UnitedHealth (UNH)
Market Price (7/29/2026): $427.3 | Market Cap: $388.0 BilInvestor Relations Sector: Health Care | Industry: Managed Health Care
UnitedHealth (UNH)
Market Price (7/29/2026): $427.3Market Cap: $388.0 BilSector: Health CareIndustry: Managed Health Care
Investment Highlights Why It Matters Detailed financial logic regarding cash flow yields vs trend-riding momentum.
Attractive yieldTotal YieldTotal Yield = Earnings Yield + Dividend Yield, Earnings Yield = Net Income / Market Cap Dividend Yield = Total Dividends / Market Cap is 5.2%, Dividend Yield is 2.1%, FCF Yield is 5.1% Stock buyback supportStock Buyback 3Y Total is 21 Bil Attractive cash flow generationCFO LTM is 23 Bil, FCF LTM is 20 Bil Low stock price volatilityVol 12M is 39% Megatrend and thematic driversMegatrends include Digital Health & Telemedicine, and Aging Population & Chronic Disease. Themes include Telehealth Platforms, Remote Patient Monitoring, Show more. | Trading close to highsDist 52W High is -1.7% Weak multi-year price returns2Y Excs Rtn is -53%, 3Y Excs Rtn is -74% | Expensive valuation multiplesP/EPrice/Earnings or Price/(Net Income) is 32x Valuation getting more expensiveP/S 6M Chg %Price/Sales change over 6 months. Declining P/S indicates valuation has become less expensive. is 58% Key risksUNH key risks include [1] intense regulatory scrutiny and antitrust probes targeting its Medicare Advantage and Optum businesses, Show more. |
| Attractive yieldTotal YieldTotal Yield = Earnings Yield + Dividend Yield, Earnings Yield = Net Income / Market Cap Dividend Yield = Total Dividends / Market Cap is 5.2%, Dividend Yield is 2.1%, FCF Yield is 5.1% |
| Stock buyback supportStock Buyback 3Y Total is 21 Bil |
| Attractive cash flow generationCFO LTM is 23 Bil, FCF LTM is 20 Bil |
| Low stock price volatilityVol 12M is 39% |
| Megatrend and thematic driversMegatrends include Digital Health & Telemedicine, and Aging Population & Chronic Disease. Themes include Telehealth Platforms, Remote Patient Monitoring, Show more. |
| Trading close to highsDist 52W High is -1.7% |
| Weak multi-year price returns2Y Excs Rtn is -53%, 3Y Excs Rtn is -74% |
| Expensive valuation multiplesP/EPrice/Earnings or Price/(Net Income) is 32x |
| Valuation getting more expensiveP/S 6M Chg %Price/Sales change over 6 months. Declining P/S indicates valuation has become less expensive. is 58% |
| Key risksUNH key risks include [1] intense regulatory scrutiny and antitrust probes targeting its Medicare Advantage and Optum businesses, Show more. |
Qualitative Assessment
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UnitedHealth (UNH) stock has gained about 60% since 3/31/2026 because of the following key factors:
1. Exceptional Financial Performance and Upgraded Outlook in Fiscal Q1 and Q2 2026.
UnitedHealth Group reported robust earnings that significantly surpassed analyst expectations for both fiscal Q1 and Q2 2026. For fiscal Q1 2026, the company announced adjusted earnings of $7.23 per share on revenue of $111.7 billion, beating analyst estimates by $0.58 and $1.05 billion, respectively. Following this, the company raised its full-year 2026 adjusted earnings outlook to "greater than $18.25" per share and accelerated at least $2 billion in share repurchases. This positive momentum continued into fiscal Q2 2026, with adjusted earnings of $6.38 per share, exceeding consensus estimates (ranging from $4.84 to $4.91) by approximately $1.47 to $1.51 per share, and revenue of $112.03 billion, surpassing expectations by over $1.2 billion. Critically, UnitedHealth Group further increased its full-year 2026 adjusted earnings guidance to a range of $19.50-$20.00 per share and boosted operating cash flow projections by $6 billion, signaling strong confidence in future performance and consistent execution. The company also affirmed plans to repurchase at least $5 billion in shares for the full year 2026.
2. Favorable Medicare Advantage (MA) Rate Revisions and Improved Medical Cost Trends.
A significant macroeconomic factor contributing to the stock's gain was the Centers for Medicare & Medicaid Services' (CMS) final 2027 Medicare Advantage rate notice. This notice delivered an effective increase of approximately 5%, a substantial improvement compared to the near-flat 0.09% initially proposed in January. This positive adjustment cleared a notable regulatory overhang for the healthcare services sector, including UnitedHealth, by easing concerns about MA costs. Concurrently, the first quarter of fiscal 2026 provided clear evidence that medical cost trends were cooling rather than escalating, which positively impacted the entire healthcare services industry. UnitedHealth itself demonstrated improved medical cost management, with its medical care ratio declining to 83.9% in fiscal Q1 2026 and further improving to 86.7% in fiscal Q2 2026, compared to 89.4% a year prior. These factors significantly alleviated investor concerns regarding rising medical costs and regulatory pressures.
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UnitedHealth (UNH) stock has gained about 60% since 3/31/2026 because of the following key factors:
1. Exceptional Financial Performance and Upgraded Outlook in Fiscal Q1 and Q2 2026.
UnitedHealth Group reported robust earnings that significantly surpassed analyst expectations for both fiscal Q1 and Q2 2026. For fiscal Q1 2026, the company announced adjusted earnings of $7.23 per share on revenue of $111.7 billion, beating analyst estimates by $0.58 and $1.05 billion, respectively. Following this, the company raised its full-year 2026 adjusted earnings outlook to "greater than $18.25" per share and accelerated at least $2 billion in share repurchases. This positive momentum continued into fiscal Q2 2026, with adjusted earnings of $6.38 per share, exceeding consensus estimates (ranging from $4.84 to $4.91) by approximately $1.47 to $1.51 per share, and revenue of $112.03 billion, surpassing expectations by over $1.2 billion. Critically, UnitedHealth Group further increased its full-year 2026 adjusted earnings guidance to a range of $19.50-$20.00 per share and boosted operating cash flow projections by $6 billion, signaling strong confidence in future performance and consistent execution. The company also affirmed plans to repurchase at least $5 billion in shares for the full year 2026.
2. Favorable Medicare Advantage (MA) Rate Revisions and Improved Medical Cost Trends.
A significant macroeconomic factor contributing to the stock's gain was the Centers for Medicare & Medicaid Services' (CMS) final 2027 Medicare Advantage rate notice. This notice delivered an effective increase of approximately 5%, a substantial improvement compared to the near-flat 0.09% initially proposed in January. This positive adjustment cleared a notable regulatory overhang for the healthcare services sector, including UnitedHealth, by easing concerns about MA costs. Concurrently, the first quarter of fiscal 2026 provided clear evidence that medical cost trends were cooling rather than escalating, which positively impacted the entire healthcare services industry. UnitedHealth itself demonstrated improved medical cost management, with its medical care ratio declining to 83.9% in fiscal Q1 2026 and further improving to 86.7% in fiscal Q2 2026, compared to 89.4% a year prior. These factors significantly alleviated investor concerns regarding rising medical costs and regulatory pressures.
3. Strategic Reforms, Operational Efficiency, and Positive Analyst Sentiment.
UnitedHealth Group implemented several strategic reforms and operational improvements that resonated positively with investors. The company committed to eliminating 30% of current prior authorization volume by the end of 2026, including nearly two-thirds of requirements for pediatric care. It also introduced a transparent, fee-based pharmacy care model, aiming for 100% pass-through of manufacturer rebates by 2028. These initiatives are designed to enhance affordability and streamline the healthcare experience for patients and providers. Operationally, UnitedHealthcare's operating margin rose to 4.6% in fiscal Q2 2026 from 2.4% in fiscal Q2 2025 due to improved medical management and pricing controls, while Optum segments also showed margin expansion. This demonstrated progress in simplifying operations and applying technology for efficiency. Consequently, Wall Street analysts responded with widespread optimism, issuing numerous "Buy" and "Strong Buy" ratings, and significantly raising price targets. For instance, Robert W. Baird upgraded the stock from "Underperform" to "Neutral" and increased its price target from $287 to $453, while other firms like UBS, RBC Capital, and Truist Securities also raised their targets, reflecting a strong belief in the company's continued execution and long-term prospects.
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Stock Movement Drivers
Fundamental Drivers
The 59.4% change in UNH stock from 3/31/2026 to 7/28/2026 was primarily driven by a 59.5% change in the company's P/E Multiple.| (LTM values as of) | 3312026 | 7282026 | Change |
|---|---|---|---|
| Stock Price ($) | 269.05 | 428.79 | 59.4% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 447,567 | 449,713 | 0.5% |
| Net Income Margin (%) | 2.7% | 2.7% | -0.6% |
| P/E Multiple | 20.3 | 32.3 | 59.5% |
| Shares Outstanding (Mil) | 908 | 908 | 0.0% |
| Cumulative Contribution | 59.4% |
Market Drivers
3/31/2026 to 7/28/2026| Return | Correlation | |
|---|---|---|
| UNH | 59.4% | |
| Market (SPY) | 13.9% | -2.8% |
| Sector (XLV) | 14.1% | 31.8% |
Fundamental Drivers
The 31.7% change in UNH stock from 12/31/2025 to 7/28/2026 was primarily driven by a 92.7% change in the company's P/E Multiple.| (LTM values as of) | 12312025 | 7282026 | Change |
|---|---|---|---|
| Stock Price ($) | 325.70 | 428.79 | 31.7% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 435,159 | 449,713 | 3.3% |
| Net Income Margin (%) | 4.0% | 2.7% | -33.7% |
| P/E Multiple | 16.8 | 32.3 | 92.7% |
| Shares Outstanding (Mil) | 906 | 908 | -0.2% |
| Cumulative Contribution | 31.7% |
Market Drivers
12/31/2025 to 7/28/2026| Return | Correlation | |
|---|---|---|
| UNH | 31.7% | |
| Market (SPY) | 8.9% | 11.1% |
| Sector (XLV) | 8.5% | 35.8% |
Fundamental Drivers
The 41.1% change in UNH stock from 6/30/2025 to 7/28/2026 was primarily driven by a 157.9% change in the company's P/E Multiple.| (LTM values as of) | 6302025 | 7282026 | Change |
|---|---|---|---|
| Stock Price ($) | 303.83 | 428.79 | 41.1% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 410,057 | 449,713 | 9.7% |
| Net Income Margin (%) | 5.4% | 2.7% | -50.3% |
| P/E Multiple | 12.5 | 32.3 | 157.9% |
| Shares Outstanding (Mil) | 912 | 908 | 0.4% |
| Cumulative Contribution | 41.1% |
Market Drivers
6/30/2025 to 7/28/2026| Return | Correlation | |
|---|---|---|
| UNH | 41.1% | |
| Market (SPY) | 20.9% | 16.7% |
| Sector (XLV) | 25.7% | 42.2% |
Fundamental Drivers
The -5.2% change in UNH stock from 6/30/2023 to 7/28/2026 was primarily driven by a -56.5% change in the company's Net Income Margin (%).| (LTM values as of) | 6302023 | 7282026 | Change |
|---|---|---|---|
| Stock Price ($) | 452.38 | 428.79 | -5.2% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 335,944 | 449,713 | 33.9% |
| Net Income Margin (%) | 6.2% | 2.7% | -56.5% |
| P/E Multiple | 20.4 | 32.3 | 58.6% |
| Shares Outstanding (Mil) | 933 | 908 | 2.8% |
| Cumulative Contribution | -5.2% |
Market Drivers
6/30/2023 to 7/28/2026| Return | Correlation | |
|---|---|---|
| UNH | -5.2% | |
| Market (SPY) | 73.0% | 10.6% |
| Sector (XLV) | 31.9% | 40.6% |
Price Returns Compared
| 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | Total [1] | |
|---|---|---|---|---|---|---|---|
| Returns | |||||||
| UNH Return | 45% | 7% | 1% | -2% | -33% | 28% | 31% |
| Peers Return | 33% | 12% | -9% | -26% | 11% | 32% | 46% |
| S&P 500 Return | 27% | -19% | 24% | 23% | 16% | 8% | 97% |
Monthly Win Rates [3] | |||||||
| UNH Win Rate | 58% | 42% | 42% | 50% | 50% | 71% | |
| Peers Win Rate | 52% | 60% | 42% | 45% | 58% | 51% | |
| S&P 500 Win Rate | 75% | 42% | 67% | 75% | 67% | 43% | |
Max Drawdowns [4] | |||||||
| UNH Max Drawdown | -11% | -17% | -15% | -22% | -60% | -27% | |
| Peers Max Drawdown | -18% | -19% | -24% | -37% | -34% | -26% | |
| S&P 500 Max Drawdown | -5% | -25% | -10% | -8% | -19% | -9% | |
[1] Cumulative total returns since the beginning of 2021
[2] Peers: CVS, CI, ELV, HUM, CNC. See UNH Returns vs. Peers.
[3] Win Rate = % of calendar months in which monthly returns were positive
[4] Max drawdown represents maximum peak-to-trough decline within a year
[5] 2026 data is for the year up to 7/28/2026 (YTD)
How Low Can It Go
| Event | UNH | S&P 500 |
|---|---|---|
| 2020 COVID-19 Crash | ||
| % Loss | -35.9% | -33.7% |
| % Gain to Breakeven | 56.0% | 50.9% |
| Time to Breakeven | 67 days | 140 days |
| Q4 2018 Fed Policy Error / Growth Scare | ||
| % Loss | -13.7% | -19.2% |
| % Gain to Breakeven | 15.9% | 23.8% |
| Time to Breakeven | 37 days | 105 days |
| 2015-2016 China Devaluation / Global Growth Scare | ||
| % Loss | -11.2% | -12.2% |
| % Gain to Breakeven | 12.6% | 13.9% |
| Time to Breakeven | 27 days | 62 days |
| 2011 US Debt Ceiling Crisis & European Contagion | ||
| % Loss | -20.7% | -17.9% |
| % Gain to Breakeven | 26.0% | 21.8% |
| Time to Breakeven | 148 days | 123 days |
| 2008-2009 Global Financial Crisis | ||
| % Loss | -72.3% | -53.4% |
| % Gain to Breakeven | 261.3% | 114.4% |
| Time to Breakeven | 1225 days | 1085 days |
| Summer 2007 Credit Crunch | ||
| % Loss | -12.7% | -8.6% |
| % Gain to Breakeven | 14.6% | 9.5% |
| Time to Breakeven | 96 days | 47 days |
In The Past
UnitedHealth's stock fell 0.0% during the 2024 Yen Carry Trade Unwind. Such a loss loss requires a 0.0% gain to breakeven.
Preserve Wealth
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Asset Allocation
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| Event | UNH | S&P 500 |
|---|---|---|
| 2020 COVID-19 Crash | ||
| % Loss | -35.9% | -33.7% |
| % Gain to Breakeven | 56.0% | 50.9% |
| Time to Breakeven | 67 days | 140 days |
| 2011 US Debt Ceiling Crisis & European Contagion | ||
| % Loss | -20.7% | -17.9% |
| % Gain to Breakeven | 26.0% | 21.8% |
| Time to Breakeven | 148 days | 123 days |
| 2008-2009 Global Financial Crisis | ||
| % Loss | -72.3% | -53.4% |
| % Gain to Breakeven | 261.3% | 114.4% |
| Time to Breakeven | 1225 days | 1085 days |
In The Past
UnitedHealth's stock fell 0.0% during the 2024 Yen Carry Trade Unwind. Such a loss loss requires a 0.0% gain to breakeven.
Preserve Wealth
Limiting losses and compounding gains is essential to preserving wealth.
Asset Allocation
Actively managed asset allocation strategies protect wealth. Learn more.
About UnitedHealth (UNH)
UnitedHealth Group (UNH) is a prominent diversified healthcare company operating across the United States. A significant part of its business is through its UnitedHealthcare segment, which provides a comprehensive array of health benefit plans and services. These offerings include medical, dental, and well-being coverage tailored for various client groups such as national, public sector, mid-sized, and small employers, as well as individuals. UnitedHealthcare also specializes in managing health plans for seniors (Medicare) and administering government-sponsored programs like Medicaid.
Beyond traditional health insurance, UnitedHealth Group operates an extensive Optum division, which comprises three integrated segments. Optum Health focuses on direct care delivery, managing access to vast networks of care providers, and offering health management services to individuals, employers, and government entities. Concurrently, Optum Insight provides essential software and information products, advisory consulting arrangements, and managed services outsourcing contracts to a wide range of healthcare stakeholders, including hospital systems, physicians, health plans, and life sciences companies.
The third key component of the Optum division is Optum Rx, which specializes in pharmacy care services. This segment manages retail network contracting, offers home delivery and specialty pharmacy services, and leverages its purchasing power and clinical capabilities to develop programs for effective formulary management, drug adherence, and disease/drug therapy management. Optum Rx aims to optimize the access and management of prescription medications for its clients and their members.
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Analogies for UnitedHealth (UNH):
- It's like the Cigna of health insurance combined with the CVS Caremark of prescription management.
- Think of it as the Accenture of healthcare technology and consulting, but also a massive health insurer.
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- Health Benefit Plans: Comprehensive health, dental, and well-being benefit plans and services for various populations, including employers, individuals, seniors, and government program beneficiaries (Medicaid).
- Health Management & Care Delivery Services: Provides access to care provider networks, health management services, and direct care delivery systems for individuals, employers, and government entities.
- Healthcare Technology & Consulting: Offers software, information products, advisory consulting, and managed services outsourcing to various healthcare organizations and governments.
- Pharmacy Care Services: Provides comprehensive pharmacy benefit management including retail network contracting, home delivery, specialty pharmacy, and clinical programs for medication management.
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UnitedHealth (UNH) serves a diverse range of customers, which can be categorized into the following major groups:
- Employers: This extensive category includes national employers, public sector employers, mid-sized employers, and small businesses. These entities purchase health benefit plans and services from UnitedHealth for their employees and members.
- Individuals: This group comprises general consumers seeking health coverage, individuals aged 50 and older (particularly for Medicare Advantage plans and services), and those eligible for government-sponsored programs such as Medicaid and the Children's Health Insurance Program (CHIP).
- Healthcare Organizations and Government Entities: This category includes various institutional clients such as hospital systems, physicians, other health plans, and life sciences companies, primarily for OptumInsight's software, information products, advisory consulting, and managed services. It also covers federal and state government entities, which engage UnitedHealth for services or through contracts for public health programs.
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- McKesson Corporation (MCK)
- Cardinal Health (CAH)
- AmerisourceBergen Corporation (ABC)
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Stephen J. Hemsley, Chief Executive Officer
Stephen J. Hemsley was appointed Chief Executive Officer of UnitedHealth Group effective May 13, 2025. He previously served as the company's CEO from 2006 to 2017. He joined UnitedHealth Group in 1997 as Chief Operating Officer and became President in 1999. Mr. Hemsley also serves as the Chairman of the company's Board of Directors.
Wayne S. DeVeydt, Chief Financial Officer
Wayne S. DeVeydt was appointed Chief Financial Officer of UnitedHealth Group, effective September 2, 2025. Prior to joining UnitedHealth Group, he most recently served as a Managing Director and Operating Partner at Bain Capital, a private equity firm. From 2018 to 2020, he was Chairman and CEO of Surgery Partners, Inc. Mr. DeVeydt also served as the CFO of Anthem, Inc. (now Elevance) from 2007 to 2016. Earlier in his career, he was a Partner at PricewaterhouseCoopers LLP, focusing on the healthcare sector.
John F. Rex, Strategic Advisor to the CEO
John F. Rex transitioned to the role of Strategic Advisor to the CEO on September 2, 2025, after serving as UnitedHealth Group's Chief Financial Officer and Executive Vice President since 2016. He joined UnitedHealth Group in 2012 as the CFO of its Optum business. His prior experience includes serving as Chief Financial Officer and Executive Vice President for InGensa, Inc., as well as holding positions as a leading equity research analyst at firms such as JP Morgan Chase & Co., Robertson Stephens, Inc., and Bear Stearns Companies Inc. He also worked as a strategy and operational consultant and is a Certified Public Accountant.
Dr. Patrick Conway, Chief Executive Officer, Optum
Dr. Patrick Conway, M.D., became Chief Executive Officer of Optum effective April 29, 2025. He has an extensive background as a public and private healthcare leader and practicing pediatrician. Before this role, he held senior leadership positions at Optum Rx and Optum Health.
Heather Cianfrocco, Executive Vice President, Governance, Compliance and Information Security
Heather Cianfrocco was appointed UnitedHealth Group’s Executive Vice President of Governance, Compliance and Information Security, effective April 29, 2025. She brings deep knowledge of the company's business from her experience in senior leadership roles across UnitedHealthcare and Optum, coupled with a decade working as a lawyer.
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The key risks to UnitedHealth (UNH) primarily revolve around regulatory challenges, rising medical costs impacting its Medicare Advantage segment, and the ongoing fallout from significant cyberattacks.
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Regulatory Scrutiny and Government Intervention: UnitedHealth faces significant regulatory and legal risks due to ongoing government investigations and potential legislative changes. The Department of Justice (DOJ) has initiated criminal and civil investigations into Medicare Advantage billing practices, alongside antitrust probes into Optum's vertical integration, particularly concerning its Pharmacy Benefit Manager (PBM) business and the acquisition of Change Healthcare. Proposed legislation aimed at increasing transparency for PBMs could also lead to changes in business models and reduced profitability for Optum Rx. Additionally, evolving regulatory frameworks, including adjustments to Medicare Advantage and Medicaid reimbursement rates and risk adjustment models, continue to exert cost pressures and could compress profit margins.
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Rising Medical Costs and Medicare Advantage Margin Pressure: UnitedHealth is grappling with higher-than-expected healthcare utilization and increased medical costs, particularly within its Medicare Advantage segment and Optum Health. This trend has led to elevated medical care ratios (MCR) and pressure on profit margins, with Medicare Advantage margins expected to be significantly lower than historical targets. New risk adjustment models, such as the V28 revisions by the Centers for Medicare & Medicaid Services (CMS), are designed to tighten coding for patient conditions, which could "structurally impair" Optum Health and reduce payments.
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Cyberattack Fallout: The February 2024 ransomware attack on Change Healthcare, a subsidiary within UnitedHealth's Optum segment, poses a significant and ongoing risk. This cyberattack caused widespread disruption across the U.S. healthcare sector, affecting pharmacies, patient prescription access, and billing processes. The incident has resulted in substantial financial costs for UnitedHealth, including over $3 billion in 2024, and continues to present reputational damage and necessitate significant cybersecurity investments to mitigate future threats.
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There are two clear emerging threats to UnitedHealth:
- The aggressive expansion of Amazon Pharmacy (including services like PillPack and RxPass) into home delivery, specialty pharmacy, and potentially broader pharmacy benefit management (PBM) services, which directly threatens OptumRx's market share and business model.
- The rapid growth and consolidation of tech-enabled primary care and integrated care delivery networks by new entrants and competitors, such as Amazon's acquisition of One Medical and CVS's acquisition of Oak Street Health, which directly competes with OptumHealth's care delivery and provider network capabilities by offering alternative, often digitally enhanced, access to healthcare services.
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UnitedHealth Group (UNH) operates across diversified health care segments, each addressing substantial markets primarily within the United States.
UnitedHealthcare Segment
This segment focuses on health benefit plans and services for various consumer groups.
- U.S. Health & Medical Insurance Market: The overall U.S. health and medical insurance market was valued at approximately $1.6 trillion in 2026 and is projected to reach $2.15 trillion by 2031, growing at a CAGR of 5.37%. Other estimates placed the market at $1.23 trillion in 2024, expected to grow to $1.77 trillion by 2030, with a CAGR of 6.98%. Another source valued the U.S. health insurance market at $613.0 billion in 2024, projected to increase to $1,161.7 billion by 2032 at an 8.5% CAGR.
- U.S. Group Health Insurance Market (Commercial): The U.S. group health insurance market, also known as employer-sponsored insurance, was estimated at $1.41 trillion in 2024 and is projected to grow at a CAGR of 2.2% from 2025 to 2030. UnitedHealth Group held a 16% market share in the national commercial health insurance market in 2024.
- U.S. Medicare Advantage Market: The U.S. Medicare Advantage market size was estimated at $445.97 billion in 2025 and is projected to expand to $1,060.04 billion by 2034, growing at a CAGR of 10.1%. Enrollment in Medicare Advantage reached 34.1 million beneficiaries in 2025, accounting for 54% of all eligible Medicare individuals in the U.S. By February 2026, 51% of the Medicare population was enrolled in Medicare Advantage plans, totaling 35.4 million beneficiaries.
- U.S. Medicaid Market: In January 2025, 71.4 million people were enrolled in Medicaid in the U.S. Total Medicaid spending was $884.4 billion in fiscal year 2023. In fiscal year 2024, total Medicaid spending was $919 billion. UnitedHealth Group held a 9% share of the Medicaid Managed Care Organization (MCO) market as of September 2024.
- U.S. Hospital Services Market: The U.S. hospital services market was valued at $2.64 trillion in 2025 and is predicted to increase to approximately $4.16 trillion by 2035, expanding at a CAGR of 4.65% from 2025 to 2034.
OptumRx Segment
This segment provides pharmacy care services and programs.
- U.S. Pharmacy Benefit Management (PBM) Market: The U.S. pharmacy benefit management market size was calculated at $459.65 billion in 2025 and is expected to reach approximately $1,041.11 billion by 2034, growing at a CAGR of 9.7% from 2025 to 2034. Another report valued the market at $626.47 billion in the U.S. in 2026. In 2024, OptumRx, along with two other major PBMs, processed roughly 80% of all U.S. pharmacy claims.
OptumHealth & OptumInsight Segments
These segments offer health management, care delivery, software, information products, and consulting.
- U.S. Healthcare IT Market: The U.S. healthcare IT market size was valued at $160.52 billion in 2024 and is projected to reach approximately $566.48 billion by 2034, expanding at a CAGR of 13.44% from 2025 to 2034. Other estimates place the U.S. healthcare IT market at $182.09 billion in 2025, reaching $396.82 billion by 2030 at a CAGR of 14.0%. The total IT spend by healthcare organizations in the U.S. is projected to reach $176.6 billion, representing 63% of the global healthcare IT market size in 2025.
- U.S. Healthcare Consulting Services Market: The U.S. healthcare consulting services market was valued at $10.1 billion in 2024 and is anticipated to grow at a CAGR of 7.6% between 2025 and 2034. Another source projected the healthcare consulting services market size to reach $52.0 billion by 2030 from $32.2 billion in 2025, at a CAGR of 10.1%. North America held the largest share of 40.3% of the global healthcare consulting services market in 2024.
- U.S. Healthcare Business Process Outsourcing (BPO) Market: The U.S. healthcare BPO market is valued at $165.05 billion in 2026 and is projected to reach $245.46 billion by 2031, growing at an 8.26% CAGR.
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UnitedHealth Group (UNH) is focusing on several key areas to drive future revenue growth over the next two to three years, despite facing immediate headwinds such as proposed flat Medicare Advantage reimbursement rates for 2027 and rising medical costs. The company is implementing strategic initiatives to stabilize its core businesses and expand its health services segments.
Here are 3-5 expected drivers of future revenue growth:
- Expansion of Optum Segment, particularly Optum Rx and Optum Health: The Optum segment is consistently identified as a primary growth engine. Optum Rx has secured over 800 new client relationships for the 2026 and 2027 selling seasons, which is anticipated to boost operating earnings and margin expansion, supported by AI automation and operational efficiencies. Concurrently, Optum Health projects approximately 9% operating earnings growth in 2026, driven by a renewed focus on integrated value-based care within key markets and improved execution.
- Strategic Repricing and Operational Discipline within UnitedHealthcare: UnitedHealthcare is undergoing a "re-baselining" of its operations and is aligning its pricing discipline to account for higher medical trends and the impact of healthcare policy changes. This strategic repricing across the enterprise and efforts to improve the medical care ratio are aimed at stabilizing and eventually growing revenue in its health benefits business, even amidst external challenges.
- Growth of Value-Based Care Models: A strategic shift towards integrated value-based care arrangements within Optum Health is expected to be a significant driver. These models aim to manage the total cost of care more effectively, leading to improved outcomes and supporting the retention of cash, which can attract more clients and expand service offerings over time.
- Leveraging AI and Technology for Efficiency and Service Enhancement: UnitedHealth Group is investing in AI automation to drive operating efficiencies, particularly within Optum Rx, which is expected to support margin expansion. While not a direct revenue driver, these technological advancements can enhance competitiveness, improve cost management, and free up resources for further growth initiatives and improved service delivery, ultimately supporting revenue expansion.
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Share Repurchases
- UnitedHealth Group's repurchase of common stock averaged $6.909 billion annually from fiscal years ending December 2021 to 2025.
- Annual share repurchases were $5 billion in 2021, $7 billion in 2022, $8 billion in 2023, $9 billion in 2024, and $5.545 billion in 2025.
- In 2024, the company returned over $16 billion to shareholders through dividends and share repurchases.
Share Issuance
- UnitedHealth Group's shares outstanding have generally declined over the past few years, with 0.911 billion shares outstanding in 2025 (a 1.94% decline from 2024), 0.929 billion in 2024 (a 0.96% decline from 2023), and 0.938 billion in 2023 (a 1.26% decline from 2022).
Outbound Investments
- UnitedHealth Group made 6 investments across sectors including Healthcare IT, Clinical Labs IT, and Healthcare Booking Platforms.
- Notable recent investments include a Seed round in Carpl (February 2024), a Seed round in Mundial Media (September 2023), and a Series A in Morgan's Wonderland (October 2022).
- The company merged Change Healthcare in 2022, enhancing Optum's analytics and pharmacy capabilities.
- Optum Health integrated large groups such as LHC Group in 2023 and aims to expand to thousands more clinical sites by 2025–2026 through acquisitions and affiliations.
Capital Expenditures
- UnitedHealth Group's capital expenditures for fiscal years ending December 2021 to 2025 averaged $3.153 billion.
- Capital expenditures consistently increased, rising from $2.454 billion in 2021 to $3.622 billion in 2025.
- The company plans to invest nearly $1.5 billion in 2026 and a similar amount in 2027 to support enterprise-wide AI initiatives, focusing on accelerating AI-first product development at OptumInsight and expanding automation across OptumRx and UnitedHealthcare.
- Forecasted capital expenditures are $3.9 billion for 2026, $4.042 billion for 2027, and $4.173 billion for 2028.
Latest Trefis Analyses
Research & Analysis
Invest in Strategies
Wealth Management
Peer Comparisons
| Peers to compare with: |
Financials
| Median | |
|---|---|
| Name | |
| Mkt Price | 343.39 |
| Mkt Cap | 81.4 |
| Rev LTM | 239,476 |
| Op Inc LTM | 11,691 |
| FCF LTM | 7,253 |
| FCF 3Y Avg | 5,653 |
| CFO LTM | 8,378 |
| CFO 3Y Avg | 7,311 |
Growth & Margins
| Median | |
|---|---|
| Name | |
| Rev Chg LTM | 9.5% |
| Rev Chg 3Y Avg | 10.5% |
| Rev Chg Q | 5.6% |
| QoQ Delta Rev Chg LTM | 1.3% |
| Op Inc Chg LTM | -43.7% |
| Op Inc Chg 3Y Avg | -10.3% |
| Op Mgn LTM | 2.9% |
| Op Mgn 3Y Avg | 3.1% |
| QoQ Delta Op Mgn LTM | 0.2% |
| CFO/Rev LTM | 3.4% |
| CFO/Rev 3Y Avg | 2.7% |
| FCF/Rev LTM | 2.9% |
| FCF/Rev 3Y Avg | 2.1% |
Valuation
| Median | |
|---|---|
| Name | |
| Mkt Cap | 81.4 |
| P/S | 0.3 |
| P/Op Inc | 20.7 |
| P/EBIT | 16.2 |
| P/E | 24.6 |
| P/CFO | 12.3 |
| Total Yield | 4.9% |
| Dividend Yield | 1.9% |
| FCF Yield 3Y Avg | 6.6% |
| D/E | 0.4 |
| Net D/E | 0.0 |
Returns
| Median | |
|---|---|
| Name | |
| 1M Rtn | 0.7% |
| 3M Rtn | 23.3% |
| 6M Rtn | 53.8% |
| 12M Rtn | 63.2% |
| 3Y Rtn | -6.4% |
| 1M Excs Rtn | -0.3% |
| 3M Excs Rtn | 27.4% |
| 6M Excs Rtn | 21.1% |
| 12M Excs Rtn | 44.9% |
| 3Y Excs Rtn | -73.5% |
Comparison Analyses
Segment Financials
Revenue by Segment| $ Mil | 2025 | 2024 | 2023 | 2022 | 2021 |
|---|---|---|---|---|---|
| UnitedHealthcare | 344,903 | 298,208 | 281,360 | 249,741 | 222,899 |
| Optum Rx | 154,726 | 133,231 | 116,087 | 99,773 | 35,535 |
| Optum Health | 101,957 | 105,358 | 95,319 | 71,174 | 24,831 |
| Optum Insight | 19,417 | 18,757 | 18,932 | 14,581 | 4,332 |
| Optum Eliminations | -5,480 | -4,389 | -3,703 | -2,760 | |
| Corporate and Eliminations | -167,956 | -150,887 | -136,373 | -108,347 | |
| Total | 447,567 | 400,278 | 371,622 | 324,162 | 287,597 |
| $ Mil | 2025 | 2024 | 2023 | 2022 | 2021 |
|---|---|---|---|---|---|
| UnitedHealthcare | 9,425 | 15,584 | 16,415 | 14,379 | 11,975 |
| Optum Rx | 7,193 | 5,836 | 5,115 | 4,436 | 4,135 |
| Optum Insight | 2,624 | 3,097 | 4,268 | 3,588 | 3,398 |
| Corporate and Eliminations | 0 | 0 | 0 | 0 | |
| Optum Eliminations | 0 | 0 | 0 | 0 | |
| Optum Health | -278 | 7,770 | 6,560 | 6,032 | 4,462 |
| Total | 18,964 | 32,287 | 32,358 | 28,435 | 23,970 |
| $ Mil | 2025 | 2024 | 2023 | 2022 | 2021 |
|---|---|---|---|---|---|
| UnitedHealthcare | 124,051 | 119,009 | 110,943 | 107,094 | 102,967 |
| Optum Health | 100,991 | 96,472 | 89,432 | 68,950 | 60,474 |
| Optum Rx | 62,262 | 59,086 | 51,266 | 47,476 | 40,181 |
| Optum Insight | 35,400 | 34,452 | 34,173 | 31,090 | 16,868 |
| Optum Eliminations | 0 | 0 | 0 | 0 | |
| Corporate and Eliminations | -13,123 | -10,741 | -12,094 | -8,905 | -8,284 |
| Total | 309,581 | 298,278 | 273,720 | 245,705 | 212,206 |
Price Behavior
| Market Price | $428.79 | |
| Market Cap ($ Bil) | 389.3 | |
| First Trading Date | 03/26/1990 | |
| Distance from 52W High | -1.7% | |
| 50 Days | 200 Days | |
| DMA Price | $407.63 | $340.49 |
| DMA Trend | up | up |
| Distance from DMA | 5.2% | 25.9% |
| 3M | 1YR | |
| Volatility | 25.7% | 39.4% |
| Downside Capture | -56.07 | 22.53 |
| Upside Capture | 30.64 | 71.07 |
| Correlation (SPY) | -2.5% | 17.6% |
| 1M | 2M | 3M | 6M | 1Y | 3Y | |
|---|---|---|---|---|---|---|
| Beta | 0.02 | -0.03 | 0.01 | 0.35 | 0.55 | 0.26 |
| Up Beta | -1.23 | -0.82 | -0.34 | 0.23 | 0.40 | 0.40 |
| Down Beta | 0.26 | 0.61 | 0.49 | 0.72 | 0.98 | 0.22 |
| Up Capture | 89% | 38% | 100% | 43% | 47% | 3% |
| Bmk +ve Days | 11 | 24 | 40 | 67 | 140 | 429 |
| Stock +ve Days | 11 | 20 | 36 | 66 | 129 | 384 |
| Down Capture | -22% | -50% | -130% | -6% | 33% | 41% |
| Bmk -ve Days | 10 | 17 | 23 | 58 | 112 | 321 |
| Stock -ve Days | 10 | 21 | 27 | 59 | 123 | 367 |
[1] Upside and downside betas calculated using positive and negative benchmark daily returns respectively
Based On 1-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with UNH | |
|---|---|---|---|---|
| UNH | 56.9% | 39.4% | 1.23 | - |
| Sector ETF (XLV) | 24.3% | 15.8% | 1.18 | 40.5% |
| Equity (SPY) | 17.3% | 12.7% | 0.99 | 17.4% |
| Gold (GLD) | 20.2% | 28.1% | 0.64 | 6.1% |
| Commodities (DBC) | 29.1% | 19.5% | 1.19 | 0.5% |
| Real Estate (VNQ) | 14.4% | 14.1% | 0.72 | 16.7% |
| Bitcoin (BTCUSD) | -46.4% | 42.9% | -1.33 | 20.4% |
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Based On 5-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with UNH | |
|---|---|---|---|---|
| UNH | 2.5% | 32.0% | 0.13 | - |
| Sector ETF (XLV) | 7.0% | 15.0% | 0.28 | 48.5% |
| Equity (SPY) | 12.9% | 17.1% | 0.58 | 22.3% |
| Gold (GLD) | 16.9% | 18.4% | 0.74 | 4.0% |
| Commodities (DBC) | 9.1% | 19.5% | 0.36 | 1.8% |
| Real Estate (VNQ) | 2.9% | 18.9% | 0.05 | 19.3% |
| Bitcoin (BTCUSD) | 16.2% | 53.4% | 0.48 | 10.4% |
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Based On 10-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with UNH | |
|---|---|---|---|---|
| UNH | 13.6% | 30.3% | 0.48 | - |
| Sector ETF (XLV) | 10.3% | 16.6% | 0.50 | 62.2% |
| Equity (SPY) | 14.9% | 17.9% | 0.71 | 44.9% |
| Gold (GLD) | 11.3% | 16.1% | 0.57 | 3.6% |
| Commodities (DBC) | 6.8% | 18.0% | 0.30 | 12.0% |
| Real Estate (VNQ) | 5.2% | 20.7% | 0.21 | 37.8% |
| Bitcoin (BTCUSD) | 57.5% | 66.2% | 0.98 | 9.9% |
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Returns Analyses
Earnings Returns History
Updated 7/26/2026| Forward Returns | |||
|---|---|---|---|
| Earnings Date | 1D Returns | 5D Returns | 21D Returns |
| 7/16/2026 | 1.2% | 3.1% | |
| 4/21/2026 | 7.0% | 9.6% | 20.3% |
| 1/27/2026 | -19.6% | -18.8% | -19.2% |
| 10/28/2025 | 0.5% | -8.8% | -10.8% |
| 7/29/2025 | -7.5% | -14.6% | 6.5% |
| 4/17/2025 | -22.4% | -27.5% | -50.1% |
| 1/16/2025 | -6.0% | -2.5% | -3.7% |
| 10/15/2024 | -8.1% | -5.6% | 1.5% |
| ... | |||
| SUMMARY STATS | |||
| # Positive | 13 | 11 | 14 |
| # Negative | 12 | 14 | 10 |
| Median Positive | 3.8% | 6.2% | 7.4% |
| Median Negative | -3.1% | -4.1% | -6.7% |
| Max Positive | 7.2% | 12.6% | 20.3% |
| Max Negative | -22.4% | -27.5% | -50.1% |
| Forward Returns | |||
|---|---|---|---|
| Earnings Date | 1D Returns | 5D Returns | 21D Returns |
| 7/16/2026 | 1.2% | 3.1% | |
| 4/21/2026 | 7.0% | 9.6% | 20.3% |
| 1/27/2026 | -19.6% | -18.8% | -19.2% |
| 10/28/2025 | 0.5% | -8.8% | -10.8% |
| 7/29/2025 | -7.5% | -14.6% | 6.5% |
| 4/17/2025 | -22.4% | -27.5% | -50.1% |
| 1/16/2025 | -6.0% | -2.5% | -3.7% |
| 10/15/2024 | -8.1% | -5.6% | 1.5% |
| 7/16/2024 | 6.5% | 8.4% | 11.4% |
| 4/16/2024 | 5.2% | 10.2% | 15.3% |
| 1/12/2024 | -3.4% | -6.7% | -4.1% |
| 10/13/2023 | 2.6% | 1.2% | 3.0% |
| 7/14/2023 | 7.2% | 12.6% | 13.5% |
| 4/14/2023 | -2.7% | -7.4% | -6.7% |
| 1/13/2023 | -1.2% | -1.8% | -0.1% |
| 10/14/2022 | 0.6% | 2.2% | 2.4% |
| 7/15/2022 | 5.4% | 4.0% | 8.2% |
| 4/14/2022 | -0.4% | 0.1% | -9.6% |
| 1/19/2022 | 0.3% | -0.9% | 4.1% |
| 10/14/2021 | 4.2% | 7.8% | 13.3% |
| 7/15/2021 | 1.3% | -0.0% | -2.1% |
| 4/15/2021 | 3.8% | 6.2% | 8.8% |
| 1/20/2021 | -0.4% | -2.6% | -6.8% |
| 10/14/2020 | -2.9% | -2.4% | 6.1% |
| 7/15/2020 | -1.4% | -1.1% | 4.5% |
| SUMMARY STATS | |||
| # Positive | 13 | 11 | 14 |
| # Negative | 12 | 14 | 10 |
| Median Positive | 3.8% | 6.2% | 7.4% |
| Median Negative | -3.1% | -4.1% | -6.7% |
| Max Positive | 7.2% | 12.6% | 20.3% |
| Max Negative | -22.4% | -27.5% | -50.1% |
SEC Filings
Expand for More| Report Date | Filing Date | Filing |
|---|---|---|
| 03/31/2026 | 05/05/2026 | 10-Q |
| 12/31/2025 | 03/02/2026 | 10-K |
| 09/30/2025 | 10/28/2025 | 10-Q |
| 06/30/2025 | 08/11/2025 | 10-Q |
| 03/31/2025 | 05/07/2025 | 10-Q |
| 12/31/2024 | 02/27/2025 | 10-K |
| 09/30/2024 | 11/04/2024 | 10-Q |
| 06/30/2024 | 08/09/2024 | 10-Q |
| 03/31/2024 | 05/09/2024 | 10-Q |
| 12/31/2023 | 02/28/2024 | 10-K |
| 09/30/2023 | 11/06/2023 | 10-Q |
| 06/30/2023 | 08/02/2023 | 10-Q |
| 03/31/2023 | 05/03/2023 | 10-Q |
| 12/31/2022 | 02/24/2023 | 10-K |
| 09/30/2022 | 11/02/2022 | 10-Q |
| 06/30/2022 | 08/03/2022 | 10-Q |
| Report Date | Filing Date | Filing |
|---|---|---|
| 03/31/2026 | 05/05/2026 | 10-Q |
| 12/31/2025 | 03/02/2026 | 10-K |
| 09/30/2025 | 10/28/2025 | 10-Q |
| 06/30/2025 | 08/11/2025 | 10-Q |
| 03/31/2025 | 05/07/2025 | 10-Q |
| 12/31/2024 | 02/27/2025 | 10-K |
| 09/30/2024 | 11/04/2024 | 10-Q |
| 06/30/2024 | 08/09/2024 | 10-Q |
| 03/31/2024 | 05/09/2024 | 10-Q |
| 12/31/2023 | 02/28/2024 | 10-K |
| 09/30/2023 | 11/06/2023 | 10-Q |
| 06/30/2023 | 08/02/2023 | 10-Q |
| 03/31/2023 | 05/03/2023 | 10-Q |
| 12/31/2022 | 02/24/2023 | 10-K |
| 09/30/2022 | 11/02/2022 | 10-Q |
| 06/30/2022 | 08/03/2022 | 10-Q |
| 03/31/2022 | 05/04/2022 | 10-Q |
| 12/31/2021 | 02/15/2022 | 10-K |
| 09/30/2021 | 11/03/2021 | 10-Q |
| 06/30/2021 | 08/03/2021 | 10-Q |
| 03/31/2021 | 05/05/2021 | 10-Q |
| 12/31/2020 | 03/01/2021 | 10-K |
| 09/30/2020 | 11/02/2020 | 10-Q |
| 06/30/2020 | 08/03/2020 | 10-Q |
| 03/31/2020 | 05/06/2020 | 10-Q |
| 12/31/2019 | 02/14/2020 | 10-K |
| 09/30/2019 | 11/06/2019 | 10-Q |
| 06/30/2019 | 08/07/2019 | 10-Q |
Recent Forward Guidance
Updated 7/17/2026Latest: Q2 2026 Earnings Reported 7/16/2026
| Forward Guidance | Guidance Change | ||||||
|---|---|---|---|---|---|---|---|
| Metric | Low | Mid | High | % Chg | % Delta | Change | Prior |
| 2026 Adjusted Net Earnings per Share | 19.5 | 19.8 | 20 | 8.2% | Raised | Guidance: 18.2 for 2026 | |
| 2026 Diluted Net Earnings per Share | 18.4 | 18.7 | 18.9 | ||||
| 2026 UnitedHealthcare Reported Operating Earnings | 12.00 Bil | ||||||
| 2026 Optum Health Reported Operating Earnings | 2.27 Bil | ||||||
| 2026 Optum Insight Reported Operating Earnings | 4.92 Bil | ||||||
| 2026 Optum Rx Reported Operating Earnings | 6.25 Bil | ||||||
| 2026 UnitedHealth Group Reported Operating Earnings | 25.45 Bil | ||||||
| 2026 Medical Care Ratio | 0.88 | ||||||
| 2026 Cash Flows from Operations | 24.00 Bil | ||||||
| 2026 Share Repurchase | 5.00 Bil | ||||||
Prior: Q1 2026 Earnings Reported 4/21/2026
| Forward Guidance | Guidance Change | ||||||
|---|---|---|---|---|---|---|---|
| Metric | Low | Mid | High | % Chg | % Delta | Change | Prior |
| Q2 2026 Share Repurchases | 2.00 Bil | ||||||
| 2026 Adjusted EPS | 18.2 | 2.8% | Raised | Guidance: 17.8 for 2026 | |||
| 2026 Debt-to-Capital Ratio | 0.4 | ||||||
Q4 2025 Earnings Reported 1/27/2026
| Forward Guidance | Guidance Change | ||||||
|---|---|---|---|---|---|---|---|
| Metric | Low | Mid | High | % Chg | % Delta | Change | Prior |
| 2026 Revenue | 439.00 Bil | ||||||
| 2026 Earnings from Operations | 24.00 Bil | ||||||
| 2026 Adjusted Earnings per Share | 17.8 | 9.2% | Higher New | Guidance: 16.2 for 2025 | |||
| 2026 Cash Flows from Operations | 18.00 Bil | ||||||
| 2026 Operating Margin | 5.5% | ||||||
Q3 2025 Earnings Reported 10/28/2025
| Forward Guidance | Guidance Change | ||||||
|---|---|---|---|---|---|---|---|
| Metric | Low | Mid | High | % Chg | % Delta | Change | Prior |
| 2025 EPS | 14.9 | 1.7% | Raised | Guidance: 14.7 for 2025 | |||
| 2025 Adjusted EPS | 16.2 | 1.6% | Raised | Guidance: 16 for 2025 | |||
| 2025 Net Earnings | 13.60 Bil | ||||||
Investor Activity (13F)
Updated Jul 29, 2026Active managers (13F portfolio over $250M, at least 3 holdings) with a position over $5M that is either over 10% of their portfolio or held in a concentrated book of 50 or fewer total positions. Index/ETF, sovereign, bank, community-bank and charitable/donor-advised filers are excluded.
| Active Manager | Value | % of Portfolio | Total Positions | QoQ | Filing |
|---|---|---|---|---|---|
| Naya Capital Management UK LTD | $273.4 Mil | 23.2% | 4 | ADD +10.7% | 13F |
| Solel Partners LP | $55.9 Mil | 11.9% | 19 | Hold | 13F |
| Marshfield Associates | $511.6 Mil | 10.2% | 17 | ADD +14.0% | 13F |
| Seilern Investment Management Ltd | $76.1 Mil | 9.1% | 24 | TRIM -21.0% | 13F |
| Warther Private Wealth, LLC | $31.9 Mil | 7.5% | 40 | ADD +5.7% | 13F |
| GUARDCAP ASSET MANAGEMENT Ltd | $126.8 Mil | 7.3% | 27 | TRIM -43.9% | 13F |
| Boone Capital Management LLC | $21.4 Mil | 6.6% | 13 | ADD +28.3% | 13F |
| Vulcan Value Partners, LLC | $247.0 Mil | 6.5% | 33 | TRIM -15.7% | 13F |
| Route One Investment Company, L.P. | $144.2 Mil | 6.3% | 18 | ADD +5.0% | 13F |
| Gobi Capital LLC | $104.5 Mil | 6.1% | 10 | TRIM -5.2% | 13F |
| MFF Capital Investments Ltd | $84.5 Mil | 5.6% | 19 | ADD +11.8% | 13F |
| Bowie Capital Management, LLC | $96.2 Mil | 4.6% | 29 | ADD +27.6% | 13F |
| Patient Capital Management, LLC | $118.3 Mil | 4.4% | 38 | ADD +18.7% | 13F |
| Generali Powszechne Towarzystwo Emerytalne | $24.4 Mil | 4.3% | 28 | Hold | 13F |
| Focused Investors LLC | $132.5 Mil | 4.3% | 22 | Hold | 13F |
| Longview Partners (Guernsey) LTD | $303.5 Mil | 4.3% | 25 | TRIM -10.6% | 13F |
| One Fin Capital Management LP | $8.9 Mil | 3.4% | 19 | New | 13F |
| AltraVue Capital, LLC | $38.3 Mil | 3.3% | 49 | ADD +80.6% | 13F |
| Ruane, Cunniff & Goldfarb L.P. | $197.1 Mil | 3.3% | 50 | Hold | 13F |
| TB Alternative Assets Ltd. | $12.8 Mil | 2.7% | 36 | New | 13F |
| Sector Gamma AS | $9.9 Mil | 2.3% | 42 | New | 13F |
| Concord Investment Counsel Inc. | $6.5 Mil | 2.2% | 41 | Hold | 13F |
| PARUS FINANCE (UK) Ltd | $7.3 Mil | 2.2% | 37 | Hold | 13F |
| Smead Capital Management, Inc. | $93.9 Mil | 2.0% | 32 | ADD +12.4% | 13F |
| BloombergSen Inc. | $18.2 Mil | 2.0% | 27 | Hold | 13F |
| Active Manager | Value | % of Portfolio | Total Positions | QoQ | Filing |
|---|---|---|---|---|---|
| H&H International Investment, LLC | $162.7 Mil | 0.8% | 19 | New | 13F |
| Unisphere Establishment | $108.2 Mil | 0.9% | 50 | New | 13F |
| Maple Rock Capital Partners Inc. | $58.3 Mil | 1.9% | 44 | New | 13F |
| Crake Asset Management LLP | $41.4 Mil | 1.4% | 20 | New | 13F |
| Spear Holdings RSC Ltd | $14.3 Mil | 1.5% | 17 | New | 13F |
| PBCay One RSC Ltd | $14.3 Mil | 1.5% | 17 | New | 13F |
| TB Alternative Assets Ltd. | $12.8 Mil | 2.7% | 36 | New | 13F |
| Sector Gamma AS | $9.9 Mil | 2.3% | 42 | New | 13F |
| One Fin Capital Management LP | $8.9 Mil | 3.4% | 19 | New | 13F |
| Cincinnati Specialty Underwriters Insurance CO | $7.0 Mil | 1.7% | 46 | New | 13F |
| AltraVue Capital, LLC | $38.3 Mil | 3.3% | 49 | ADD +80.6% | 13F |
| Boone Capital Management LLC | $21.4 Mil | 6.6% | 13 | ADD +28.3% | 13F |
| Bowie Capital Management, LLC | $96.2 Mil | 4.6% | 29 | ADD +27.6% | 13F |
| Patient Capital Management, LLC | $118.3 Mil | 4.4% | 38 | ADD +18.7% | 13F |
| Marshfield Associates | $511.6 Mil | 10.2% | 17 | ADD +14.0% | 13F |
| Smead Capital Management, Inc. | $93.9 Mil | 2.0% | 32 | ADD +12.4% | 13F |
| MFF Capital Investments Ltd | $84.5 Mil | 5.6% | 19 | ADD +11.8% | 13F |
| Naya Capital Management UK LTD | $273.4 Mil | 23.2% | 4 | ADD +10.7% | 13F |
| Kinsale Capital Group, Inc. | $9.2 Mil | 1.5% | 41 | ADD +6.8% | 13F |
| Warther Private Wealth, LLC | $31.9 Mil | 7.5% | 40 | ADD +5.7% | 13F |
| Route One Investment Company, L.P. | $144.2 Mil | 6.3% | 18 | ADD +5.0% | 13F |
| Active Manager | Value | % of Portfolio | Total Positions | QoQ | As Of | Filing |
|---|---|---|---|---|---|---|
| Eminence Capital, LP | $124.9 Mil | 2.0% | 39 | Exited | Dec 31, 2025 | 13F |
| Bristol Gate Capital Partners Inc. | $80.4 Mil | 4.6% | 33 | Exited | Dec 31, 2025 | 13F |
| RK Capital Management, LLC/FL | $61.1 Mil | 3.8% | 20 | Exited | Dec 31, 2025 | 13F |
| Parsifal Capital Management, LP | $49.6 Mil | 5.0% | 15 | Exited | Dec 31, 2025 | 13F |
| Iron Triangle Partners LP | $23.1 Mil | 2.6% | 27 | Exited | Dec 31, 2025 | 13F |
| Casdin Capital, LLC | $16.5 Mil | 1.0% | 38 | Exited | Dec 31, 2025 | 13F |
| Iyo Bank, Ltd. | $7.6 Mil | 2.4% | 37 | Exited | Dec 31, 2025 | 13F |
| GUARDCAP ASSET MANAGEMENT Ltd | $126.8 Mil | 7.3% | 27 | TRIM -43.9% | Mar 31, 2026 | 13F |
| Seilern Investment Management Ltd | $76.1 Mil | 9.1% | 24 | TRIM -21.0% | Mar 31, 2026 | 13F |
| Vulcan Value Partners, LLC | $247.0 Mil | 6.5% | 33 | TRIM -15.7% | Mar 31, 2026 | 13F |
| Longview Partners (Guernsey) LTD | $303.5 Mil | 4.3% | 25 | TRIM -10.6% | Mar 31, 2026 | 13F |
| Venator Management LLC | $6.2 Mil | 1.5% | 28 | TRIM -6.8% | Mar 31, 2026 | 13F |
| Gobi Capital LLC | $104.5 Mil | 6.1% | 10 | TRIM -5.2% | Mar 31, 2026 | 13F |
| Active Manager | Value | % of Portfolio | Total Positions | QoQ | Filing |
|---|---|---|---|---|---|
| Sanders Capital, LLC | $1.6 Bil | 1.9% | 44 | Hold | 13F |
| Marshfield Associates | $511.6 Mil | 10.2% | 17 | ADD +14.0% | 13F |
| Longview Partners (Guernsey) LTD | $303.5 Mil | 4.3% | 25 | TRIM -10.6% | 13F |
| Naya Capital Management UK LTD | $273.4 Mil | 23.2% | 4 | ADD +10.7% | 13F |
| Vulcan Value Partners, LLC | $247.0 Mil | 6.5% | 33 | TRIM -15.7% | 13F |
| PineStone Asset Management Inc. | $218.9 Mil | 1.5% | 44 | Hold | 13F |
| Ruane, Cunniff & Goldfarb L.P. | $197.1 Mil | 3.3% | 50 | Hold | 13F |
| H&H International Investment, LLC | $162.7 Mil | 0.8% | 19 | New | 13F |
| Route One Investment Company, L.P. | $144.2 Mil | 6.3% | 18 | ADD +5.0% | 13F |
| Focused Investors LLC | $132.5 Mil | 4.3% | 22 | Hold | 13F |
| GUARDCAP ASSET MANAGEMENT Ltd | $126.8 Mil | 7.3% | 27 | TRIM -43.9% | 13F |
| Patient Capital Management, LLC | $118.3 Mil | 4.4% | 38 | ADD +18.7% | 13F |
| Unisphere Establishment | $108.2 Mil | 0.9% | 50 | New | 13F |
| Gobi Capital LLC | $104.5 Mil | 6.1% | 10 | TRIM -5.2% | 13F |
| Bowie Capital Management, LLC | $96.2 Mil | 4.6% | 29 | ADD +27.6% | 13F |
| Smead Capital Management, Inc. | $93.9 Mil | 2.0% | 32 | ADD +12.4% | 13F |
| MFF Capital Investments Ltd | $84.5 Mil | 5.6% | 19 | ADD +11.8% | 13F |
| Seilern Investment Management Ltd | $76.1 Mil | 9.1% | 24 | TRIM -21.0% | 13F |
| Maple Rock Capital Partners Inc. | $58.3 Mil | 1.9% | 44 | New | 13F |
| Solel Partners LP | $55.9 Mil | 11.9% | 19 | Hold | 13F |
| Crake Asset Management LLP | $41.4 Mil | 1.4% | 20 | New | 13F |
| AltraVue Capital, LLC | $38.3 Mil | 3.3% | 49 | ADD +80.6% | 13F |
| Greenwoods Asset Management Hong Kong Ltd. | $35.3 Mil | 0.9% | 35 | Hold | 13F |
| Warther Private Wealth, LLC | $31.9 Mil | 7.5% | 40 | ADD +5.7% | 13F |
| Generali Powszechne Towarzystwo Emerytalne | $24.4 Mil | 4.3% | 28 | Hold | 13F |
UNH Trade Sentinel
Constructive
CONVICTION RATIONALE
Conviction is constructive based on tangible evidence of a successful turnaround. The company is executing a disciplined strategy of sacrificing unprofitable memberships to improve pricing, which has already lowered its medical cost ratio. Management has raised its full-year 2026 earnings outlook twice, signaling confidence that this margin recovery is on track.
STOCK ARCHETYPE
Diversified Health Services & Contractual Insurance(Number of Members x Premium PMPM) + (Volume of Services/Scripts x Price per Unit) Margin recovery through disciplined repricing of the insurance book and operational improvements in the Optum Health care delivery business.
INVESTMENT THESIS
Evidence suggests the strategy is working, as disciplined pricing actions are already improving margins despite lower membership.
- Full-year 2026 adjusted EPS guidance was raised to a new range of $19.50 to $20.00.
- The Q2 2026 medical care ratio improved to 86.7% from 89.4% in the prior year.
- Optum Health's 2026 operating earnings outlook was increased to at least $2.2 billion.
- UnitedHealthcare's 2026 operating earnings outlook was increased to at least $12 billion.
- Optum Rx client retention rates remain in the high 90s.
PRIMARY RISK
Persistently high medical cost trends, which management notes are 'modestly above 11%' in commercial plans, could neutralize pricing gains and keep margins compressed for years.
- Commercial medical cost trends are 'stubbornly high' and running above 11%.
- Management stated full commercial margin recovery is now delayed 'past 2027'.
- Trailing operating margin collapsed to 4.2% from 8.2% a year earlier.
- Operating expenses grew 15.9% year-over-year, far outpacing 9.7% revenue growth.
- Medicare Advantage rate notices from the government remain 'well below' cost trends.
| KPI | Status | Rationale |
|---|---|---|
| Total Medical Membership | 49,050 total medical members as of 2026 - Decelerating | The decline in membership is a deliberate strategy to improve profitability. Management is prioritizing margin recovery by repricing contracts and exiting less profitable markets, particularly in Medicare Advantage, where it expects enrollment to decline by approximately 1.1 million for the full year 2026. |
| Medical Care Ratio (MCR) | 86.7% for Q2 2026 - Turning around | The year-over-year improvement is a direct result of management's pricing, benefit design, and market actions taken over the past year. This indicates that the strategy of sacrificing membership for better profitability is working. The company raised its full-year MCR outlook to 88.1% ± 25 basis points. |
| Total UnitedHealthcare Medical Members | 49.1 million (Q1 2026) | Indicates the scale and market reach of the core health insurance business. The company expects this to contract in 2026 due to pricing actions. |
| People Served by Optum Health | 93 million (as of March 31, 2026) | Represents the reach of the care delivery and value-based care business, a key strategic growth area. |
| Optum Rx Adjusted Scripts Fulfilled | 1,659 million (FY2025) | Measures the volume of the pharmacy care services business, a primary driver of Optum Rx revenue and earnings. |
Repricing Power vs. Stubborn Cost Trends
BULL VIEW
Bulls believe management's pricing discipline is potent enough to offset cost pressures, pointing to the improved medical cost ratio and two consecutive raises to 2026 earnings guidance as proof.
CORE TENSION
Can the demonstrated success in repricing, which improved the Q2 medical ratio to 86.7%, overcome the 'stubbornly high' commercial cost trend running above 11%?
PREVAILING SENTIMENT
The latest evidence favors the bulls. The company's ability to raise its full-year earnings outlook for both UnitedHealthcare and Optum Health demonstrates the repricing strategy is currently winning.
BEAR VIEW
Bears focus on management's warning that commercial cost trends above 11% will delay full margin recovery past 2027, arguing the market is underestimating this structural headwind.
| Timeline | Event & Metric To Watch |
|---|---|
in the back half of 2026 | Investor Conference Convened Watch: Company plans to convene its investor conference, providing a strategic update. |
10/19/2026 | Peer Read-Across on Medical Costs Watch: Peer commentary on Q3 commercial and Medicaid medical loss ratios and forward-looking cost trend guidance. |
10/26/2026 | Q3 Commercial Margin Disappointment Watch: UnitedHealthcare segment operating margin and specific commentary on the commercial book's performance versus plan. |
10/26/2026 | Optum Health Turnaround Stalls Watch: Optum Health segment operating income and margin, with commentary on progress in value-based care and operational discipline. |
10/26/2026 | Next UNH Earnings Report Watch: UnitedHealth is scheduled to report its next quarterly earnings, providing updates on segment margins and cost trends. |
10/27/2026 | Centene and CVS Earnings Watch: Peers Centene (CNC) and CVS Health (CVS) are scheduled to report earnings, offering further data on industry trends. |
10/28/2026 | Cigna Earnings Report Watch: Peer Cigna (CI) is scheduled to report earnings. |
by year-end | Optum Health AI Rollout Watch: Optum Health's AI-based ambient listening capabilities are on track to be available to over 90% of employed providers. |
| Date | Event | Stock Impact |
|---|---|---|
2026-07-16 | Q2 Earnings Beat Expectations Details: The company reported second quarter 2026 results that exceeded expectations and raised its full-year 2026 guidance for Adjusted Net Earnings per Share, with a new midpoint of 19.8. | +1.8% $418.52 -> $426.09 |
2026-05-29 | Pediatric Prior Authorizations Reduced Details: On May 29, 2026, UnitedHealthcare announced it was eliminating nearly two-thirds of prior authorization requirements for pediatric care by year's end to simplify the healthcare system. | -0.7% $380.36 -> $377.70 |
2026-04-21 | Positive Q1 Earnings Reaction Details: The stock reacted positively around the April 21, 2026 earnings call, with a two-day reaction of 9.0%, aided by a final 2027 CMS Medicare Advantage rate notice that was better than initial expectations. | +9.3% $321.64 -> $351.51 |
2026-03-17 | Director Fiduciary Duty Investigation Details: On March 17, 2026, law firm Scott+Scott announced an investigation into whether certain officers and directors breached their fiduciary duties to the company. | -0.4% $283.87 -> $282.72 |
2026-02-05 | Analysts Question Margin Pressure Details: Following the Q4 2025 earnings call, analysts focused on ongoing margin pressure, with margins below sector and historical averages due to elevated Medical Care Ratio and funding changes. | +0.3% $272.24 -> $272.96 |
2026-01-27 | Weak Medicare Rate Proposal Details: A government proposal for 2027 Medicare insurer payments was much lower than expected, contributing to a -16.0% two-day stock reaction around the January 27th earnings call. | -16.4% $346.95 -> $290.10 |
Position Sizing
4% - 6%
NORMAL POSITION
Sizing is volatility-based: UNH trades at roughly 30% annualized options-implied volatility versus about 15% for the S&P 500 (2.0x the market), around the 23rd percentile of its own trailing year. A 4% - 6% position keeps a single-name swing of that size within a diversified portfolio's risk budget.
Diversification Alternatives
CVS - CVS Health
Vertically-Integrated PeerCVS Health offers a different integration model with a massive retail pharmacy and store footprint, providing direct consumer health touchpoints that UnitedHealth lacks.
CI - Cigna
Focused Health ServicesCigna provides more focused exposure to the attractive pharmacy benefit management and commercial insurance markets without the complexities of managing a large Medicare Advantage book.
A two-engine enterprise navigating a major margin reset: a mature, massive insurance business (UnitedHealthcare) is being repriced for profitability, while a portfolio of higher-growth health services businesses (Optum) is being retooled for consistent performance.
UnitedHealth Group is a story of scale and strategic evolution. The company is leveraging its massive insurance base to fuel the growth of its Optum health services arm, which is focused on value-based care, pharmacy services, and technology. After a period of significant margin compression from elevated medical costs, management has initiated a 'back to basics' turnaround focused on disciplined pricing and operational execution. The near-term narrative is about margin recovery at the expense of membership growth, with a long-term bet on AI and an integrated care model to drive future performance.
Evidence of stabilizing or improving medical cost trends, margin expansion in Optum Health, and successful execution of AI-driven efficiency initiatives.
Continued high medical cost trends that outpace pricing actions, further deterioration in Optum Health's profitability, or significant adverse changes to Medicare Advantage reimbursement rates.
Small bolt-on acquisitions or divestitures of non-core assets.
Repricing Catalyst
The company has undertaken a significant repricing of its insurance portfolio for 2026 to restore profitability after a period of elevated medical costs, which is the central catalyst for near-term earnings improvement.
UnitedHealthcare
$344.9B TTM (77% of Total) · 3% MarginWhat It Is
Offers a comprehensive array of health benefit plans and services to a wide range of customers, including large national employers, public sector employers, mid-sized employers, small businesses, individuals, seniors (Medicare), and economically disadvantaged populations (Medicaid).
Who Pays & How
Employers, government agencies (CMS for Medicare, states for Medicaid), and individuals pay fixed monthly premiums to assume the financial risk of health care costs and gain access to the company's extensive network of discounted care providers and care management services.
Competition
Optum Health
$102.0B TTM (23% of Total) · 0% MarginWhat It Is
Provides patient-centered care delivery, including primary, specialty, and surgical care, as well as care management, wellness, and health financial services. It serves patients, consumers, care delivery systems, providers, employers, payers, and public-sector entities.
Who Pays & How
Payers (health plans) and patients pay for care. Payers enter into fully accountable value-based arrangements, paying a monthly premium for Optum Health to assume responsibility for health care costs, aiming for better outcomes at a lower total cost.
Competition
Optum Insight
$19.4B TTM (4% of Total) · 14% MarginWhat It Is
Sells data, analytics, research, consulting, technology, and managed services solutions to hospital systems, physicians, health plans, state governments, and life sciences companies.
Who Pays & How
Health systems, health plans, and other healthcare organizations pay for services and technology to improve operating performance, reduce administrative costs, advance care quality, and modernize their core systems.
Competition
Optum Rx
$154.7B TTM (35% of Total) · 5% MarginWhat It Is
Provides a full spectrum of pharmacy care services, including retail pharmacy networks, home delivery, and specialty pharmacy. It serves health benefits providers, large national employer plans, unions, and public-sector entities.
Who Pays & How
Clients (health plans, employers) pay for pharmacy benefit management services to manage prescription drug spending. Revenue is also derived from products sold through its pharmacy network.
Competition
UnitedHealth — Investor Video Playlist
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