UnitedHealth Group, a US-based multinational health care and health insurance company, reported a sharp drop in profit for 2025, weighed down by Medicare funding pressure, higher medical costs, and expenses linked to the Change Healthcare cyberattack.
Net earnings attributable to common shareholders fell to $12.1 bn, down 16% from $14.4 bn a year earlier. The decline included a $1.6 bn after-tax charge booked in the fourth quarter.
The company pointed to accelerating medical cost trends as a central factor. Its adjusted medical care ratio climbed to 88.9% in 2025 from 85.5% in 2024, reflecting higher utilization and cost intensity across lines.
Revenue growth remained strong. Total revenue rose 12% year on year to $447.5 bn, compared with $400.2 bn in 2024.
- Within UnitedHealthcare, the Employer & Individual segment posted revenue of $79.2 bn, slightly above $78.2 bn last year.
- The Medicare & Retirement business delivered the largest increase. Revenue reached $171.3 bn, up $31.8 bn, or 23%, driven by growth in membership and the impact of Inflation Reduction Act Part D provisions.
- Community & State revenue climbed 17% to $94.4 bn, supported by higher Medicaid rates and expanded services for members with complex care needs.
Fourth-quarter results were distorted by one-off items. Net earnings attributable to shareholders came in at $10 mn, compared with $5.5 bn in the prior-year quarter. Quarterly revenue increased to $113.2 bn from $100.8 bn.
The group guided to 2026 revenue above $439 bn, a projected 2% decline tied to what it described as planned right-sizing across the enterprise.
Earnings from operations are expected to exceed $24 bn, with a net margin near 3.6%, compared with 2.7% in 2025.
CEO Stephen Hemsley said the company addressed challenges head-on and exited 2025 in a stronger position, with momentum to improve core performance and service delivery.
We confronted challenges directly and finished 2025 as a much stronger company, giving us the momentum to better serve those who count on us and continue to improve our core performance.
Stephen Hemsley, UnitedHealth Group CEO
The results arrive amid heightened scrutiny. Earlier this month, a US Senate Judiciary Committee investigation, reported by the Wall Street Journal, alleged UnitedHealth used aggressive tactics to increase Medicare Advantage payments by expanding diagnoses that qualify for higher funding.
The committee reviewed about 50,000 pages of internal documents.
Policy pressure is also building. The Trump administration recently proposed an average Medicare Advantage payment increase of 0.09% for next year, a level insurers widely view as insufficient.
The government estimates the update would add more than $700 mn in payments by 2027.
