Health Care Dances the Samba

Maybe the management team at UnitedHealth Group (NYS: UNH) has been watching Dancing With the Stars and really liked the samba. The large U.S. insurer just announced plans to acquire Brazil's largest health-care organization, Amil Participacoes S.A.

Terms of the $4.9 billion deal call for UnitedHealth to conduct two transactions. The first will be to buy the 60% stake currently held by controlling shareholders. The second will be to extend a tender offer to buy 30% more from public shareholders. All of this depends, though, on approval by Brazilian regulators. UnitedHealth expects to gain this approval in fourth quarter this year.

What it means
UnitedHealth was already the largest health insurer in the U.S. ranked by market value. Now, it can lay claim to being the largest health-care organization in all of the Americas.

The move makes sense financially. Brazil represents the largest and fastest-growing market for private health care in Latin America. The country has a growing middle class and boasts a per-capita GDP that's 2.5 times that of China. While 80% of the U.S. population uses managed care, only around 25% of Brazil's population does so.

By scooping up Amil, UnitedHealth gains instant access to a well-established provider network and membership base. Amil currently serves more than 5 million members in Brazil. The company's network includes 44,000 doctors and 3,300 hospitals. Amil owns 22 hospitals and nearly 50 clinics.

Amil's revenue doubled over the last three years to $5 billion. While that's a drop in the bucket compared with the $101.8 billion for UnitedHealth last year, expansion into Latin American markets should lead to higher revenue down the road.

UnitedHealth expects the acquisition to be slightly accretive to 2013 earnings. The company projects that its debt to total capital ratio to rise a little to 36% temporarily but then go back below 35% by mid-2013.

Looking ahead
More international expansion could be the wave of the future for managed-care companies. Cigna (NYS: CI) maintains a footprint in 30 countries and expanded into India last year through a joint venture.

Aetna (NYS: AET) had already operated in Europe, Asia, and the Middle East prior to announcing the hire of a general manager to oversee its Americas expansion earlier this year. WellPoint (NYS: WLP) , on the other hand, doesn't have much of an international presence. The company's expansion plans focus on the U.S. with its announced merger with Amerigroup (NYS: AGP) .

Regardless of what the competition does, UnitedHealth's acquisition of Amil should prove to be a good move. Investors seem to have given high marks to the news, with shares up around 1% in intraday trading Monday on a day that the overall markets declined.

The scores from Bruno, Carrie Ann, and Len haven't been announced yet.

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Fool contributor Keith Speights has no positions in the stocks mentioned above. The Motley Fool owns shares of WellPoint. Motley Fool newsletter services recommend UnitedHealth Group and WellPoint. Try any of our Foolish newsletter services free for 30 days. We Fools may not all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.

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