UNH
UnitedHealth Group
Dividend / Cash flow
★ Quality 52/100Price today
$397.14
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What this business is made of
The business
Almost every dollar the US spends on healthcare passes through its register.
UnitedHealth insures around 50 million people through UnitedHealthcare and, with Optum, runs pharmacies, clinics, and patient data. It collects monthly premiums on insurance and fees on Optum's services. It bills $447.6B a year.
It's vertically integrated: insurer, owner of doctors, prescription manager, and owner of the data, all at once. That combination lets it see costs and negotiate prices like no one else. Replicating the four pieces together would take decades and enormous capital.
Revenue history
From $287.6B to $447.6B in 4 years. The business grows steadily.
Where each $100 of sales goes
Revenue $447.6B · FY2025
Of every $100 in sales, $97 goes to costs and operations; $3 is left as net profit (3% margin).
Catalysts and risks
Normalization of medical costs after a 2025 with runaway spending.
Optum grows faster than insurance and already contributes a good chunk of the flow.
US aging pushes enrollment in Medicare Advantage.
FY2025 hit hard: medical costs rose faster than premiums.
Political and regulatory pressure on prescription managers and Medicare Advantage.
Government investigations and the aftermath of the 2024 Change Healthcare cyberattack.
Charlie's note
“Paying 18 times flow for a business growing 12% with 89% margins is no extravagance. 2025 was truly ugly; the whole thesis rides on whether medical costs return to normal.”
Analysis · July 2026
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