Tim Archer, CEO, New England, UnitedHealthcare
In an interview with Invest:, Tim Archer, CEO of UnitedHealthcare in New England, reflected on the company’s achievements over the past year, including a significant $1 billion investment in affordable housing nationwide and the elimination of 20% of prior authorizations to streamline care access.
What were some of UnitedHealthcare’s achievements in New England during the past year?
At UnitedHealthcare, we’ve made meaningful strides that align with our core mission of improving the health care system and helping people live healthier lives. One area we continue to invest in is addressing social drivers of health, which are conditions in a person’s environment that can impact their health outcomes. These are factors such as housing, economic stability, education and access to food and health care that drive about 80% of a person’s overall health.
Unfortunately, around two-thirds of the health care spending still goes toward medical treatment rather than addressing these underlying issues. In response, we’ve invested over $1 billion in affordable housing initiatives across the country, including in Massachusetts. In 2023 alone, we contributed more than $3 million to support communities most affected by these social determinants of health throughout the state.
We’ve also worked to modernize the prior authorization process and simplify the health care experience for consumers and providers. Last year, we took a big step by removing the prior authorization requirement from nearly 20% of our total prior authorization volume, for services that demonstrated consistent adherence to evidence-based guidelines and were almost always approved.
On October 1st, we launched our first-of-its-kind national Gold Card program which recognizes provider groups that consistently adhere to evidence-based care guidelines.
Why is Massachusetts a key market for UnitedHealthcare?
Massachusetts, especially the Boston area, is a prime location for us. It has a dynamic employer sector and a growing population, giving us the opportunity to impact more individuals by providing affordable access to high value healthcare.
Beyond these numbers, Massachusetts is home to top-tier educational institutions and continues to grow with significant real estate and city development. This steady growth and vibrant economic landscape make it an important market for our commercial business in New England.
We’re proud to serve Massachusetts, with over 5,000 employees under the UnitedHealth Group umbrella. Our team is dedicated to tackling challenges like access to care, affordability and social determinants of health, while also bringing innovative products and cutting-edge technology to the market. Our ongoing focus on innovation and addressing critical health care needs is why we continue to have a strong presence in Massachusetts, and we’re committed to expanding our footprint in this dynamic region.
What trends are you seeing in the industry, and how is UnitedHealthcare adapting?
We’re seeing a strong shift toward technology and innovation, with a focus on convenience and accessibility.
Our lives increasingly revolve around smartphones and the health care industry is adapting to meet people where they are, especially in the commercial sector. In response, we’re investing heavily in digital-first solutions. Our mobile app is currently ranked #4 in the medical category on the App Store, and we’re continuously enhancing it to simplify care access. We’re also developing member-centric products like the Nexus ACO in Massachusetts and our Surest health plan, our fastest growing commercial product nationally. Surest has an innovative design and offers a better member experience, eliminating deductibles and coinsurance in favor or copays that members can see before they seek care. Members are empowered to comparison shop and more easily access high-quality care providers that meet their specific needs and that fit their budget, helping to avoid surprise medical bills and improve health outcomes. The results so far show employers have saved an average of 11% and employees have 54% lower out-of-pocket costs.
As we look ahead, UnitedHealthcare will continue to invest in these types of innovative solutions and technology to help simplify every member’s experience.
How are partnerships and collaborations contributing to growth and customer engagement?
Partnerships are vital to keeping members at the heart of their health care journey. For example, the One Pass program offers members access to a wide range of gyms, yoga studios and wellness facilities for a flat fee, providing both variety and nationwide convenience. We also offer the UHC Rewards program, which allows members to earn up to $1,000 for completing health-related goals such as walking 5,000 steps a day, getting an annual checkup or event tracking sleep. The program is designed to incentivize members to take charge of their health and promote healthier lifestyle habits. These collaborations are designed to equip members with the tools and motivation they need to stay engaged in their wellness journey.
What opportunities or challenges do you foresee for the industry?
Access and affordability are ongoing challenges in the health care industry, which are intensified by rising costs, specialty medications and new gene therapies. We’re addressing these issues through innovative solutions like the Surest health plan, giving members up-front pricing and eliminating deductibles.
Additionally, we’re shifting towards value-based care and moving away from the traditional fee-for-service model. This approach encourages providers to focus on patients’ overall health and well-being rather than individual services. Members in these arrangements show increased primary care visits, lower ER visits and higher adherence to certain preventative cancer screenings. By driving innovation in value-based care, we’re not only improving health outcomes but also positioning ourselves to capitalize on industry shifts.
