UnitedHealth Group (UNH) Q4 2025 earnings summary

Executive summary

• 2025 revenues reached $447.6B, up 12% year-over-year, with adjusted EPS of $16.35, slightly ahead of expectations, excluding a $1.6B net-of-tax, largely non-cash charge related to Optum restructuring, cyber-attack true-ups, and portfolio optimization.

• 2026 outlook targets adjusted EPS greater than $17.75, at least 8.6% growth, with measured growth across all four business segments and double-digit improvements at UnitedHealthcare.

• 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 and AI adoption, value-based care, and innovation to drive sustainable growth and improved value for stakeholders.

Financial highlights

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

• 2025 revenues reached nearly $448B, up 12% year-over-year, with domestic membership growth of over 415,000.

• 2025 cash flows from operations were $19.7B, about 1.5x net income, exceeding expectations due to timing of payments.

• 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 88.9% from 85.5% in 2024, reflecting higher medical costs and regulatory impacts.

Outlook and guidance

• 2026 adjusted EPS guidance of >$17.75, reflecting at least 8.6% growth.

• Revenue guidance for 2026 is ~$440B, with at least $18B in operating cash flow.

• Medical care ratio expected at 88.8% ±50bps; operating cost ratio at 12.8% ±50bps.

• UnitedHealthcare revenues projected over $335.0B, Optum over $257.5B.

• Dividend expected to remain well-supported; leverage to improve, targeting ~40% debt-to-capital by year-end.