UnitedHealth Group Incorporated
UNH · NYSE
Dec 2026
Next quarter
Expected to report Jan 26, 2027 — estimated from last year’s reporting date.
Consensus is $2.28 EPS for Dec 2026 across 10 estimates, ranging $2.19 to $2.54.
UNH Sep 2026
- 13.83%
- $4.12
- $4.69
- —
- $112.69B
Reported results
- $112.69B
- 87.84%
- $6.56B
- 5.82%
- $4.11B
- $4.56
Highlights
- Adjusted EPS: $4.69, $0.57 above the $4.12 consensus; GAAP diluted EPS was $4.56.
- Operating recovery: Operating earnings rose 52% year over year to $6.6 billion, while revenue slipped 0.4% to $112.7 billion.
- Medical costs: The medical care ratio improved to 88.4% from 89.9% a year ago, including $610 million of favorable medical reserve development related to 2026 service dates.
- Efficiency: The operating cost ratio fell to 12.8% from 13.5% a year ago.
- Segment earnings: UnitedHealthcare operating earnings increased to $2.8 billion from $1.8 billion; Optum’s rose to $3.7 billion from $2.5 billion.
- Membership pressure: UnitedHealthcare covered 48.3 million people, down from 50.1 million a year ago; Medicare Advantage seniors served, including complex populations in Medicaid, contracted by 935,000 since year-end 2025.
- 2026 outlook: The company raised its full-year outlook to at least $19.50 per share in earnings and at least $20.50 in adjusted earnings.
- Cash and capital: Operating cash flow was $5.1 billion, or 1.2 times net income; year-to-date share repurchases were $5.0 billion and dividends paid were $6.2 billion.
Analysis
UnitedHealth delivered a clear earnings beat, with adjusted EPS of $4.69 versus the $4.12 consensus, even as revenue remained nearly flat. Revenue of $112.7 billion was 0.4% below the year-ago quarter’s $113.2 billion and 0.6% above Q2’s $112.0 billion. Operating earnings of $6.6 billion were up from $4.3 billion a year ago, but down from $8.0 billion in Q2; GAAP diluted EPS of $4.56 compared with $2.59 a year ago and $6.04 last quarter.
The quarter’s improvement centered on better medical economics and stronger operating results across both UnitedHealthcare and Optum. The medical care ratio fell 150 basis points year over year to 88.4%, although $610 million of favorable reserve development contributed to the quarter’s ratio. The operating cost ratio also improved, to 12.8% from 13.5%. UnitedHealthcare and Optum both increased operating earnings year over year, but membership contraction and lower Optum revenue remain important counterweights. Management raised its 2026 outlook to at least $19.50 per share in earnings and at least $20.50 in adjusted earnings. Cash generation remained solid, with $5.1 billion of operating cash flow.
Medical costs and margins
- Medical care ratio: 88.4%, down from 89.9% in Q3 2025. The company attributed the improvement to medical cost management, pricing and benefit alignment, and care-delivery changes; the quarter also included $610 million of favorable reserve development for 2026 dates of service.
- Operating costs: The operating cost ratio was 12.8%, versus 13.5% a year ago. The company cited realized efficiencies, partly offset by investment in technology, processes and people.
- Profitability: Operating earnings were $6.6 billion versus $4.3 billion a year ago, and net margin was 3.6% versus 2.1%. The sequential comparison was weaker: Q2 operating earnings were $8.0 billion and net margin was 4.9%.
UnitedHealthcare and Optum
- UnitedHealthcare: Revenue was $86.3 billion, down from $87.1 billion a year ago, while operating earnings rose to $2.8 billion from $1.8 billion and margin expanded to 3.3% from 2.1%. Management cited benefit changes, pricing discipline and medical and operating cost management.
- Optum: Revenue declined to $66.9 billion from $69.2 billion, but operating earnings increased to $3.7 billion from $2.5 billion; margin improved to 5.6% from 3.6%.
- Optum Health: Revenue fell 10% to $22.9 billion as the business served fewer value-based-care patients in markets where it lacked sufficient presence to sustain clinicians. Operating earnings nevertheless rose to $735 million from $41 million, reflecting stronger operating discipline and medical cost management.
- Other Optum businesses: Optum Insight revenue grew 3% to $5.5 billion and operating earnings increased to $1.3 billion from $920 million. Optum Rx revenue was $39.9 billion versus $39.7 billion, with operating earnings of $1.7 billion versus $1.5 billion.
Membership and mix
- UnitedHealthcare coverage: The company served 48.3 million medical members at quarter-end, down from 50.1 million a year earlier and 48.5 million at the end of Q2.
- Senior and Medicaid plans: Medicare Advantage membership was 7.6 million, compared with 8.4 million at year-end 2025; Medicaid membership was 6.7 million, down from 7.4 million. The company said seniors served through Medicare Advantage, including complex populations in Medicaid, had contracted by 935,000 since year-end 2025.
- Other indicators: Employer and Individual membership declined by 165,000 during the quarter, which the company attributed to employer attrition. UnitedHealthcare reported that at least 69% of members were in 4+ Star Medicare Advantage plans for 2027, in line with expectations.
Outlook and capital
- Full-year outlook: UnitedHealth raised its 2026 outlook to at least $19.50 per share in earnings and at least $20.50 per share in adjusted earnings, incorporating experience through Q3.
- Cash and leverage: Quarterly operating cash flow was $5.1 billion, or 1.2 times net income. The debt-to-capital ratio was 41.7% at September 30, versus 41.2% at the end of Q2; the company continues to target approximately 40% by year-end.
- Shareholder returns: Through the first nine months, the company repurchased $5.0 billion of shares and paid $6.2 billion in dividends.
Affordability initiatives
- Prior approvals: UnitedHealthcare plans to eliminate 30% of current prior-approval volume by year-end 2026, including nearly two-thirds of pediatric-care requirements. It also plans to remove home-health approval requirements, which the company says will eliminate nearly 10% of total prior-approval volume.
- Coverage and community support: UnitedHealth Group committed $1 billion to the United Health Foundation and said it would voluntarily eliminate and rebate profits from individual ACA coverage offerings in 2026, returning the money to approximately 1 million members. It is also expanding doula coverage and behavioral-health coaching access.
- Pharmacy benefits: Optum Rx launched a fee-based pharmacy-care model that decouples PBM pricing from drug list prices and prescription volume. The company committed to passing through 100% of manufacturer rebates to clients by January 1, 2028.
