UnitedHealth Group
UnitedHealth Group Incorporated is an American multinational diversified health care company that operates as a managed care organization, providing health insurance benefits through UnitedHealthcare and health services, technology, data analytics, and pharmacy care through Optum.[1][2]
Founded in 1977 by Richard T. Burke and headquartered in Minnetonka, Minnesota, the company has grown into the largest health insurer in the United States by revenue and membership, serving approximately 51 million individuals across commercial, Medicare, and Medicaid programs as of recent reports.[3][4]
In fiscal year 2024, UnitedHealth Group reported record revenues of $400.3 billion, an 8% increase from the prior year, with net earnings of $14.4 billion, underscoring its dominant position in the U.S. health care sector amid ongoing debates over consolidation, vertical integration, and their impacts on costs and access.[5][6]
The firm's expansion via acquisitions and Optum's role in provider networks and claims processing has enabled efficiencies in care delivery but attracted regulatory antitrust scrutiny for potentially reducing competition in health services markets.[7][8]
History
Founding and Early Development (1970s–1990s)
United HealthCare Corporation traces its origins to 1974, when Richard T. Burke established the company to manage the Physicians Health Plan of Minnesota, a non-profit health maintenance organization (HMO).[9] In January 1977, it was formally incorporated as United HealthCare Corporation, reorganizing Charter Med Incorporated as its subsidiary and focusing on managed care services through HMOs and prepaid health plans.[9] Early operations emphasized cost-effective healthcare delivery by contracting with providers to serve enrollees, initially concentrated in Minnesota but expanding regionally.[9] The company's model aligned with the growing HMO movement, influenced by precursors like InterStudy, founded in 1970 by Dr. Paul Ellwood to promote prepaid group practices.[9] By 1984, United HealthCare had grown to manage 11 HMOs across 10 states and went public, trading over-the-counter, with annual revenues reaching approximately $216 million.[9] Expansion accelerated through targeted acquisitions: in June 1985, it purchased Share Development Corp. for $60 million, adding 167,000 enrollees and extending operations to 22 states by year-end, serving 822,400 members total; in November 1986, it acquired Peak Health Care Inc. for $83 million, boosting enrollment to 1.6 million.[9] These moves diversified its geographic footprint and enrollee base, though the company reported a $15.8 million loss in 1987 amid rapid scaling and industry competition.[9] Into the 1990s, further consolidation strengthened its position, including the March 1990 acquisition of PrimeCare Health Plan Inc. with 103,000 members, and 1991 actions such as merging Physicians Health Plan and Share Health Plan into Medica (480,000 enrollees) and acquiring Samaritan Health Plan (adding 157,000 members post-merger).[9] Additional purchases followed, like Physicians Health Plan of Ohio in January 1992 for $84 million (154,000 members) and Western Ohio Health Care Corp. in early 1993 for $100 million (185,000 members).[9] Financial performance improved markedly, with revenues climbing to $605.5 million and net income of $33.9 million in 1990, then $1.4 billion in revenues and $111.5 million in income by 1992.[9] Leadership evolved with Kenneth Simmons succeeding Burke as CEO in November 1987 (Burke retained chairmanship until 1991), followed by Dr. William McGuire's appointment as president in 1989 and chair/CEO in February 1991.[9]Expansion and Challenges (2000s)
During the 2000s, UnitedHealth Group significantly expanded its operations through strategic acquisitions and revenue growth, particularly in Medicaid and specialized care segments. In 2002, the company acquired AmeriChoice for $530 million, enhancing its Medicaid services and broadening access to government-sponsored health plans. Revenue grew steadily, rising from $21.12 billion in 2000 to $23.45 billion in 2001 and $25.02 billion in 2002, reflecting gains in market share across insurance segments. This period marked a shift toward diversified offerings, including pharmacy benefits management and international ventures, such as the 2009 acquisition of UK-based ScriptSwitch for approximately £50 million to bolster data-driven prescribing tools.[10][11][12] The company faced substantial challenges, including regulatory scrutiny and litigation over reimbursement practices. In March 2000, the American Medical Association filed a class-action lawsuit alleging that UnitedHealth used a flawed database—Ingenix—that systematically underreported "usual, customary, and reasonable" charges, thereby reducing payouts to out-of-network physicians by excluding higher legitimate fees. The suit, pending for nearly a decade, highlighted concerns over data integrity in claims processing and culminated in a $350 million settlement in 2009, with UnitedHealth agreeing to phase out the database.[13][14][15] A more severe setback occurred in 2006 amid revelations of stock options backdating, where grants to executives, including CEO William McGuire, were retroactively dated to maximize value, concealing over $1 billion in compensation expenses from 1994 to 2005 and overstating net income. McGuire resigned in October 2006, forfeiting options gains, and in 2007 settled SEC charges by repaying $468 million without admitting wrongdoing. The scandal triggered shareholder lawsuits, IRS inquiries dating to 2003, and a $895 million class-action settlement in 2009, eroding investor confidence and prompting governance reforms. These events underscored vulnerabilities in executive compensation amid rapid expansion, though the company maintained operations without criminal convictions at the corporate level.[16][17][18][19]Acquisitions and Diversification (2010s)
In the 2010s, UnitedHealth Group accelerated diversification beyond core health insurance by expanding its Optum division, which unified previously separate health services units under a single brand in April 2011 to focus on data-driven care, pharmacy management, and provider services.[20] This restructuring enabled vertical integration, allowing the company to capture value across the healthcare supply chain amid uncertainties from the Affordable Care Act's implementation, with Optum's businesses generating growing revenue shares through technology-enabled efficiencies and service bundling.[21] A series of targeted acquisitions underpinned this strategy, beginning with health IT firms in 2010 such as Picis (critical care software), Axolotl (health information exchange), A-Life Medical (revenue cycle management), and Executive Health Resources (physician advisor services), which bolstered OptumInsight's analytics and consulting capabilities.[22] In October 2012, UnitedHealth acquired approximately 90% of Amil Participações S.A., Brazil's largest private health insurer serving over 3 million members, for $4.9 billion in cash, providing entry into Latin American markets with integrated hospital and insurance operations.[23] [24] The acquisition of Catamaran Corporation in March 2015 for $12.8 billion represented the decade's largest deal, merging the pharmacy benefit manager into OptumRx to create a top-tier player managing prescriptions for over 100 million members and enhancing control over drug costs through integrated medical-pharmacy data.[25] [26] The transaction closed in July 2015 after shareholder and regulatory approvals, immediately expanding OptumRx's client base and negotiating leverage with pharmaceutical manufacturers.[27] Further Optum expansion targeted care delivery. In January 2017, Optum acquired Surgical Care Affiliates, operator of over 200 ambulatory surgery centers and surgical hospitals, for $2.3 billion, adding outpatient procedure capacity and aligning with shifts toward lower-cost site-neutral care.[28] In December 2017, UnitedHealth announced the $4.9 billion purchase of DaVita Medical Group, a physician organization with 300 clinics and 35,000 affiliated providers focused on value-based kidney and primary care, which integrated into OptumHealth upon closing in June 2019 after Federal Trade Commission review.[29] [30] These acquisitions, totaling over $25 billion in disclosed values, diversified revenue as Optum's segments—OptumHealth, OptumInsight, and OptumRx—outpaced UnitedHealthcare's growth rates, contributing to overall enterprise resilience against insurance margin volatility.[31]Recent Growth and Headwinds (2020s–present)
UnitedHealth Group's revenues expanded substantially in the early 2020s, reaching $400.3 billion in 2024, an 8% increase from $371.6 billion in 2023, driven by growth across its UnitedHealthcare insurance operations and Optum health services segments.[32] Optum Health revenues more than doubled from $16.6 billion in 2020 to $39.2 billion in 2024, reflecting expansion in value-based care models and primary care services.[33] The company's Medicare Advantage enrollment grew alongside industry trends, with UnitedHealth maintaining the largest market share—covering about 18% of total enrollees as of 2025—and benefiting from higher penetration in 41% of U.S. counties.[34][35] Strategic acquisitions supported this trajectory, including the $3.5 billion purchase of Landmark Health in 2021 to enhance in-home care for chronic conditions and the $5.4 billion acquisition of LHC Group, completed in 2023 after announcement in March 2022, which added home health and hospice capabilities serving over 200 locations.[31] The $3.3 billion merger with Amedisys closed in August 2025, further bolstering Optum's home-based care network despite antitrust reviews requiring divestitures of certain facilities.[36] These moves aligned with a business model emphasizing integrated care, contributing to overall earnings from operations despite sector-wide pressures on medical loss ratios.[37] However, the period also brought operational and regulatory headwinds. A ransomware cyberattack on subsidiary Change Healthcare in February 2024 by the ALPHV group disrupted claims processing and payments nationwide, affecting one-third of U.S. patient records and incurring over $2.3 billion in direct costs by mid-2025, alongside lawsuits from providers over delayed reimbursements.[38][39] Rising medical costs, particularly in Medicare Advantage due to increased utilization post-COVID, compressed profit margins, with 2024 net earnings falling year-over-year despite record revenues.[40][41] Regulatory scrutiny intensified, including Department of Justice investigations into Medicare Advantage risk adjustment practices and potential antitrust violations from Optum's market dominance in pharmacy benefits and physician practices.[42] In December 2024, UnitedHealthcare CEO Brian Thompson was fatally shot in Manhattan, an incident linked by authorities to resentment over insurance denials, heightening public and political criticism of denial rates and prior authorization processes.[41] Facing these pressures, UnitedHealth scaled back Medicare Advantage offerings for 2025, terminating plans in 109 counties across 16 states and impacting approximately 600,000 enrollees, as part of efforts to improve financial sustainability amid proposed federal payment cuts.[43][44]Corporate Structure
UnitedHealthcare Division
UnitedHealthcare serves as the primary health insurance operating division of UnitedHealth Group, delivering health benefit programs and insurance coverage to approximately 50 million individuals across the United States as of the second quarter of 2025.[45] This division generated $86.1 billion in revenue during that quarter, reflecting a 17% year-over-year increase driven by membership growth and premium adjustments.[45] It functions as the largest single health carrier in the country, offering plans that emphasize affordable access, simplified administration, and integration with high-quality care networks.[46] The division operates through three principal segments: Employer & Individual, Medicare & Retirement, and Community & State. The Employer & Individual segment provides employer-sponsored group health plans, including medical, dental, and vision coverage, alongside options for self-employed and individual purchasers; these plans incorporate features like zero-dollar copays for certain services, virtual primary care, and rewards-based wellness programs to encourage preventive care utilization.[47][48] In 2024, domestic membership in this area contributed to overall UnitedHealthcare growth, with total consumers served expanding by 2.1 million year-over-year.[5] Medicare & Retirement focuses on government-sponsored programs, encompassing Medicare Advantage plans, Medicare Part D prescription drug coverage, Medicare Supplement insurance, and group retiree benefits for those eligible under federal programs.[49] Premium revenues from the Centers for Medicare & Medicaid Services (CMS) accounted for 40% of UnitedHealth Group's total consolidated revenues in 2024, predominantly from this segment's Medicare offerings.[50] UnitedHealthcare's Medicare Advantage enrollment saw moderated growth into 2025, with plans to retain core membership while adjusting for regulatory and cost dynamics.[51] The Community & State segment targets Medicaid-eligible populations, the economically disadvantaged, medically underserved individuals, and those lacking alternative coverage options, delivering state-sponsored health plans that integrate behavioral health, long-term services, and community-based care coordination.[37] Dual Special Needs Plans (D-SNPs) under this segment cater specifically to beneficiaries qualifying for both Medicare and Medicaid, providing coordinated benefits to address overlapping eligibility.[52] Overall, UnitedHealthcare's structure enables diversified risk pools and revenue streams, with operations supported by provider networks, claims processing, and data analytics to manage utilization and costs.[4]Optum Division
Optum, established in April 2011 as a division of UnitedHealth Group, integrates the company's health services, technology platforms, and pharmacy operations to deliver care coordination, data analytics, and medication management. Headquartered in Eden Prairie, Minnesota, it employs around 310,000 people globally and focuses on leveraging technology to improve health outcomes and reduce costs across payers, providers, and consumers.[53][49] In 2024, Optum generated $253 billion in revenue, representing a 12% increase from the prior year and comprising a substantial portion of UnitedHealth Group's total $400.3 billion revenue.[32][54] Optum operates through three core segments: OptumHealth, OptumInsight, and OptumRx. OptumHealth delivers direct patient care and population health management, serving patients under value-based arrangements and expanding into primary, secondary, and home-based services; its 2024 revenues reached $105.4 billion, driven by increased patient volume and diversified care offerings.[55][54] OptumInsight provides data analytics, consulting, revenue cycle management, and technology solutions to healthcare organizations, with a backlog of $32.1 billion as of December 31, 2023, including contracts for affiliated services.[37] OptumRx, the pharmacy care services arm, manages prescription benefits for millions, handling dispensing, formulary design, and rebate negotiations; it reported revenues exceeding $116 billion in 2023, with continued double-digit growth into 2024 fueled by network expansion and specialty drug handling.[55][56] The division's expansion has relied heavily on strategic acquisitions to build capabilities in care delivery and data infrastructure. Notable deals include the $8 billion acquisition of Change Healthcare in 2022, enhancing analytics and payment processing; the $5.4 billion purchase of LHC Group in 2022 for home health and hospice services; and the $3.3 billion acquisition of Amedisys in August 2025, further strengthening post-acute care networks.[57][58] Optum has completed 22 acquisitions as of September 2025, targeting areas like mental health (e.g., Refresh Mental Health in 2022) and technology integration to support vertical coordination between services and UnitedHealthcare's insurance operations.[59] This approach has drawn regulatory scrutiny over potential antitrust risks in consolidating provider and payer influences, though deals have proceeded with concessions such as divestitures in overlapping markets.[60] Overall, Optum's model emphasizes technology-driven efficiencies, such as AI-enabled analytics and telehealth, to manage care costs amid rising healthcare expenditures.[61]Supporting Subsidiaries and Operations
UnitedHealth Group maintains a vast network of subsidiaries and affiliates, totaling approximately 2,694 as of the third quarter of 2024, which facilitate regulatory compliance, localized service delivery, and operational efficiency across domestic and international markets.[31] These entities, primarily wholly owned, include state-specific insurance and health maintenance organization (HMO) subsidiaries required for licensing in each U.S. jurisdiction where the company offers products.[37] For example, subsidiaries such as UnitedHealthcare Insurance Company of New York and United HealthCare of Alabama, Inc., handle regional policy issuance, claims processing, and member services tailored to state insurance regulations.[62] This structure ensures adherence to varying state mandates on product offerings, solvency standards, and periodic financial reporting.[63] Supporting operations extend to administrative, financial, and technology functions that underpin the core divisions. Entities like OptumHealth Financial Services, Inc., provide revenue cycle management, billing, and financial consulting to healthcare providers, optimizing cash flows and reducing administrative burdens.[64] International subsidiaries, such as Optum Operations (Ireland) Limited and Aquitania Chilean Holding SpA, support global data processing, technology services, and holding activities for overseas expansions.[65][66] These operations involve coordinated vision care through subsidiaries like Coordinated Vision Care, Inc., and pharmacy-related holdings such as Apothecary Holdings, Inc., which integrate with broader supply chain and benefit management activities.[62] The parent company's oversight ensures consolidated financial reporting, with subsidiaries not individually significant in aggregate constituting a major segment.[66] This subsidiary framework enables risk segmentation, where localized entities mitigate exposure to jurisdiction-specific liabilities, such as litigation or regulatory penalties, while central operations handle enterprise-wide functions like IT infrastructure and compliance monitoring. As of December 31, 2023, the SEC-listed subsidiaries spanned sectors including data analytics support via OptumInsight affiliates and operational consulting through entities like AppleCare Medical Management, LLC.[66] Overall, these supporting elements contribute to the company's scale, with operations emphasizing efficiency in claims adjudication, provider network management, and data security across 50 states and select international locations.[37]Business Model and Operations
Core Insurance Products and Services
UnitedHealthcare, the primary insurance operating unit of UnitedHealth Group, delivers health coverage through a variety of commercial and government-funded plans, emphasizing broad provider networks and managed care models to control costs while providing access to medical services. Its core products encompass employer-sponsored group insurance, individual and family policies, and participation in public programs like Medicare and Medicaid, with benefits typically including hospital stays, physician visits, preventive screenings, and prescription drug coverage. These plans often utilize preferred provider organization (PPO) structures, allowing members to seek care from in-network providers without referrals to specialists or designation of a primary care physician.[67][49] Employer-sponsored plans form a cornerstone of UnitedHealthcare's commercial offerings, targeting large national employers with customizable options such as high-deductible health plans paired with health savings accounts (HSAs), copay-only designs, and tiered networks that incentivize use of lower-cost providers to enhance affordability. These plans incorporate digital tools for claims management, virtual care visits, and personalized support, serving millions of covered lives through self-funded and fully insured arrangements. In 2025, product lines like UnitedHealthcare Multi-Choice enable employers to bundle multiple benefit designs, including surplus refund potential for qualifying groups, reflecting adaptations to rising healthcare costs.[48][68] For individuals and families, UnitedHealthcare provides marketplace-compliant plans under the Affordable Care Act (ACA), short-term medical coverage for interim needs, and supplemental policies addressing gaps in primary coverage, such as dental, vision, accident, and critical illness indemnity. These offerings prioritize flexibility, with options for self-employed individuals, students, and those ineligible for employer plans, often featuring national PPO networks exceeding 1.3 million physicians and facilities to minimize out-of-pocket expenses for in-network utilization.[69][70] Government program participation constitutes a significant revenue driver, with Medicare Advantage (Part C) plans bundling Original Medicare benefits (Parts A and B) alongside extras like routine dental, vision, hearing aids, and over-the-counter allowances, available in most U.S. counties as of 2025. Medicare Supplement (Medigap) policies help cover deductibles and coinsurance not addressed by Original Medicare, while Part D plans manage prescription costs through formularies and mail-order options. UnitedHealthcare's Community & State segment administers Medicaid managed care for low-income populations, integrating behavioral health and long-term services in state-specific contracts.[52][71][49]Health Services, Technology, and Pharmacy Management
Optum Health delivers a range of health services focused on care delivery, including primary, specialty, and behavioral health care, as well as population health management and home-based services, aiming to integrate providers, payers, and patients for coordinated care.[72] It operates an extensive network supporting approximately 130,000 physicians and 90% of U.S. hospitals across all 50 states and the District of Columbia, facilitating value-based care models that emphasize preventive services and chronic condition management.[73] In 2024, Optum Health expanded its offerings through partnerships and acquisitions to enhance surgical care and urgent care access, serving millions of patients with data-informed interventions to reduce hospital readmissions and improve outcomes.[74] Optum Insight provides technology and analytics solutions, leveraging vast datasets from claims, electronic health records, and real-world evidence to enable predictive modeling, revenue cycle management, and operational efficiencies for healthcare organizations.[75] Its platforms support four out of five U.S. health plans in operations and performance improvement, incorporating machine learning for tasks such as fraud detection and care gap identification.[73] As of October 2025, Optum Insight introduced Optum Real, an AI system designed to automate medical claims processing, potentially reducing administrative burdens by analyzing clinical documentation in real time to accelerate approvals and minimize errors.[76] These tools draw on UnitedHealth Group's proprietary data assets, enabling clients to benchmark performance and optimize resource allocation without relying on generalized industry averages.[77] Optum Rx functions as a pharmacy benefit manager (PBM), handling prescription drug benefits for employers, health plans, and government programs by negotiating rebates, managing formularies, and overseeing mail-order and specialty pharmacy distribution.[78] It supports 67,000 retail pharmacies and processes a significant share of U.S. prescriptions, ranking among the top three PBMs alongside CVS Caremark and Express Scripts, which collectively managed about 80% of equivalent claims in 2024.[73] Optum Rx emphasizes transparency in pricing and rebate pass-through, with initiatives in 2025 to align reimbursements more closely with pharmacy acquisition costs amid manufacturer price fluctuations.[79] In October 2025, it deployed AI-driven tools to enhance pharmacy operations, forecasting demand, reducing dispensing errors, and streamlining prior authorizations for faster patient access to medications.[80] These efforts aim to balance drug affordability and adherence, though critics note that PBM practices like spread pricing have drawn regulatory scrutiny for potentially inflating costs despite rebate negotiations.[81]Medicare Advantage Programs and Risk Management
UnitedHealthcare, the insurance arm of UnitedHealth Group, administers Medicare Advantage (MA) plans, which provide an alternative to traditional Medicare through private insurers under Part C of the Medicare program. These plans offer comprehensive coverage including hospital, medical, and often prescription drug benefits, with additional supplemental services such as dental, vision, and wellness programs, frequently branded in partnership with AARP. As of 2024, UnitedHealthcare enrolled approximately 9.4 million beneficiaries in MA plans, representing about 29% of the total eligible Medicare population and maintaining a leading market position.[82] For 2025, the company expanded access to $0 premium plans with $0 copays for primary care and Tier 1 prescriptions in many markets, while anticipating 78% of its MA membership to be in 4-star or higher rated plans based on CMS star ratings.[83] [84] Risk management in UnitedHealthcare's MA programs relies on CMS's risk adjustment model, which uses Hierarchical Condition Categories (HCCs) derived from beneficiary diagnosis codes to determine capitated payments, with higher-risk enrollees receiving elevated reimbursements to account for anticipated healthcare costs. The company employs practices such as in-home assessments, telehealth visits, and electronic chart reviews to capture and submit comprehensive diagnosis data, enabling more accurate HCC coding and risk score calculation.[85] In 2023, UnitedHealthcare's average risk scores were 36.2% higher than those of nonprofit health plans in a comparative analysis by the Alliance of Community Health Plans (ACHP), reflecting intensive diagnosis documentation that boosts payments but has raised questions about overcoding.[86] UnitedHealth Group maintains that the majority of home visit diagnoses do not lead to increased risk adjustment payments and that such practices improve care coordination, though federal auditors have identified billions in potentially improper payments tied to unsubstantiated assessments.[87] [88] These strategies have drawn scrutiny amid broader concerns over MA overpayments, with a 2025 study estimating that differential coding practices across MA plans inflated payments by $33 billion in 2021 alone, varying significantly by insurer including UnitedHealth.[89] The U.S. Department of Justice launched civil and criminal investigations into UnitedHealthcare's Medicare billing as early as 2024, focusing on potential fraud in diagnosis coding for risk adjustment, prompting the company to initiate an internal review of its practices under new leadership.[90] [91] UnitedHealth Group has cooperated with authorities, asserting compliance with regulations, while critics including the HHS Office of Inspector General highlight ongoing risks from health risk assessments (HRAs) that generate payments without corresponding services, contributing an estimated $7.5 billion in questionable reimbursements industry-wide in recent years.[92] [93] Despite these challenges, proponents of full-risk MA models, including UnitedHealth, cite empirical data showing superior health outcomes for enrollees under accountable care arrangements, with resources directed toward preventive interventions rather than reactive treatment.[94] In response to utilization pressures and regulatory shifts, UnitedHealthcare scaled back certain MA offerings for 2025, exiting plans in over 100 counties across 16 states to optimize profitability amid rising medical costs.[44]Financial Performance
Historical Revenue and Profitability
UnitedHealth Group's revenues have grown substantially over the past decade, reflecting increases in membership across commercial, Medicare, and Medicaid plans, alongside expansion in its Optum health services and technology divisions. From $157.3 billion in 2015 to $400.3 billion in 2024, the company achieved a compound annual growth rate exceeding 10%, driven by organic enrollment gains and strategic acquisitions such as the 2019 purchase of Davita Medical Group.[95] Net profitability has similarly trended upward in most years, with net income rising from $5.8 billion in 2015 to a record $22.4 billion in 2023, before a decline to $14.4 billion in 2024 amid elevated medical loss ratios and costs associated with a cyberattack on its Change Healthcare subsidiary.[96][97] This 2024 drop represented the lowest net earnings since 2019, highlighting vulnerabilities to operational disruptions and rising healthcare utilization.[40] The table below details annual revenues and net income from 2015 to 2024, sourced from consolidated financial statements:| Year | Revenue ($ billions) | Net Income ($ billions) |
|---|---|---|
| 2015 | 157.3 | 5.8 |
| 2016 | 184.8 | 7.0 |
| 2017 | 201.6 | 10.6 |
| 2018 | 226.3 | 12.0 |
| 2019 | 242.2 | 13.8 |
| 2020 | 257.1 | 14.7 |
| 2021 | 287.6 | 17.3 |
| 2022 | 324.2 | 20.1 |
| 2023 | 371.6 | 22.4 |
| 2024 | 400.3 | 14.4 |
Key Metrics and Investor Relations
UnitedHealth Group's common stock trades on the New York Stock Exchange under the ticker symbol UNH. As of October 24, 2025, the shares closed at $362.61, reflecting a market capitalization of $320.35 billion and an enterprise value of $367.53 billion.[99][100] For the trailing twelve months ended June 30, 2025, the company reported revenue of $422.82 billion, net income of $21.3 billion, and diluted earnings per share of $23.09.[100] Key valuation metrics included a trailing price-to-earnings ratio of 15.31, a forward P/E of 20.08, a price-to-sales ratio of 0.77, and a price-to-book ratio of 3.38.[100] The company served approximately 50 million medical members as of mid-2025, supporting its scale in health insurance and services.[101]| Metric | Value (TTM as of 6/30/2025) |
|---|---|
| EBITDA | $33.58 billion |
| Operating Cash Flow | $28.96 billion |
| Levered Free Cash Flow | $27.21 billion |
| Total Debt | $79.19 billion |
| Total Cash | $32.02 billion |
| Beta (5Y Monthly) | 0.48 |
| Book Value Per Share | $104.67 |
Recent Trends and Cost Pressures (2024–2025)
In 2024, UnitedHealth Group's medical loss ratio (MLR), the percentage of premiums spent on medical claims, rose to 85.5% for the full year, up from 83.2% in 2023, driven primarily by increased utilization in Medicare Advantage plans and elevated costs for behavioral health services.[106] This uptick reflected broader industry pressures from post-pandemic care deferrals resolving into higher demand, alongside specialty drug expenses and provider coding practices that boosted reimbursements but strained profitability.[107] Despite revenue growth to approximately $400 billion annually, operating earnings in the UnitedHealthcare segment faced compression as medical cost trends accelerated beyond initial projections.[108] Entering 2025, cost pressures intensified, with Q1 MLR at 84.8%, a slight increase from 84.3% in Q1 2024, attributed to revenue adjustments from Medicare funding changes and ongoing utilization spikes.[109] By Q2 2025, MLR surged to a record 89.4%, up from 85.1% year-over-year, leading to a $1.9 billion drop in UnitedHealthcare operating earnings to $2.1 billion despite $86.1 billion in segment revenue.[110] [111] The company cited $6.5 billion in unanticipated medical costs for the year, with over half—about $3.6 billion—stemming from underpriced Medicare Advantage rates and unexpectedly high behavioral health claims, prompting a revision of full-year earnings guidance downward to at least $16.00 per share on an adjusted basis.[112] [113] Medicare Advantage emerged as the epicenter of these pressures, with medical cost trends projected at 7.5% for 2025 and potentially nearing 10% in 2026 due to factors including provider upcoding, specialty pharmacy utilization, and demographic shifts toward higher-acuity seniors.[114] In response, UnitedHealth announced exits from Medicare Advantage markets in 109 counties across 16 states starting in 2026, affecting approximately 180,000 members, as well as broader plan reductions impacting up to 600,000 enrollees in 2025 to mitigate unprofitable pricing.[115] [116] These moves followed federal scrutiny over coding practices that allegedly inflated payments, though the company maintained that such adjustments reflect accurate risk capture rather than overbilling.[117]| Quarter | Medical Loss Ratio | Key Driver of Change |
|---|---|---|
| Q4 2024 | ~85% (estimated from annual) | Elevated MA utilization |
| Q1 2025 | 84.8% | Medicare revenue effects, steady claims growth[109] |
| Q2 2025 | 89.4% | Behavioral health surge, MA underpricing[111] |