UnitedHealthcare outperforms market benchmarks in total cost of care
New third-party analysis finds that UnitedHealthcare delivered a more than 11% lower total cost of care compared to national benchmarks.
An independent actuarial analysis commissioned by UnitedHealthcare and completed by Milliman in March 2026 has found that UnitedHealthcare’s total cost of care was more than 11% lower than national benchmarks. Milliman’s analysis considered historical medical claims and enrollment data for UnitedHealthcare and national benchmarks.
The study further revealed that UnitedHealthcare delivered:
- 9.3% lower outpatient costs
- 13.8% lower inpatient costs
- 16.7% lower professional services costs
Additional savings for employers with Naviguard® as their out-of-network management program
UnitedHealthcare clients with Naviguard as their out-of-network management program saw even higher savings, with the total cost of care being more than 13% lower than national benchmarks.
Although Milliman did not study these specific plan features, these cost savings may be attributed to UnitedHealthcare's strategic approach to network design and utilization management, including:
- Helping navigate members from higher-cost settings like the ER toward more cost-efficient outpatient care settings, when appropriate, such as ambulatory surgery centers
- Managing inpatient care more appropriately and effectively within hospital settings by reducing the number of bed days, ensuring quality of care and lowering the likelihood of hospital-born complications
- Prioritizing value-based care and reducing unnecessary spending by streamlining processes and improving claims and coding accuracy
- Resolving and reducing out-of-network bills by negotiating directly with providers on behalf of members with access to Naviguard
What does this mean for self-funded employers?
Employer costs are driven by multiple factors, including unit costs, utilization management, care coordination and network effectiveness — all of which can influence the overall total cost of care. Traditional analyses may capture network discounts but often miss the broader picture of total cost of care performance. The risk-adjusted total cost of care provides employers with visibility into comprehensive cost management effectiveness across all service categories and geographic markets.
Without considering the total cost of care performance a carrier can provide, an employer may not have the complete financial picture when selecting a health insurance carrier. Employers looking to optimize their total cost of care strategy can:
- Talk to their broker or consultant about how their evaluation considers UnitedHealthcare's ability to drive total cost of care savings
- Connect with their UnitedHealthcare representative to understand the potential savings delivered through UnitedHealthcare's comprehensive total cost of care strategy across all service categories and regions
- Consider the enhanced savings potential that Naviguard, a UnitedHealthcare service, can offer
Full details on the study can be found in the Milliman white paper, commissioned by UnitedHealthcare.
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