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UnitedHealth Group Reports 2023 Results

  • Revenues of $371.6 Billion Grew 15% Year-Over-Year
  • Earnings from Operations Grew 14%
  • Cash Flows from Operations were $29.1 Billion or 1.3x Net Income
  • Full Year and Fourth Quarter Net Earnings were $23.86 and $5.83 Per Share
  • Full Year and Fourth Quarter Adjusted Net Earnings were $25.12 and $6.16 Per Share

UnitedHealth Group (NYSE: UNH) reported full year and fourth quarter 2023 results reflecting broad-based growth at Optum and UnitedHealthcare.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20240112297126/en/

UnitedHealth Group corporate headquarters (Photo: Business Wire)

UnitedHealth Group corporate headquarters (Photo: Business Wire)

“UnitedHealth Group enters 2024 well prepared to build on our efforts to improve patient care and consumer experiences broadly, and to continue delivering strong and balanced growth,” said Andrew Witty, chief executive officer of UnitedHealth Group.

UnitedHealth Group affirmed the 2024 performance objectives established at its November 29th Investor Conference, excluding the potential impacts from the pending sale of its Brazil operations, which is expected to close in the first half of 2024. Upon closing, the Company’s net earnings outlook will be impacted by the previously announced expected charge and the Company confirmed the adjusted earnings outlook presented at its Investor Conference.

Quarterly and Annual Financial Performance

 

 

Three Months Ended

Year Ended

 

December 31,

2023

December 31,

2022

September 30,

2023

December 31,

2023

December 31,

2022

Revenues

$94.4 billion

$82.8 billion

$92.4 billion

$371.6 billion

$324.2 billion

Earnings from Operations

$7.7 billion

$6.9 billion

$8.5 billion

$32.4 billion

$28.4 billion

 

 

 

 

 

 

Net Margin

5.8%

5.8%

6.3%

6.0%

6.2%

  • UnitedHealth Group’s 2023 revenues grew $47.5 billion or 14.6% year-over-year to $371.6 billion, including double-digit growth at both Optum and UnitedHealthcare, driven by serving more people, more comprehensively across its offerings. Full year 2023 earnings from operations were $32.4 billion, an increase of 13.8%.
  • The full year medical care ratio at 83.2% compared to 82% last year, driven by previously noted outpatient care, primarily serving seniors, and business mix. The fourth quarter medical care ratio was 85%. Days claims payable of 47.9 compared to 49.9 at year end 2022 and 50.7 in the third quarter 2023. Medical reserve development was $840 million favorable for full year 2023 and $100 million unfavorable in the fourth quarter.
  • The full year 2023 operating cost ratio of 14.7% was consistent with last year, reflecting strong operating cost management, offset by continued growth of the services businesses and investments to support growth.
  • Cash flows from operations for the full year were $29.1 billion or 1.3-times net income. During 2023, the company returned $14.8 billion to shareholders through dividends and share repurchases. Return on equity of 27% in 2023 reflected the company’s strong overall growth and efficient capital structure.

UnitedHealthcare provides health care benefits globally, serving individuals and employers, and Medicare and Medicaid beneficiaries. UnitedHealthcare is dedicated to improving the value customers and consumers receive by improving health and wellness, enhancing the quality of care received, simplifying the health care experience and reducing the total cost of care.

Quarterly and Annual Financial Performance

 

 

Three Months Ended

Year Ended

 

December 31,

2023

December 31,

2022

September 30,

2023

December 31,

2023

December 31,

2022

Revenues

$70.8 billion

$63.0 billion

$69.9 billion

$281.4 billion

$249.7 billion

Earnings from Operations

$3.1 billion

$2.9 billion

$4.6 billion

$16.4 billion

$14.4 billion

 

 

 

 

 

 

Operating Margin

4.4%

4.7%

6.6%

5.8%

5.8%

  • UnitedHealthcare full year revenues of $281.4 billion grew $31.6 billion or 12.7% year-over-year and operating earnings increased 14.2% to $16.4 billion. People served by UnitedHealthcare grew by over 1 million in 2023.
  • The number of consumers served with commercial benefits grew by over 800,000 in 2023, reflecting the strong customer response to the company’s innovative and affordable benefit offerings.
  • The number of people served by the company’s offerings for seniors and people with complex needs grew by 950,000 due to product designs tailored to meet the specific needs of individuals and their families with limited economic resources and who are often underserved.
  • People served by the company’s state-based community offerings declined by 700,000 due to the ongoing Medicaid eligibility redetermination process. The UnitedHealthcare team remains actively engaged with the individuals impacted and continues with its comprehensive outreach to help families maintain, reinstate or find other affordable coverage.

Optum’s health services businesses serve the global health care marketplace, including payers, care providers, employers, governments, life sciences companies and consumers. Using market-leading information, analytics and technology to yield clinical insights, Optum helps improve overall health system performance by optimizing care quality, reducing care costs and improving the consumer experience.

Quarterly and Annual Financial Performance

 

 

Three Months Ended

Year Ended

 

December 31,

2023

December 31,

2022

September 30,

2023

December 31,

2023

December 31,

2022

Revenues

$59.5 billion

$47.9 billion

$56.7 billion

$226.6 billion

$182.8 billion

Earnings from Operations

$4.6 billion

$4.0 billion

$3.9 billion

$15.9 billion

$14.1 billion

 

 

 

 

 

 

Operating Margin

7.7%

8.3%

6.9%

7.0%

7.7%

  • Optum full year revenues of $226.6 billion grew $43.9 billion or 24% year-over-year and operating earnings increased 13.4% to $15.9 billion.
  • Optum Health revenue increased 33.9% over last year, driven by growth in patients served under value-based arrangements and continued expansion of the types and levels of care provided. The operating results reflect previously noted higher care activity and continued investments to improve patient health outcomes. The number of patients served under value-based arrangements grew by nearly 900,000 to more than 4.1 million.
  • Optum Insight revenue increased 29.8% due to the addition of Change Healthcare and growth in its technology-enabled offerings, which serve health systems, care providers, health plans and life sciences organizations. Optum Insight continues to build and invest in advanced data capabilities to meet the rising needs of customers. The revenue backlog increased by more than $2 billion to over $32 billion.
  • Optum Rx revenue increased 16.4% in 2023 due to growth in serving new clients, expanded relationships with existing clients and continued advancement in the comprehensive scope of pharmacy services offered, including specialty and community-based pharmacies. Adjusted scripts grew to 1.54 billion compared to 1.44 billion last year.

About UnitedHealth Group

UnitedHealth Group (NYSE: UNH) is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone through two distinct and complementary businesses. Optum delivers care aided by technology and data, empowering people, partners and providers with the guidance and tools they need to achieve better health. UnitedHealthcare offers a full range of health benefits, enabling affordable coverage, simplifying the health care experience and delivering access to high-quality care. Visit UnitedHealth Group at www.unitedhealthgroup.com and follow UnitedHealth Group on LinkedIn.

Earnings Conference Call

As previously announced, UnitedHealth Group will discuss the Company’s results, strategy and future outlook on a conference call with investors at 8:45 a.m. Eastern Time today. UnitedHealth Group will host a live webcast of this conference call from the Investor Relations page of the company’s website (www.unitedhealthgroup.com). Following the call, a webcast replay will be on the Investor Relations page and at https://uhg.com/Replay through January 26, 2024. This earnings release and the Form 8-K dated January 12, 2024, can also be accessed from the Investor Relations page of the company’s website.

Non-GAAP Financial Information

This news release presents non-GAAP financial information provided as a complement to the results provided in accordance with accounting principles generally accepted in the United States of America (“GAAP”). A reconciliation of the non-GAAP financial information to the most directly comparable GAAP financial measure is provided in the accompanying tables found at the end of this release.

Forward-Looking Statements

The statements, estimates, projections, guidance or outlook contained in this document include “forward-looking” statements which are intended to take advantage of the “safe harbor” provisions of the federal securities law. The words “believe,” “expect,” “intend,” “estimate,” “anticipate,” “forecast,” “outlook,” “plan,” “project,” “should” and similar expressions identify forward-looking statements. These statements may contain information about financial prospects, economic conditions and trends and involve risks and uncertainties. Actual results could differ materially from those that management expects, depending on the outcome of certain factors including: our ability to effectively estimate, price for and manage medical costs; new or changes in existing health care laws or regulations, or their enforcement or application; reductions in revenue or delays to cash flows received under government programs; changes in Medicare, the CMS star ratings program or the application of risk adjustment data validation audits; the DOJ’s legal action relating to the risk adjustment submission matter; our ability to maintain and achieve improvement in quality scores impacting revenue; failure to maintain effective and efficient information systems or if our technology products do not operate as intended; cyberattacks, other privacy/data security incidents, or our failure to comply with related regulations; risks and uncertainties associated with our businesses providing pharmacy care services; competitive pressures, including our ability to maintain or increase our market share; changes in or challenges to our public sector contract awards; failure to achieve targeted operating cost productivity improvements; failure to develop and maintain satisfactory relationships with health care payers, physicians, hospitals and other service providers; the impact of potential changes in tax laws and regulations; increases in costs and other liabilities associated with litigation, government investigations, audits or reviews; failure to complete, manage or integrate strategic transactions; risk and uncertainties associated with the pending sale of operations in Brazil; risks associated with public health crises arising from large-scale medical emergencies, pandemics, natural disasters and other extreme events; failure to attract, develop, retain, and manage the succession of key employees and executives; our investment portfolio performance; impairment of our goodwill and intangible assets; failure to protect proprietary rights to our databases, software and related products; downgrades in our credit ratings; and our ability to obtain sufficient funds from our regulated subsidiaries or from external financings to fund our obligations, maintain our debt to total capital ratio at targeted levels, maintain our quarterly dividend payment cycle, or continue repurchasing shares of our common stock.

This above list is not exhaustive. We discuss these matters, and certain risks that may affect our business operations, financial condition and results of operations, more fully in our filings with the SEC, including our reports on Forms 10-K, 10-Q and 8-K. By their nature, forward-looking statements are not guarantees of future performance or results and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Actual results may vary materially from expectations expressed or implied in this document or any of our prior communications. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made. We do not undertake to update or revise any forward-looking statements, except as required by law.

UNITEDHEALTH GROUP
 
Earnings Release Schedules and Supplementary Information
Year Ended December 31, 2023
 
- Condensed Consolidated Statements of Operations
 
- Condensed Consolidated Balance Sheets
 
- Condensed Consolidated Statements of Cash Flows
 
- Supplemental Financial Information - Businesses
 
- Supplemental Financial Information - Business Metrics
 
- Reconciliation of Non-GAAP Financial Measure
UNITEDHEALTH GROUP
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(in millions, except per share data)
(unaudited)
 
Three Months Ended

December 31,
Year Ended

December 31,

2023

2022

2023

2022

Revenues
Premiums

$

73,228

 

$

64,700

 

$

290,827

 

$

257,157

 

Products

 

11,311

 

 

9,398

 

 

42,583

 

 

37,424

 

Services

 

8,709

 

 

7,834

 

 

34,123

 

 

27,551

 

Investment and other income

 

1,179

 

 

855

 

 

4,089

 

 

2,030

 

 
Total revenues

 

94,427

 

 

82,787

 

 

371,622

 

 

324,162

 

 
Operating costs
Medical costs

 

62,231

 

 

53,591

 

 

241,894

 

 

210,842

 

Operating costs

 

13,339

 

 

13,009

 

 

54,628

 

 

47,782

 

Cost of products sold

 

10,194

 

 

8,314

 

 

38,770

 

 

33,703

 

Depreciation and amortization

 

974

 

 

982

 

 

3,972

 

 

3,400

 

 
Total operating costs

 

86,738

 

 

75,896

 

 

339,264

 

 

295,727

 

 
Earnings from operations

 

7,689

 

 

6,891

 

 

32,358

 

 

28,435

 

 
Interest expense

 

(830

)

 

(676

)

 

(3,246

)

 

(2,092

)

 
Earnings before income taxes

 

6,859

 

 

6,215

 

 

29,112

 

 

26,343

 

 
Provision for income taxes

 

(1,184

)

 

(1,307

)

 

(5,968

)

 

(5,704

)

 
Net earnings

 

5,675

 

 

4,908

 

 

23,144

 

 

20,639

 

 
Earnings attributable to noncontrolling interests

 

(220

)

 

(147

)

 

(763

)

 

(519

)

 
Net earnings attributable to UnitedHealth Group common shareholders

$

5,455

 

$

4,761

 

$

22,381

 

$

20,120

 

 
Diluted earnings per share attributable to UnitedHealth Group common shareholders

$

5.83

 

$

5.03

 

$

23.86

 

$

21.18

 

 
Adjusted earnings per share attributable to UnitedHealth Group common shareholders (a)

$

6.16

 

$

5.34

 

$

25.12

 

$

22.19

 

 
Diluted weighted-average common shares outstanding

 

935

 

 

947

 

 

938

 

 

950

 

 

(a) See page 6 for a reconciliation of the non-GAAP measure

UNITEDHEALTH GROUP
CONDENSED CONSOLIDATED BALANCE SHEETS
(in millions)
(unaudited)
 

December 31,

December 31,

2023

2022

Assets
Cash and short-term investments

$

29,628

$

27,911

Accounts receivable, net

 

21,276

 

17,681

Other current assets

 

27,533

 

23,477

 
Total current assets

 

78,437

 

69,069

 
Long-term investments

 

47,609

 

43,728

Other long-term assets

 

147,674

 

132,908

 
Total assets

$

273,720

$

245,705

 
 
Liabilities, redeemable noncontrolling interests and equity
Medical costs payable

$

32,395

$

29,056

Short-term borrowings and current maturities of long-term debt

 

4,274

 

3,110

Other current liabilities

 

62,385

 

57,071

 
Total current liabilities

 

99,054

 

89,237

 
Long-term debt, less current maturities

 

58,263

 

54,513

Other long-term liabilities

 

17,484

 

15,608

Redeemable noncontrolling interests

 

4,498

 

4,897

Equity

 

94,421

 

81,450

Total liabilities, redeemable noncontrolling interests and equity

$

273,720

$

245,705

UNITEDHEALTH GROUP
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(in millions)
(unaudited)
 

Year Ended

December 31,

2023

2022

Operating Activities
Net earnings

$

23,144

 

$

20,639

 

Noncash items:
Depreciation and amortization

 

3,972

 

 

3,400

 

Deferred income taxes and other

 

(750

)

 

(1,004

)

Share-based compensation

 

1,059

 

 

925

 

Net changes in operating assets and liabilities

 

1,643

 

 

2,246

 

 
Cash flows from operating activities

 

29,068

 

 

26,206

 

 
Investing Activities
Purchases of investments, net of sales and maturities

 

(1,777

)

 

(6,837

)

Purchases of property, equipment and capitalized software

 

(3,386

)

 

(2,802

)

Cash paid for acquisitions, net

 

(10,136

)

 

(21,458

)

Other, net

 

(275

)

 

2,621

 

 
Cash flows used for investing activities

 

(15,574

)

 

(28,476

)

 
Financing Activities
Common share repurchases

 

(8,000

)

 

(7,000

)

Dividends paid

 

(6,761

)

 

(5,991

)

Net change in short-term borrowings and long-term debt

 

4,280

 

 

12,536

 

Other, net

 

(1,048

)

 

4,681

 

 
Cash flows (used for) from financing activities

 

(11,529

)

 

4,226

 

 
Effect of exchange rate changes on cash and cash equivalents

 

97

 

 

34

 

 
Increase in cash and cash equivalents

 

2,062

 

 

1,990

 

 
Cash and cash equivalents, beginning of period

 

23,365

 

 

21,375

 

 
Cash and cash equivalents, end of period

$

25,427

 

$

23,365

 

UNITEDHEALTH GROUP

SUPPLEMENTAL FINANCIAL INFORMATION - BUSINESSES

(in millions, except percentages)

(unaudited)

 
Three Months Ended

December 31,
Year Ended

December 31,

2023

2022

2023

2022

Revenues
UnitedHealthcare

$

70,808

 

$

63,046

 

$

281,360

 

$

249,741

 

Optum

 

59,495

 

 

47,868

 

 

226,635

 

 

182,768

 

Eliminations

 

(35,876

)

 

(28,127

)

 

(136,373

)

 

(108,347

)

 
Total consolidated revenues

$

94,427

 

$

82,787

 

$

371,622

 

$

324,162

 

 
Earnings from Operations
UnitedHealthcare

$

3,122

 

$

2,932

 

$

16,415

 

$

14,379

 

Optum (a)

 

4,567

 

 

3,959

 

 

15,943

 

 

14,056

 

 
Total consolidated earnings from operations

$

7,689

 

$

6,891

 

$

32,358

 

$

28,435

 

 
Operating Margin
UnitedHealthcare

 

4.4

%

 

4.7

%

 

5.8

%

 

5.8

%

Optum

 

7.7

%

 

8.3

%

 

7.0

%

 

7.7

%

Consolidated operating margin

 

8.1

%

 

8.3

%

 

8.7

%

 

8.8

%

 
 
Revenues
UnitedHealthcare Employer & Individual - Domestic

$

17,030

 

$

16,281

 

$

67,187

 

$

63,599

 

UnitedHealthcare Employer & Individual - Global

 

2,402

 

 

2,168

 

 

9,307

 

 

8,668

 

UnitedHealthcare Employer & Individual - Total

 

19,432

 

 

18,449

 

 

76,494

 

 

72,267

 

UnitedHealthcare Medicare & Retirement

 

32,394

 

 

28,051

 

 

129,862

 

 

113,671

 

UnitedHealthcare Community & State

 

18,982

 

 

16,546

 

 

75,004

 

 

63,803

 

 
Optum Health

$

24,534

 

$

18,446

 

$

95,319

 

$

71,174

 

Optum Insight

 

4,785

 

 

4,387

 

 

18,932

 

 

14,581

 

Optum Rx

 

31,166

 

 

25,854

 

 

116,087

 

 

99,773

 

Optum Eliminations

 

(990

)

 

(819

)

 

(3,703

)

 

(2,760

)

(a) Earnings from operations for Optum for the three months and year ended December 31, 2023 included $1,691 and $6,560 for Optum Health; $1,284 and $4,268 for Optum Insight; and $1,592 and $5,115 for Optum Rx, respectively. Earnings from operations for Optum for the three months and year ended December 31, 2022 included $1,692 and $6,032 for Optum Health; $895 and $3,588 for Optum Insight; and $1,372 and $4,436 for Optum Rx, respectively.
UNITEDHEALTH GROUP
SUPPLEMENTAL FINANCIAL INFORMATION - BUSINESS METRICS
 
UNITEDHEALTHCARE CUSTOMER PROFILE
(in thousands)
 
People Served December 31, 2023 September 30, 2023 December 31, 2022
 
Commercial - Domestic:
Risk-based

 

8,115

 

8,120

 

8,045

Fee-based

 

19,200

 

19,130

 

18,640

 
Total Commercial - Domestic

 

27,315

 

27,250

 

26,685

 
Medicare Advantage

 

7,695

 

7,645

 

7,105

Medicaid

 

7,845

 

8,065

 

8,170

Medicare Supplement (Standardized)

 

4,355

 

4,345

 

4,375

 
Total Community and Senior

 

19,895

 

20,055

 

19,650

Total UnitedHealthcare - Domestic Medical

 

47,210

 

47,305

 

46,335

 
Commerical - Global

 

5,540

 

5,475

 

5,360

 
Total UnitedHealthcare - Medical

 

52,750

 

52,780

 

51,695

 
 
Supplemental Data
 
Medicare Part D stand-alone

 

3,315

 

3,335

 

3,295

 
 
 
OPTUM PERFORMANCE METRICS
 
December 31, 2023 September 30, 2023 December 31, 2022
 
Optum Health Consumers Served (in millions)

 

103

 

103

 

102

Optum Insight Contract Backlog (in billions)

$

32.1

$

31.6

$

30.0

Optum Rx Quarterly Adjusted Scripts (in millions)

 

400

 

383

 

370

 
 
Note: UnitedHealth Group served 152 million unique individuals across all businesses at December 31, 2023.
UNITEDHEALTH GROUP
RECONCILIATION OF NON-GAAP FINANCIAL MEASURE
(in millions, except per share data)
(unaudited)
 
ADJUSTED NET EARNINGS PER SHARE(a)
 

Three Months Ended

December 31,

Year Ended

December 31,

2023

2022

2023

2022

GAAP net earnings attributable to UnitedHealth Group common shareholders

$

5,455

 

$

4,761

 

$

22,381

 

$

20,120

 

Intangible amortization

 

400

 

 

396

 

 

1,578

 

 

1,292

 

Tax effect of intangible amortization

 

(100

)

 

(98

)

 

(392

)

 

(331

)

Adjusted net earnings attributable to UnitedHealth Group common shareholders

$

5,755

 

$

5,059

 

$

23,567

 

$

21,081

 

 
GAAP diluted earnings per share

$

5.83

 

$

5.03

 

$

23.86

 

$

21.18

 

Intangible amortization per share

 

0.44

 

 

0.42

 

 

1.68

 

 

1.36

 

Tax effect per share of intangible amortization

 

(0.11

)

 

(0.11

)

 

(0.42

)

 

(0.35

)

Adjusted diluted earnings per share

$

6.16

 

$

5.34

 

$

25.12

 

$

22.19

 

 

(a)

Adjusted net earnings per share is a non-GAAP financial measure. Non-GAAP financial measures should be considered in addition to, but not as a substitute for, or superior to, financial measures prepared in accordance with GAAP.

 

 

Adjusted net earnings per share excludes from the relevant GAAP metric, as applicable, intangible amortization and other items, if any, that do not relate to the Company's underlying business performance. Management believes that the use of adjusted net earnings per share provides investors and management useful information about the earnings impact of acquisition-related intangible asset amortization. As amortization fluctuates based on the size and timing of the Company’s acquisition activity, management believes this exclusion provides a more useful comparison of the Company's underlying business performance and trends from period to period. While intangible assets contribute to the Company’s revenue generation, the intangible amortization is not directly related. Therefore, the related revenues are included in adjusted earnings per share.

 

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