UnitedHealth Group (UNH) — Company Research
Last Updated: 28 Sep 2026
UnitedHealth Group (NYSE: UNH) is the largest US health insurer and one of the largest US healthcare services companies. Its business has two platforms. UnitedHealthcare provides health benefits. Optum covers care delivery (Optum Health), data and technology (Optum Insight) and pharmacy benefit management (Optum Rx).
FY2025 revenue was $447.6bn, but adjusted EPS fell to $16.35 from $27.66 as medical costs ran well above pricing. Stephen Hemsley returned as CEO in May 2025, and 2026 has been a repair year. Q2 2026 adjusted EPS was $6.38 against $4.08 a year earlier, the medical care ratio improved to 86.7%, and in July management raised 2026 adjusted EPS guidance to $19.50–$20.00.
Formal DOJ criminal and civil requests about Medicare Advantage practices remain unresolved. This refresh draws on UnitedHealth press releases, SEC 10-K/10-Q/8-K filings, SEC XBRL company facts and Form 4 filings, all retrieved on 28 Sep 2026. Follow the price on ChartsView Live Charts.
1. Company Snapshot
| Field | Value |
|---|---|
| Full name | UnitedHealth Group Incorporated |
| Ticker | UNH (NYSE) |
| Sector | Healthcare & Pharma |
| Industry | Managed care, health services and pharmacy benefit management |
| CEO / Leadership | Stephen Hemsley (Chair and CEO since May 2025); Wayne DeVeydt (CFO since Sep 2025); Patrick Conway (CEO, Optum); Tim Noel (CEO, UnitedHealthcare) |
| Market cap | ~$338.4bn (share price $377.02 at the 25 Sep 2026 close) |
| Revenue (FY2025) | $447,567m (+11.8% YoY), per FY2025 10-K |
| Net income (FY2025) | $12,056m GAAP attributable to UnitedHealth shareholders |
| Employees | More than 390,000 at 31 Dec 2025, including nearly 165,000 clinical professionals, per FY2025 10-K |
| People served | UnitedHealthcare served 48.5m people at 30 Jun 2026 |
| Dividend | $2.32 per quarter ($9.28 annualised) since Jun 2026 |
2. Bull Case vs Bear Case
Distilled from the full report below. Factual only, no ratings.
Bull Case
- Earnings recovery under way: Q2 2026 adjusted EPS was $6.38 against $4.08 in Q2 2025. The 2026 adjusted EPS guide was raised twice, from more than $17.75 in January to $19.50–$20.00 in July.
- Medical cost ratio back under control: The medical care ratio improved to 86.7% in Q2 2026 from 89.4% a year earlier. UnitedHealthcare's operating earnings rose to $3,942m from $2,075m.
- High-margin Optum businesses: Optum Insight earned a 25.3% operating margin in Q2 2026 and Optum Rx earned $1,490m. Management targets a 6–8% Optum Health margin by 2028.
- Cash generation and capital return: H1 2026 operating cash flow was $19,964m against capex of $1,562m. Management plans at least $5bn of buybacks in 2026, and the quarterly dividend is $2.32.
Bear Case
- Unresolved federal investigations: UNH is complying with formal DOJ criminal and civil requests about its Medicare Advantage practices, first disclosed on 24 Jul 2025. A Senate report in January 2026 criticised its coding practices, and an HHS-OIG audit on 17 Sep 2026 found estimated overpayments of $46.9m.
- Lower-quality earnings mix in Q2: The 86.7% medical care ratio included $860m of favourable prior-period reserve development. Full-year 2026 guidance is for 88.1% ± 25bp.
- Optum Health reset: Optum Health revenue fell 5% in Q2 2026 as about 700k fewer patients were served under value-based care. Management guides to a margin of about 2% in 2026.
- Government-funding dependence: Medicare, Medicaid and ACA funding rules, Star ratings and RADV coding audits directly drive revenue. Management expects Medicaid margins, near −1.1%, to trough in 2026.
3. What Does This Company Actually Do?
UnitedHealthcare sells health benefits in four markets:
- employer-sponsored plans;
- individual plans;
- Medicare Advantage and other Medicare products;
- Medicaid plans run on contract for states.
Optum sells services to UnitedHealthcare and to outside payers, employers, providers and government. Optum Health runs clinics, physician groups, home health (including Amedisys, acquired August 2025) and value-based care arrangements. Optum Insight provides data, analytics, software and revenue-cycle services, including Change Healthcare's claims network. Optum Rx is a pharmacy benefit manager and pharmacy operator.
| Segment | % of revenue | What it is |
|---|---|---|
| UnitedHealthcare | 55.5% of gross segment revenue ($344,903m FY2025) | Health benefits. FY2025 revenue by market: Employer & Individual $79.2bn, Medicare & Retirement $171.3bn, Community & State (Medicaid) $94.4bn |
| Optum Rx | 24.9% ($154,726m) | Pharmacy benefit management and pharmacy services. 1.66bn adjusted scripts in FY2025 |
| Optum Health | 16.4% ($101,957m) | Care delivery: clinics, physician groups, home and community care, value-based care |
| Optum Insight | 3.1% ($19,417m) | Data, analytics, software and revenue-cycle technology, including Change Healthcare |
Shares are of gross segment revenue of $621,003m, before inter-segment and corporate eliminations of $173,436m that reconcile to consolidated revenue of $447,567m. From 1 Jan 2026, Optum Financial moved from Optum Health to Optum Insight; on that basis FY2025 revenue was $100,051m for Optum Health and $21,034m for Optum Insight. Source: Q4 2025 earnings release (SEC 8-K, 27 Jan 2026) and Q1 2026 release.
4. The Business Model
How it makes money. Risk-based premiums are close to 80% of revenue, per the 10-K. UnitedHealthcare collects fixed premiums from employers, individuals and government programmes and pays members' medical and pharmacy claims. Its margin is the gap between premiums and medical costs (the medical care ratio) less operating costs. Optum earns fees, capitated payments and product revenue, much of it from UnitedHealthcare and the rest from outside clients.
Where the moat sits. The moat is scale and vertical integration. UnitedHealthcare's 48.5m members give it bargaining power with providers and a large data set. Optum's claims network, analytics and PBM purchasing volumes serve the insurer and outside clients alike. There are also high regulatory and capital barriers to entry in Medicare Advantage and Medicaid. The same integration draws regulatory scrutiny, including DOJ conditions on the Amedisys deal and the investigations described in Section 10.
What changed in 2025–2026. Medical cost trend ran well ahead of pricing in 2025, especially in Medicare Advantage. FY2025 adjusted EPS fell to $16.35 from $27.66, and Q4 2025 included a $1.6bn after-tax charge ($1.78 per share) for restructuring, cyberattack costs and portfolio actions.
Management's repair plan has five parts:
- 2026 repricing;
- exits from unprofitable markets, such as the Louisiana Medicaid plan;
- right-sizing Optum Health's value-based care book;
- a transparent, fee-based Optum Rx model with 100% rebate pass-through by 1 Jan 2028;
- a multi-billion-dollar AI and automation cost programme.
5. Financial Health
Sources: UnitedHealth quarterly and annual earnings releases (SEC 8-K), the FY2025 Form 10-K, and SEC XBRL company facts (data.sec.gov) for debt, cash flow, D&A and operating income.
| Fiscal Year | Revenue ($m) | YoY % | GAAP EPS | Adjusted EPS | Dividend/share | Long-term debt (YE) |
|---|---|---|---|---|---|---|
| FY2021 | $287,597m | +11.8% | $18.08 | $19.02 | $5.60 | $42,383m |
| FY2022 | $324,162m | +12.7% | $21.18 | $22.19 | $6.40 | $54,513m |
| FY2023 | $371,622m | +14.6% | $23.86 | $25.12 | $7.29 | $58,263m |
| FY2024 | $400,278m | +7.7% | $15.51† | $27.66 | $8.18 | $72,359m |
| FY2025 | $447,567m | +11.8% | $13.23† | $16.35 | $8.73 | $72,320m |
† FY2024 GAAP EPS includes an ~$8.3bn loss, mainly on the sale of the Brazil operations. FY2025 GAAP EPS includes a $1.78 per share Q4 charge covering restructuring, cyberattack costs and portfolio actions. Dividend/share is the calendar-year sum of quarterly payments. Long-term debt is the noncurrent portion at year-end. Current debt was a further $6,069m at FY2025 year-end.
Quarterly results (most recent first)
| Quarter / Half | Revenue | Adjusted EPS | GAAP EPS |
|---|---|---|---|
| Q2 2026 | $112,032m | $6.38 | $6.04 |
| Q1 2026 | $111,721m | $7.23 | $6.90 |
| Q4 2025 | $113,215m | $2.11 | $0.01 |
| Q3 2025 | $113,161m | $2.92 | $2.59 |
| Q2 2025 | $111,616m | $4.08 | $3.74 |
| Q1 2025 | $109,575m | $7.20 | $6.85 |
| FY2025 total | $447,567m | $16.35 | $13.23 |
Cash flow and balance sheet.
- Cash flow.
- FY2025 operating cash flow was $19,697m and capital expenditure was $3,622m, giving free cash flow of $16,075m.
- FY2025 depreciation and amortisation was $4,361m, and operating income was $18,964m.
- For H1 2026, operating cash flow was $19,964m, capex $1,562m and operating income $16,981m.
- Balance sheet at 30 Jun 2026.
- Cash and cash equivalents were $28,585m and short-term investments $2,883m.
- Current debt was $3,827m and long-term debt $69,501m.
- Debt-to-capital was 41.2%, and management targets about 40% by Q4.
- 2026 guidance (updated 16 Jul 2026): GAAP EPS $18.45–$18.95, adjusted EPS $19.50–$20.00, operating earnings above $25.45bn, operating cash flow about $24bn and capex about $3.8bn.
6. Valuation & Market Data
Raw metrics, September 2026. Not opinions on whether the stock is cheap or expensive.
| Metric | Value |
|---|---|
| Market cap | ~$338.4bn (share price $377.02 at the 25 Sep 2026 close, per MarketBeat) |
| Enterprise value | ~$380.3bn. Calculated as market cap ~$338.4bn + total debt ~$73.3bn (current debt $3.8bn + long-term debt $69.5bn) − cash and short-term investments ~$31.5bn, per the 30 Jun 2026 10-Q balance sheet. Long-term investment portfolios held against insurance liabilities are not deducted. |
| Trailing P/E (GAAP) | ~24.2x. Calculated as $377.02 / TTM GAAP diluted EPS of $15.56 (FY2025 $13.23 − H1 2025 $10.61 + H1 2026 $12.94). On TTM adjusted EPS of $18.64 (Q3 2025 to Q2 2026) the multiple is ~20.2x. |
| P/E (forward) | ~19.1x ($377.02 / 2026 adjusted EPS guidance midpoint of $19.75) |
| P/S (TTM) | ~0.75x. Calculated as market cap / TTM revenue of $450.1bn (FY2025 $447.6bn − H1 2025 $221.2bn + H1 2026 $223.8bn) |
| EV/EBITDA (TTM) | ~14.6x (EV ~$380.3bn / EBITDA ~$26.0bn). EBITDA = TTM operating income $21.7bn + TTM depreciation and amortisation $4.3bn. The TTM window includes the Q4 2025 restructuring, cyberattack and portfolio charges. |
| P/FCF | ~21.1x. Calculated as market cap ~$338.4bn / FY2025 FCF ~$16.1bn, where FCF = operating CF $19.70bn − capex $3.62bn per the FY2025 cash flow statement. On TTM FCF of ~$23.6bn the multiple is ~14.3x; operating cash flow can swing with the timing of CMS payments. |
| 52-week high | $461.62 |
| 52-week low | $255.96 |
| Short interest (% of float) | 1.48% (13.22m shares, settlement date 15 Sep 2026, per MarketBeat; 1.7% at 31 Aug 2026) |
| Days to cover | 2.47 (MarketBeat, 15 Sep 2026) |
| Dividend yield | ~2.5% ($9.28 annualised / $377.02) |
Share-price-based metrics use the 25 Sep 2026 close. For live prices see ChartsView Live Charts.
7. What Are They Building
AI and automation. The Q2 2026 release says targeted investments in infrastructure, AI and care delivery drove an operating cost ratio of 12.7%. Specific initiatives include:
- Optum Insight products for autonomous coding and digital prior authorisation;
- a UnitedHealthcare AI Companion for members, launched 26 Mar 2026;
- full automation of Optum's finance function by the end of 2027, as described at the Wells Fargo healthcare conference on 9 Sep 2026.
Resetting Optum Health. Optum Health is shrinking its value-based care book, serving about 700k fewer patients, and expects around 4.1m fully accountable patients in 2026. It targets a 6–8% margin by 2028, from about 2% in 2026 and about 4% in 2027. In September 2026 it sold an interest in some Florida WellMed clinics to TPG.
Pharmacy model changes. On 11 May 2026 Optum Rx announced a transparent, fee-based model with no spread pricing, and it has committed to 100% rebate pass-through by 1 Jan 2028.
Prior authorisation reform. UnitedHealthcare aims to cut prior-authorisation volume by 30% by the end of 2026. About 1,700 codes come off prior authorisation from 1 Oct 2026.
Portfolio. Recent moves:
- The Alegeus acquisition (consumer-directed accounts) closed on 2 Jul 2026.
- The Optum UK sale completed in Q1 2026.
- The about $1bn sale of Banmedica (South America) to Patria is expected to close in H2 2026.
Management has said it will re-engage in M&A in value-based care and Optum Insight. Capex is guided at about $3.8bn for 2026.
8. Competitive Landscape
| Peer | Market cap (Sep 2026) | Key 2025 metric |
|---|---|---|
| CVS Health (CVS) | ~$114.0bn | FY2025 revenue $402.1bn, +7.8%; adjusted EPS $6.75 (CVS FY2025 release) |
| Elevance Health (ELV) | ~$85.9bn | FY2025 operating revenue $197.6bn, +13%; adjusted EPS $30.29 (Elevance Q4 2025 release) |
| Cigna Group (CI) | ~$72.3bn | FY2025 revenue $274.9bn, +11%; adjusted EPS $29.84 (Cigna FY2025 release) |
| Humana (HUM) | ~$47.7bn | FY2025 revenue $129,664m; adjusted EPS $17.14, GAAP EPS $9.84 (Humana Q4 2025 release) |
| Centene (CNC) | ~$30.8bn | FY2025 revenue $194,777m; GAAP EPS −$13.53, adjusted EPS $2.08 (Centene FY2025 release) |
Market caps are from MarketBeat quote pages, 22–25 Sep 2026.
Where UnitedHealth competes with each peer:
- Medicare Advantage: mainly Humana, CVS (Aetna) and Elevance.
- Medicaid: Centene, Elevance and Molina.
- Pharmacy benefit management: Optum Rx against CVS Caremark and Cigna's Express Scripts.
- Care delivery: large health systems, physician groups and retailer-owned clinic chains.
9. Leadership and Ownership
Stephen Hemsley returned as Chair and CEO on 13 May 2025, replacing Andrew Witty. Other management changes:
- Wayne DeVeydt (Elevance CFO from 2007 to 2016) became CFO on 2 Sep 2025.
- About half of the top-100 leadership roles have been refreshed.
- Jodee Kozlak became Chief Administrative Officer from 28 Sep 2026.
The board added a Public Responsibility Committee and a Lead Independent Director, and Scott Gottlieb joined on 18 Nov 2025. Hemsley held 1,055,339 shares directly as of 22 Sep 2026. Berkshire Hathaway, which disclosed a stake in August 2025, had sold it entirely by Q1 2026.
| Name | Date | Type | Shares | Price | Value | Plan Type |
|---|---|---|---|---|---|---|
| Wayne DeVeydt (CFO) | 02 Sep 2026 | Shares withheld for tax | 1,209 | $399.66 | ~$0.48m | Tax withholding, not a market trade |
| Patrick Conway (CEO, Optum) | 21 Aug 2026 | Open-market sale | 1,169 | $390.00 | $455,910 | Not marked 10b5-1 on Form 4 |
| Patrick Conway (CEO, Optum) | 05 Aug 2026 | Sale | 500 | $410.00 | $205,000 | Not confirmed |
| Patrick Conway (CEO, Optum) | 23 Apr 2026 | Sale | 800 | $355.00 | $284,000 | Not confirmed |
| Stephen Hemsley (Chair and CEO) | 16 May 2025 | Open-market purchase | 86,700 | $288.57 (avg) | ~$25.0m | Discretionary purchase |
| John Rex (then CFO) | 16 May 2025 | Open-market purchase | 17,200 | $291.12 | ~$5.0m | Discretionary purchase |
| Kristen Gil (Director) | 15 May 2025 | Open-market purchase | 3,700 | $271.17 | ~$1.0m | Discretionary purchase |
| Timothy Flynn (Director) | 14 May 2025 | Open-market purchase | 1,533 | $320.80 | ~$0.49m | Discretionary purchase |
Sources: SEC Form 4 filings (via secform4.com and EDGAR) and contemporaneous reporting of the May 2025 purchases. No open-market insider purchases were found in 2026.
10. Risks and Challenges
- Government investigations (Legal/Regulatory): DOJ criminal and civil requests about Medicare Advantage practices remain open. Reports say the criminal probe also covers Optum Rx billing and physician pay. Under the False Claims Act, penalties and possible programme exclusion are among the stated risks.
- Medical cost trend (Financial): Risk-based premiums are close to 80% of revenue, so misjudging utilisation, costs or reserves feeds straight into earnings, as happened in 2025.
- Government funding and coding audits (Regulatory): Revenue depends on Medicare Advantage benchmarks and risk-adjustment rules, Star ratings (four or more stars earn quality bonuses), Medicaid redeterminations, ACA subsidies and RADV recoupments. The 17 Sep 2026 HHS-OIG audit is a live example.
- PBM reform (Regulatory): Legislative or regulatory changes to pharmacy benefit management could hit Optum Rx economics while the business moves to a transparent pass-through model.
- Cyber and data (Operational): The 2024 Change Healthcare cyberattack cost a further $799m in Q4 2025. UNH holds sensitive health data for a large share of the US population.
- Execution on the turnaround (Operational): Delivering the Optum Health margin reset, the AI cost programme and market exits while keeping members and providers happy is a multi-year task under new leadership.
11. Recent Developments
- 24 Sep 2026 — New Chief Administrative Officer. UNH named Jodee Kozlak Chief Administrative Officer, effective 28 Sep 2026.
- 17 Sep 2026 — HHS-OIG audit of UnitedHealthcare of Wisconsin. The audit estimated $46.9m of Medicare Advantage overpayments for 2020–21 based on unsupported diagnosis codes. UnitedHealthcare disputes the methodology.
- 15 Sep 2026 — Q3 date set. UNH will report Q3 2026 results on 13 Oct 2026.
- 09 Sep 2026 — Wells Fargo healthcare conference. Management said:
- Medicare Advantage margins are tracking in the upper half of the 2–4% range.
- Medicaid margins, near −1.1%, should trough in 2026.
- Optum Health is targeting a 6–8% margin by 2028.
- Buybacks will be at least $5bn.
- 08 Sep 2026 — TPG invests in Florida WellMed clinics. Optum sold an interest in some Florida WellMed clinics to TPG on undisclosed terms. The shares fell about 3% on 9 Sep.
- 01 Sep 2026 — Prior authorisation cut. UnitedHealthcare said about 1,700 codes will no longer need prior authorisation from 1 Oct 2026.
- 12 Aug 2026 — Dividend declared. The board declared a $2.32 per share quarterly dividend, paid 22 Sep 2026.
- 16 Jul 2026 — Q2 2026 results and guidance raised.
- Revenue was $112,032m, GAAP EPS $6.04 and adjusted EPS $6.38.
- The medical care ratio was 86.7%, including $860m of favourable prior-period development.
- 2026 adjusted EPS guidance was raised to $19.50–$20.00.
12. Key Dates Coming Up
- 01 Oct 2026 — About 1,700 codes come off UnitedHealthcare's prior-authorisation list.
- Expected Oct 2026 — CMS publishes 2027 Medicare Advantage Star ratings. The exact date has not been confirmed.
- 13 Oct 2026 — Q3 2026 results before the market open, with the conference call at 8:00am ET. The replay is available until 27 Oct 2026.
- 15 Oct 2026 — The Medicare Annual Enrollment Period opens.
- Expected H2 2026 — Closing of the Banmedica (South America) sale to Patria.
- TBC — Next dividend declaration. UNH typically announces dividends in Feb, Jun, Aug and Nov.
Macro events are on the ChartsView Economic Calendar, and you can discuss UnitedHealth on the ChartsView Forum.
Disclaimer: This research is produced by ChartsView for educational and informational purposes only. It does not constitute financial advice or a recommendation to buy or sell any security. All information is sourced from publicly available company filings, press releases, and official data. ChartsView does not use analyst opinions or third-party ratings. Always conduct your own due diligence and consider your personal financial situation before making investment decisions. Past performance is not indicative of future results.
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13. Thesis Verdict
The central thesis. UnitedHealth Group collects risk-based premiums through UnitedHealthcare (about 80% of revenue comes from risk-based premiums) and earns fees and product revenue across Optum Health, Optum Insight and Optum Rx, with its margin set by the gap between premiums and medical costs. FY2025 revenue grew 11.8% to $447.6bn but adjusted EPS fell to $16.35 as medical costs outran pricing; in 2026 the medical care ratio has improved to 86.7% in Q2 and management has raised adjusted EPS guidance to $19.50–$20.00. The Q3 2026 results on 13 Oct 2026 and the 2027 Medicare Advantage Star ratings due in October are the next catalysts.
What would confirm or break it. Confirmation would come from the medical care ratio holding near the 88.1% full-year guide without reliance on reserve releases, Optum Health margins tracking toward the 6–8% 2028 target, and delivery of at least $5bn of buybacks. The thesis would break if the DOJ criminal and civil Medicare Advantage investigations lead to charges or large settlements, if coding audits and funding changes cut Medicare Advantage economics, or if medical cost trend re-accelerates as it did in 2025.
Watchpoints
- ConfirmsQ3 2026 earnings (15 days) landing in line with or above management guidance.
- ConfirmsEvidence supporting the "Earnings recovery under way:" thesis continuing to build across subsequent filings.
- InvalidatesMaterialisation of the "Government investigations (Legal/Regulatory):" risk, or any disclosure that fundamentally alters the capital-return or growth profile stated by management.
Diagnostic grid
Generated by ChartsView research tooling. Thesis strength measures how well the evidence in this report supports the company's stated thesis — it is NOT a buy/sell rating or price target. ChartsView is not authorised by the FCA to provide regulated investment advice. Generated 28 Sep 2026.