$139
3.4%
2.9%
2.0%
$0
05
06
07
08
09
05
06
07
08
09
NM*
*Not Meaningful
UnitedHealth Group 2009 Summary Annual Report
37
Officers and Board Members
Reed V. Tuckson, M.D.
Executive Vice President
and Chief of Medical Affairs
Christopher J. Walsh
Executive Vice President
and General Counsel
Anthony Welters
Executive Vice President
and President,
Public and Senior Markets Group
David S. Wichmann
Executive Vice President
and President,
UnitedHealth Group Operations
Mitchell E. Zamoff
Executive Vice President
and General Counsel
Board of Directors
William C. Ballard, Jr.
Former Of Counsel,
Greenebaum Doll & McDonald PLLC
Richard T. Burke
Non-Executive Chairman,
UnitedHealth Group
Robert J. Darretta
Retired Vice Chairman
and Chief Financial Officer,
Johnson & Johnson
Stephen J. Hemsley
President and
Chief Executive Officer,
UnitedHealth Group
Michele J. Hooper
President and
Chief Executive Officer,
The Directors’ Council
Douglas W. Leatherdale
Retired Chairman
and Chief Executive Officer,
The St. Paul Companies, Inc.
Glenn M. Renwick
President and
Chief Executive Officer,
The Progressive Corporation
Kenneth I. Shine, M.D.
Executive Vice Chancellor
for Health Affairs,
The University of Texas System
Gail R. Wilensky, Ph.D.
Senior Fellow,
Project HOPE
Audit Committee
William C. Ballard, Jr., Chair
Robert J. Darretta
Glenn M. Renwick
Nominating and
Corporate Governance Committee
Michele J. Hooper, Chair
William C. Ballard, Jr.
Douglas W. Leatherdale
Compensation and
Human Resources Committee
Douglas W. Leatherdale, Chair
Robert J. Darretta
Gail R. Wilensky, Ph.D.
Public Policy Strategies
and Responsibility Committee
Gail R. Wilensky, Ph.D., Chair
Michele J. Hooper
Kenneth I. Shine, M.D.
Officers and Leaders
Stephen J. Hemsley
President and
Chief Executive Officer
Gail K. Boudreaux
Executive Vice President
and President,
UnitedHealthcare
G. Mike Mikan
Executive Vice President
and Chief Financial Officer
William A. Munsell
Executive Vice President
and President,
Enterprise Services Group
Don Nathan
Senior Vice President and
Chief Communications Officer
John S. Penshorn
Senior Vice President,
Capital Markets Communications
and Strategy
Eric S. Rangen
Senior Vice President
and Chief Accounting Officer
Larry C. Renfro
Executive Vice President
and Chief Executive Officer,
Public and Senior Markets Group
Jeannine M. Rivet
Executive Vice President
Simon Stevens
Executive Vice President
and President,
Global Health
Lori K. Sweere
Executive Vice President,
Human Capital
38
Forward-Looking Statements
This Summary Annual Report may contain statements, estimates,
changes in Medicare; potential reductions in revenue received from
projections, guidance or outlook that constitute “forward-looking”
Medicare and Medicaid programs, including as a result of reduced
statements as defined under U.S. federal securities laws. Generally
payments to private plans offering Medicare Advantage; our ability
the words “believe,” “expect,” “intend,” “estimate,” “anticipate,”
to execute contracts on competitive terms with physicians, hospitals
“plan,” “project,” “should” and similar expressions identify forward-
and other service professionals; our ability to attract, retain and provide
looking statements, which generally are not historical in nature.
support to a network of independent third party brokers, consultants
These statements may contain information about financial prospects,
and agents; failure to comply with restrictions on patient privacy and
economic conditions, trends and uncertainties and involve risks and
data security regulations; events that may negatively affect our contracts
uncertainties. We caution that actual results could differ materially
with AARP; increases in costs and other liabilities associated with
from those that management expects, depending on the outcome
increased litigation; possible impairment of the value of our intangible
of certain factors. Some factors that could cause results to differ
assets if future results do not adequately support goodwill and intangible
materially from the forward-looking statements include: the outcome
assets recorded for businesses that we acquire; increases in health care
of proposed health care reform, which could materially adversely affect
costs resulting from large-scale medical emergencies; failure to maintain
our revenues, financial position and results of operations, including
effective and efficient information systems; misappropriation of our
increasing our costs, subjecting us to new and potentially significant
proprietary technology; our ability to obtain sufficient funds from our
taxes, exposing us to expanded liability, requiring us to revise the ways
regulated subsidiaries to fund our obligations; failure to complete or
in which we conduct business or putting us at risk for loss of business
receive anticipated benefits of acquisitions; potential downgrades in
(our financial outlook does not account for any potential impact of
our credit ratings; and failure to achieve targeted operating cost
health care reform on our businesses); our ability to effectively estimate,
productivity improvements, including savings resulting from technology
price for and manage our medical costs, including the impact of any
enhancement and administrative modernization.
new coverage requirements; the potential impact that new laws or
regulations or changes in existing laws or regulations or their enforce-
This list of important factors is not intended to be exhaustive.
ment could have on our results of operations, financial position and
A further list and description of some of these risks and uncertainties
cash flows, including as a result of increases in medical, administrative,
can be found in our reports filed with the Securities and Exchange
technology or other costs resulting from federal and state regulations
Commission from time to time, including the cautionary statements
affecting the health care industry; the potential impact of adverse
in our annual reports on Form 10-K, quarterly reports on Form 10-Q
economic conditions on our revenues (including decreases in
and current reports on Form 8-K. Any or all forward-looking statements
enrollment resulting from increases in the unemployment rate and
we make may turn out to be wrong. You should not place undue
commercial attrition) and results of operations; regulatory and
reliance on forward-looking statements, which speak only as of the
other risks and uncertainties associated with the pharmacy benefits
date they are made. We do not undertake to update or revise any
management industry; competitive pressures, which could affect our
forward-looking statements.
ability to maintain or increase our market share; uncertainties regarding
UnitedHealth Group 2009 Summary Annual Report
39
Investor Information
Market price of common stock
Investor relations
The following table shows the range of high and low sales prices
for the company’s common stock as reported by the New York
Stock Exchange, where it trades under the symbol UNH. These
prices do not include commissions or fees associated with
purchasing or selling this security.
high
low
2010
First Quarter thru February 3, 2010
$36.07
$30.97
2009
First Quarter
Second Quarter
Third Quarter
Fourth Quarter
2008
First Quarter
Second Quarter
Third Quarter
Fourth Quarter
$30.25
$29.69
$30.00
$33.25
$57.86
$38.33
$33.49
$27.31
$16.18
$19.85
$23.69
$23.50
$33.57
$25.50
$21.00
$14.51
You can contact UnitedHealth Group Investor Relations to order,
without charge, financial documents such as the Annual Report
on Form 10-K and the Summary Annual Report.
You can write to us at:
Investor Relations, MN008-T930
UnitedHealth Group
P.O. Box 1459
Minneapolis, Minnesota 55440-1459
You can also obtain information about UnitedHealth Group
and its businesses, including financial documents, online at
www.unitedhealthgroup.com.
Annual meeting
We invite UnitedHealth Group shareholders to attend our annual
meeting, which will be held on Monday, May 24, 2010, 12:00 p.m.
Central Time at the Sheraton Overland Park Hotel at the
Convention Center, 6100 College Boulevard, Overland Park,
Kansas. You will need to bring your admission card with you to the
annual meeting in order to be admitted.
As of February 3, 2010, the company had 18,145 shareholders of record.
Common stock dividends
UnitedHealth Group’s Board of Directors regularly reviews the
company’s financial statements and decides whether it is advisable
to declare a dividend on the outstanding shares of common stock.
The Board of Directors has declared the following dividends in
2009 and 2010: Shareholders of record on April 2, 2009, received
an annual dividend for 2009 of $0.03 per share, which was
paid on April 16, 2009; shareholders of record on April 6, 2010,
received an annual dividend of $0.03 per share, which will be paid
on April 20, 2010.
Shareholder account questions
Our transfer agent, Wells Fargo Shareowner Services, can help
you with a variety of shareholder-related services, including:
• Change of address
• Lost stock certificates
• Transfer of stock to another person
• Additional administrative services
You can write to them at:
Wells Fargo Shareowner Services
P.O. Box 64854
St. Paul, Minnesota 55164-0854
Or you can call our transfer agent toll free at (800) 468-9716
or locally at (651) 450-4064.
You can e-mail our transfer agent at:
stocktransfer@wellsfargo.com
40
www.unitedhealthgroup.com/main/Investors.aspx
Table of contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Letter to Shareholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Responsive, Efficient Service . . . . . . . . . . . . . . . . . . . . . . . . 6
Increasing Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Containing Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Personalizing the Experience . . . . . . . . . . . . . . . . . . . . . . . 16
Strengthening the
Physician-Patient Relationship . . . . . . . . . . . . . . . . . . . . . 18
Improving Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Transformative Technology . . . . . . . . . . . . . . . . . . . . . . . . 22
Business Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Foundations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
2009 Financial Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Officers and Board Members . . . . . . . . . . . . . . . . . . . . . . . 38
Forward-Looking Statements . . . . . . . . . . . . . . . . . . . . . . . 39
Investor Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Mission and Values . . . . . . . . . . . . . . . . inside back cover
The names and health information for individuals included in this report
have been used with their express permission.
Our mission is to help people live healthier lives.
Mission statement
We seek to enhance the performance of the health system and improve the
overall health and well-being of the people we serve and their communities.
We work with health care professionals and other key partners to expand access
to quality health care so people get the care they need at an affordable price.
We support the physician/patient relationship and empower people with the
information, guidance and tools they need to make personal health choices
and decisions.
Our values
We serve people through a value and performance culture based on integrity,
quality, innovation, diversity and social responsibility. The best way we can satisfy
the millions of people we serve — our customers and members, employees,
shareholders and partners — is to execute on the fundamentals of our business
to the very best of our abilities, each and every day. That means as an organization,
we are accountable for adding value to the health care system.
For more information on how our 80,000 people work to fulfill our mission every
day, please see our Social Responsibility Report at
www.unitedhealthgroup.com/2009-social-responsibility-report
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BV-COC-940655
This annual report is printed on recycled
papers certified by Bureau Veritas per FSC
(Forest Stewardship Council) standards for
Chain of Custody ensuring environmentally
responsible, socially beneficial and
economically viable forest management,
and also uses reduced VOC (Volatile
Organic Compounds) vegetable-based inks.
UnitedHealth Group 2009 Summary Annual Report
Modernizing Health Care
UnitedHealth Group Center
9900 Bren Road East
Minnetonka, Minnesota 55343
unitedhealthgroup.com
2009 Summary Annual Report
100-9409 4/10