Slain executive faced ongoing court battles, threats
Before UnitedHealthcare CEO Brian Thompson was gunned down in Midtown Manhattan this week, he was steering his company through court battles and legislative threats at a time of public frustration over health insurance industry tactics.
UnitedHealthcare’s parent company — which generates $400 billion in annual revenue — has been under increasing scrutiny by lawmakers and federal officials for allegedly hurting consumers with monopolistic practices. Some Democratic lawmakers have accused UnitedHealthcare of intentionally denying claims to boost profits. And Thompson himself has been accused of insider trading.
Thompson, 50, was well liked internally at UnitedHealth, where he had risen in the ranks over 17 years before being named CEO of the insurance giant in 2021, according to his LinkedIn profile and company statements. He had previously run the Medicare business within UnitedHealthcare.
Legal scrutiny around UnitedHealthcare’s Medicare business regarding potentially overbilling the government affected Thompson personally during that time, said a former colleague, who spoke on the condition of anonymity given the sensitivity of Thompson’s death.
“He called me and said, ‘I’m from Iowa, my parents have difficulty explaining what I do, let alone being sued for a billion dollars,’” he said.
Colleagues described him as smart and affable, with an Iowa farm background that allowed him to explain complexities of health care in relatable terms. Known affectionately as “BT,” with the build of a former high school athlete, Thompson had the presence to give major speeches and lead corporate events — and a self-effacing manner that drew staff to him in more intimate settings, remembering personal details about hundreds of UnitedHealth employees, colleagues said. Thompson was known within the company for his focus on keeping premiums low, said one UnitedHealthcare staffer who spoke on the condition of anonymity to protect their job.
Thompson was on his way to present at UnitedHealth Group’s annual investor conference Wednesday when he was shot from behind by a masked gunman. Bullet casings recovered at the crime scene echoed words critics use to deride insurance company tactics — “delay, deny, defend” — according to a person with knowledge of the investigation, who spoke on the condition of anonymity to discuss the ongoing probe.
He told his wife, Paulette Thompson, 51, a physical therapist, that there were “some people that had been threatening him,” according to NBC News.
Thompson joined UnitedHealth Group in 2004 and over the next two decades rose quickly through the ranks of the company’s largest unit, UnitedHealthcare, which provides employer and individual health coverage to 50 million people in the United States. He enjoyed being part of a major company with lots of resources, believing that it enabled him to figure out big problems, said the former colleague.
That former colleague described Thompson as possessing strong business acumen and being likable, but also unafraid to be blunt and direct. As a public university graduate in an industry replete with Ivy League pedigrees, Thompson was fueled in part by wanting to prove himself, said the former colleague.
“I just saw a guy that wanted to be somebody and the reason he was going to be somebody was because of the chip that he had on his shoulder,” the former colleague said. “He had a much more modest background than probably a lot of the circles that he was running in. I don’t think it generated insecurity, but I think it motivated him.”
He was also a top executive of the parent company, though not its public face, typically playing a supporting role to CEO Andrew Witty in calls with financial analysts. Some colleagues saw him as a potential successor to the 60-year-old Witty, who has run UnitedHealth Group — the nation’s fourth-largest company — since February 2021.
Scrutiny on the company has mounted in recent years. Under Thompson, UnitedHealthcare ramped up its use of tactics such as “prior authorization,” in which physicians must submit additional paperwork to justify their treatments and prescriptions, according to reports by congressional investigators and federal watchdogs. The company also increasingly relied on automated programs to immediately reject claims, lawmakers and watchdogs have said.
Industry analysts have said that denying claims has helped UnitedHealthcare and other insurers cut costs and boost profits. The tactics have been faulted by lawmakers, federal officials and advocacy groups who say the health insurance giant has wrongly denied care to customers.
UnitedHealthcare has defended its practices, saying that lawmakers’ scrutiny is misplaced and that it is working to prioritize patient care.
The Department of Health and Human Services’ Office of the Inspector General investigated UnitedHealthcare and other health insurers that operated managed-care organizations, or MCOs. The probe focused on insurers’ Medicaid denials in 2019 — during part of which, Thompson ran UnitedHealthcare’s Medicaid business — and concluded that the program had high rates of prior authorization denials.
“These findings raise serious concerns that Medicaid MCOs are systematically and improperly denying necessary care which they are required by law to provide to the low-income children and families, seniors, and people with disabilities who rely on these plans for access to critical health care services,” congressional Democrats in September 2023 wrote to UnitedHealthcare.
Consumers’ frustrations with the company spilled out in protests long before Thompson’s killing.
When Witty, UnitedHealth Group’s CEO, testified in Congress in May, he was swarmed by protesters from People’s Action. The progressive advocacy group blamed the company for wrongly denying care.
“Stop using prior authorization to kill people,” Jennifer Coffey, a woman from Manchester, New Hampshire, said to Witty.
In a subsequent interview, Coffey and fellow protesters shared their stories of having their care requests rejected by UnitedHealthcare.
“Regulators shouldn’t have to be looking over insurers’ shoulders every time a senior citizen falls or suffers a stroke,” Sen. Richard Blumenthal (D-Connecticut) said in a video accompanying a Senate report released in October that faulted UnitedHealthcare and other insurers for repeatedly turning down Medicare Advantage patients’ requests. Blumenthal oversaw the investigation.
When asked for comment, a spokesman for UnitedHealthcare pointed to a company statement. “While our hearts are broken, we have been touched by the huge outpouring of kindness and support in the hours since this horrific crime took place,” the statement said. “Our priorities are, first and foremost, supporting Brian’s family; ensuring the safety of our employees; and working with law enforcement to bring the perpetrator to justice.”
Earlier this year, a local firefighters’ pension fund and the California Public Employees’ Retirement System, which calls itself the nation’s largest public pension fund, filed a lawsuit against UnitedHealth Group, Thompson and two other senior executives.
The suit alleged that they took part in deceitful business practices designed to artificially inflate UnitedHealth’s revenue and stock price, and then, in the case of Thompson and one other executive, sold their stock before news of a federal investigation into the company became public. The Wall Street Journal reported in February that the Justice Department had launched an antitrust probe into UnitedHealth Group.
Thompson, the suit said, sold more than 31 percent of his UnitedHealth stock for $15 million less than two weeks before the investigation became public.
The case is ongoing. The latest filing in the case came on Wednesday, the day Thompson was killed, according to court records. It was a judge’s order, stating that Thompson’s responses to the suit were due by March 1.
James Scullary, a spokesman for the California Public Employees’ Retirement System, said that the organization had not issued a statement related to the lawsuit or “any other pending matters.”
“We were shocked to hear of the events in New York and have shared our condolences with the company’s leadership,” he said.
Thompson grew up the son of a grain elevator worker and farmer in Jewell, Iowa — population 1,100 — and was the valedictorian of his high school, according to news reports. He graduated from the University of Iowa with a bachelor’s degree in business administration with an accounting major in May 1997, with special honors and highest distinction, meaning his GPA was 3.95 or above, the university said.
He lived in the upscale Whistling Pines neighborhood of Maple Grove, a small city outside of Minneapolis, according to public records. Thompson’s compensation package last year was valued at $10.2 million, the fourth highest among top executives at UnitedHealth Group, the insurer’s parent company.
“Brian was a wonderful person with a big heart and who lived life to the fullest,” his wife said in a statement to the Minnesota Star Tribune. “He will be greatly missed by everybody. Our hearts are broken, and we are completely devastated by this news. He touched so many lives.”
Thompson had been living separately from his wife and their two teenage sons in recent years, interviews with colleagues and neighbors showed.
Jim Pitzner, Thompson’s neighbor, said that Thompson had moved into a home on 62nd Avenue N. in Maple Grove a few years ago. Property records show Thompson purchased the five-bedroom, five-bath home for around $1 million in 2018. It’s now worth about $1.5 million.
Thompson’s sons visited occasionally, he said. Otherwise, Pitzner said, Thompson traveled often and was rarely home.
“He had a crazy travel schedule. The house is probably modest compared to what a CEO makes. It was just kind of a home base,” Pitzner said.
Daniel Gilbert, Aaron Schaffer and Caroline O’Donovan contributed to this report.
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