Brian Thompson led one of the biggest health insurers in the U.S. but was unknown to millions of people his decisions affected.
Then Wednesday's targeted fatal shooting of the UnitedHealthcare CEO on a midtown Manhattan sidewalk thrust the executive and his business into the national spotlight.
Thompson, who was 50, had worked at the giant UnitedHealth Group Inc for 20 years and run the insurance arm since 2021 after running its Medicare and retirement business.
As CEO, Thompson led a firm that provides health coverage to more than 49 million Americans -- more than the population of Spain. United is the largest provider of Medicare Advantage plans, the privately run versions of the U.S. government's Medicare program for people age 65 and older. The company also sells individual insurance and administers health insurance coverage for thousands of employers and state- and federally-funded Medicaid programs.
The business run by Thompson brought in $281 billion in revenue last year, making it the largest subsidiary of the Minnetonka, Minnesota-based UnitedHealth Group. His $10.2 million annual pay package, including salary, bonus, and stock options awards, made him one of the company's highest-paid executives.
The University of Iowa graduate began his career as a certified public accountant at PwC and had little name recognition beyond the healthcare industry. Even to investors who own its stock, the parent company's face belonged to CEO Andrew Witty, a knighted British triathlete who has testified before Congress.
When Thompson did occasionally draw attention, it was because of his role in shaping the way Americans get healthcare.
At an investor meeting last year, he outlined his company's shift to "value-based care," paying doctors and other caregivers to keep patients healthy rather than focusing on treating them once sick.
"Healthcare should be easier for people," Thompson said at the time. "We are cognizant of the challenges. But navigating a future through value-based care unlocks a situation where the ... family doesn't have to make the decisions on their own."
Thompson also drew attention in 2021 when the insurer, like its competitors, was widely criticized for a plan to start denying payment for what it deemed non-critical visits to hospital emergency rooms.
"Patients are not medical experts and should not be expected to self-diagnose during what they believe is a medical emergency," the chief executive of the American Hospital Association wrote in an open letter addressed to Thompson. "Threatening patients with a financial penalty for making the wrong decision could have a chilling effect on seeking emergency care."
UnitedHealthcare responded by delaying rollout of the change.
Thompson, who lived in a Minneapolis suburb and was the married father of two sons in high school, was set to speak at an investor meeting in a midtown New York hotel. He was on his own and about to enter the building when he was shot in the back by a masked assailant who fled on foot before pedaling an e-bike into Central Park a few blocks away, the New York Police Department said.
Chief of Detectives Joseph Kenny said investigators were looking at Thompson's social media accounts and interviewing employees and family members.
"Didn't seem like he had any issues at all," Kenny said. "He did not have a security detail."