UnitedHealth Group (NYSE: UNH) is sending health care stakeholders – including the providers it works with – a two-part message.
First, executives want providers to know that prior authorization isn’t going away any time soon, but that UnitedHealth Group is trying to make the practice faster and less frequent. Separately, the health care giant and its care-delivery arm – Optum – are increasingly focused around steering patients away from higher-cost settings.
Both themes, laid out during UnitedHealth Group’s first-quarter 2026 earnings call on Tuesday, have implications for ambulatory surgery center (ASC) operators navigating payer friction and the broader migration of procedures to lower-cost sites of care.
“We’re encouraged by the way the year has started,” CEO Stephen Hemsley said on the call. “We remain grounded in the need for consistent execution in managed care fundamentals and on a strategy to help build an integrated value-based health system that together makes things better and simpler for care providers, patients and customers.”
In typical UnitedHealth Group fashion, the company didn’t discuss SCA Health at all.
Prior auth: faster, fewer (but not going away)
Prior authorization has emerged as one of health care’s most politically charged flashpoints, with the Trump administration and members of Congress from both parties publicly pressuring payers to scale back the practice. On their end, ASCs and other providers have argued prior auth delays care and drives up administrative costs.
Tim Noel, CEO of UnitedHealthcare, defended prior authorization as essential. He did so even as he outlined steps to reduce its volume and speed up decisions.
“Prior authorization remains a critically important tool for eliminating fraud, waste and abuse and for helping ensure patient safety and quality care,” Noel said on the call. “We also recognize it is a source of frustration, and we are working to reduce that.”
Nearly 95% of prior authorization requests are now submitted electronically, according to Noel, with about half processed in real time and more than 90% approved within one business day on average. UnitedHealthcare is also “working to enable more prior authorization submissions to be made directly within care provider workflows,” he noted.
Ultimately, UnitedHealthcare plans to cut the overall number of medical prior authorizations by 30% or more by the end of 2026, Noel said.
To point to something concrete, Noel cited his company’s efforts to accelerate payment for rural health care providers.
“We will accelerate payments in all lines of business by 50% for rural hospitals and exempt rural health care providers for most medical prior authorization requirements,” he said. “And we are building network partnerships between rural providers and leading regional health systems. Together, these initiatives will help lower costs and simplify processes for care providers and greatly enhance access to quality care for people in rural communities.”
Value-based care and the site-of-care story
The second theme – value-based care as a hospital-avoidance strategy – is another that intersects with ASCs and the factors shaping that space.
Optum, under CEO Patrick Conway, is in the middle of what leadership described as a return to a “disciplined, integrated value-based care model.” The UnitedHealth Group subsidiary is looking more closely at aligning incentives around outcomes, rather than volume, while reducing unnecessary utilization and improving total cost of care.
“Both patients and care providers do better when incentives are aligned towards care outcomes and not the quantity of services provided,” Conway said on Tuesday’s call.
Currently, Optum serves more than 20 million patients across its care models, including more than 4 million in fully value-based arrangements, according to Conway. He cited data showing that among nearly 2 million dual-eligible patients, those in value-based care arrangements had 24% fewer acute inpatient hospital admissions and 29% fewer emergency room visits than patients in traditional Medicare.
As Optum looks to, perhaps, shift hospital spend to other settings, ASC stakeholders have an example to follow in what it has done with skilled nursing facility (SNF) admissions).
Early results from the company’s 2026 operating changes show skilled nursing admissions “trending sharply below historical levels,” according to Conway. Specifically, Optum saw a roughly 35% reduction in SNF admissions in the first month of 2026 compared to last year.
Bobby Hunter, CEO of government programs and head of Medicare insurance, slightly piggybacked on some of those ideas.
When asked about how the U.S. Centers for Medicare & Medicaid Services (CMS) is modernizing Medicare and how UnitedHealth Group feels about recent changes, Hunter said his company is generally “appreciative” of CMS’ efforts.
“We are committed to making the system simpler, more efficient, more transparent, and … we see value-based care as a critical and foundational tool to ensuring that success long term,” he said.
The financial backdrop
This story really isn’t about how UnitedHealth Group did during its most recent quarter, but ASC News will give you the high-level takeaways anyway (in case you’re curious).
UnitedHealth Group reported first-quarter 2026 revenue of $111.7 billion, up roughly 2% year over year, and adjusted earnings per share of $7.23. The company raised its full-year 2026 adjusted EPS outlook to greater than $18.25.
Optum revenues were $63.7 billion.
During the call, executives explained that elevated utilization is not easing, which will likely impact future earnings results.
Medicare Advantage medical trends remain elevated, Noel said, but in line with UnitedHealthcare’s pricing assumptions. That, he added, reflects “continued service intensity and higher provider billing patterns consistent with what we saw exiting last year.”
Overall, Hemsley framed the quarter as a step in a multi-year rebuild.
“As we kind of build on the momentum as we get started in this year, we realize there’s a great deal more work to do,” Hemsley said. “And I think you’ll see sustainable progress to position this enterprise to serve all of its stakeholders in a progressively better way quarter after quarter. That’s kind of our agenda.”
