Sometimes it's easy to see parallels between Wal-Mart, the king of the retail world, and UnitedHealth Group, the king of the health benefits world.

Wal-Mart tries to be all things to most people. It sells tires, eyeglasses, groceries, potted plants, jeans and so much more. It's even expanding its role into primary-care health services, although apparently not to the extent that original reports indicated.

UnitedHealth is looking to cover all bases of the healthcare world. It's long sold healthcare benefits, along with dental, behavioral health and vision services. Now, its pharmacy benefit management company wants to expand its drug benefit reach UnitedHealth is also buying physician practices and opening store fronts to show off its Medicare-related products. And just this November, the insurer's OptumInsights company announced its Accountable Care Solutions business has hung out its shingle to connect physicians, health plans and hospitals in the ACO movement.

UnitedHealth is an obvious company to come out with such a service. It has the technical knowledge and hundreds of long-time provider relationships to make it smart on ACOs. The most telling part of Optum's announcement, however, was the size of its ACO team, which it says is 700!

Seriously, 700 on an ACO team. Would the division of the Centers for Medicare & Medicaid Services that will be overseeing Medicare ACOs employ that many people. Just that one part of one UnitedHealth company is larger than many of its competitor health plans entire workforces. You have to wonder how much more difficult it's going to be to compete with UnitedHealth on practically every front of healthcare.

It's been interesting watching UnitedHealth's actions over the year and a half following passage of the Affordable Care Act. The company has made smart moves to position itself for nearly every change the law is bringing about. Now, we can add ACO development to the list in a big way.

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