UnitedHealth Group Reports First Quarter 2024 Results

UnitedHealth Group (NYSE: UNH) reported first quarter 2024 results reflecting broad-based growth at Optum and UnitedHealthcare, medical care activity consistent with expectations and the impact of the recent cyberattack on Change Healthcare.

"The core story at UnitedHealth Group remains our colleagues delivering improved experiences for the people we serve and driving balanced growth even while swiftly and effectively addressing the attack on Change Healthcare," said Andrew Witty, chief executive officer of UnitedHealth Group.

The company continues to make significant progress in restoring the affected Change Healthcare services while providing financial support to impacted health care providers. To date, the company has provided over $6 billion in advance funding and interest-free loans to support care providers in need.

Total cyberattack impacts in the first quarter amounted to $0.74 per share and the company estimates full year 2024 impacts of $1.15 to $1.35 per share. In the first quarter, this included $0.49 per share to support direct response efforts such as the Change Healthcare clearinghouse platform restoration and increased medical care expenditures as the company suspended some care management activities to help care providers with their workflow processes. The company estimates direct response costs of $0.85 to $0.95 per share for full year 2024. Direct response costs are included in net earnings and excluded from adjusted earnings per share. Additionally, Change Healthcare business disruption impacts, reflecting lost revenue and the costs of maintaining full readiness of the affected Change Healthcare services, were $0.25 per share in the first quarter. The company currently estimates $0.30 to $0.40 per share business disruption impact for full year 2024. These business disruption impacts are included in both net earnings and adjusted earnings per share.

As reported previously, the company recorded an approximately $7 billion charge in the quarter due to the sale of its Brazil operations, the majority of which was noncash and due to the cumulative impact of foreign currency translation losses.

The company updated its full year 2024 net earnings outlook to $17.60 to $18.20 per share to reflect the Brazil sale and the estimated direct response costs of the cyberattack. The company maintained its adjusted net earnings outlook of $27.50 to $28.00 per share. This adjusted earnings per share outlook excludes the impacts of the direct response costs and Brazil sale, while including the estimated $0.30 to $0.40 per share of business disruption impacts for the affected Change Healthcare services.

• UnitedHealth Group's first quarter 2024 revenues grew nearly $8 billion year over year to $99.8 billion. First quarter earnings from operations were $7.9 billion, including $872 million in unfavorable cyberattack effects. Adjusted earnings from operations of $8.5 billion include the Change Healthcare business disruption impacts and exclude the cyberattack direct response costs. Growth was led by a strong expansion in the number of people served at Optum and UnitedHealthcare.
• The company did not reflect any favorable earnings impacting medical reserve development in the quarter. Out of prudence, due to the potential for the cyberattack to affect claims receipt timing, the company reflected an additional $800 million of claims reserves.
• Days claims payable of 47.1 compared to 47.9 in fourth quarter 2023 and 47.8 in first quarter 2023. Within this, the acceleration of payments to care providers and the Brazil sale reduced reported days claims payable by three days. The company's medical costs payable balance increased $1.6 billion from year-end 2023 to $34 billion. The change was due to a $3 billion increase in the incurred but not yet reported (IBNR) component of this balance in part to prudently accommodate the related ongoing claims receipt assessment, partially offset by a reduction in the fully processed claims component due to accelerated care provider claims payments.
• Overall care patterns in the first quarter were consistent with the company's expectations. The first quarter 2024 medical care ratio at 84.3% included 40 basis points of impact due to accommodations to support care providers. The increase from the prior year 82.2% was due to the previously noted revenue effects of the Medicare funding reductions, considerations driven by the Change Healthcare cyberattack, including accommodations to support care providers, medical reserve and development effects, and business mix.
• The first quarter 2024 operating cost ratio of 14.1% included approximately 30 basis points of impact due to costs incurred to support the company's direct response efforts. The result compared to 14.8% in 2023, reflecting strong operating cost management, partially offset by continued growth of the services businesses and investments to support growth.
• Cash flows from operations from the first quarter 2024 were $1.1 billion and were affected by approximately $3 billion due to the company's cyberattack response actions, including funding acceleration to care providers, and were additionally impacted due to the timing of public sector cash receipts. The company returned $4.8 billion to shareholders in the first quarter through dividends and share repurchases.

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.

• UnitedHealthcare first quarter revenues of $75.4 billion increased nearly $5 billion over the prior year reflecting growth in the number of people served domestically. Operating earnings were $4.4 billion and adjusted operating earnings were $4.6 billion.
• UnitedHealthcare total domestic consumers served grew by nearly 2 million in the first quarter 2024, led by commercial and senior, offset by expected member attrition in Medicaid due to ongoing eligibility redeterminations. Growth across the UnitedHealthcare portfolio reflects strong customer response to the company's innovative and affordable benefit offerings.
• The number of consumers served with domestic commercial offerings grew in the first quarter 2024 to 29.4 million. This growth reflects recognition among the employer and individual markets of UnitedHealthcare's diverse and innovative product portfolio that drives affordability and consumer ease.
• The total number of people served by the company's offerings for seniors and people with complex needs grew to 9.4 million. UnitedHealthcare offerings feature product designs tailored to meet the specific needs of people with limited economic resources and who are often underserved. Unique offerings, such as integrated card and simplified transportation offerings, led to a significant increase in member engagement and greater consumer satisfaction.
• Total people served by the company's state-based community offerings moderated to 7.7 million, with the year-over-year change due to the ongoing Medicaid eligibility redetermination process. The UnitedHealthcare team is continuing its comprehensive outreach to help families maintain, reinstate or find other affordable coverage. During the first quarter, UnitedHealthcare was selected to provide expanded care services in Texas and to continue providing services in Virginia and Michigan, with the additional support commencing in 2025.
  

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.

• Optum first quarter revenues of $61 billion grew $7 billion. The growth was led by Optum Health and Optum Rx due to continued strong expansion in the number of people served. Operating earnings were $3.5 billion and adjusted earnings were $3.9 billion. Adjusted operating earnings exclude costs to support the direct Change Healthcare response efforts. Operating earnings and adjusted operating earnings include $279 million in business disruption impacts at Change Healthcare.
• Optum Health revenue increased 16% over last year, driven by growth in the number of patients served under value-based care offerings and continued expansion of the types and level of care provided. Operating earnings were $1.9 billion and adjusted operating earnings were $2 billion. Optum Health continued to advance and deepen its clinical support for patients, including those with complex medical needs, through virtual, in-home, and in-clinic engagement.
• Optum Insight first quarter operating earnings were $490 million and adjusted operating earnings, which exclude direct response costs, were $715 million. Operating earnings and adjusted operating earnings include the $279 million of Change Healthcare business disruption impacts. The revenue backlog grew by over $2 billion compared to the year ago quarter, bringing backlog to nearly $33 billion, reflecting new health system partnerships.
• Optum Rx revenue increased 12% in the first quarter due to growth in serving new customers, 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 395 million compared to 378 million 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 April 30, 2024. This earnings release and the Form 8-K dated April 16, 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 laws. 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; cyberattacks, other privacy/data security incidents, or our failure to comply with related regulations; 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; 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; 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, reinvest in our business, 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.

• Condensed Consolidated Statements of Operations
• Condensed Consolidated Balance Sheets
• Condensed Consolidated Statements of Cash Flows
• Revenues by Business - Supplemental Financial Information
• Earnings by Business - Supplemental Financial Information
• People Served and Performance Metrics - Supplemental Financial Information
• Reconciliation of Non-GAAP Financial Measures