I have been following this sector recently and I know that a lot of effort by these companies is to build out systems and processes (like ACOs and IT) to control med costs and be the industry leader. But, really which company has the best chance? Second, I think that all of these companies have a finite growth in the USA and, so, if they are to grow, they will need a major global footprint. Who is the best? Seems like Cigna, but maybe not. Love to see some knowledgeable posts
UNH has four different global efforts underway which I have seen, there may be many others which I am not aware of but here goes..
A.) Amil, the merger with the largest managed care provider in Brazil... It has to be the largest single foreign investment move by any of the US HMO's ...
B.) a move into Portugal as a side bar to the Amil merger, Amil just happened to be expanding there and those interests have fallen to UNH
C.) The National Health Service (England), in an effort to control the endemic corruption in the "neighborhood associations" which control healthcare distribution there, have encouraged the physicians to sidestep the local bureaucracies and form ACOs... Unh has been involved there (and met with some controversy)
D.) I recall reading somewhere that UNH has been actively building provider networks in India ... There is a growing class of wealthier professionals in India and business travelers who desire nationwide access to high quality standardized healthcare... UNH has been working on that..
UNH also uses Indian tech support and call centers... There used to be disgruntled former employees posting angry messages on this chat board as their jobs were out sourced..
I shorted a few Cigna puts a few (five?)years ago when they were bumping $10 but I really don't follow their business model.
I think that we will see a bit of a shakeout as some of these HMOs take on more "exchange" business than they can chew... UNH seems to be standing off a bit there, watching, waiting... When that business is better defined UNH will move in...
A thing to watch with UNH is what Hemsley is planning to do... If he steps aside the transition is sure to be a risky thing... He has done a great job in a difficult time.
UNH is probably the most diversified and best run HMO of the top five... That being said, they have become ever more dependent on Federal healthcare dollars ...(Tri-Care, Medicaid, Medicare and government contracts in the Optum division) ...