United Health Group's (UHG) acquisition of Change Healthcare was challenged by the Department of Justice on grounds of antitrust violation.

However, in September 2022 a Federal Court sided with UHG so now the purchase of Change Healthcare may proceed.

Change Healthcare is the main billing clearing house for 5,500 hospitals and 800,000 doctors to send their bills to commercial insurance companies.

Change Healthcare processes $1 Trillion of claims annually.

Change Healthcare is a very small company compared to UHG with only $3.1 Billion in annual revenue compared to United's $288 Billion.

The claims data that Change Healthcare has for all the commercial health insurance plans including CVS Aetna, the Blue Cross plans and Cigna gives United a wealth of opportunities:

1. United could use the claims data to more accurately price their fullyinsured quotes to take groups away from their competitors.

2. United could use the claims data to identify and target healthier seniors who just became eligible for Medicare Advantage so United can sign them up for their Medicare Advantage Plans.

3. United could identify the outlier 35% of specialists that have very high rates of surgeries and procedures compared to their peers and carve them out of the network to create a 'High Performing Network.' This network would be more cost effective and still be very large, with only 35% fewer of the most procedureintensive specialists.

Sources:
https://www.bloomberg.com/news/articl....

https://www.healthcareitnews.com/news...

https://kvgo.com/guggenheim/changehe...

https://en.wikipedia.org/wiki/Change_...

https://www.ledgerinsights.com/change...

https://www.bassberry.com/experience/...

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