From a first-quarter earnings beat to a wave of physician practice closures and a fresh entanglement in ASC antitrust remedies, Optum has spent the past few months navigating a mix of financial recovery and operational retrenchment.
Here’s a breakdown of Optum’s notable initiatives and developments since April 1:
Financial turnaround
Optum Health posted adjusted earnings of $1.3 billion in the first quarter of 2026, ahead of analyst expectations, in an April 21 earnings call. Executives credited the results to a return to “disciplined, integrated value-based care” following significant restructuring across the company’s care delivery portfolio. In the West Region, more intensive clinical navigation targeting hospital admissions, skilled nursing facility placements and ED encounters cut skilled nursing facility admissions by about 35% in the first month versus the prior year.
UnitedHealth Group remains on track to invest nearly $1.5 billion in AI in 2026, including a new prior authorization tool already showing a 96% approval rate. Still, Medicaid remains a drag on performance, with negative margins expected through 2026, and full-year adjusted EPS guidance was raised only modestly, to greater than $18.25.
That progress followed a first-quarter earnings report released the same week. Optum reported $63.7 billion in total revenue for the quarter, roughly flat year over year, with operating earnings of $3.3 billion and a 5.2% operating margin, down from 6.1% a year earlier. Optum Health’s revenue declined 3% to $24.1 billion, which the company attributed to continued investments and persistently elevated medical costs. Optum Insight posted modest revenue growth to $5.1 billion, though its operating margin slipped to 18.8% from 23.2% amid continued investment in people, technology and new products.
Practice closures and network reductions
Optum has continued to shed physician practice. In Indiana, Optum Primary Care’s Franklin location closed, with several providers relocating to a nearby Whiteland clinic, one physician retiring, and three others departing for Franciscan Physician Network, the Daily Journal reported May 25. Weeks later, Optum said it would close its Zionsville, Ind., practice on June 26, following earlier 2026 closures in Rock Hill, N.Y., and Portland, Ore. In both cases, an Optum spokesperson said the moves reflect “our commitment to making care more affordable” and efforts to transition patients to nearby Optum clinics or another provider of their choice.
The retrenchment extends beyond Indiana. Optum confirmed to Becker’s on June 24 that it is in talks with several large New York health systems to sell off certain specialties, including orthopedics, general surgery and urology, tied to Optum Medical Care and Crystal Run Healthcare, which it acquired in 2023. Jon Nasser, MD, CEO of Optum New York and New Jersey, said the goal is to keep that care local while Optum refocuses on primary care, pediatrics and ambulatory medical specialties. In December, New York lawmakers had pushed the state health department to investigate Optum’s closures and network reductions.
The move follows comments Optum CEO Patrick Conway made on an October earnings call, when he said the company’s care services division had “strayed from the initial intent,” resulting in an oversized provider network, and that Optum expected to work with fewer providers in 2026.
M&A and staffing deals
Optum-affiliated entities remained active on the deal side. Under a Federal Trade Commission consent order tied to Ascension’s $3.9 billion acquisition of Amsurg, published June 2, Ascension must divest seven ASCs across five states before the deal can close — and six of those seven centers are set to go to SC Affiliates, a subsidiary of SCA Health and Optum.
Separately, Optum-backed physician staffing firm Sound Physicians signed a deal to take over hospitalist services at Fresno, Calif.-based Community Health System, effective Sept. 1, The Fresno Bee reported July 17. Sound Physicians, acquired in 2018 by Summit Partners and OptumHealth, is hiring for several hospitalist and advanced practice roles at Community Regional Medical Center and Clovis Community Medical Center, with physician salaries ranging from $315,000 to $420,000. A Community Health System executive said the switch followed more than a year of quality improvement efforts and a request-for-proposals process, calling Sound “the strongest fit.”
Reimbursement policy
Optum also clarified its payment policy for anesthesia services delivered during electroconvulsive therapy, according to a June 10 American Society of Anesthesiologists news release. The company confirmed such services are eligible for separate reimbursement under certain conditions, depending on whether a facility operates under a bundled or unbundled payment arrangement. Optum also specified that CPT codes 00104 and 90870 cannot be billed together when submitted by the same physician specialty, but may both be reported when anesthesia and ECT services are performed by different specialties.
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