Health insurance company UnitedHealth (NYSE: UNH) met Wall Streets revenue expectations in Q4 CY2025, with sales up 12.3% year on year to $113.2 billion. On the other hand, the company’s full-year revenue guidance of $439 billion at the midpoint came in 3.7% below analysts’ estimates. Its non-GAAP profit of $2.11 per share was in line with analysts’ consensus estimates.

Is now the time to buy UnitedHealth? Find out by accessing our full research report, it’s free.

“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, chief executive officer of UnitedHealth Group.

Company Overview

With over 100 million people served across its various businesses and a workforce of more than 400,000, UnitedHealth Group (NYSE: UNH) operates a health insurance business and Optum, a healthcare services division that provides everything from pharmacy benefits to primary care.

Revenue Growth

Reviewing a company’s long-term sales performance reveals insights into its quality. Any business can put up a good quarter or two, but the best consistently grow over the long haul. Over the last five years, UnitedHealth grew its sales at a decent 11.7% compounded annual growth rate. Its growth was slightly above the average healthcare company and shows its offerings resonate with customers.

We at StockStory place the most emphasis on long-term growth, but within healthcare, a half-decade historical view may miss recent innovations or disruptive industry trends. UnitedHealth’s annualized revenue growth of 9.7% over the last two years is below its five-year trend, but we still think the results were respectable.

This quarter, UnitedHealth’s year-on-year revenue growth was 12.3%, and its $113.2 billion of revenue was in line with Wall Street’s estimates.

Looking ahead, sell-side analysts expect revenue to grow 1.8% over the next 12 months, a deceleration versus the last two years. This projection is underwhelming and implies its products and services will face some demand challenges. At least the company is tracking well in other measures of financial health.

Microsoft, Alphabet, Coca-Cola, Monster Beverage—all began as under-the-radar growth stories riding a massive trend. We’ve identified the next one: a profitable AI semiconductor play Wall Street is still overlooking. Go here for access to our full report.

Operating Margin

Operating margin is an important measure of profitability as it shows the portion of revenue left after accounting for all core expenses – everything from the cost of goods sold to advertising and wages. It’s also useful for comparing profitability across companies with different levels of debt and tax rates because it excludes interest and taxes.

UnitedHealth was profitable over the last five years but held back by its large cost base. Its average operating margin of 7.5% was weak for a healthcare business.

Looking at the trend in its profitability, UnitedHealth’s operating margin decreased by 4.1 percentage points over the last five years. The company’s two-year trajectory also shows it failed to get its profitability back to the peak as its margin fell by 4.5 percentage points. This performance was poor no matter how you look at it - it shows its expenses were rising and it couldn’t pass those costs onto its customers.

This quarter, UnitedHealth’s breakeven margin was down 7.4 percentage points year on year. This contraction shows it was less efficient because its expenses grew faster than its revenue.

Earnings Per Share

Revenue trends explain a company’s historical growth, but the long-term change in earnings per share (EPS) points to the profitability of that growth – for example, a company could inflate its sales through excessive spending on advertising and promotions.

UnitedHealth’s flat EPS over the last five years was below its 11.7% annualized revenue growth. This tells us the company became less profitable on a per-share basis as it expanded due to non-fundamental factors such as interest expenses and taxes.

We can take a deeper look into UnitedHealth’s earnings to better understand the drivers of its performance. As we mentioned earlier, UnitedHealth’s operating margin declined by 4.1 percentage points over the last five years. This was the most relevant factor (aside from the revenue impact) behind its lower earnings; interest expenses and taxes can also affect EPS but don’t tell us as much about a company’s fundamentals.

In Q4, UnitedHealth reported adjusted EPS of $2.11, down from $6.81 in the same quarter last year. This print was close to analysts’ estimates. Over the next 12 months, Wall Street expects UnitedHealth’s full-year EPS of $16.31 to grow 8.8%.

Key Takeaways from UnitedHealth’s Q4 Results

We struggled to find many positives in these results. Its full-year revenue guidance missed and its revenue was in line with Wall Street’s estimates. Overall, this quarter could have been better. The stock traded down 12.3% to $308.54 immediately following the results.

UnitedHealth may have had a tough quarter, but does that actually create an opportunity to invest right now? What happened in the latest quarter matters, but not as much as longer-term business quality and valuation, when deciding whether to invest in this stock. We cover that in our actionable full research report which you can read here (it’s free).