UnitedHealth forecast a decline in 2026 revenue, the first annual contraction in more than three decades, as the company works to rebuild confidence with investors after a stunning fall last year.
The health-care giant grew aggressively through deals over the past decade, but is now shedding assets in a bid to improve profits. The insurer’s earnings outlook for 2026 did come in slightly ahead of Wall Street’s views. Adjusted profit will be greater than $17.75 a share, the company said in a news release, which is 6 cents higher than the average of analyst estimates in a Bloomberg survey.
The company faces other new pressures. Late Monday, the US proposed holding payments to private Medicare plans flat next year, a huge disappointment that caused the stock to tumble as much as 10% in after-hours trading on Monday.
Shares sank more than 12% in New York on Tuesday, before the start of regular trading.
UnitedHealth’s 2026 outlook signals a company with a smaller footprint, fewer members and higher profits.
The health-care giant is shedding insurance membership, divesting overseas assets and shrinking the US footprint of its care delivery unit, Optum Health, the company said. Revenue is set to drop at both UnitedHealthcare, the company’s insurance arm, and its Optum services division as a result.
Chief Financial Officer Wayne DeVeydt said Optum Health’s care sites and membership will shrink by about 20%, or 550 locations, with some medical practices being closed or sold to hospitals or providers. In an interview before the company’s public earnings release, he described it as “pruning back to the core” of Optum Health.
Optum Health had been the engine driving profit growth in recent years as the company scooped up doctors offices, surgery centers and other care sites. It aimed to serve patients on Medicare — both UnitedHealthcare’s plans and its rivals — and take on a share of the premium for those patients. But profit in that segment has evaporated, as new federal rules lower Medicare payments to insurers.
Overall, UnitedHealth’s revenue for 2026 will be greater than $439 billion, a 2% decline from 2025 and short of analyst estimates. It would be the first annual revenue decrease for UnitedHealth since 1989, according to data compiled by Bloomberg.
Still, the company forecasts operating earnings to jump by at least $5 billion, an increase of more than 25% over last year.
The company took a one-time charge of $1.6 billion after taxes that was excluded from adjusted results. The charge reflects costs related to the Change Healthcare Inc. cyberattack, gains on divestitures and restructuring costs.
DeVeydt said the impacts of divestitures and other transactions would be excluded from adjusted results. UnitedHealth previously included earnings from opaque deals that boosted earnings by billions of dollars in 2024.
UnitedHealth’s outlook for a key gauge of medical costs was slightly more favorable than analyst estimates, an improvement from last year that reflects “repricing.
The UnitedHealthcare insurance business expects to shed as many as 2.8 million members, with shrinking enrollment across all its major segments — commercial health plans, Medicare and Medicaid.
DeVeydt said the company now sees Medicare Advantage membership shrinking by 1.3 million to 1.4 million, a greater number than it previously thought, though it expects to improve margins.
The company expects to close the sale of European operations in the first quarter and South American businesses in the second half of the year, DeVeydt said.
Overall, adjusted earnings per share growth for 2026 is expected to be about 8.5%, though DeVeydt said the company hopes to do better.
“We think we’ll perform better than that, but we want to be prudent in our outlook,” he said.
Comments