UnitedHealth Group
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UnitedHealth Group (UNH) investor relations material

UnitedHealth Group Q4 2025 earnings summary

Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.
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Q4 2025 earnings summary27 Jan, 2026

Executive summary

  • 2025 revenues reached $448B, up 12% year-over-year, with adjusted EPS of $16.35, slightly ahead of expectations, excluding a $1.6B net non-cash charge related to cyber-attack, portfolio optimization, and restructuring.

  • 2026 outlook targets adjusted EPS greater than $17.75 (at least 8.6% growth), revenues of ~$440B, and net earnings of at least $17.10 per share.

  • Major restructuring in late 2025 included a $1.6B after-tax charge for cyberattack costs, divestitures, and operational resets, excluded from adjusted results.

  • Strategic focus on operational discipline, technology/AI investment, and margin recovery across all segments, with renewed emphasis on pricing and transparency.

Financial highlights

  • 2025 operating earnings were $19.0B, including a $2.8B charge; adjusted operating earnings were $21.7B.

  • Cash flows from operations were $19.7B (1.5x net income), exceeding expectations due to payment timing.

  • Debt-to-capital ratio stood at 43.9% at year-end 2025, with a target of 40% for 2026.

  • Adjusted medical care ratio rose to 89.1% in 2025; 2026 guidance is 88.8% ±50bps.

  • Adjusted operating cost ratio was 13.3% in 2025; 2026 guidance is 12.8% ±50bps.

Outlook and guidance

  • 2026 adjusted EPS growth of at least 8.6%, with double-digit improvements at UnitedHealthcare and single-digit growth at Optum segments.

  • 2026 revenues expected to exceed $439.0B, a 2% decline due to planned right-sizing.

  • Margin recovery prioritized over membership growth, especially in Medicare Advantage.

  • Membership contraction of 2.3–2.8M at UnitedHealthcare, mainly in Medicare and Medicaid.

  • Continued investment in AI and technology (~$1.5B), with further transparency initiatives.

Detail 2026 revenue decline drivers
Optum Health loss contracts impact on 2026
Key repricing efforts for 2026 MCR improvement
Impact of $625M Optum loss contract reserve
How will 2027 MA rate notice impact footprint?
AI investment impact on 2026 operating cost savings
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Frequently asked questions

Diverse Healthcare Services

UnitedHealth Group is an American healthcare company that operates through two primary divisions: UnitedHealthcare and Optum. UnitedHealthcare offers healthcare coverage and benefits services, while Optum provides information and technology-enabled health services. The company delivers a broad spectrum of healthcare products and services to its customers, encompassing health coverage, Medicare plans, short-term health insurance, Medicaid plans, health management, and global health solutions. It is headquartered in Minnetonka, Minnesota, and its shares are listed on the NYSE.

UnitedHealthcare

The UnitedHealthcare segment of UnitedHealth Group is primarily focused on health insurance services. It offers a wide range of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries. The company provides access to healthcare services through its extensive network of healthcare providers, offering various insurance products that include but are not limited to, health maintenance organization, preferred provider organization, and point-of-service plans. The company is one of the largest providers of health insurance in the country and also offers coverage to customers outside of the US. Some similar companies traded on the public markets include Cigna and Humana.

The Optum Business Segment

The Optum segment of the company operates as a health services and innovation company, complementing the health insurance offerings of UnitedHealthcare by providing a broad spectrum of services and solutions. Optum is organized into three main divisions: OptumHealth, OptumInsight, and OptumRx, each focusing on different aspects of healthcare and technology.

  • OptumHealth: This division offers health management services, care delivery, and wellness programs. It provides personalized and scalable health and wellness solutions, including physical health, mental health, complex care management, and financial services to individuals and employers. It also operates an extensive network of care providers, offering primary care, urgent care, and specialty services.

  • OptumInsight: OptumInsight provides data, analytics, research, consulting, technology, and managed services solutions to hospitals, physicians, health plans, governments, and life sciences companies. The focus is on improving operational efficiency, reducing costs, and enhancing the quality of care.

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