Striking a balance between escalating costs and rising demand have brought challenging situations to the front steps of many health care providers, including UnitedHealth Group (NYSE: UHN). These factors represented key issues impacting growth this year of the company’s subsidiary OptumHealth.

The insurance giant and health care provider has seen slower than anticipated revenue growth across its business lines thus far in 2025.

Several leadership, operational and pricing changes have been brewing at the company intended to strengthen its bottom line and improve outcomes for patients and providers, UnitedHealth Group CEO Stephen Hemsley said during an earnings call on Tuesday.

“This is a challenging year at this enterprise, but I feel strongly that we can overcome these challenges,” Hemsley said during the earnings call. “It’s important to convey the tone we’re setting. More than anything, it is a tone of change and reform. We have embarked on a real cultural shift in our relationship with regulators and all external stakeholders. We’re rebuilding trust through both change and increased transparency.”

UnitedHealth projected its overall revenue to reach $445.5–$448.0 billion by the end of 2025 in its second quarter earnings report. The company’s Q2 revenue reached $111.6 billion, experiencing a $12.8 billion year-over-year increase. The climb was attributed to growth within UnitedHealthcare and Optum.

Revenues at the insurance mammoth UnitedHealthcare reached $86.1 billion that quarter, a 17% rise year over year.

The health services business Optum operates three subsidiaries: Optum Health, OptumRx and OptumInsight. The company’s consolidated second quarter revenues held at $67.2 billion, up by $4.3 billion compared to last year. Optum projected its full-year 2025 revenues to reach $266–267.5 billion, with rates for Optum Health expected to see a 4% year-over-year decline.

Minnesota-headquartered Optum was founded in 2011 and has about 310,000 employees providing care across more than 2,000 care sites. The company provides hospice and palliative care, post-acute and pharmacy services, behavioral health, as well as ambulatory surgical, primary, urgent and in-home care, among other services.

The company has launched an “agenda of change” designed to bolster its health care service offerings, according to Optum CEO Dr. Patrick Conway. The agenda includes refocusing on more effective health care delivery practices to improve outcomes and costs. Optum also expects that deeper integration of AI technology will help the company reach a wider base of underserved patient populations, Conway indicated.

The approach has also included an “evolution” of its executive leadership, Conway stated. Roger Connor has become Optum’s new CFO, with the company naming Krista Nelson as new COO of Optum Health and Dhivya Suryadevara as new CEO at Optum Insight.

“We know Optum’s performance has not met expectations,” Conway said during the earnings call. “Optum health [is] where improved execution is needed most, and we’re experiencing the greatest pressures to our business. We’re approaching this with humility and the need for deep analysis of key issues and commitment to substantially improved execution. The problems are fixable. We have a talented team in place now to continue to recruit talent to develop the next generation of products rooted in AI.”

Pricing and operational “mistakes” created significant financial headwinds for UnitedHealth Group, alongside a challenging health care environment, according to Hemsely. The biggest issues facing health care companies today include pullback of Medicare funding, unprecedented trends of rising medical costs and contraction of the Medicaid market growth, he stated.

The company is undergoing several critical review processes by independent, external experts in an effort to evaluate aspects of its care management practices, pharmaceutical services and risk status, among other areas of its business.

Other changes taking shape at UnitedHealth Group included “extensive” management and operational changes such as new leadership and board governance oversight, as well as a renewed focus on strengthening its organizational culture, Hemsley said.

“Looking to 2026 at this distance, I would expect solid, but moderate earnings growth” Hemsley said. “As we look further ahead, we see our earnings growth outlook strengthening quickly in 2027 and pacing steadily upward over the succeeding years. It begins with respecting pricing basics, advancing our foresight acumen and just better, more intense and more decisive overall management. We will be driving better business practices, better consumer and provider experiences, and accelerating investments in key areas to both strengthen our foundations and modernize our businesses anchored in practical innovations and scaled AI applications.”

UnitedHealth Group still expects to close its purchase of Amedisys (Nasdaq: AMED) despite ongoing legal and regulatory challenges. In June 2023, the company agreed to acquire Amedisys in an all-cash transaction of $101 per share, or about $3.3 billion.

The company is working to address antitrust concerns raised in a lawsuit by the U.S. Department of Justice.

“We continue to work through that process with the regulators in a productive way,” UnitedHealth Group CFO John Rex said. “But we committed to those assets and certainly very committed to the capabilities where we can serve people in the home. It’s super important in terms of the foundational part of value-based care in terms of how we actually serve them.”