The MoatNarrow moat

UnitedHealth Group (UNH) — moat facet

UnitedHealth's advantage is an insurer that owns its own supplier, and 2025 proved that the same ownership doubles the damage when costs rise.

UnitedHealth's moat is scale doubled by ownership. UnitedHealthcare served 49.8 million people with medical benefits in 20251, and Optum sells that insurer most of its pharmacy, technology and care services: about 62% of Optum's revenue came from inside the group23. The combination of a network, a pharmacy manager, a claims system and clinics under one owner is the advantage.

Return on invested capital (%)13.6201516.8201716.5201917.3202118.1202218.2202315.420249.72025Moat Explorer calculation from SEC EDGAR XBRL; hurdle 8%
A decade above 13%, then 9.7%.

For a decade the combination earned good returns. Return on invested capital, computed from EDGAR, was between 13.6% and 18.2% every year from 2015 to 20234. The medical care ratio stayed near 82%56, and operating earnings grew from $11,021 million in 2015 to $32,358 million in 202378.

In 2025 the model showed its weakness: integration concentrates risk as well as advantage. Medical costs rose, the medical care ratio reached 89.1%9, and both the insurer and Optum Health's clinics, which bear medical cost risk, were hit at once. Operating earnings fell to $18,964 million10 and return on invested capital to 9.7%11, just above an assumed 8% cost of capital.

The recovery in 2026 is real: second-quarter operating earnings were $7,991 million against $5,150 million12. But the moat's limits are now visible: prices set a year ahead, a government that sets much of the price13, and investigators looking at how the businesses deal with each other14.

The ownership also shows in the capital. The segments' total assets at the end of 2025 were $124,051 million at UnitedHealthcare, $100,991 million at Optum Health, $35,400 million at Optum Insight and $62,262 million at Optum Rx15. Optum Health, the business that lost money in 2025, carried about four-fifths as many assets as the insurer. That is the capital the moat has to earn a return on, and in 2025 the part that carried the most assets per dollar of profit was the part that failed.

Pricing power is the weakest element. The government sets the Medicare Advantage rate, and the 10-K says those rates have for years been well below the industry's forward medical cost trend16; states set Medicaid rates and eligibility17. What UnitedHealth controls is its cost of care, its quality scores and its willingness to walk away from members it cannot price profitably, which it exercised in 2026 by shedding about 880,000 Medicare Advantage members181920.

The moat is narrow and stable. The number that tests it is return on invested capital: back above 13% in 2026 or 2027 would say the 2025 collapse was a pricing error that has been corrected; staying near 10% would say the integrated model no longer earns much more than it costs.

Moat trajectory: Holding steady

ROIC 9.7% in 2025; earnings recovering in 2026.

The number that tests this moat
Moat Explorer calc
ROIC vs 8% hurdle (EDGAR calc)
9.7% in 2025; 15.4% in 2024; 18.2% in 2023

Returns on the capital employed; staying near 10% would mean the integrated model barely earns its cost.

How it's calculated: NOPAT divided by average operating invested capital from SEC EDGAR XBRL, using the tools_roic_edgar.py method. Operating income is after amortisation of acquired intangibles.
Source: Moat Explorer ROIC calculation from EDGAR ↗
Aspects of the moat
DIG DEEPER 01
UnitedHealthcare: Pricing Risk at Scale
UnitedHealthcare serves 49.8 million people with medical benefits, and 2025 showed that size does not protect a price set a year too low.
DIG DEEPER 02
Optum: The Supplier That Is Mostly Its Own Customer
Optum owns the pharmacy manager, the claims pipes and the clinics its own insurer buys from, and 62% of its revenue comes from that insurer.
DIG DEEPER 03
Optum Health: Owning the Care
Optum Health was built to profit from managing costs and instead lost money when costs rose, because it carried the same risk as the insurer.
DIG DEEPER 04
The Balance Sheet Behind the Promise
UnitedHealth carries $72 billion of long-term debt and $110 billion of goodwill, and in 2025 its return on capital fell to 9.7%.
References
  1. ReportedUnitedHealthcare served 49.8 million people with medical benefits in 2025, and Optum sells that insurer most of its pharmacy, technology and care services: about 62% of Optum's revenue came from inside the group.
    UnitedHealth Group fourth-quarter and full-year 2025 results release and 2026 outlook, Form 8-K exhibit 99.1. — FY2025 · publ. 27 January 2026 · source ↗
  2. ReportedUnitedHealthcare served 49.8 million people with medical benefits in 2025, and Optum sells that insurer most of its pharmacy, technology and care services: about 62% of Optum's revenue came from inside the group.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 7 MD&A: consolidated and segment results, medical care ratio, membership and operating metrics. — FY2025 · publ. 2 March 2026 · source ↗
  3. Moat Explorer calcUnitedHealthcare served 49.8 million people with medical benefits in 2025, and Optum sells that insurer most of its pharmacy, technology and care services: about 62% of Optum's revenue came from inside the group.
    Moat Explorer calculation from UnitedHealth Group's reported figures ($ 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.
  4. Moat Explorer calcReturn on invested capital, computed from EDGAR, was between 13.6% and 18.2% every year from 2015 to 2023.
    Moat Explorer calculation, tools_roic_edgar.py method on SEC EDGAR XBRL for CIK 731766: return on invested capital 13.6% (2015), 13.9% (2016), 16.8% (2017), 16.4% (2018), 16.5% (2019), 16.3% (2020), 17.3% (2021), 18.1% (2022), 18.2% (2023), 15.4% (2024), 9.7% (2025). — 2015-2025 · publ. September 2026 · source ↗
    Method: NOPAT (operating income x (1 - effective tax rate)) divided by average operating invested capital (total assets less current liabilities less cash), from SEC EDGAR XBRL via the tools_roic_edgar.py method.
  5. Moat Explorer calcThe medical care ratio stayed near 82%, and operating earnings grew from $11,021 million in 2015 to $32,358 million in 2023.
    Moat Explorer calculation from UnitedHealth Group's reported figures ($ 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.
  6. ReportedThe medical care ratio stayed near 82%, and operating earnings grew from $11,021 million in 2015 to $32,358 million in 2023.
    UnitedHealth Group Form 10-K for fiscal 2022 - medical care ratio, return on equity and diluted EPS for 2020-2022. — FY2022 · publ. February 2023 · source ↗
  7. Moat Explorer calcThe medical care ratio stayed near 82%, and operating earnings grew from $11,021 million in 2015 to $32,358 million in 2023.
    Moat Explorer calculation from UnitedHealth Group's reported figures ($ 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.
  8. ReportedThe medical care ratio stayed near 82%, and operating earnings grew from $11,021 million in 2015 to $32,358 million in 2023.
    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 ↗
  9. ReportedMedical costs rose, the medical care ratio reached 89.1%, and both the insurer and Optum Health's clinics, which bear medical cost risk, were hit at once.
    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 earnings fell to $18,964 million and return on invested capital to 9.7%, just above an assumed 8% cost of capital.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1 business: segments, products, people served and leadership. — FY2025 · publ. 2 March 2026 · source ↗
  11. Moat Explorer calcOperating earnings fell to $18,964 million and return on invested capital to 9.7%, just above an assumed 8% cost of capital.
    Moat Explorer calculation, tools_roic_edgar.py method on SEC EDGAR XBRL for CIK 731766: return on invested capital 13.6% (2015), 13.9% (2016), 16.8% (2017), 16.4% (2018), 16.5% (2019), 16.3% (2020), 17.3% (2021), 18.1% (2022), 18.2% (2023), 15.4% (2024), 9.7% (2025). — 2015-2025 · publ. September 2026 · source ↗
    Method: NOPAT (operating income x (1 - effective tax rate)) divided by average operating invested capital (total assets less current liabilities less cash), from SEC EDGAR XBRL via the tools_roic_edgar.py method.
  12. ReportedThe recovery in 2026 is real: second-quarter operating earnings were $7,991 million against $5,150 million.
    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 ↗
  13. ReportedBut the moat's limits are now visible: prices set a year ahead, a government that sets much of the price, and investigators looking at how the businesses deal with each other.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1 business: segments, products, people served and leadership. — FY2025 · publ. 2 March 2026 · source ↗
  14. ReportedBut the moat's limits are now visible: prices set a year ahead, a government that sets much of the price, and investigators looking at how the businesses deal with each other.
    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. ReportedThe segments' total assets at the end of 2025 were $124,051 million at UnitedHealthcare, $100,991 million at Optum Health, $35,400 million at Optum Insight and $62,262 million at 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 ↗
  16. ReportedThe government sets the Medicare Advantage rate, and the 10-K says those rates have for years been well below the industry's forward medical cost trend; states set Medicaid rates and eligibility.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1 business: segments, products, people served and leadership. — FY2025 · publ. 2 March 2026 · source ↗
  17. ReportedThe government sets the Medicare Advantage rate, and the 10-K says those rates have for years been well below the industry's forward medical cost trend; states set Medicaid rates and eligibility.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1 business: segments, products, people served and leadership. — FY2025 · publ. 2 March 2026 · source ↗
  18. ReportedWhat UnitedHealth controls is its cost of care, its quality scores and its willingness to walk away from members it cannot price profitably, which it exercised in 2026 by shedding about 880,000 Medicare Advantage members.
    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 ↗
  19. ReportedWhat UnitedHealth controls is its cost of care, its quality scores and its willingness to walk away from members it cannot price profitably, which it exercised in 2026 by shedding about 880,000 Medicare Advantage members.
    UnitedHealth Group second-quarter 2026 results release, Form 8-K exhibit 99.1 - segment results, operating metrics and people served. — Q2 2026 · publ. 16 July 2026 · source ↗
  20. Moat Explorer calcWhat UnitedHealth controls is its cost of care, its quality scores and its willingness to walk away from members it cannot price profitably, which it exercised in 2026 by shedding about 880,000 Medicare Advantage members.
    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.
Sources
Generated September 26, 2026