UnitedHealth Group Inc (NYSE:UNH) reported mixed fourth-quarter 2025 results on Tuesday.The company reported adjusted earnings of $2.11, down from $6.81 a year ago, beating the consensus of $2.10. Revenues increased 12% year over year to $113.215 billion, missing the consensus of $113.817 billion.“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,” said Stephen Hemsley, CEO ...

We recently published 10 Big Names With Painful Declines. UnitedHealth Group Inc. (NYSE:UNH) was one of the worst performers on Tuesday. UnitedHealth dropped its share prices by 19.61 percent on Tuesday to close at $282.70 apiece as investors soured on its weaker outlook for 2026, as well as disappointing Medicare Advantage payment rates for next year. In a statement on Monday, the Centers for Medicare & Medicaid Services (CMS) announced a mere 0.09 percent increase in Medicare Advantage payments for nex ...

Group 1 - Alignment Healthcare Inc. (NASDAQ:ALHC) experienced a significant decline of 11.97% on Tuesday, closing at $20.96, as investors reacted negatively to lower-than-expected preliminary payment proposals for the Medicare Advantage program [1][3] - The Centers for Medicare and Medicaid Services (CMS) projected a net average payment increase of only 0.09%, which is substantially lower than the anticipated growth of 4 to 6 percent by analysts [2] - The CMS also proposed tighter risk-adjustment rules, including the exclusion of diagnoses made solely via audio calls and some chat reviews starting in 2027 [2] Group 2 - Alignment Healthcare's stock drop was in line with other major players in the industry, such as UnitedHealth Group, CVS Health, Centene Corp., and Oscar Health, raising concerns about their performance due to exposure to the government-sponsored Medicare program [3] - Investors are expected to monitor Alignment Healthcare's short-term outlook closely, particularly following updates to the Medicare program, with the company scheduled to release its financial and operating highlights in the last week of February 2026 [4]

If you are interested in keeping up to date with stocks making moves within the biotech, pharma, and healthcare industries and understanding the key trends and catalysts driving valuations ahead of the market, why not subscribe to my weekly newsletter via my Investing Group, Haggerston BioHealth ?Yesterday, US health insurance stocks took an almighty beating, as news broke that the Centers for Medicaid and Medicare Services ("CMS") had announced a proposed rate increase for Medicare Advantage ("MA") Capitat ...

UnitedHealth Group (NYSE: UNH) faced a number of challenges in 2025 that weighed on stock performance: from the higher costs of healthcare, which hurt earnings, to a Justice Department probe into its Medicare billing practices. The stock slid 53% from the start of the year through early August. But the health insurance giant didn't sit still. Instead, UnitedHealth made moves to address its earnings challenges, commissioned an independent review of its processes to ensure top performance, and set solid reco ...

Core Viewpoint - Elevance Health anticipates a slight decline in revenue for 2026 and projects full-year profit below Wall Street expectations, indicating ongoing challenges from elevated medical costs impacting insurers [1] Group 1: Financial Forecast - The company expects total operating revenue to decrease by a low-single-digit percentage in 2026, raising investor concerns following UnitedHealth's similar revenue decline announcement [3] - The forecast includes a low-double-digit decline in membership for certain plans, partially offset by increased premiums and growth in Carelon, its health services division [3] Group 2: Market Conditions - The outlook reflects continued pressure in the Medicaid sector, contributing to a negative market sentiment and stock selloff [4] - Health insurers are facing persistently high medical costs due to increased demand for behavioral health services and specialty drugs, which have elevated costs over the past two years [5] Group 3: Membership and Policy Changes - The company anticipates a sicker member pool in its Obamacare business due to the expiration of enhanced tax credits that previously supported plan purchases [6] - The expiration of these tax credits, which capped out-of-pocket premiums at 8.5% of income, is expected to lead to higher premiums for millions, potentially discouraging healthier individuals from enrolling [7] Group 4: Regulatory Impact - Shares of health insurers fell after the U.S. health insurance agency announced a rate increase of only 0.09% for Medicare Advantage plans, which was below expectations [8]

Core Insights - The company aims for at least 12% adjusted EPS growth by 2027, with a 2026 adjusted diluted EPS guidance of at least $25.50, reflecting prudent assumptions and strategic repositioning [1][22][24] - The focus for 2026 is on execution and repositioning, with an emphasis on improving care coordination and managing costs effectively [2][9] Financial Performance - Adjusted diluted EPS for Q4 was $3.33, with a full-year EPS of $30.29, benefiting from favorable tax items and solid underlying performance [16][18] - Operating revenue for Q4 reached $49.3 billion, a 10% increase year-over-year, driven by premium rate adjustments and acquisitions [18] - The consolidated benefit expense ratio was 93.5% for Q4 and 90% for the full year, aligning with guidance [18] Membership and Market Dynamics - The company ended the year with 45.2 million members, a decrease of approximately 500,000, primarily due to Medicaid membership declines [17] - Medicaid operating margin is expected to be approximately -1.75% in 2026, with improvements anticipated as rates adjust to current experiences [5][20] - Medicare Advantage membership is projected to decline in the high teens percentage range in 2026, reflecting deliberate portfolio actions [6][20] Strategic Initiatives - The company is enhancing analytics to identify high-cost treatment patterns and improve care coordination, particularly in Medicaid [11][10] - Investments are being made in specialty pharmacy management and behavioral health support to strengthen care management programs [12][11] - The company is focused on maintaining operational discipline while investing in technology and simplifying the member experience [23][25] Long-term Outlook - The long-term enterprise margin target is set at 5% to 6%, with health benefits targeting mid-single-digit margins [9][24] - The company is recalibrating long-term margin expectations to reflect the current business mix and operating environment [25][54] - Confidence in achieving at least 12% adjusted EPS growth in 2027 is based on multiple independent levers and disciplined execution across various segments [24][49]

Financial Performance - Adjusted diluted EPS for Q4 was reported at $3.33, with a full-year EPS of $30.29, benefiting from greater tax favorability and non-recurring items contributing $3.75 per share [1] - Q4 operating revenue reached $49.3 billion, reflecting a 10% year-over-year increase, driven by premium rate adjustments and acquisitions [4][7] - Operating cash flow for 2025 was $4.3 billion, with a target of at least $5.5 billion for 2026, and the company returned $4.1 billion to shareholders in 2025 [4][9] Guidance and Future Outlook - Elevance Health set a 2026 adjusted diluted EPS guidance of at least $25.50, with expectations to return to at least 12% adjusted EPS growth in 2027 [2][6][23] - The company anticipates 2026 to be a trough year for Medicaid, expecting an operating margin of approximately -1.75% and a decline of about 750,000 Medicaid members [5][10][12] - Medicare Advantage membership is expected to decline in the high teens percentage range, while targeting at least a 2% margin [5][13] Membership and Market Positioning - The company ended 2025 with 45.2 million members, a decrease of about 500,000 year-over-year, primarily due to lower Medicaid membership [8] - For the individual ACA business, Elevance expects at least 900,000 members by year-end 2026, with a 10% increase in membership coming out of open enrollment [14] - In commercial segments, employer group risk membership is projected to decline in the high single-digit percentage range due to deliberate pricing decisions [15] Operational Strategies - Executives emphasized "execution and repositioning" as key themes for 2026, focusing on portfolio actions across Medicaid, Medicare Advantage, and the individual ACA market [3] - Carelon is expected to see strong demand, particularly in high-cost areas, but near-term growth may be moderated by lower health plan membership [16] - The company updated its long-term enterprise margin target to 5%–6%, with mid-single-digit margins targeted for health benefits and Carelon segments [19][20]

Earnings Overview - Elevance Health reported fourth-quarter 2025 revenues of $49.3 billion, a 10% increase year over year, but below the consensus estimate of $49.82 billion [1] - The operating revenue for the full year 2025 was $197.6 billion, reflecting a 13% increase [1] - Adjusted earnings per share for the fourth quarter were $3.33, surpassing the consensus of $3.10 [2] Expense Ratios - The benefit expense ratio for the fourth quarter was 93.5%, an increase of 110 basis points, attributed to higher medical costs in Affordable Care Act plans and Medicare Part D seasonality [2] - For the full year, the benefit expense ratio was 90%, up 150 basis points year over year [2] - The operating expense ratio was 11% in the fourth quarter and 10.6% for the full year [3] Segment Performance - The Health Benefits segment generated operating revenue of $41.8 billion in Q4 2025, an 11% increase driven by higher premium yields and Medicare Advantage membership growth [4] - Medical membership totaled approximately 45.2 million as of December 31, 2025, a 1% decrease year over year due to Medicaid attrition [4] - Carelon's operating revenue was $18.7 billion, up 27%, driven by growth in CarelonRx and the acquisition of CareBridge [5] Future Guidance - For fiscal 2026, Elevance Health expects adjusted earnings to be at least $25.50 per share, below the Wall Street estimate of $26.90 [9] - The company forecasts a mid-single-digit decline in sales due to lower premiums and anticipates a benefit expense ratio of 90.2% +/- 50 basis points [9] - Year-end medical enrollment is projected to be between 43,175 and 43,875, down from 45,232 in 2025 [9] Market and Regulatory Environment - The company anticipates a significant decline in Medicare Advantage membership, projected to be in the high teens percentage range for 2026 [7] - Concerns were raised regarding the proposed payment rates for Medicare in 2027, which are expected to be significantly lower than anticipated [10]

Elevance Health (NYSE:ELV) Q4 2025 Earnings call January 28, 2026 08:30 AM ET Company ParticipantsA.J. Rice - Managing Director and Equity ResearchAndrew Mok - Director, Equity ResearchBen Hendrix - VP and Assistant VPDave Windley - Managing DirectorFelicia Norwood - President, Government Health BenefitsGail Boudreaux - President and CEOLisa Gill - Managing DirectorMark Kaye - CFOMorgan Kendrick - President, Commercial Health BenefitsNathan Rich - VP of Investor RelationsPete Haytaian - President of Carelon ...