UnitedHealth Group 2024 Calendar Year Results 📊

A look at UHC's CY 2024 financial results. Membership, Revenues, Loss Ratios, Profits.

This week’s newsletter is Sponsored By: PX

Here is what you’ll find in this week’s newsletter!

  1. Important links 🔗 - the best articles we found this week about the Medicare Market along with links to Jared’s recent LinkedIn posts.

  2. Deep Dive đŸ“š - UnitedHealth Group 2024 Calendar Year Results 📊

  3. Data Visual of the Week 📊 - UHC visual

  4. Sponsor Snapshot 🚀 - brought to you by PX

  5. Compliance Chatter đŸ“˘ - Several new regulations to review!

It’s only a 5 minute read, but it will make you 10x smarter.

Here are IMPORTANT LINKS 🔗 for the week:

  1. Medicare will negotiate Novo’s GLP-1 drug price. Here’s what that means for Ozempic, Wegovy. - (link)

  2. State of the 2025 Medicare Advantage industry: Dual-eligible plan valuation and selected benefit offerings - (link)

  3. Alignment Healthcare names new president as insurer eyes growth - (link)

  4. Trump Blocks Medicare's Efforts to Create a $2 Prescription Drug List - (link)

  5. PODCAST: Episode 73: Insurance Industry Disaster Headlines Spark National Debate! - (link)

  6. Average Medicare Supplement Rate Increases Continue Trending Higher in 2025 - (link)

Jared’s recent LinkedIn posts:

  1. Clover Reported 27% MA Growth during AEP. - (link)

  2. UnitedHealth Group (UNH) reported Q4 2024 results this morning. - (link)

  3. Top Medicare Conferences in 2025. - (link)

  4. The value in general MA plans decreased in 2025. - (link)

DEEP DIVE 📚

UnitedHealth Group 2024 Calendar Year Results 📊

When it comes to companies focused on the Medicare market, UnitedHealth Group (NYSE: UNH) is the leader.

But, they didn’t simply hit the scene overnight.

It’s been a long consistent growth over time along with vertical integration that has resulted in their consistent positive results.

Last week UNH released Q4 ‘24 financials. The Medical Loss Ratio was higher than it was expected to be, with Q4 experiencing the highest Loss Ratio in recent history. That, combined with the financial impacts stemming from the Change Healthcare cyber attack, resulted in operating profits that were flat compared to 2023, and a profit margin that declined.

In this week’s deep dive we are analyzing year-over-year (“YoY”) and past 7 years results to better understand recent trends.

Before we get to the numbers it’s important to understand their two main business units, UnitedHealthcare and Optum.

UnitedHealthcare is an insurance carrier, providing health insurance benefits. They collect premiums, pay health insurance benefits, and make a profit on what’s left over.

Optum is (for the most part) a healthcare provider. This includes doctors, hospitals, value-based care clinics, technology and pharmacies.

They receive revenues via health insurance benefits, pay expenses associated with running health provider systems, and make a profit on what’s left over.

This is what is called vertical integration!

Okay, now let’s look at some numbers.

Membership

Surprisingly, overall membership growth has been very modest over the last 7 years.

  • YE 2017 membership: 46.68 million

  • YE 2024 membership: 53.73 million

  • Overall Growth: 15%

  • % Change (current yr.): 1.8%

  • % Change (prior yr.): 2.0%

  • CAGR: 2.0%

  • The largest membership segment is their Commercial line. 2024 saw significant growth after modest growth in 2023 and being mostly flat for several years before that.

  • UNH is the market leader in the Medicare Supplement market, but the membership in that line of business has decreased in recent years.

  • The Medicaid line had seen steady growth until 2023. The decline is likely due to Medicaid “unwinding”. This decline has continued into 2024, with a decline of 5.2%.

  • The Medicare Advantage line has seen significant growth of 77% since 2017. However, the rapid growth slowed in 2024, with an increase of only 1.9% in 2024. UNH is the market leader in Medicare Advantage enrollment.

Revenues

UNH reports revenues by vertical (UnitedHealthcare and Optum), and provides further details within each vertical. In addition, “eliminations” are reported in order to remove revenues that Optum receives from UnitedHealthcare (can’t count that revenue twice).

UnitedHealthcare Revenues (the insurance Carrier segment) have grown steadily over the past 7 years, though 2024 showed a slower year of growth when compared to 2023.

  • YE 2017 Revenues: $163.3 billion

  • YE 2024 Revenues: $298.2 billion

  • Overall Growth: 83%

  • % Change (current yr.): 6.0%

  • % Change (prior yr.): 12.7%

  • CAGR: 9.0%

  • The largest segment is the Medicare & Retirement segment. A more modest 2024 growth of 7.4% pales in comparison to the 14.2% growth in 2023.

  • The Community & State segment has seen the highest growth rates in recent years (17.6% in 2023, 18.2% in 2022), but 2024 growth is only 7.4%, equal to the 2024 growth in the Medicare & Retirement segment.

Optum Revenues (the healthcare provider segment) have grown 2.7x over the past 7 years.

  • YE 2017 Revenues: $91.19 billion

  • YE 2024 Revenues: $252.96 billion

  • Overall Growth: 177%

  • % Change (current yr.): 11.6%

  • % Change (prior yr.): 24.0%

  • CAGR: 15.7%

  • The largest segment, Optum Health, has seen significant growth in both recent years (34% in 2023) and over the last 7 years (26% CAGR), but revenue growth slowed to 10.5% in 2024.

  • Optum Insights saw substantial growth of 30% in 2023, but 2024 shows a decline in revenue of 1% compared to 2023.

  • Optum Rx saw continued notable revenue growth this year (16% in 2023 and 15% in 2024).

Combining UnitedHealthcare, Optum, and including eliminations, results in the company’s Total Consolidated Revenues.

  • YE 2017 Revenues: $201.16 billion

  • YE 2024 Revenues: $400.28 billion

  • Overall Growth: 99%

  • % Change (current yr.): 7.7%

  • % Change (prior yr.): 14.6%

  • CAGR: 10.3%

As you can see, revenue eliminations have grown steadily over the past 7 years, and has grown faster than overall top line revenue.

This indicates there is more vertical integration today than there was 7 years ago.

More of the insurance company benefit expense is going to Optum providers and pharmacies as revenue. (Since they already recognized the revenue in the insurance company, they can’t also recognize it as revenue in the provider company.)

Operating Income

Okay, so membership is growing, revenues are growing. What about operating income (profit)? Again, these are reported by vertical.

The combined UnitedHealth Group’s Operating Income has grown steadily over the past 7 years, but 2024 results are flat compared to 2023.

  • YE 2017 Operating Income: $15.21 billion

  • YE 2024 Operating Income: $32.29 billion

  • Overall Growth: 112%

  • % Change (current yr.): -0.2%

  • % Change (prior yr.): 13.8%

  • CAGR: 11.4%

  • Operating Income is nearly 50/50 between the UHC (insurance operations) and Optum (healthcare provider operations). For the first time Optum generated more Operating Income than UHC.

  • Optum Health had the highest growth % in 2024 (18.4%)

Medical Loss Ratio

The profit margin in 2024 (8.1%) shows a decline over 2023 (8.7%). The decrease in profit margin was primarily driven by higher loss ratios combined with the financial impacts of the Change Healthcare cyber attack. You can see in the graph below that the Q4 2024 loss ratio of 88% is the by far the highest quarter in the last 8 years.

Bottom Line

  • Membership growth has been modest overall, with Medicare Advantage leading at 77% growth since 2017, though growth slowed to 1.9% in 2024. Medicaid membership declined by 5.2% in 2024 due to Medicaid unwinding, while Commercial membership saw faster growth than in recent years.

  • UnitedHealthcare’s revenues have grown faster than membership, driven by the increasing share of Medicare Advantage membership, which generates higher premiums per member, combined with medical inflation.

  • Optum’s revenues have grown 2.7x over seven years, driven by expansion of its footprint and an increase in value-based care payment arrangements. However, 2024 growth slowed compared to prior years.

  • Vertical integration has significantly increased, with more insurance members using Optum providers and pharmacies. This is evident from the rise in revenue eliminations between segments.

  • Despite flat operating income in 2024, the company has maintained a strong profit margin of 8.1%. For the first time, Optum contributed more to operating income than UnitedHealthcare.

  • The higher Medical Loss Ratio (88% in Q4 2024, the highest in seven years) is a potential concern in 2025.

DATA VISUAL OF THE WEEK 📊

What MMI + Subscribers read this week…

  • December '24 MA/MAPD and PDP enrollment data - December enrollment data has been loaded. Here are a few observations. (link)

SPONSOR SNAPSHOT đŸš€: PX

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What if you could identify them before they switch, and retain them? 

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Find out more here → (link)

Make sure you check out the Retention Calculator to see how much revenue you might retain with PX.

COMPLIANCE CHATTER 📢

Check out this week’s Insurance Regulatory Insights newsletter which includes several regulations and rules impacting Medicare Supplement, Fixed Indemnity, Dental, Medicare Advantage and more.

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