Krista Nelson told investors Optum Health's recovery rests on clinical improvements, tighter operating controls and selective partnership changes that aim to restore margins in 2027–2028.
Clinical metrics improved after new programs targeting transitions of care, care coordination and patient support reduced skilled nursing admissions, readmissions and length of stay.
Operating-cost management became a major focus in 2026: physician productivity and scheduling changes raised patient-facing hours by 12% (about 200,000 hours) in H1.
Optum reviewed payer contracts to fix misalignment for 2027 and is assessing network performance and partnerships, including selling certain Florida clinic interests to TPG.
# What happened At the Wells Fargo Healthcare Conference, Optum Health CEO Krista Nelson described the company's approach to reversing the weak results that helped drive UnitedHealth's 2025 earnings collapse. She laid out concrete actions across clinical care, operations and contracts that management says are improving performance.
# Clinical response Nelson credited new programs launched after the 2025 downturn with improving a range of clinical metrics. Those programs focused on transitions of care, care coordination and patient support across multiple touchpoints. Optum Health reported measurable improvements in areas that had been a drag on results:
Nelson said these clinical improvements are "performing better than we expected," and called them a primary driver of the turnaround visible in UnitedHealth's second-quarter results for Medicare Advantage.
# Operating-cost management A big shift in 2026 was a concentrated push on operating-cost management. Optum boosted physician productivity and updated scheduling processes. The company reported a 12% increase in patient-facing hours in the first half of the year, equal to roughly 200,000 additional hours.
Nelson described operating cost management as a sustained theme that produced "significantly more cost savings" than before, and one that will continue through the rest of 2026 and into future years.
# Contract and network work Optum dug into other payer contracts to identify areas of misalignment and close gaps ahead of 2027. Management said the "vast majority" of addressable contracts for 2027 have been managed.
# Financial outlook and priorities Nelson said performance enhancements are pacing ahead of schedule and will allow reinvestment into Optum Health in the latter part of the year. The company expects those gains to support margin expansion across 2027 and 2028.
She signaled a change in emphasis for next year: top-line growth is "probably not going to be the focus" in 2027. Instead, management will prioritize cost and margin improvement while launching new strategic initiatives aimed at affordability and quality.
# What to watch next Watch whether the reported clinical and operating gains are sustained across upcoming quarterly results and whether the contract adjustments translate into measurable margin improvement. Monitor the TPG deal for Florida clinics to see how Optum deploys proceeds and whether the partnership model is expanded to other markets.
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UnitedHealth Group Inc. has sold an interest in some of its Optum Health operations in Florida to private equity company TPG Inc. as the health conglomerate is working to recover from a collapse in profits last year. “We didn’t need …
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