This is Zack Fuss. Today, we're tackling a giant in a controversial and incredibly complex industry, UnitedHealth Group. At its recent apex, UNH was a half-trillion-dollar market cap business, the 15th largest listed business in the United States. Today, that market cap sits at just $275 billion.

The company generates an excess of $400 billion in sales annually and produces $40 billion in EBITDA as it touches every facet of the American healthcare system. To break down UnitedHealthcare, I'm joined by Stephanie Niven, a co-PM of the Global Sustainable Equity Strategy within the Sustainable Equity Team at Ninety One.

Stephanie has been following the company since 2012 and she helps us to unravel this intricate business. We explore how UnitedHealthcare operates as a fully integrated healthcare system from its insurance arm to its high-margin health services business. We also dive into the concept of value-based care, the recent headwinds from Medicare Advantage scrutiny, and whether the market is mispricing this complex giant amidst regulatory noise and leadership changes. Please enjoy this breakdown of UnitedHealth Group.

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Show Notes

(00:00:00) Welcome to Business Breakdowns

(00:04:51) Understanding the US Healthcare System

(00:10:24) UnitedHealth Group's Origins and Evolution

(00:13:41) UnitedHealth Group's Business Model

(00:22:36) Optum: The Overlooked Powerhouse

(00:29:24) Value-Based Care: A New Approach

(00:34:51) Current State of US Healthcare System

(00:36:49) Regulatory Scrutiny and Media Attention

(00:37:27) Investor Concerns and Company Response

(00:42:49) Structural vs. Cyclical Issues

(00:48:42) UnitedHealth's Technological Edge

(00:52:07) Political Risks and Regulatory Environment

(00:57:16) Medicare Advantage: A Closer Look

(01:02:02) Lessons from UnitedHealth's Strategy