Healthcare · Profile from Healthcare Research Companion
Change Healthcare (now part of Optum, UnitedHealth Group)
The largest claims clearinghouse and healthcare payment network in the United States, assembled over two decades from WebMD's transaction businesses (Emdeon), private-equity ownership, a 2017 joint venture with most of McKesson's health IT business, a 2019 IPO and, in October 2022, a ~$13bn sale to UnitedHealth Group's Optum that the Department of Justice tried and failed to block. By 2024 it said it processed ~15 billion transactions a year and touched about one in three US patient records. That centrality made it valuable and, in February 2024, made it the single point of failure in the largest health-data breach in US history (~192.7m people notified) and a nationwide stoppage of claims and pharmacy transactions. Change is the defining case of concentration risk in healthcare's plumbing.
At a glance
- Founded
- Roots in electronic claims networks of the 1980s–90s (including Envoy) consolidated by Healtheon/WebMD around 1999–2000; Emdeon Business Services carved out in 2006; renamed Change Healthcare in 2015 after acquiring a Nashville company of that name (2013)
- Founders
- No single founder. Key builders: WebMD/Emdeon management; General Atlantic (2006), Hellman & Friedman and Blackstone (2011) as owners; Neil de Crescenzo, CEO from 2013 to 2022
- Headquarters
- Nashville, Tennessee
- Ownership / structure
- Emdeon public on NYSE (2009–2011); Blackstone-led private ownership (2011–2017); McKesson ~70% JV (2017–2020); Nasdaq-listed Change Healthcare Inc. (CHNG, June 2019 – October 2022); since 3 October 2022 part of Optum Insight within UnitedHealth Group
- Leadership (2026)
- Part of Optum (Optum CEO Patrick Conway from 2025; UnitedHealth CEO Stephen Hemsley from May 2025) (verify current Optum Insight leadership)
- Segment and buyer
- Health IT and payments infrastructure. Buyers are providers (hospitals, practices, labs), payers, pharmacies and PBMs, and the vendors that route through it (practice-management and billing systems)
- Scale
- ~$3bn+ annual revenue before the Optum deal (company filings, approximate); ~15bn transactions a year; connections to hundreds of thousands of providers and pharmacies and most US payers (company statements, reported)
- Capital / price
- Emdeon IPO (2009); Blackstone take-private ~$3bn (2011, reported); McKesson JV (2017); Change IPO at $13 per share (2019); Optum acquisition $25.75 per share, ~$8bn equity, ~$13bn including debt (closed 2022); ClaimsXten sold to TPG ~$2.2bn as a remedy
- Signature moves (incl. failures)
- Emdeon carve-out from WebMD (2006); Blackstone take-private (2011); rebrand as Change Healthcare (2015); McKesson JV (2017); IPO and McKesson split-off (2019–20); sale to Optum (2021); DOJ trial and ClaimsXten divestiture (2022); ransomware attack (2024)
8 strategic moves analysed
Each one gets a full strategy file in the companion: context, the decision, the financing, what happened, and the lesson.
2006
Emdeon Carve Out from WebMD
Divestiture / carve-out (majority sale to private equity), followed by IPO
2011
Blackstone Take Private
Take-private (leveraged buyout)
2015
Rebrand as Change Healthcare
Rebrand / acquisitions (buy-and-build)
2017
McKesson Joint Venture
Joint venture
2019
Nasdaq IPO and Split Off
IPO, followed by spin-off (split-off) of the majority owner's stake
2021
Agreement to Sell to Optum
Acquisition (sale of company)
2022
DOJ Trial and ClaimsXten Divestiture
Antitrust litigation / divestiture
2024
Ransomware Attack and Recovery
Crisis / operational failure and rebuild