Sunlight Report Update: UnitedHealth Group, 2024 to 2026

The Sunlight Report on UnitedHealth Group, published in July 2025, counted 219 UnitedHealth entities in 2013 and 2,694 in 2023, using state insurance filings (Schedule Y) through the first quarter of 2024. This update adds the year-end 2024 and 2025 Schedule Y filings, 2026 transactions that can be confirmed from public sources, and the company’s SEC filings through the second quarter of 2026. UnitedHealth Group’s acquisition growth has slowed significantly since the original report’s data ended. The structure the report described is still in place.

Entity growth has slowed

• Additions. In contrast to the tenfold growth of the prior decade, 368 entities were added and 268 left between early 2024 and the end of 2025. Amedisys, a home health and hospice company acquired in August 2025, accounted for the bulk of new entities (168). Other additions continue the pattern the original report described, at lower volume: surgery centers (80), pharmacy (38) and home health (23).

• 2026. Only two purchases can be confirmed so far: Alegeus Technologies, which administers health savings and spending accounts (about $3.0 billion), and six surgery centers acquired under an FTC order.

• Departures. Of the 180 entities that left in 2025, 82 were home health entities and 24 were international. Optum UK was sold in March 2026, and the Chilean and Colombian businesses of Banmédica are under agreement to be sold. Leaving the filing is a legal event, not proof that a clinic closed. However, our reporting has documented significant closures: Optum closed 108 of the 216 behavioral health locations it had acquired.

The company’s financial statements show three trends

1. Internal revenue continued through 2025. UnitedHealth units billed each other $168.0 billion in 2025, and UnitedHealthcare supplied about 62% of Optum’s revenue. The share was lower in the first half of 2026 because UnitedHealthcare covered fewer people.

2. Acquisition spending slowed. Of the $4.5 billion spent in 2025, $3.7 billion came in the quarter Amedisys closed. Spending was $98 million in the first half of 2026.

3. Optum Health earnings reversed. A $7.8 billion operating profit in 2024 became a $278 million loss in 2025, including about $2.5 billion of restructuring. The company said it had narrowed its affiliated physician network by nearly 20% and would close or sell about 550 care sites.

Insurance enrollment declined

UnitedHealthcare served 1.2 million fewer people at mid-2026 than at the end of 2025. Medicare Advantage fell by 880,000, Medicaid by 600,000 and commercial plans where the insurer bears risk by 510,000, while employer self-funded plans grew by 780,000. The company attributes the Medicare Advantage decline to benefit and pricing changes and to plan and county exits. Its medical care ratio improved from 89.1% in 2025 to 85.3% in the first half of 2026.

What this means for patients

• Coverage. For 2026 the company left Medicare Advantage in 109 counties, affecting about 180,000 members, and has confirmed further service-area reductions for 2027.

• Access. Patients of a closed or sold practice must find new clinicians. No public data shows how many did, how long it took, or what care they went without.

• Affordability. A Health Affairs study found UnitedHealthcare pays Optum physician practices about 17% more than other practices for the same services. A second study found prices rose 11% at surgery centers after Optum acquired them.

• Health spending accounts. The Alegeus acquisition fits the vertical integration pattern, but it extends UnitedHealth into territory that is new for an insurer. The platform runs health savings, flexible spending and reimbursement accounts for more than 26 million people, including on behalf of other health plans, administrators and banks. Together with Optum Bank, the company now sits on the flow of consumers' own health care dollars as well as premiums. The intended effects are simpler administration and payment. The unintended effects are less understood: how account balances, fees and card payments generate revenue, how much of the return on balances reaches account holders, and whether spending data from other plans' members could inform pricing or direct patients to Optum providers and pharmacies. This area has had little independent study and warrants dedicated research and clearer disclosure.

• Company commitments. UnitedHealth has announced a 30% cut in prior authorization requirements and a move to pass all drug rebates to Optum Rx clients by 2028. However, our analysis and reporting shows this is largely a PR stunt. These should be tracked against results.

Transparency and oversight

• Less transparency. The subsidiary list in the company’s SEC annual report was cut from thousands of names to only 10. The state Schedule Y filings used here still name every entity and are now the only public source for the company’s structure.

• Oversight. July 2025, UnitedHealth told investors it was responding to formal requests for information from the Justice Department in criminal and civil investigations of its Medicare business. No charges have been reported. “Regulators allowed the Amedisys acquisition after 164 locations were divested. The Break Up Big Medicine Act and related bills are pending. No law or order has required UnitedHealth to separate its insurer from its providers or pharmacies.

What to watch

Third-quarter 2026 results are due October 13, 2026, and the year-end 2026 Schedule Y, due around March 2027, will give the first full count of 2026 additions and departures. Management has said it expects to return to acquisitions, and further Medicare Advantage exits take effect in January 2027.

Research Methods and Project Background

The Sunlight Report on UnitedHealth Group is a project of the Center for Health & Democracy (CHD), made possible through funding from Arnold Ventures. First developed in 2024, the project aims to bring greater transparency to UnitedHealth Group's vast corporate structure by collecting, analyzing, and publishing information from publicly available regulatory filings.

The latest edition incorporates UnitedHealth Group's most recent available filings, identifying 2,807 entities within its corporate structure.

Our research draws primarily from Schedule Y filings submitted to state insurance regulators, which disclose subsidiaries and related entities within insurance holding companies. We collected filings dating back to 2010, supplemented them with other public records, and manually extracted and consolidated information about company names, identification numbers, ownership relationships, and estimated establishment dates. Duplicate entries were removed, and entities were classified into five broad categories based on their primary functions.

Because regulatory filings do not always distinguish between acquisitions and newly created subsidiaries, establishment dates are estimates based on when entities first appeared in available records. We also consulted publicly available sources to better understand each company's operations and role within UnitedHealth Group.

The Sunlight Report is intended for educational and informational purposes. While CHD has worked to ensure accuracy, the underlying filings may contain errors or omissions, and transcription or classification inaccuracies may occur. Neither CHD nor its funders accepts liability for such errors.

Our goal is transparency. If you identify information that appears inaccurate or incomplete, please contact us at info@sunlightreportinsurance.com.

Sources: UnitedHealth Schedule Y filings (through Q1 2024, year-end 2024 and year-end 2025); UnitedHealth Group SEC filings and earnings releases, July 2025 to August 2026; linked reports. Entity-level data and full sourcing are in the detailed update.