The news: UnitedHealth Group is forecasting an annual decline in revenues for the first time in over 35 years.
- Company revenues are forecast to reach $439 billion in 2026, a 2% YoY decline and short of analyst estimates.
- It would mark UnitedHealth’s first annual revenue decline since 1989, per Bloomberg data.
- Shares of UnitedHealth are down ~20% at the time of writing.
Why it matters: UnitedHealth is one of the largest publicly traded US companies by revenues, and it’s still projecting massive earnings this year—but it has disappointed investors and analysts who are accustomed to its steady annual revenue growth.
UnitedHealth has expanded into the largest vertically integrated healthcare entity in the US, spanning across health insurance, care delivery, and pharmacy operations.
UnitedHealth’s expansion appears to have plateaued, however, and it is now downsizing key parts of its business, like Medicare Advantage (MA). After years of MA growth—boosted by government bonus payments for lowering members’ costs—UnitedHealth is cutting MA enrollment by over 10%, or upwards of 1.4 million seniors. Like other MA insurers, UnitedHealth has struggled to keep costs down for older members who are using more medical services than anticipated.
UnitedHealth is also scaling back its Optum business, with care delivery sites and membership decreasing by about 20%, or 550 locations, per Bloomberg. Optum Health—the patient care arm of Optum—posted a $278 million loss in 2025, a sharp reversal from a $7.8 billion gain the prior year. After years of acquiring medical groups and other providers, Optum Health has struggled to align them under its value-based care model and rein in utilization.
Implications for healthcare companies: UnitedHealth is viewed as the industry bellwether whose strategic guidance shapes expectations for the US healthcare sector. Plus, investors were hoping for a quick financial turnaround this year with a new CEO at the helm.
But the company’s first earnings of 2026 show it is still facing headwinds on multiple fronts—and two DOJ probes into its Medicare Advantage operations. While nothing technically prevents further expansion, the payoff isn’t what it once was, amid tighter government scrutiny and mispriced healthcare utilization. As other major insurers and vertically integrated healthcare players report earnings in the coming weeks, they’ll likely emphasize financial discipline, organizational restructuring, and margin expansion over membership growth as they seek greater stability.
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