Washington, D.C. — Optum Financial has grown into an essential component of UnitedHealth Group’s monopoly power, one that it uses to tighten an iron grip of control over independent physician practices, a new brief released by the American Economic Liberties Project today details. The analysis documents how UnitedHealth’s FDIC-insured industrial bank, something that has largely been overlooked in debates over health care consolidation, has become another lever the company uses to push independent practices toward financial dependence, closure, or sale, often during moments of acute distress and volatility.

“Optum Financial is no longer a side business for UnitedHealth Group. It has quietly become one of the key ways the notorious healthcare monopolist maintains its death grip over independent physicians,” said Emma Freer, Senior Policy Analyst for Healthcare at the American Economic Liberties Project. “When the same company wields complete control over reimbursement, claims processing, and access to credit, independent practices don’t really have a choice but to play by their rules – and hope UnitedHealth doesn’t change them unexpectedly. They either borrow on UnitedHealth’s terms, sell to UnitedHealth or another conglomerate, or shut their doors.”

“This was no accident. Federal policy choices over the past decades enabled the rise of this core financial dominance,” Freer added. “But regulators and enforcers still have the authority to step in before this model kills more independent businesses and locks in even more control.”

The brief, “UnitedHealth Group Is a Bank: How Policymakers Can Protect Independent Physician Practices From Becoming Loan Shark Bait,” details Optum Financial’s evolution from a health savings account provider to a larger financial operation and explains how its growth reinforces UnitedHealth’s platform power. It examines the industrial loan company structure that allows a commercial parent to own a bank, then connects that structure to Optum Financial’s expanding influence over physician practices — including extending emergency loans after the Change Healthcare outage and, more recently, using reimbursement flows as a collection mechanism.

The brief also lays out short-term reforms focused on protecting independent practices and increasing oversight — including examining Optum Financial’s banking practices and creating an emergency support fund for at-risk practices — alongside long-term reforms aimed at closing the industrial loan company loophole, restoring the viability of independent practice, and breaking up or structurally separating health care platforms that combine payer, provider, claims processor, and lender.

Read the full analysis, “UnitedHealth Group is a Bank” here. 

Learn more about the fight to Break Up Big Medicine here.

Learn more about Economic Liberties here.

###

The American Economic Liberties Project works to ensure America’s system of commerce is structured to advance, rather than undermine, economic liberty, fair commerce, and a secure, inclusive democracy. Economic Liberties believes true economic liberty means entrepreneurs and businesses large and small succeed on the merits of their ideas and hard work; commerce empowers consumers, workers, farmers, and engineers instead of subjecting them to discrimination and abuse from financiers and monopolists; foreign trade arrangements support domestic security and democracy; and wealth is broadly distributed to support equitable political power.