Becker's Healthcare December 19, 2025
UnitedHealth Group has released findings from multiple independent reviews of its business practices following a June pledge from CEO Stephen Hemsley to conduct a transparent and comprehensive examination of company processes.
The reviews, conducted by FTI Consulting and Analysis Group, examined Medicare Advantage risk adjustment operations, utilization management practices, and Optum Rx’s administration of manufacturer discounts. UnitedHealth has adopted 23 action plans in response, with 65% targeted for completion by year-end and full implementation by March 31, 2026.
Ten things to know:
1. Across all three areas, the auditors concluded that UnitedHealth maintains strong operational controls and documentation. However, a common theme emerged: policy organization, centralization and governance structures need improvement. The risk adjustment review found policies weren’t always codified...
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