Oct 13, 2026 earnings call — Modernizing Optum and Medicare Advantage focus
Reported Q3 revenue of $113 billion and adjusted EPS of $4.69.
Revenue $112.7B (est $111.3B) · EPS $4.69 (est $4.14)
Key quotes
"Across the businesses, AI-enabled capabilities are beginning to help clinicians spend more time with patients, improve service speed and experience, streamline administration, and reduce friction for both consumers and clinicians."
"More than 94% of Medicare-eligible individuals nationwide will have access to a UnitedHealthcare Medicare plan, and approximately 90% of Medicare-eligible consumers will have access to one of our Medicare Advantage plans with a $0 premium option."
"As we previously noted, trends for commercial benefits are exceeding our initial expectations of 11%, driven by an acceleration of costs related to the No Surprises Act, greater cost intensity from clinicians, and high-cost specialty drugs."
Analyst Q&A 13
Medicaid trends and MA margins
Q (Justin Lake · Wolfe): Analyst asked about Medicaid performance in Q3 and whether it's back to break even, and asked where Medicare Advantage margins sit for 2026.
A: Mike said membership and performance are within expectations and that full 2026 performance is now expected moderately better than their forecasted range. He named drivers like complex care cost management, AI coaching, and removing fraud, waste, and abuse, and said Q3 showed good improvement that they expect to continue. Bobby said Medicare Advantage is pacing near the top end of the 2%-4% range because of recovery actions and cost management.
"We did see good improvement in Q3, and we believe that will continue on for the rest of the year." — Mike
2027 growth in MA and PBM selling seasons
Q (Lance Wilkes · Bernstein): Analyst asked how United is approaching 2027 growth in Medicare Advantage as they near the top of their range, and how national account and PBM selling seasons are progressing.
A: Bobby said they expanded footprint so over 94% of Medicare eligibles now have access to a United plan, and they are focused on D-SNP, C-SNP, and high-value HMOs as growth areas. Brandon said national account sales and retention look very strong going into 2027, and John said PBM retention is in the high 90s with membership now north of 50% of covered lives.
"Now more than 94% of American eligibles for Medicare have access to one of our plan offerings." — Bobby
Top-line color for Health and Insight
Q (Stephen Baxter · Wells Fargo): Analyst asked for color on top-line dynamics for Optum Health and Optum Insight and how they are being repositioned for growth into 2028 and beyond.
A: Steve said they would start the response with Krista and then Sandeep, indicating separate detailed answers would follow from those executives.
"We'll start out with Krista, and then we'll go to Sandeep." — Steve Hemsley (CEO·CHAIR)
Optum Health and Insight growth plans
Q (Krista): Analyst wanted detail on how Optum Health and Optum Insight are being repositioned for growth and what to expect longer term.
A: Krista said Optum Health had strong Q3 clinical performance, is improving inpatient and home care access, and sees growth opportunities from expanding fully accountable relationships, high-performing service lines, and new products like post-acute risk management; she called this a multi-year journey toward a 6%-8% target margin by 2028. Sandeep said Optum Insight is a multi-year AI investment, rationalizing products, infusing AI, and launching AI-first offerings, citing accelerating client adoption of new AI products and partnerships with Anthropic, Microsoft, and Google.
Commercial risk margin recovery and IDR effect
Q (A.J. Rice · UBS): Analyst asked about pacing of margin recovery in the commercial risk business and whether the IDR issues are stabilizing.
A: Tim said medical cost trends in commercial are stabilizing but remain high and they priced 2027 rationally expecting trends to persist. He warned that elevated utilization will stretch out the timing to reach long-term margin objectives and said more detail will come in a couple months.
"As we priced for 2027, we took the view that we would see these trends continue and persist into 2027 and priced rationally, consistent with all of that." — Tim Noel
MA competitiveness and membership outlook
Q (Ann Hynes · Mizuho): Analyst asked how United views its competitiveness on benefits versus peers and whether it can deliver membership growth next year.
A: Bobby said they will not give specific guidance now but took a deliberate approach investing in benefits and products to stabilize and grow. He emphasized focus on D-SNP, C-SNP, and HMO plans and said they see opportunity to capture growth in those areas as they modernize.
"Think about that again in the context of our D-SNP, our C-SNP, and our HMO plans." — Bobby
Trend acceleration and 2027 pricing
Q (Kevin Fischbeck · BofA): Analyst asked if trends are accelerating through the year and whether 2027 pricing is being set to exit-rate trends.
A: Tim said they are not seeing the trend acceleration described; commercial is stabilizing but still tracking north of 11%, and government program trends are moderating. He said they are using better analytics and real-time information to set forward pricing and are not seeing the elevated acceleration referenced.
"In fact, we are seeing some moderation in the government programs business and stabilization in the commercial business." — Tim Noel
Medicaid margins and OBBB reforms
Q (Scott Fidel · Goldman Sachs): Analyst asked how cyclical Medicaid margin recovery and the rollout of OBBB reforms from 2027–2030 will offset each other and what reasonable margins might average.
A: Mike said Medicaid is likely to go through a cyclical process and they expect improvement driven by clinical care management, cost management, and AI tools, with an opportunity to return to rate at margins in 2028. Tim said their goal is to get back to those margins and remain there through 2030, and that Medicaid remains a durable market long term.
"We think there is an opportunity to get back to rate at margins in 2028." — Mike
Specialty pharmacy, infusion, biosimilars, integration
Q (Lisa Gill · JPMorgan): Analyst asked about infusion capabilities, opportunities in biosimilars, and how medical and pharmacy are integrated for external clients.
A: Patrick said they are increasingly aligning specialty pharmacy with care delivery and clinicians, and that infusion is a lower-cost, more convenient setting payers want to grow. John said specialty pharmacy volumes were up 2.6% this quarter, driven by provider choice, therapeutic centers of excellence (15), and strong consumer experience; Patrick added robust biosimilar uptake and that their specialty distribution is working well, with close collaboration between clinicians and pharmacies to provide integrated care.
"If you look at overall volumes, while volumes might have been down 5% for the quarter, specialty volumes actually up 2.6% for the quarter, and that's driven by a couple of initiatives." — John
Optum Health margins and long-term upside
Q (Erin Wright · Morgan Stanley): Analyst asked where Optum Health margins may land in 2027 relative to 6%-8% and whether automation/AI could push margins above that range long term.
A: Krista said core performance improvements in 2026, including Q3, are durable and will contribute to a positive 2027 outlook. She expects 2027 to show a strong pace toward reaching the 6%-8% target by 2028 and sees further opportunities beyond that, though they will provide more detail later.
"Again, I think 2027 is a year where we'll see a strong pace towards that 6%-8% by 2028." — Krista
Optum Health Q4 seasonality and investments
Q (Andrew Mok · Barclays): Analyst asked why Optum Health guidance implies a meaningfully negative fourth quarter and to quantify 4Q investments affecting EBIT.
A: Krista said Q4 reflects normal risk seasonality for the business plus additional investments for long-term performance, including technology, AI, and clinician workflow improvements. She described investments like AI-enabled care summaries, ambient next-best-action insights, and scheduling work to enable durable long-term performance, while noting Q3 performance will be durable into Q4.
"I mentioned the third quarter performance will be durable into the fourth quarter, but fourth quarter does reflect risk seasonality, which is normal course for this business and some additional investments that we are making for long term performance." — Krista
IDR process and CMS modernization
Q (Matthew Gillmor · KeyBanc): Analyst asked how the IDR/dispute resolution process and CMS modernization should evolve to be constructive for the system.
A: Tim said they support the spirit of the law but have issues with the IDR dispute resolution outcomes and inefficiencies, noting awards multiple times Medicare in some instances and the associated costs. Bobby said they support thoughtful modernization and have proposed ideas around quality, payment, affordability, administrative efficiency, and tech interoperability, stressing broad stakeholder engagement and program stability.
"So our issue with the IDR process relates specifically to the dispute resolution and the inefficiencies of it, the cost associated with it, and the outcomes that it is resulting in generating." — Tim Noel
Stars investments and broker strategy
Q (Ryan Langston · TD Cowen): Analyst asked for detail on the size and types of investments in the Stars program and on broker strategy for open enrollment.
A: Bobby said they executed well on controllables and improved nearly every HEDIS and Rx measure year-over-year, and they will continue to accelerate investments in quality and Stars into Q4 2026 and 2027. He added the broker and marketing strategies are more dynamic and aligned to capture growth in D-SNP, C-SNP, and HMO areas while maintaining base stability.
"Think of our continued investment in 2026, Q4 and into 2027 as continuing to accelerate, not slow down, given the criticality of quality and Stars to the overall business." — Bobby