UnitedHealth raises 2026 outlook after third-quarter results
UnitedHealth Group (NYSE: UNH), the largest US health insurer, reported its third-quarter 2026 results on Tuesday, October 13, 2026, and raised its outlook for the full year.
Third-quarter results
According to the company's release:
- revenue was $112.7 billion, compared with $113.2 billion in the third quarter of 2025
- earnings from operations were $6.6 billion, compared with $4.3 billion a year earlier
- diluted earnings per share were $4.56, and adjusted earnings per share were $4.69, compared with $2.59 and $2.92 a year earlier
- cash flow from operations was $5.1 billion
Medical costs
The medical care ratio, which shows medical costs as a percentage of premium revenue, was 88.4%, compared with 89.9% a year earlier. A lower ratio means a smaller share of premiums was spent on medical care. The company said the figure included $610 million of favourable development related to earlier periods. It attributed the improvement to medical cost management, benefit design changes, pricing discipline and care delivery enhancements.
Business segments
UnitedHealthcare, the insurance business, reported revenue of $86.3 billion, compared with $87.1 billion a year earlier. It served 48.3 million people at the end of September, compared with 50.1 million a year earlier.
Optum, the health services business, reported revenue of $66.9 billion, compared with $69.2 billion. Within Optum, Optum Health revenue fell 10%, which the company linked to serving fewer patients in value-based care arrangements in certain markets. Optum Insight revenue rose 3% to $5.5 billion, and Optum Rx revenue was $39.9 billion.
Updated 2026 outlook
UnitedHealth now expects 2026 earnings of at least $19.50 per share and adjusted earnings of at least $20.50 per share. In July, the company had guided for adjusted earnings of $19.50 to $20.00 per share. According to market reports, this was the third time the company raised its 2026 adjusted earnings outlook this year.
Chief executive Stephen Hemsley said the results "reflect the discipline and execution" of the company's teams.
Costs and efficiency
UnitedHealth said its operating cost ratio, which compares operating costs with revenue, fell to 12.8% from 13.5% a year earlier. The company linked this to operating efficiencies, partly offset by investments in technology, processes and people. Optum Rx filled 393 million adjusted prescriptions in the quarter, compared with 414 million a year earlier, which the company linked to lower membership in UnitedHealthcare and among other customers.
Revenue versus earnings
In the quarter, earnings were higher while revenue was slightly lower than a year earlier. Over the same period, both the medical care ratio and the operating cost ratio were lower, and UnitedHealthcare served fewer people. Investors often look at whether cost levels can be sustained alongside changes in membership.
Why the results are watched
UnitedHealth is one of the largest companies in the US healthcare sector, and its results are often used as an indicator of trends in medical costs and health insurance. Its results come during a busy week for health insurers, after new Medicare Advantage star ratings were published last week.
What to watch
Key items for the coming months include medical cost trends, membership levels, Medicare Advantage payment rates and the company's first outlook for 2027, which is usually provided around the start of the year.
Risks and uncertainties
Health insurers' results can be affected by changes in medical costs, government payment rates and regulation, membership changes, competition and legal or regulatory reviews. The favourable reserve development included in the quarter may not recur. Guidance reflects the company's current expectations, and actual results may differ materially.
What this means for investors
For Investing.one users following UNH, the third-quarter results and the higher 2026 outlook may be relevant. The figures above are reported results and company guidance; past results do not indicate future performance.
Sources
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