Using 2025 SEC filings and insurance-subsidiary data, researchers traced how much revenue at five major insurers, covering 126 million members, comes from their own affiliated physician and clinical arms rather than the open market.
Key numbers:
1. Optum Health, UnitedHealth’s physician and clinical services arm, took in $100.5 billion in 2025, 63% from UnitedHealth’s own insurance plans. Optum has separately reported having roughly 90,000 physicians on staff or affiliated with it, more than any other organization in the country.
2. Humana’s CenterWell primary care arm generated $6 billion, with 63% coming from Humana’s own health plans; its home health subsidiary drew 60% of revenue the same way.
3. Elevance’s health services division pulled 75% of its revenue from internal affiliates rather than external clients.
4. Kaiser Permanente’s Permanente Medical Groups received about $33.3 billion in professional-service payments from Kaiser’s own health plans, a longstanding, more transparent version of the same integrated model.
5. The authors cautioned this concentration cuts both ways: It can enable better care coordination, but it also lets insurers shift profits internally in ways that are hard for regulators — and physicians negotiating employment or contract terms — to see clearly.
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