Steward Health Care System is preparing to sell its physician network to OptumCare, a subsidiary of health care giant UnitedHealth Group, according to documents filed in Massachusetts.

The state’s Health Policy Commission received notices Tuesday about the sale of Stewardship Health Inc., the parent company of Stewardship Health Medical Group Inc., which employs primary care physicians and other clinicians across nine states.

The documents also state Steward Health Care Network Inc., a contracting network, would be acquired by OptumCare.

Commission Executive Director David Seltz, according to a statement on the commission’s website, said details of the proposal would be reviewed by the commission to “examine potential impacts on health care costs, quality, access and equity.”

The sale cannot be completed until after the review and any simultaneous review by state or U.S. antitrust authorities.

“As described in the notice, this is a significant proposed change involving two large medical providers, both in Massachusetts and nationally, with important implications for the delivery and cost of healthy care across Massachusetts,” Seltz said.

According to the notice, Stewardship Health Medical Group providers would retain their clinical practice autonomy and OptumCare “is dedicated to maintaining Stewardship’s workforce.” Also, OptumCare doesn’t anticipate diminished health care services, the notice states.

“This arrangement will support the growth and expansion of Stewardship’s care model, which delivers value to the patient through the provision of value-based, high-quality care at lower total medical expense,” the notice states.

Steward Health Care, based in Dallas, is struggling financially.

In January, there were reports the health care system, which operates more than 30 hospitals in eight states — including Trumbull Regional Medical Center in Warren, Hillside Rehabilitation Hospital in Howland and Sharon Regional Medical Center in Sharon, Pa. — owed $50 million back rent at the end of 2023 to its landlord, Alabama-based Medical Trust Properties Inc., one of the largest owners of hospital real estate in the world.

Then in February, the system announced an action it said would allow the organization to “emerge as a sustainable business” that included a $150 million cash infusion to provide additional liquidity as the company moved toward selling its asset physician group, Stewardship Health, according to a press release.

In Trumbull County, Commissioner Denny Malloy and Warren Mayor Doug Franklin wrote an open letter to the public to express their concern about the health care provider’s financial situation and how it could affect delivery at Trumbull Regional.

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