The UnitedHealthcare sign is displayed at its office building in Minnetonka, Minnesota, United States, December 11, 2025.
Tim Evans | Reuters
UnitedHealth Group on Friday released the first results of a broad independent audit of its business practices and pledged to take a wide range of steps to monitor and implement improvements in three specific areas.
The healthcare giant said it has adopted 23 ongoing “action plans” to implement and monitor recommended improvements, under the supervision of its internal audit and consulting services team. Around 65% of these actions will be completed by the end of 2025, while 100% of these plans will be completed by the end of March next year.
These findings come as private insurers attempt to rebuild trust with the American public after violent and pent-up backlash against their practices and the U.S. health care system as a whole. Critics say insurers’ sales tactics have made it harder for some patients to access and pay for care. The company owns UnitedHealthcare, the nation’s largest and most powerful insurer.
While Friday’s announcement is a step toward improving the company, it’s unclear how much it will change the public’s opinion of the company and the industry as a whole.
UnitedHealth announced in July that two independent consulting firms had launched an independent review of its business policies and performance metrics. The same day, UnitedHealth also confirmed that it was the subject of Justice Department investigations regarding its Medicare billing practices.
The independent audit marked one of Steve Hemsley’s first steps as CEO after taking the reins in May, following the abrupt departure of Andrew Witty.
“We hope you will view these assessments as a commitment to setting a new standard of transparency for the health care marketplace, because we believe you and everyone who engages with our health care system deserve to understand how we do our work,” Hemsley said in a letter Friday.
“We know that our actions and decisions have significant impacts on patients, healthcare providers and the healthcare system as a whole, and we are committed to upholding the highest standards,” he added.
FTI Consulting examined UnitedHealthcare’s approaches to risk assessment operations within its Medicare Advantage programs, which refers to how the company assesses the health status of members of these private plans. The firm also reviewed the company’s care services management policies, procedures and processes.
Consulting firm Analysis Group also evaluated policies and processes at Optum Rx — the company’s pharmacy benefits manager, or PBM — to ensure that prescription rebates from drugmakers are “accurately collected and distributed to customers.” PBMs are intermediaries that negotiate discounts with drug manufacturers on behalf of insurers, create lists of drugs covered by insurance, and reimburse pharmacies for prescriptions.
Hemsley said the companies have determined that company policies and practices are “robust, rigorous and generally sound; and, in many ways, at the forefront of the industry.” But he noted they also made recommendations for improvement.
For example, an analysis group review found that OptumRx has “implemented a comprehensive and well-structured framework that governs all stages of manufacturer rebate administration.”
The assessment identified at least 25 separate “controls” in place that collectively reduce the risk of miscalculation or delay in distributing rebates owed to customers and collecting incomplete rebates from drugmakers, Aaron Yeater, managing director of Analysis Group’s Boston office, said in a filing Friday.
The review found “no deficiencies or need for corrective action” but recommended ways to improve Optum Rx’s practices. This includes strengthening Optum Rx’s escalation processes to resolve non-payment and dispute cases through communication with manufacturers. One of UnitedHealth’s plans of action is to develop a formal policy that supports procedures for handling these cases.
Yeater emphasized that he looked at business processes and not the legal and regulatory issues the company faces with its PBM.
Meanwhile, FTI Consulting found that UnitedHealth performed better than its peers in several measures when it came to Medicaid and Medicare. But the firm highlighted slow decision-making on permitting, documentation issues and the need to better address findings raised during regulatory audits.
Beyond these initial results, UnitedHealth announced that it will share findings from a medical records review of diagnosis codes during the first quarter. The company will also report on its processes for developing what it calls “evidence-based medical policy” by mid-year.
Shares of UnitedHealth Group have fallen more than 35% for the year after it suspended its 2025 guidance amid skyrocketing medical costs, announced Witty’s surprise exit and grappled with investigations into its Medicare Advantage business. This follows a difficult 2024 marked by a historic cyberattack and public backlash following the murder of UnitedHealthcare CEO Brian Thompson.
Correction: UnitedHealth Group had a difficult 2024. An earlier version misstated the year.