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UnitedHealth Group Q4 2025 earnings summary
Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.Q4 2025 earnings summary27 Jan, 2026
Executive summary
2025 revenues reached $447.6B, up 12% year-over-year, with adjusted EPS of $16.35, slightly ahead of expectations, excluding a $1.6B net-of-tax, largely non-cash charge related to Optum restructuring, cyber-attack true-ups, and portfolio optimization.
2026 outlook targets adjusted EPS greater than $17.75, at least 8.6% growth, with measured growth across all four business segments and double-digit improvements at UnitedHealthcare.
Major restructuring in late 2025 included a $1.6B after-tax charge for cyberattack costs, divestitures, and operational resets, excluded from adjusted results.
Strategic focus on operational discipline, technology and AI adoption, value-based care, and innovation to drive sustainable growth and improved value for stakeholders.
Financial highlights
2025 operating earnings were $19.0B, including a $2.8B charge; adjusted operating earnings were $21.7B.
2025 revenues reached nearly $448B, up 12% year-over-year, with domestic membership growth of over 415,000.
2025 cash flows from operations were $19.7B, about 1.5x net income, exceeding expectations due to timing of payments.
Debt-to-capital ratio stood at 43.9% at year-end 2025, with a target of 40% for 2026.
Adjusted medical care ratio rose to 88.9% from 85.5% in 2024, reflecting higher medical costs and regulatory impacts.
Outlook and guidance
2026 adjusted EPS guidance of >$17.75, reflecting at least 8.6% growth.
Revenue guidance for 2026 is ~$440B, with at least $18B in operating cash flow.
Medical care ratio expected at 88.8% ±50bps; operating cost ratio at 12.8% ±50bps.
UnitedHealthcare revenues projected over $335.0B, Optum over $257.5B.
Dividend expected to remain well-supported; leverage to improve, targeting ~40% debt-to-capital by year-end.
Detail 2026 revenue decline drivers
Optum Health loss contracts impact on 2026
Key repricing efforts for 2026 MCR improvement
Impact of $625M Optum loss contract reserve
How will 2027 MA rate notice impact footprint?
AI investment impact on 2026 operating cost savings
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Next UnitedHealth Group earnings date
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UnitedHealth Group
Next UnitedHealth Group earnings date
Q1 202616 Apr, 2026
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Frequently asked questions
Diverse Healthcare Services
UnitedHealth Group is an American healthcare company that operates through two primary divisions: UnitedHealthcare and Optum. UnitedHealthcare offers healthcare coverage and benefits services, while Optum provides information and technology-enabled health services. The company delivers a broad spectrum of healthcare products and services to its customers, encompassing health coverage, Medicare plans, short-term health insurance, Medicaid plans, health management, and global health solutions. It is headquartered in Minnetonka, Minnesota, and its shares are listed on the NYSE.
UnitedHealthcare
The UnitedHealthcare segment of UnitedHealth Group is primarily focused on health insurance services. It offers a wide range of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries. The company provides access to healthcare services through its extensive network of healthcare providers, offering various insurance products that include but are not limited to, health maintenance organization, preferred provider organization, and point-of-service plans. The company is one of the largest providers of health insurance in the country and also offers coverage to customers outside of the US. Some similar companies traded on the public markets include Cigna and Humana.
The Optum Business Segment
The Optum segment of the company operates as a health services and innovation company, complementing the health insurance offerings of UnitedHealthcare by providing a broad spectrum of services and solutions. Optum is organized into three main divisions: OptumHealth, OptumInsight, and OptumRx, each focusing on different aspects of healthcare and technology.
OptumHealth: This division offers health management services, care delivery, and wellness programs. It provides personalized and scalable health and wellness solutions, including physical health, mental health, complex care management, and financial services to individuals and employers. It also operates an extensive network of care providers, offering primary care, urgent care, and specialty services.
OptumInsight: OptumInsight provides data, analytics, research, consulting, technology, and managed services solutions to hospitals, physicians, health plans, governments, and life sciences companies. The focus is on improving operational efficiency, reducing costs, and enhancing the quality of care.
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