See more of the story

Over the past year or so, the story of health care in the U.S. — much like the public discussion of Minnetonka-based UnitedHealth Group — has been something of a head fake. Broadly speaking, the health care narrative has been dominated by the troubled fate of the federal Affordable Care Act (ACA), even though the law's most sweeping provisions impact only a minority of all patients. Similarly, while UnitedHealth Group's financial losses on the ACA's new health insurance exchanges were a recurring theme in 2016 coverage about the company, overall financial results provided investors with a much happier story.

"2016 was a fantastic year for the stock," said David Heupel, senior health care analyst at Thrivent, the Minneapolis-based financial services group. "The exchanges were never a huge part of the business."

UnitedHealth Group is once again at the top of the list in the Star Tribune's annual survey of largest publicly traded companies in Minnesota. The company's 2016 revenue of $184.8 billion represented an increase of nearly 18 percent over the previous year, while annual profit of $7 billion was up nearly 21 percent.

UnitedHealth's health insurance division, UnitedHealthcare, competed on exchanges in 34 states during 2016 and posted $850 million in losses. It was the second year of significant red ink.

While those losses mounted, the company's Medicare and Medicaid businesses grew, Heupel said, and UnitedHealthcare maintained its large business providing insurance or administrative services to employer-sponsored health plans. Plus, UnitedHealth Group's Optum, which administers pharmaceutical benefits and other services, grew at even a faster rate.

"UnitedHealthcare spends $2.9 billion annually on technology and innovation," said Tyler Mason, spokesman for the company that employs 15,000 in Minnesota.

Over the past year, UnitedHealth Group's market capitalization grew by about one-third. On that basis, the company is still the largest in the state's health care sector, but is closer in size to the medical technology firms that round out the Star Tribune's list.

UnitedHealth in 2016 posted more than five times the annual revenue of Medtronic, which remains the state's largest medical device manufacturer. But in terms of market capitalization, United's value to shareholders wasn't even twice that of Medtronic, which had an April market capitalization of $110 billion.

"The profitability of a medical device company compared to a managed care company — it's significantly higher," Heupel said. Device manufacturers in 2016 were pretty much "steady as you go."

"Medtronic certainly had a choppy 2016 with regard to its results, but I think they're seeing some improvement this year," Heupel said. "The stock's reflected that."

Christopher Snowbeck • 612-673-4744