UnitedHealth $UNH Group reported first-quarter 2026 results that beat Wall Street expectations and lifted its full-year profit forecast, as the company improved its management of medical costs and streamlined operations.
Full-year adjusted earnings guidance was lifted to greater than $18.25 per share for 2026, compared with the previous forecast of greater than $17.75 per share. Adjusted earnings came to $7.23 per share for the quarter, well ahead of the $6.57 per share consensus estimate from analysts surveyed by LSEG, as reported by Reuters. UnitedHealth is maintaining its full-year revenue guidance of more than $439 billion.
First-quarter consolidated revenue came in at $111.72 billion, up from $109.58 billion in the year-ago period. Net income for the quarter totaled $6.28 billion, translating to $6.90 per share — nearly unchanged from the year-ago figure of $6.29 billion, or $6.85 per share. Earnings from operations reached $9.0 billion, and cash flows from operations were $8.9 billion.
A key measure of insurance profitability also improved. At 83.9%, the medical benefit ratio — which tracks what portion of premium revenue is consumed by care costs — improved by nearly a full percentage point relative to the 84.8% recorded in the same period last year. Analysts had expected a ratio of 85.5%, according to CNBC. Driving the favorable ratio were disciplined cost controls and the unwinding of reserves previously held against money-losing Optum contracts; however, UnitedHealth cautioned that persistently high medical costs weighed against those gains, describing them as "consistently elevated."
The Optum health services unit was a drag on results. Within Optum, a drop in coordinated care plan enrollment pushed quarterly revenue down slightly to $24.1 billion, while operating income contracted 15% to $3.3 billion. Revenue at Optum Rx, UnitedHealth's pharmacy benefit manager, rose 2% to $35.7 billion. The company said the enrollment decline was deliberate, reflecting the exit from less favorable contracts.
Speaking on the Medicaid side, DeVeydt indicated a projected loss of roughly 1.3 million members, though attrition is running slightly below initial expectations. On the broader earnings outlook, he told analysts the company prefers to hold its guidance conservatively until there is greater clarity on whether cost patterns hold through the spring, according to Reuters.
"We are continuing to help simplify and modernize health care for the people and care providers we serve, bringing greater value, affordability, transparency and connectivity," CEO Stephen Hemsley said in a statement.
UnitedHealth stock rose almost 6% in premarket trading following the release.