Unitedhealth Group Incorporated (UNH)

UnitedHealth Group reported on 13 October 2026 that third-quarter revenue was $112.7 billion, a little below the $113.2 billion of a year earlier, while earnings from operations rose to $6.6 billion from $4.3 billion 1. The medical care ratio, the share of premiums paid out for patients' care, fell to 88.4 percent from 89.9 percent 1. The company raised its 2026 outlook to adjusted earnings of at least $20.50 per share 1.

The company credits medical cost management, benefit design changes and pricing discipline, after a 2025 in which its prices fell well short of what care actually cost 12. It is also smaller: UnitedHealthcare served 48.3 million people, and its Medicare Advantage rolls for seniors have shrunk by 935,000 since the end of 2025 1. Optum Health's revenue fell 10 percent as it served fewer patients under value-based care, contracts where it takes a set monthly sum and carries the cost of a patient's care 12.

The open questions sit in Washington: in July 2025 the company said it had begun complying with formal criminal and civil requests from the Justice Department about its part in Medicare 6. Medicare's 2027 rates came in at an average increase of 2.48 percent for its private plans, far above the 0.09 percent proposed in January, Home Health Care News reported 20.

UnitedHealth Group was incorporated in Minnesota in January 1977 and moved its legal home to Delaware on 1 July 2015 8. It grew into two businesses: UnitedHealthcare, which sells health coverage and pays for members' care, and Optum, which delivers care, runs drug benefits and sells data and software 2.

The pharmacy arm grew by purchase: in the third quarter of 2015 the company bought Catamaran Corporation, a pharmacy benefit manager, for $14.3 billion in cash 8. That deal and growth in members lifted revenue in 2016 18 percent to $184.8 billion 8.

The pandemic shook 2020: in the second quarter patients put off care on a scale never seen before, and by the third quarter care was back near normal 9. Revenue still rose 6 percent to $257.1 billion, with Optum up 21 percent 9.

On 3 October 2022 the company bought Change Healthcare, which runs the clinical, paperwork and payment links between doctors and insurers, for $13.9 billion in cash 10. Revenue that year rose 13 percent to $324.2 billion 10.

That purchase became the crisis of 2024: on 21 February 2024 the company found that a hacker tied to a nation-state had broken into Change Healthcare's systems, and the attack touched about 190 million people 1211. To keep doctors paid while claims stalled, it lent care providers more than $9 billion free of interest 11.

The same month it sold its Brazil operations, booking a loss of $7.1 billion, and revenue still grew 8 percent to $400.3 billion 11. On 4 December 2024 the company announced the death of Brian Thompson, the chief executive of UnitedHealthcare, and said it was working with the New York Police Department 13.

On 13 May 2025 the company named Stephen Hemsley, its chief executive from 2006 to 2017, to replace Andrew Witty 5. It also suspended its 2025 outlook because medical costs were running higher than expected 5. Wayne DeVeydt, finance chief of Anthem from 2007 to 2016, became chief financial officer on 2 September 2025 7.

In August 2025 it completed the purchase of Amedisys, a deal agreed in June 2023 18. For the full year, revenue grew 12 percent to $447.6 billion, but earnings from operations fell to $19.0 billion from $32.3 billion 2. The medical care ratio rose to 89.1 percent from 85.5 percent, on Medicare funding cuts, rising medical costs and the Inflation Reduction Act's changes to Medicare drug plans 2.

Those earnings carried a charge of $2.8 billion for the last costs of the cyberattack, business exits and broader restructuring 4.

UnitedHealthcare: plans for employers and individuals

UnitedHealthcare Employer & Individual sells health plans to employers of every size and to individuals, either taking the risk of the medical bills for a premium or running an employer's own self-funded plan for a fee 2. It served 29.7 million people at the end of 2025 2. Third-quarter revenue was $20.2 billion against $19.9 billion a year earlier, and it lost 165,000 people in the quarter as employers left 1.

UnitedHealthcare: Medicare and Medicaid

Medicare & Retirement sells Medicare Advantage, private plans the government pays a fixed monthly sum per member, plus drug plans and Medicare Supplement policies 2. It had 8.4 million Medicare Advantage members at the end of 2025, and premiums from the government's Medicare agency made up 44 percent of group revenue that year 2. Third-quarter revenue was $42.4 billion against $43.4 billion, and at least 69 percent of members are in plans rated 4 stars or better for 2027 1.

Its HouseCalls program sends nurse practitioners to members' homes, and they made 3.1 million preventive visits in 2025 2. The company says an independent review found the sampled HouseCalls diagnoses were overwhelmingly supported by medical records 1.

Community & State runs Medicaid plans for 32 states and the District of Columbia, and served nearly 7.4 million people at the end of 2025 2. Its third-quarter revenue was $23.7 billion, and it served 85,000 fewer people in the quarter as states changed who qualifies for Medicaid 1.

Optum Health: doctors and care

Optum Health runs primary, specialty and surgical care in clinics, at home and online, for 95 million consumers and more than 100 health plans 2. Much of it is value-based care, where Optum takes a monthly premium and carries the cost of the care 2. In the third quarter its revenue fell 10 percent to $22.9 billion, but earnings from operations rose to $735 million from $41 million 1.

Optum Insight: data, software and Change Healthcare

Optum Insight sells software, analytics, payment checking and consulting to hospitals, health plans, states and drug makers, and on 1 January 2026 it took over Optum Financial and Optum Bank 2. Its backlog of contracted work was about $31.1 billion at the end of 2025, with $18.3 billion expected within a year 2. Third-quarter revenue rose 3 percent to $5.5 billion and earnings from operations reached $1.3 billion 1.

Optum Rx: pharmacy care

Optum Rx runs drug benefits for health plans, employers and unions through about 64,000 retail pharmacies, plus home delivery and specialty pharmacies 2. It managed $188 billion of drug spending in 2025, nearly $87 billion of it on specialty drugs 2. Third-quarter revenue was $39.9 billion, while adjusted prescriptions fell to 393 million from 414 million as UnitedHealthcare and other clients lost members 1.

It has launched what it calls a fully transparent, fee-based pharmacy model, separating its pay from drug list prices 1. It has committed to pass 100 percent of drug makers' rebates to clients by 1 January 2028 1.

Rivals

In Medicare Advantage, UnitedHealth Group plans held 26 percent of enrollment in 2026, down from 29 percent, while Humana rose to 20 percent from 17 percent, KFF found 19. UnitedHealth's enrollment fell by nearly 647,000 between March 2025 and March 2026, and Elevance lost the second most 19. In drug benefits, the FTC counts Optum Rx with Caremark and Express Scripts among the six largest managers, which handle nearly 95 percent of US prescriptions 21.

Offices, people and leadership

The company has executive offices in Eden Prairie, Minnesota, and Washington, DC, and owns and leases property in the United States and other countries 12. At the end of 2025 it had more than 390,000 employees, nearly 165,000 of them clinical professionals 2. Stephen Hemsley, 73, is chair and chief executive; Wayne DeVeydt is finance chief, Patrick Conway runs Optum and Timothy Noel runs UnitedHealthcare 2.

In August 2025 the board created a Public Responsibility Committee to oversee pricing, regulatory and reputational risks, and made F. William McNabb, a former Vanguard chief executive, lead independent director 23. Scott Gottlieb, a former head of the FDA, joined the board in November 2025 27. At the June 2026 annual meeting shareholders rejected a proposal for an independent board chair, with 20.24 percent of votes for it 22.

Problems on file

The company says it is complying with formal criminal and civil requests from the Justice Department about its Medicare business 6. Medicare auditors are also checking the coding behind payments to some of its plans, which may lead to payments being taken back 2.

In an older civil case over Medicare risk payments, a court-appointed Special Master recommended in March 2025 a ruling for the company 3. In April 2025 the department asked the court to reject that report 3.

The cyberattack still costs money: in the fourth quarter of 2025 the company added $799 million to reserves for provider loans and other balances it may not collect 2. It says Medicare Advantage rates have trailed medical costs for years, and Medicaid rates lag the health needs of the people it serves 2.

The umbrella, in words

UnitedHealth Group is the parent, and its two brands are UnitedHealthcare and Optum, both registered trademarks 2. Its annual report lists ten significant subsidiaries, among them Optum, OptumHealth Holdings, OptumRx Group Holdings, UHIC Holdings and United HealthCare Services, and leaves the smaller ones out 14. It owns Amedisys outright, and owns Optum Bank, which Utah's banking department supervises 182.

It agreed in the fourth quarter of 2025 to sell its remaining South American operations, a sale expected to close in the second half of 2026 3. It also holds put and call options on businesses it does not consolidate, with an estimated obligation of $4.8 billion at the end of 2025 2.

It has one class of common stock, with 908,213,180 shares entitled to vote at the April 2026 record date 15. Vanguard Capital Management reported 7.5 percent of the shares on a Schedule 13G, and State Street Corporation 5 percent 1617. The proxy lists BlackRock with 72,595,811 shares from a 2024 filing, and notes that The Vanguard Group stopped reporting its units' shares as its own after an internal realignment 15.

A person's own stake: chief executive Stephen Hemsley received a one-time stock option award of $60 million in May 2025 that vests after three years 26. In February 2026 the board added a rule that he must hold any shares he gets from it until 14 May 2030 28.

The company expects 2026 adjusted earnings of at least $20.50 per share, and at least $19.50 per share under standard accounting, an outlook it raised on 13 October 2026 1. In July it had guided to $19.50 to $20.00 adjusted, and in January to more than $17.75 244.

In January it set its 2026 revenue outlook at more than $439.0 billion and earnings from operations at more than $24.0 billion 4. It says it aims to bring debt to about 40 percent of its capital by year end, from 41.7 percent on 30 September 2026 1.

Its annual report said it expected its Medicare Advantage membership to contract in 2026, and Medicaid membership too, as eligibility tightens and it leaves one state 2. For 2027, Medicare Advantage plans get an average payment increase of 2.48 percent, about $13 billion across the industry, under rates the government finalized on 6 April 2026 20.

By the end of 2026 the company plans to remove 30 percent of prior approval volume, the advance sign-off a doctor needs, and nearly two-thirds of such rules for children's care 1. It says more than 7 million members are to become eligible for doula care by January 2027, and that further commitments are expected in 2027 1. Optum Rx's promise to pass on every drug maker rebate runs to 1 January 2028 1.

The company committed $1 billion to the United Health Foundation, its charity, for rural, maternal and children's and behavioral health 1. The sale of its remaining South American operations is expected to close in the second half of 2026, subject to regulators 3. The court has yet to rule on the Justice Department's motion against the Special Master's report, and the company says it cannot estimate the outcome 3.

Past

Revenue grew from $185 billion in fiscal 2016 to $448 billion in fiscal 2025, up 10.3% a year, and rose in 9 of 9 years with no fall from a peak; net income was positive in all 10 of those years. Over the three fiscal years to 2025, the diluted share count shrank about 1.4% a year, and dividends and buybacks returned about 61% of operating cash flow. Officers and directors filed 3 sales and 0 purchases of their own stock on the open market in the year to 2026-10-05. Unitedhealth's filings since 2017 show 3 warning events, all material cybersecurity incidents, with the latest on 2024-04-24. 1

Present

In its latest annual figures for the fiscal year ended 2025-12-31, Unitedhealth reported revenue of $448 billion and a profit of $12 billion. Return on equity was about 12 cents of profit for every dollar of shareholders' money; gross profitability was about 128 cents per dollar of everything the company owns; it owed about 68 cents per dollar of assets, and its share count shrank 1.9% over the year. Revenue of $448 billion in fiscal 2025 ranks in the top 5% by size among 10 graded names in its family; a net margin of 2.7% ranks in the top 15%; revenue growth of 11.3% a year over the last 3 filed years ranks in the bottom 25%. 21

The 17 officers and directors filing in the last fifteen months have been on the record a median of 4.5 years; 13 officer or director changes were reported on Form 8-K since 2023-10-21, against the 17 people in charge now. 1

Future

A quarterly report for the quarter ending 2026-09-30 is due by 2026-11-09. An annual report for the fiscal year ending 2026-12-31 is due by 2027-03-01. Cash of $24 billion against debt of $72 billion leaves negative 15.5% of its assets as net cash, bottom 25% of its family; cash from operations less capital spending is 3.6% of revenue, top 25%; a gross margin of 88.7%, top 25%. 31

Revenue grew 11.3% a year over the last three filed years against 10.3% over all 10, speeding up; the newest year grew 11.8%; capital spending grew 8.9% a year. Revenue of $448 billion in fiscal 2025 came in 0.6% above the $445 billion its prior three years' pace pointed to; net income of $12 billion fell against a prior three-year average of $19 billion; a net margin of 2.7% fell against 5.3% before. 1

How the company operates

Unitedhealth is classed as an insurance business. Unitedhealth reported 5 lines of business in fiscal 2025: Unitedhealthcare at $345 billion, Total Optum at $271 billion, Optumrx at $155 billion, and 2 more; 4 of 5 grew in the latest filed year, and the largest line is 39% of revenue. 21

New moves

Operating earnings climbed to $6.6 billion from $4.3 billion, led by lower medical costs and Optum Health, prompting a third raise of the 2026 outlook this year. 4