UnitedHealth GroupNarrow moat

UNH — overall economic moat

Investment snapshot
Narrow moat→ Holding steadyConfidenceMediumValuationFair
Strongest advantageScale doubled by ownership: an insurer with 49.8m medical members buying drugs, care and technology from its own Optum businesses (about 62% of Optum revenue is internal)
Greatest threatPrices set elsewhere and costs nobody controls: the medical care ratio rose to 89.1% in 2025, CMS pays 44% of revenue at rates below the cost trend, and the DOJ is examining Medicare billing
Key metricMedical care ratio against the 88.1% guided for 2026 (86.7% in Q2 2026)
Verdict: UnitedHealth built a genuine advantage by owning the pharmacy manager, clinics and claims network its own insurer buys from, and for a decade it earned 14-18% on its capital. In 2025 medical costs outran the price, and because Optum Health carried the same risk as the insurer, both halves failed together: return on capital fell to 9.7%. The 2026 repair is real, with guidance raised twice, but it rests on shrinking and repricing under a government that sets much of the price and is investigating how it is paid. At about 18 times forward earnings the shares are fairly priced for a recovery; they are cheap only if the old margins return.
📈 UNH valuation, revenue & earnings — P/E, P/S, revenue, EPS →

UnitedHealth Group is a health insurer that also owns much of what it buys. It has two businesses, "Optum and UnitedHealthcare"1, and four reportable segments: UnitedHealthcare, the insurer, and Optum Health, Optum Insight and Optum Rx2. It had more than 390,000 employees at the end of 2025, nearly 165,000 of them clinical professionals3.

Revenue ($bn)157.12015201.22017242.22019287.62021371.62023447.62025SEC EDGAR XBRL 2015-2021; UnitedHealth Group Form 10-K FY2025
Almost tripled in ten years.

Revenue was $447,567 million in 20254. Premiums, the money collected for carrying medical risk, were $352,229 million; products, mostly drugs, $53,380 million; services $38,038 million; and investment income $3,920 million5. By segment, counting only what outside customers pay, UnitedHealthcare earned $344,903 million, Optum Rx about $57.9 billion, Optum Health about $38.3 billion and Optum Insight about $6.5 billion6.

How it makes money is simple to describe and hard to do. UnitedHealthcare collects premiums from the government, employers and individuals, and pays doctors, hospitals and pharmacies; the medical care ratio, the share of premiums paid out, was 89.1% in 20257. Optum then earns a second margin on much of that spending: about 62% of Optum's revenue came from inside the group8. Premium revenue from the Centers for Medicare & Medicaid Services was 44% of the total9.

The margins are thin. Operating margin was 8.7% in 2023, 8.1% in 2024 and 4.2% in 2025, and net margin 6.0%, 3.6% and 2.7%10. Net earnings were $12,056 million in 2025, or $13.23 a diluted share11.

2025 was the worst year in a generation. Guidance was cut and then suspended, the chief executive stepped down and Stephen Hemsley returned12. Optum Health swung from a profit of $6,902 million to a loss of $1,115 million13. The Justice Department opened criminal and civil inquiries into Medicare billing14.

2026 is the repair. In the second quarter revenue was $112,032 million and operating earnings $7,991 million, against $5,150 million a year earlier15, and guidance was raised to adjusted earnings of $19.50 to $20.00 a share16. The shares closed at $376.59 on 25 September 2026, a market value of $338.03 billion1718.

The company is also a large employer of doctors and nurses and a large holder of other people's money. Medical costs payable, claims incurred but not yet paid, were $39,337 million at the end of 202519, and the company held $74.7 billion of cash and investments, most of it inside regulated subsidiaries20. Goodwill from the acquisitions that built Optum was $110,499 million21. Long-term debt was $72,320 million and debt-to-capital 43.9% against a target of 40%2223. The shares have been listed since 198424 and have not been split since 200525.

Capital returns continued through the bad year. Dividends paid were $7,916 million in 2025, $8.73 a share26, and the annual rate rose to $9.28 in June 202627. Share repurchases fell from $9,000 million in 2024 to $5,545 million in 202528 and are guided at no less than $5,000 million for 202629. Berkshire Hathaway bought about 5 million shares in 2025 and sold the entire stake in the first quarter of 20263031.

The moat is narrow. The combination of a very large insurer with its own pharmacy manager, clinics and claims network is real, but 2025 showed it doubles the damage when costs rise. The number that would falsify a recovery is the medical care ratio: at or below the 88.1% guided for 202632, pricing is back; near 89% again, the old returns are gone.

The number that tests this moat
Reported
Revenue, and where it comes from
$447.6bn in 2025: UnitedHealthcare $344.9bn (77%); from outside customers Optum Rx $57.9bn, Optum Health $38.3bn, Optum Insight $6.5bn

After eliminating $168.0bn of sales inside the group. Watch the medical care ratio and the 44% of revenue paid by CMS.

Source: UnitedHealth Group Form 10-K, FY2025 ↗
Moat scorecardHow ratings work →
Switching costs6/10
Network effects4/10
Pricing power4/10
Hard to replicate7/10
Disruption resistance6/10
Overall durability6/10

Switching costs are moderate: employers and Medicare members change plans at renewal, but self-insured employers rarely move networks and Optum's claims systems are sticky. Network effects are modest: a larger membership wins better provider discounts. Pricing power is weak: CMS sets the Medicare rate, states set Medicaid rates, and 2025 showed costs can outrun premiums. Replication is hard because no rival combines an insurer, a pharmacy benefit manager, a claims network and clinics at this scale. Disruption resistance is moderate, with regulatory and legal risk the main threat. Durability sits in the narrow band after return on capital fell to 9.7% in 2025.

Dig deeper
DIG DEEPER 01
The Revenue Lines
Counted by what outsiders pay, UnitedHealth is 77% insurer; counted by profit in 2025, the pharmacy business earned three-quarters as much as the…
DIG DEEPER 02
The Moat
UnitedHealth's advantage is an insurer that owns its own supplier, and 2025 proved that the same ownership doubles the damage when costs rise.
DIG DEEPER 03
Competitors
UnitedHealth is worth nearly as much as six listed managed-care rivals combined, and its hardest competitors are the doctors and the government that…
DIG DEEPER 04
Major Clients
Forty-four percent of UnitedHealth's revenue comes from one customer, the federal government, and the only backlog it discloses is mostly its own.
✦ Future bets — beyond today's moat
✦ FUTURE BET 01
The Future Bets
UnitedHealth's bets are about repairing earnings, not finding new markets, and the first half of 2026 delivered two-thirds of the year's guided…
⚠ Threats to the moat
⚠ THREAT 01
The Justice Department and Medicare Billing
The Justice Department is examining, criminally and civilly, how UnitedHealth is paid by the customer that provides 44% of its revenue.
⚠ THREAT 02
Medical Costs Ran Ahead of the Price
UnitedHealth's medical care ratio rose from 83.2% to 89.1% in two years, and each point costs about $3.5 billion.
◆ What the market may be missing
◆ THE VARIANT VIEW
What the Market Isn't Pricing In
The market prices UnitedHealth as if a 4% net margin is permanent; at its 2023 margin the same revenue would earn about $26 billion.
◆ THE VARIANT VIEW
Inside the Latest Quarter (Q2 2026)
In the second quarter of 2026 UnitedHealth earned 55% more on flat revenue, because it priced its insurance for the costs it had missed in 2025.
References
  1. ReportedIt has two businesses, "Optum and UnitedHealthcare", and four reportable segments: UnitedHealthcare, the insurer, and Optum Health, Optum Insight and Optum Rx.
    UnitedHealth Group Form 10-K for fiscal 2025 - financial statements and notes: segment note, CMS concentration, balance sheet, cash flow and capital. — FY2025 · publ. 2 March 2026 · source ↗
  2. ReportedIt has two businesses, "Optum and UnitedHealthcare", and four reportable segments: UnitedHealthcare, the insurer, and Optum Health, Optum Insight and Optum Rx.
    UnitedHealth Group Form 10-K for fiscal 2025 - financial statements and notes: segment note, CMS concentration, balance sheet, cash flow and capital. — FY2025 · publ. 2 March 2026 · source ↗
  3. ReportedIt had more than 390,000 employees at the end of 2025, nearly 165,000 of them clinical professionals.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1 business: segments, products, people served and leadership. — FY2025 · publ. 2 March 2026 · source ↗
  4. ReportedRevenue was $447,567 million in 2025.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1 business: segments, products, people served and leadership. — FY2025 · publ. 2 March 2026 · source ↗
  5. ReportedPremiums, the money collected for carrying medical risk, were $352,229 million; products, mostly drugs, $53,380 million; services $38,038 million; and investment income $3,920 million.
    UnitedHealth Group Form 10-K for fiscal 2025 - financial statements and notes: segment note, CMS concentration, balance sheet, cash flow and capital. — FY2025 · publ. 2 March 2026 · source ↗
  6. Moat Explorer calcBy segment, counting only what outside customers pay, UnitedHealthcare earned $344,903 million, Optum Rx about $57.9 billion, Optum Health about $38.3 billion and Optum Insight about $6.5 billion.
    Moat Explorer calculation from UnitedHealth Group's reported figures ($ millions unless stated). External revenue by segment = segment revenue less affiliated revenue (10-K segment notes): 2021 UnitedHealthcare 222,899; Optum Health 54,065 - 29,234 = 24,831; Optum Insight 12,199 - 7,867 = 4,332; Optum Rx 91,314 - 55,779 = 35,535; total 287,597. 2022: 249,741; 71,174 - 40,883 = 30,291; 14,581 - 9,288 = 5,293; 99,773 - 60,936 = 38,837; total 324,162. 2023: 281,360; 95,319 - 57,696 = 37,623; 18,932 - 10,896 = 8,036; 116,087 - 71,484 = 44,603; total 371,622. 2024: 298,208; 105,358 - 63,883 = 41,475; 18,757 - 11,881 = 6,876; 133,231 - 79,512 = 53,719; total 400,278. 2025: 344,903; 101,957 - 63,615 = 38,342; 19,417 - 12,948 = 6,469; 154,726 - 96,873 = 57,853; total 447,567. Q2 2026 (2026 basis): 86,017; 23,472 - 14,353 = 9,119; 5,402 - 3,556 = 1,846; 38,292 - 23,242 = 15,050; total 112,032; Optum external 9,119 + 1,846 + 15,050 = 26,015. Optum external revenue = Optum revenue less corporate eliminations: 155,565 - 90,867 = 64,698 (2021); 182,768 - 108,347 = 74,421 (2022); 226,635 - 136,373 = 90,262 (2023); 252,957 - 150,887 = 102,070 (2024); 270,620 - 167,956 = 102,664 (2025); 102,664 / 102,070 - 1 = 0.6%. Optum revenue from inside the group: 90,867 / 155,565 = 58.4%; 108,347 / 182,768 = 59.3%; 136,373 / 226,635 = 60.2%; 150,887 / 252,957 = 59.6%; 167,956 / 270,620 = 62.1%; Q2 2026 39,648 / 65,663 = 60.4%. Affiliated shares 2025: Optum Health 63,615 / 101,957 = 62%; Optum Insight 12,948 / 19,417 = 67%; Optum Rx 96,873 / 154,726 = 63%. Affiliated revenue as share of UnitedHealthcare revenue 167,956 / 344,903 = 49%. Segment shares of consolidated revenue 2025: UnitedHealthcare 344,903 / 447,567 = 77%; Optum Rx 57,853 / 447,567 = 12.9%; Optum Health 38,342 / 447,567 = 8.6%; Optum Insight 6,469 / 447,567 = 1.4%. Q2 2026 UnitedHealthcare 86,017 / 112,032 = 76.8%. Compound growth 2021-2025: UnitedHealthcare (344,903 / 222,899)^(1/4) - 1 = 11.5%; Optum Rx external (57,853 / 35,535)^(1/4) - 1 = 13.0%. Segment margins: UnitedHealthcare 11,975 / 222,899 = 5.4% (2021), 14,379 / 249,741 = 5.8% (2022); Optum Rx 4,135 / 91,314 = 4.5% (2021), 4,436 / 99,773 = 4.4% (2022); Optum Insight 3,398 / 12,199 = 27.9% (2021), 3,588 / 14,581 = 24.6% (2022); Optum Health H1 2026 2,331 / 47,581 = 4.9%. Optum earnings decline 16,703 - 9,539 = 7,164, 7,164 / 16,703 = 42.9%. Optum Health H1 2026 revenue 47,581 / 49,562 - 1 = -4.0%; earnings 2,331 / 1,840 - 1 = +26.7%; affiliated revenue Q2 14,353 / 15,845 - 1 = -9.4%. Optum Health 2025 recast margin -1,115 / 100,051 = -1.1%; 2024 6,902 / 103,516 = 6.7%. Medical care ratio 2015-2019 from EDGAR XBRL medical costs / premiums: 103,875 / 127,163 = 81.7%; 117,038 / 144,118 = 81.2%; 130,036 / 158,453 = 82.1%; 145,403 / 178,087 = 81.6%; 156,440 / 189,699 = 82.5%. Premiums 127,163 (2015) and 257,157 (2022). Operating earnings 11,021 (2015, XBRL). One point of medical care ratio on 2025 premiums: 352,229 x 1% = 3,522; 3,522 / 18,964 = 18.6% of operating earnings. Q2 2026 favorable development 860 / 86,956 premiums = 1.0 point. Membership: commercial risk-based 8,845 - 7,655 = 1,190 thousand, 1,190 / 8,845 = 13.5%; Medicare Advantage 8,445 - 7,565 = 880 thousand, 880 / 8,445 = 10.4%; Medicaid 7,845 - 6,780 = 1,065 thousand, 1,065 / 7,845 = 13.6%; Part D stand-alone (3,315 - 2,710) / 3,315 = 18.3%. Community & State revenue per year-end Medicaid member 75,004 / 7.845 = 9,561 dollars (2023); 94,390 / 7.380 = 12,790 dollars (2025). Optum Rx quarterly scripts (414 - 387) / 414 = 6.5%. Optum Insight backlog: external 32.8 - 12.5 = 20.3 bn (2024), 31.1 - 12.9 = 18.2 bn (2025), change -10.3%; affiliated share 12.5 / 32.8 = 38%, 12.9 / 31.1 = 41%. Cyberattack provider loans 9,033 - 4,514 - 1,680 = 2,839 not yet repaid at end-2025. Market value against peers: 108.78 + 86.37 + 70.16 + 45.67 + 30.59 + 10.07 = 351.64 bn; 338.03 / 351.64 = 96%. CMS premium revenue 44% x 447,567 = 196,929 (about 197 bn); all other 447,567 - 196,929 = 250,638. Medicare & Retirement share of UnitedHealthcare revenue Q2 2026: 42,390 / 86,017 = 49.3%. Premiums share of revenue Q2 2026: 86,956 / 112,032 = 77.6%. Capital returns 2025: dividends 7,916 + buybacks 5,545 = 13,461; 13,461 / 12,056 = 112% of net earnings; free cash flow 19,697 - 3,622 = 16,075; 13,461 / 16,075 = 84%. Goodwill 44,453 (2015, XBRL) and 110,499 (2025); goodwill plus other intangibles 110,499 + 20,474 = 130,973; 130,973 / 309,581 = 42.3% of assets. Long-term debt 25,331 (2015, XBRL). Interest expense / operating earnings: 3,246 / 32,358 = 10.0% (2023); 4,002 / 18,964 = 21.1% (2025). Rate sensitivity net 345 - 273 = 72. Investment income (3,920 - 5,202) / 5,202 = -24.6%; 4,089 / 371,622 = 1.1% of 2023 revenue. Net interest-bearing debt: 6,069 + 72,320 - 28,121 = 50,268 (Dec 2025); 3,827 + 69,501 - 31,468 = 41,860 (Jun 2026). 2025 guidance: original adjusted EPS midpoint (29.50 + 30.00) / 2 = 29.75; April (26.00 + 26.50) / 2 = 26.25; actual 16.35 / 29.75 - 1 = -45%. 2026 adjusted EPS midpoint (19.50 + 20.00) / 2 = 19.75. Progress vs 2026 guidance: operating earnings 16,981 / 25,450 = 66.7%. Q2 2026 operating earnings 7,991 / 5,150 - 1 = +55%. Gross segment revenue 2025: 344,903 + 101,957 + 19,417 + 154,726 = 621,003; less Optum eliminations 5,480 and corporate eliminations 167,956 = 447,567. Medical costs 313,995 / 264,185 - 1 = 18.9%; medical costs payable 39,337 / 34,224 - 1 = 14.9%. Commercial risk-based members 8,165 - 7,725 = 440 thousand (Q1 2026), 7,725 - 7,655 = 70 thousand (Q2 2026). Medicaid 7,380 - 6,780 = 600 thousand (six months to June 2026); 7,845 - 7,380 = 465 thousand (2023-2025). Optum Rx Q4 2025 share of year 2,885 / 7,193 = 40%. Goodwill 110,499 - 106,734 = 3,765. Total debt 6,069 + 72,320 = 78,389. Dividend at 9.28 x 897.6 million shares = 8,330, 8,330 / 16,750 = 50%. Year-end P/E 2015-2020: 19.3, 21.7, 20.2, 20.0, 20.1, 21.6 (market value / net earnings). H1 2026 medical care ratio 148,847 / 174,517 = 85.3%. Part D stand-alone 2,740 - 2,710 = 30 thousand (Q2 2026). Rounded external revenue ($bn): Optum Rx 35.5, 38.8, 44.6, 53.7, 57.9 (2021-2025), 15.1 (Q2 2026); Optum Health 24.8, 30.3, 37.6, 41.5, 38.3, 9.1 (Q2 2026); Optum Insight 4.3, 5.3, 8.0, 6.9, 6.5, 1.8 (Q2 2026); Optum 64.7, 74.4, 90.3, 102.1, 102.7; net debt 50.3 and 41.9; total debt 78.4; UnitedHealthcare revenue 222.9, 249.7, 281.4, 298.2, 344.9. Optum 2026 guidance 13,450 / 9,539 - 1 = +41%. Corporate eliminations Q2 39,648 / 41,712 - 1 = -4.9%. Net interest-bearing debt / total equity 50,268 / 100,090 = 0.50. Valuation: 2026 net margin implied by guidance 16,750 / 439,000 = 3.8%; 2023 net margin 6.0% x 439.0 bn = 26.3 bn; 338.03 / 26.34 = 12.8 times - ratios, growth rates and membership changes. — 2015-2026 · publ. September 2026 · source ↗
    Method: Arithmetic on figures reported in UnitedHealth Group's Forms 10-K and 10-Q, results releases, SEC EDGAR XBRL and market data; operands shown in the source line.
  7. ReportedUnitedHealthcare collects premiums from the government, employers and individuals, and pays doctors, hospitals and pharmacies; the medical care ratio, the share of premiums paid out, was 89.1% in 2025.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 7 MD&A: consolidated and segment results, medical care ratio, membership and operating metrics. — FY2025 · publ. 2 March 2026 · source ↗
  8. Moat Explorer calcOptum then earns a second margin on much of that spending: about 62% of Optum's revenue came from inside the group.
    Moat Explorer calculation from UnitedHealth Group's reported figures ($ millions unless stated). External revenue by segment = segment revenue less affiliated revenue (10-K segment notes): 2021 UnitedHealthcare 222,899; Optum Health 54,065 - 29,234 = 24,831; Optum Insight 12,199 - 7,867 = 4,332; Optum Rx 91,314 - 55,779 = 35,535; total 287,597. 2022: 249,741; 71,174 - 40,883 = 30,291; 14,581 - 9,288 = 5,293; 99,773 - 60,936 = 38,837; total 324,162. 2023: 281,360; 95,319 - 57,696 = 37,623; 18,932 - 10,896 = 8,036; 116,087 - 71,484 = 44,603; total 371,622. 2024: 298,208; 105,358 - 63,883 = 41,475; 18,757 - 11,881 = 6,876; 133,231 - 79,512 = 53,719; total 400,278. 2025: 344,903; 101,957 - 63,615 = 38,342; 19,417 - 12,948 = 6,469; 154,726 - 96,873 = 57,853; total 447,567. Q2 2026 (2026 basis): 86,017; 23,472 - 14,353 = 9,119; 5,402 - 3,556 = 1,846; 38,292 - 23,242 = 15,050; total 112,032; Optum external 9,119 + 1,846 + 15,050 = 26,015. Optum external revenue = Optum revenue less corporate eliminations: 155,565 - 90,867 = 64,698 (2021); 182,768 - 108,347 = 74,421 (2022); 226,635 - 136,373 = 90,262 (2023); 252,957 - 150,887 = 102,070 (2024); 270,620 - 167,956 = 102,664 (2025); 102,664 / 102,070 - 1 = 0.6%. Optum revenue from inside the group: 90,867 / 155,565 = 58.4%; 108,347 / 182,768 = 59.3%; 136,373 / 226,635 = 60.2%; 150,887 / 252,957 = 59.6%; 167,956 / 270,620 = 62.1%; Q2 2026 39,648 / 65,663 = 60.4%. Affiliated shares 2025: Optum Health 63,615 / 101,957 = 62%; Optum Insight 12,948 / 19,417 = 67%; Optum Rx 96,873 / 154,726 = 63%. Affiliated revenue as share of UnitedHealthcare revenue 167,956 / 344,903 = 49%. Segment shares of consolidated revenue 2025: UnitedHealthcare 344,903 / 447,567 = 77%; Optum Rx 57,853 / 447,567 = 12.9%; Optum Health 38,342 / 447,567 = 8.6%; Optum Insight 6,469 / 447,567 = 1.4%. Q2 2026 UnitedHealthcare 86,017 / 112,032 = 76.8%. Compound growth 2021-2025: UnitedHealthcare (344,903 / 222,899)^(1/4) - 1 = 11.5%; Optum Rx external (57,853 / 35,535)^(1/4) - 1 = 13.0%. Segment margins: UnitedHealthcare 11,975 / 222,899 = 5.4% (2021), 14,379 / 249,741 = 5.8% (2022); Optum Rx 4,135 / 91,314 = 4.5% (2021), 4,436 / 99,773 = 4.4% (2022); Optum Insight 3,398 / 12,199 = 27.9% (2021), 3,588 / 14,581 = 24.6% (2022); Optum Health H1 2026 2,331 / 47,581 = 4.9%. Optum earnings decline 16,703 - 9,539 = 7,164, 7,164 / 16,703 = 42.9%. Optum Health H1 2026 revenue 47,581 / 49,562 - 1 = -4.0%; earnings 2,331 / 1,840 - 1 = +26.7%; affiliated revenue Q2 14,353 / 15,845 - 1 = -9.4%. Optum Health 2025 recast margin -1,115 / 100,051 = -1.1%; 2024 6,902 / 103,516 = 6.7%. Medical care ratio 2015-2019 from EDGAR XBRL medical costs / premiums: 103,875 / 127,163 = 81.7%; 117,038 / 144,118 = 81.2%; 130,036 / 158,453 = 82.1%; 145,403 / 178,087 = 81.6%; 156,440 / 189,699 = 82.5%. Premiums 127,163 (2015) and 257,157 (2022). Operating earnings 11,021 (2015, XBRL). One point of medical care ratio on 2025 premiums: 352,229 x 1% = 3,522; 3,522 / 18,964 = 18.6% of operating earnings. Q2 2026 favorable development 860 / 86,956 premiums = 1.0 point. Membership: commercial risk-based 8,845 - 7,655 = 1,190 thousand, 1,190 / 8,845 = 13.5%; Medicare Advantage 8,445 - 7,565 = 880 thousand, 880 / 8,445 = 10.4%; Medicaid 7,845 - 6,780 = 1,065 thousand, 1,065 / 7,845 = 13.6%; Part D stand-alone (3,315 - 2,710) / 3,315 = 18.3%. Community & State revenue per year-end Medicaid member 75,004 / 7.845 = 9,561 dollars (2023); 94,390 / 7.380 = 12,790 dollars (2025). Optum Rx quarterly scripts (414 - 387) / 414 = 6.5%. Optum Insight backlog: external 32.8 - 12.5 = 20.3 bn (2024), 31.1 - 12.9 = 18.2 bn (2025), change -10.3%; affiliated share 12.5 / 32.8 = 38%, 12.9 / 31.1 = 41%. Cyberattack provider loans 9,033 - 4,514 - 1,680 = 2,839 not yet repaid at end-2025. Market value against peers: 108.78 + 86.37 + 70.16 + 45.67 + 30.59 + 10.07 = 351.64 bn; 338.03 / 351.64 = 96%. CMS premium revenue 44% x 447,567 = 196,929 (about 197 bn); all other 447,567 - 196,929 = 250,638. Medicare & Retirement share of UnitedHealthcare revenue Q2 2026: 42,390 / 86,017 = 49.3%. Premiums share of revenue Q2 2026: 86,956 / 112,032 = 77.6%. Capital returns 2025: dividends 7,916 + buybacks 5,545 = 13,461; 13,461 / 12,056 = 112% of net earnings; free cash flow 19,697 - 3,622 = 16,075; 13,461 / 16,075 = 84%. Goodwill 44,453 (2015, XBRL) and 110,499 (2025); goodwill plus other intangibles 110,499 + 20,474 = 130,973; 130,973 / 309,581 = 42.3% of assets. Long-term debt 25,331 (2015, XBRL). Interest expense / operating earnings: 3,246 / 32,358 = 10.0% (2023); 4,002 / 18,964 = 21.1% (2025). Rate sensitivity net 345 - 273 = 72. Investment income (3,920 - 5,202) / 5,202 = -24.6%; 4,089 / 371,622 = 1.1% of 2023 revenue. Net interest-bearing debt: 6,069 + 72,320 - 28,121 = 50,268 (Dec 2025); 3,827 + 69,501 - 31,468 = 41,860 (Jun 2026). 2025 guidance: original adjusted EPS midpoint (29.50 + 30.00) / 2 = 29.75; April (26.00 + 26.50) / 2 = 26.25; actual 16.35 / 29.75 - 1 = -45%. 2026 adjusted EPS midpoint (19.50 + 20.00) / 2 = 19.75. Progress vs 2026 guidance: operating earnings 16,981 / 25,450 = 66.7%. Q2 2026 operating earnings 7,991 / 5,150 - 1 = +55%. Gross segment revenue 2025: 344,903 + 101,957 + 19,417 + 154,726 = 621,003; less Optum eliminations 5,480 and corporate eliminations 167,956 = 447,567. Medical costs 313,995 / 264,185 - 1 = 18.9%; medical costs payable 39,337 / 34,224 - 1 = 14.9%. Commercial risk-based members 8,165 - 7,725 = 440 thousand (Q1 2026), 7,725 - 7,655 = 70 thousand (Q2 2026). Medicaid 7,380 - 6,780 = 600 thousand (six months to June 2026); 7,845 - 7,380 = 465 thousand (2023-2025). Optum Rx Q4 2025 share of year 2,885 / 7,193 = 40%. Goodwill 110,499 - 106,734 = 3,765. Total debt 6,069 + 72,320 = 78,389. Dividend at 9.28 x 897.6 million shares = 8,330, 8,330 / 16,750 = 50%. Year-end P/E 2015-2020: 19.3, 21.7, 20.2, 20.0, 20.1, 21.6 (market value / net earnings). H1 2026 medical care ratio 148,847 / 174,517 = 85.3%. Part D stand-alone 2,740 - 2,710 = 30 thousand (Q2 2026). Rounded external revenue ($bn): Optum Rx 35.5, 38.8, 44.6, 53.7, 57.9 (2021-2025), 15.1 (Q2 2026); Optum Health 24.8, 30.3, 37.6, 41.5, 38.3, 9.1 (Q2 2026); Optum Insight 4.3, 5.3, 8.0, 6.9, 6.5, 1.8 (Q2 2026); Optum 64.7, 74.4, 90.3, 102.1, 102.7; net debt 50.3 and 41.9; total debt 78.4; UnitedHealthcare revenue 222.9, 249.7, 281.4, 298.2, 344.9. Optum 2026 guidance 13,450 / 9,539 - 1 = +41%. Corporate eliminations Q2 39,648 / 41,712 - 1 = -4.9%. Net interest-bearing debt / total equity 50,268 / 100,090 = 0.50. Valuation: 2026 net margin implied by guidance 16,750 / 439,000 = 3.8%; 2023 net margin 6.0% x 439.0 bn = 26.3 bn; 338.03 / 26.34 = 12.8 times - external revenue by segment, internal revenue shares and concentration. — 2015-2026 · publ. September 2026 · source ↗
    Method: Arithmetic on figures reported in UnitedHealth Group's Forms 10-K and 10-Q, results releases, SEC EDGAR XBRL and market data; operands shown in the source line.
  9. ReportedPremium revenue from the Centers for Medicare & Medicaid Services was 44% of the total.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 7 MD&A: consolidated and segment results, medical care ratio, membership and operating metrics. — FY2025 · publ. 2 March 2026 · source ↗
  10. ReportedOperating margin was 8.7% in 2023, 8.1% in 2024 and 4.2% in 2025, and net margin 6.0%, 3.6% and 2.7%.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1 business: segments, products, people served and leadership. — FY2025 · publ. 2 March 2026 · source ↗
  11. ReportedNet earnings were $12,056 million in 2025, or $13.23 a diluted share.
    UnitedHealth Group Form 10-K for fiscal 2025 - financial statements and notes: segment note, CMS concentration, balance sheet, cash flow and capital. — FY2025 · publ. 2 March 2026 · source ↗
  12. ReportedGuidance was cut and then suspended, the chief executive stepped down and Stephen Hemsley returned.
    UnitedHealth Group press release, Form 8-K exhibit 99.1: Andrew Witty steps down, Stephen Hemsley returns as chief executive, 2025 outlook suspended. — May 2025 · publ. 13 May 2025 · source ↗
  13. ReportedOptum Health swung from a profit of $6,902 million to a loss of $1,115 million.
    UnitedHealth Group first-quarter 2026 results release, Form 8-K exhibit 99.1 - including the recast of 2024 and 2025 segment results for the Optum Financial realignment. — Q1 2026 · publ. 21 April 2026 · source ↗
  14. ReportedThe Justice Department opened criminal and civil inquiries into Medicare billing.
    UnitedHealth Group Form 8-K, 24 July 2025 - compliance with formal criminal and civil requests from the Department of Justice. — July 2025 · publ. 24 July 2025 · source ↗
  15. ReportedIn the second quarter revenue was $112,032 million and operating earnings $7,991 million, against $5,150 million a year earlier, and guidance was raised to adjusted earnings of $19.50 to $20.00 a share.
    UnitedHealth Group second-quarter 2026 results release, Form 8-K exhibit 99.1 - consolidated results, medical care ratio, cash flow, balance sheet and the raised 2026 outlook. — Q2 2026 · publ. 16 July 2026 · source ↗
  16. ReportedIn the second quarter revenue was $112,032 million and operating earnings $7,991 million, against $5,150 million a year earlier, and guidance was raised to adjusted earnings of $19.50 to $20.00 a share.
    UnitedHealth Group second-quarter 2026 results release, Form 8-K exhibit 99.1 - consolidated results, medical care ratio, cash flow, balance sheet and the raised 2026 outlook. — Q2 2026 · publ. 16 July 2026 · source ↗
  17. ReportedThe shares closed at $376.59 on 25 September 2026, a market value of $338.03 billion.
    UnitedHealth Group (UNH) market data - $376.59 at the close on 25 September 2026; 52-week range 255.97-461.62; analyst target $481.72 from 26 analysts. — September 2026 · publ. 25 September 2026 · source ↗
  18. ReportedThe shares closed at $376.59 on 25 September 2026, a market value of $338.03 billion.
    UnitedHealth Group (UNH) statistics - market cap $338.03B, trailing P/E 24.24, forward P/E 17.70, P/S 0.75, 897.59 million shares. — September 2026 · publ. 25 September 2026 · source ↗
  19. ReportedMedical costs payable, claims incurred but not yet paid, were $39,337 million at the end of 2025, and the company held $74.7 billion of cash and investments, most of it inside regulated subsidiaries.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1A risk factors, competition, rate notices, reserve sensitivities and legal matters. — FY2025 · publ. 2 March 2026 · source ↗
  20. ReportedMedical costs payable, claims incurred but not yet paid, were $39,337 million at the end of 2025, and the company held $74.7 billion of cash and investments, most of it inside regulated subsidiaries.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1A risk factors, competition, rate notices, reserve sensitivities and legal matters. — FY2025 · publ. 2 March 2026 · source ↗
  21. ReportedGoodwill from the acquisitions that built Optum was $110,499 million.
    UnitedHealth Group Form 10-K for fiscal 2025 - financial statements and notes: segment note, CMS concentration, balance sheet, cash flow and capital. — FY2025 · publ. 2 March 2026 · source ↗
  22. ReportedLong-term debt was $72,320 million and debt-to-capital 43.9% against a target of 40%.
    UnitedHealth Group Form 10-K for fiscal 2025 - financial statements and notes: segment note, CMS concentration, balance sheet, cash flow and capital. — FY2025 · publ. 2 March 2026 · source ↗
  23. ReportedLong-term debt was $72,320 million and debt-to-capital 43.9% against a target of 40%.
    UnitedHealth Group fourth-quarter and full-year 2025 results release and 2026 outlook, Form 8-K exhibit 99.1. — FY2025 · publ. 27 January 2026 · source ↗
  24. ReportedThe shares have been listed since 1984 and have not been split since 2005.
    UnitedHealth Group (UNH) market data - $376.59 at the close on 25 September 2026; 52-week range 255.97-461.62; analyst target $481.72 from 26 analysts. — September 2026 · publ. 25 September 2026 · source ↗
  25. ReportedThe shares have been listed since 1984 and have not been split since 2005.
    UnitedHealth Group (UNH) statistics - market cap $338.03B, trailing P/E 24.24, forward P/E 17.70, P/S 0.75, 897.59 million shares. — September 2026 · publ. 25 September 2026 · source ↗
  26. ReportedDividends paid were $7,916 million in 2025, $8.73 a share, and the annual rate rose to $9.28 in June 2026.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1 business: segments, products, people served and leadership. — FY2025 · publ. 2 March 2026 · source ↗
  27. ReportedDividends paid were $7,916 million in 2025, $8.73 a share, and the annual rate rose to $9.28 in June 2026.
    UnitedHealth Group Form 10-Q for the quarter ended 30 June 2026 - segment note on the 2026 basis, share repurchases, legal matters and the IRS notices. — Q2 2026 · publ. 10 August 2026 · source ↗
  28. ReportedShare repurchases fell from $9,000 million in 2024 to $5,545 million in 2025 and are guided at no less than $5,000 million for 2026.
    UnitedHealth Group Form 10-K for fiscal 2025 - financial statements and notes: segment note, CMS concentration, balance sheet, cash flow and capital. — FY2025 · publ. 2 March 2026 · source ↗
  29. ReportedShare repurchases fell from $9,000 million in 2024 to $5,545 million in 2025 and are guided at no less than $5,000 million for 2026.
    UnitedHealth Group second-quarter 2026 results release, Form 8-K exhibit 99.1 - consolidated results, medical care ratio, cash flow, balance sheet and the raised 2026 outlook. — Q2 2026 · publ. 16 July 2026 · source ↗
  30. ReportedBerkshire Hathaway bought about 5 million shares in 2025 and sold the entire stake in the first quarter of 2026.
    24/7 Wall St, Berkshire Hathaway sells its entire UnitedHealth stake. — May 2026 · publ. 17 May 2026 · source ↗
  31. ReportedBerkshire Hathaway bought about 5 million shares in 2025 and sold the entire stake in the first quarter of 2026.
    IndexBox, UnitedHealth stock after Berkshire Hathaway exits its stake. — May 2026 · publ. 19 May 2026 · source ↗
  32. ReportedThe number that would falsify a recovery is the medical care ratio: at or below the 88.1% guided for 2026, pricing is back; near 89% again, the old returns are gone.
    UnitedHealth Group second-quarter 2026 results release, Form 8-K exhibit 99.1 - consolidated results, medical care ratio, cash flow, balance sheet and the raised 2026 outlook. — Q2 2026 · publ. 16 July 2026 · source ↗
Sources
Generated September 26, 2026