UnitedHealth Group (UHG) has experienced a few difficult years, to say the least. The Change Healthcare hack, the murder of Brian Thompson, and federal investigations and lawsuits drained the company’s morale and operational focus, resulting in a financially disastrous 2025. Its company-wide margin was cut in half compared to 2024, and its Optum Health provider arm lost money on operations after years of consistent profitability. Only its Optum Rx pharmacy benefit manager (PBM) division improved its margin from a year prior. 
 
UHG’s leadership has made no bones about needing to “change and reform.” Across the organization, UHG has committed $3B to AI spending by the end of 2027, dedicated to everything from faster processing of prior authorizations, to selling AI products to other payers and health systems, to launching an AI assistant à la Siri. “Transparency” is another key theme, as its latest insurance and PBM products promise clear, upfront, fee-based pricing. And perhaps most radically, Optum is shrinking both its employed and affiliated physician networks, while drawing a sharper line between the two. While headlines a few years ago touted Optum surpassing 90K employed or affiliated doctors, the company now emphasizes that it employs fewer than 10K physicians and has reduced its total network size to about 85K.