UnitedHealth’s revenue is rising, according to its first earnings report since its CEO’s death

UnitedHealth Group on Thursday said it earned less than expected last quarter, citing higher medical costs and pressure on its insurance division at a time when the company is still reeling from the shocking murder of a top executive last month.

UnitedHealth Group’s fourth-quarter revenue was $100.8 billion, less than analysts expected but still up 6.8 percent from the same quarter a year earlier. The company’s full-year revenue in 2024 rose to $400.3 billion. For UnitedHealthcare, its insurance division, full-year revenue rose to $298.2 billion, up 6 percent from 2023.

These were the company’s first results since Brian Thompson, UnitedHealthcare’s chief executive, was shot dead outside a hotel in midtown Manhattan.

The murder sparked public outrage against gigantic health insurers over lack of access to health care and denial of coverage and insurance claims.

Some shareholders have urged UnitedHealth to release a report on its practices that “limit or delay access to health care.”

Andrew Witty, chief executive of UnitedHealth Group, said on a call with analysts Thursday that claims frustrations, including delays in receiving care and insurance, are “key areas we must work difficult to improve.”

Mr. Thompson’s successor has not yet been named. Mr. Witty did not share details about filling the position or directly address the recent shareholder campaign.

But he and other executives talked about Mr. Thompson’s loss first.

“He dedicated his time to making the health care system work better for all the people we are honored to serve,” Witty said.

UnitedHealth’s results, which disappointed Wall Street, in many ways reflected broader trends and continuing industry problems. For several quarters, US health insurers have been experiencing a decline in their earnings due to high medical expenses and tightening government payment policies.

John Rex, the company’s chief financial officer, pointed to government rate cuts in the payment system for the Medicare Advantage program, private federal insurance for people age 65 and older. UnitedHealth does significant business in private Medicare plans.

Medicare Advantage performance has declined recently across the industry, in part due to regulatory changes aimed at preventing overcharges and due to increased health care spending among some older populations.

Witty also said there are costs to changes to Medicaid, the federal insurance program for the impoverished.

The company’s medical expense ratio, a measure of how much it costs to provide care, was higher than expected last quarter, which could heighten investor concerns that increased costs of providing care could continue, said John Boylan, an analyst at Edward Jones, an investment firm.

UnitedHealth, however, kept its full-year 2025 outlook intact, unchanged by recent pressures. Morgan Stanley analysts wrote in a research note that the company has set “reasonably conservative goals” for this year.

“Overall, we believe United is well-positioned to navigate the changing healthcare landscape due to its differentiated business model,” Boylan said.

Shares of UnitedHealth fell 6 percent on Thursday as investors digested weaker-than-expected results. The performance of UnitedHealth, often seen as the industry’s performance leader, dragged down shares of its rivals, including CVS Health, the parent of insurer Aetna.

UnitedHealth Group also owns Optum Rx, one of the nation’s largest pharmacy benefits managers hired by employers and government programs to oversee prescription drug benefits.

Optum Rx has faced criticism from regulators over concerns that it has raised drug prices by putting its own interests ahead of those of patients, employers and taxpayers. Just this week, the Federal Trade Commission released a report report detailing how PBMs can inflate drug prices.

The agency criticized Optum Rx and two other major benefit managers — CVS Health’s Caremark and Cigna’s Express Scripts — for raising prices for generic drugs for cancer, heart disease and other diseases by as much as 1,000 percent of average national costs.

Witty, CEO of UnitedHealth Group, defended Optum’s practices, emphasizing that 98 percent of the rebates were passed on to customers. He added that by 2028, all rebates will be passed on. Drug prices in the United States, Witty argued, “are de novo too high compared to any other price in the world,” which placed the blame on pharmaceutical companies.

“PBM operates on behalf of the ultimate payer – the employer, the union and the state,” Witty told analysts.

Mr. Witty did not comment on Justice Department investigations or lawsuits seeking to block the proposed takeover of Amedsys, a gigantic home care and hospice company.

In addition to rising medical costs and increasing operate of health care services, UnitedHealth executives pointed to a widespread ransomware attack in 2024 that weighed on the company’s full-year profits. A cyberattack forced the shutdown of Change Healthcare’s extensive billing and payment system. The company estimated that the health and privacy data breach affected more than 100 million people said this week that the review personal data related to the incident was “substantially complete”.

Luigi Mangione, 26, has been charged with numerous state and federal murders, as well as weapons and stalking crimes. He pleaded not guilty.

UnitedHealth and police said neither he nor his parents had medical insurance with UnitedHealth.