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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
__________________________________________________________ 
FORM 10-Q
__________________________________________________________ 
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 2024
or
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from _______ to _______
Commission File Number: 1-10864
__________________________________________________________ 
UHG(R)_CMYK.jpg
UnitedHealth Group Incorporated
(Exact name of registrant as specified in its charter)
 __________________________________________________________ 
Delaware 41-1321939
(State or other jurisdiction of
incorporation or organization)
 (I.R.S. Employer
Identification No.)
UnitedHealth Group Center 55343
9900 Bren Road East
Minnetonka,
Minnesota
(Address of principal executive offices) (Zip Code)
(952) 936-1300
(Registrant’s telephone number, including area code)
_________________________________________________________  
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $.01 par valueUNHNew York Stock Exchange
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes No
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes  No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act
Large accelerated filerAccelerated filer
Non-accelerated filer
Smaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes No 
As of April 30, 2024, there were 920,385,075 shares of the registrant’s Common Stock, $.01 par value per share, issued and outstanding.



UNITEDHEALTH GROUP
Table of Contents
 
  Page




PART I
ITEM 1.    FINANCIAL STATEMENTS
UnitedHealth Group
Condensed Consolidated Balance Sheets
(Unaudited)
(in millions, except per share data)March 31,
2024
December 31,
2023
Assets
Current assets:
Cash and cash equivalents$28,414 $25,427 
Short-term investments4,296 4,201 
Accounts receivable, net27,197 21,276 
Other current receivables, net19,284 17,694 
Assets under management3,619 3,755 
Prepaid expenses and other current assets6,132 6,084 
Total current assets88,942 78,437 
Long-term investments45,928 47,609 
Property, equipment and capitalized software, net
10,429 11,450 
Goodwill105,664 103,732 
Other intangible assets, net15,543 15,194 
Other assets17,704 17,298 
Total assets$284,210 $273,720 
Liabilities, redeemable noncontrolling interests and equity
Current liabilities:
Medical costs payable$34,032 $32,395 
Accounts payable and accrued liabilities30,738 31,958 
Short-term borrowings and current maturities of long-term debt9,787 4,274 
Unearned revenues3,206 3,355 
Other current liabilities26,668 27,072 
Total current liabilities104,431 99,054 
Long-term debt, less current maturities63,850 58,263 
Deferred income taxes4,167 3,021 
Other liabilities14,844 14,463 
Total liabilities187,292 174,801 
Redeemable noncontrolling interests4,548 4,498 
Equity:
Preferred stock, $0.001 par value - 10 shares authorized; no shares issued or outstanding
  
Common stock, $0.01 par value - 3,000 shares authorized; 920 and 924 issued and outstanding
9 9 
Retained earnings90,118 95,774 
Accumulated other comprehensive loss(3,439)(7,027)
Nonredeemable noncontrolling interests
5,682 5,665 
Total equity92,370 94,421 
Total liabilities, redeemable noncontrolling interests and equity$284,210 $273,720 
See Notes to the Condensed Consolidated Financial Statements
1

Table of Contents
UnitedHealth Group
Condensed Consolidated Statements of Operations
(Unaudited)
 Three Months Ended
March 31,
(in millions, except per share data)20242023
Revenues:
Premiums$77,988 $72,786 
Products11,909 10,267 
Services8,888 8,080 
Investment and other income1,011 798 
Total revenues99,796 91,931 
Operating costs:
Medical costs65,735 59,845 
Operating costs14,077 13,625 
Cost of products sold11,056 9,405 
Depreciation and amortization997 970 
Total operating costs91,865 83,845 
Earnings from operations7,931 8,086 
Interest expense(844)(754)
Loss on sale of subsidiary(7,086) 
Earnings before income taxes1 7,332 
Provision for income taxes(1,222)(1,558)
Net (loss) earnings(1,221)5,774 
Earnings attributable to noncontrolling interests(188)(163)
Net (loss) earnings attributable to UnitedHealth Group common shareholders$(1,409)$5,611 
(Loss) earnings per share attributable to UnitedHealth Group common shareholders:
Basic$(1.53)$6.01 
Diluted$(1.53)$5.95 
Basic weighted-average number of common shares outstanding922 933 
Dilutive effect of common share equivalents 10 
Diluted weighted-average number of common shares outstanding922 943 
Anti-dilutive shares excluded from the calculation of dilutive effect of common share equivalents15 5 
See Notes to the Condensed Consolidated Financial Statements
2

Table of Contents
UnitedHealth Group
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)
 Three Months Ended
March 31,
(in millions)20242023
Net (loss) earnings$(1,221)$5,774 
Other comprehensive income:
Gross unrealized (losses) gains on investment securities during the period(290)640 
Income tax effect68 (147)
Total unrealized (losses) gains, net of tax(222)493 
Gross reclassification adjustment for net realized (gains) losses included in net earnings(32)13 
Income tax effect7 (3)
Total reclassification adjustment, net of tax
(25)10 
Foreign currency translation (losses) gains (293)341 
Reclassification adjustment for translation losses included in net (loss) earnings4,128  
Total foreign currency translation gains3,835 341 
Other comprehensive income3,588 844 
Comprehensive income2,367 6,618 
Comprehensive income attributable to noncontrolling interests(188)(163)
Comprehensive income attributable to UnitedHealth Group common shareholders$2,179 $6,455 
See Notes to the Condensed Consolidated Financial Statements
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UnitedHealth Group
Condensed Consolidated Statements of Changes in Equity
(Unaudited)
Common StockAdditional Paid-In CapitalRetained EarningsAccumulated Other Comprehensive LossNonredeemable Noncontrolling InterestsTotal
Equity
Three months ended March 31,
(in millions)
SharesAmountNet Unrealized (Losses) Gains on InvestmentsForeign Currency Translation (Losses) Gains
Balance at January 1, 2024924 $9 $ $95,774 $(1,971)$(5,056)$5,665 $94,421 
Net (loss) earnings(1,409)149 (1,260)
Other comprehensive (loss) income(247)3,835 3,588 
Issuances of common stock, and related tax effects
2  242 242 
Share-based compensation
352 352 
Common share repurchases(6) (574)(2,518)(3,092)
Cash dividends paid on common shares ($1.88 per share)
(1,729)(1,729)
Redeemable noncontrolling interests fair value and other adjustments
(20)(20)
Acquisition and other adjustments of nonredeemable noncontrolling interests
19 19 
Distribution to nonredeemable noncontrolling interests
(151)(151)
Balance at March 31, 2024920 $9 $ $90,118 $(2,218)$(1,221)$5,682 $92,370 
Balance at January 1, 2023934 $9 $ $86,156 $(2,778)$(5,615)$3,678 $81,450 
Net earnings
5,611 113 5,724 
Other comprehensive income503 341 844 
Issuances of common stock, and related tax effects
2  350 350 
Share-based compensation
366 366 
Common share repurchases(4) (633)(1,378)(2,011)
Cash dividends paid on common shares ($1.65 per share)
(1,537)(1,537)
Redeemable noncontrolling interests fair value and other adjustments
(83)(83)
Acquisition and other adjustments of nonredeemable noncontrolling interests819 819 
Distribution to nonredeemable noncontrolling interests
(101)(101)
Balance at March 31, 2023932 $9 $ $88,852 $(2,275)$(5,274)$4,509 $85,821 
See Notes to the Condensed Consolidated Financial Statements






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UnitedHealth Group
Condensed Consolidated Statements of Cash Flows
(Unaudited)
 Three Months Ended
March 31,
(in millions)20242023
Operating activities
Net (loss) earnings$(1,221)$5,774 
Noncash items:
Depreciation and amortization997 970 
Deferred income taxes(27)(332)
Share-based compensation372 362 
Loss on sale of subsidiary7,086  
Other, net179 69 
Net change in other operating items, net of effects from acquisitions, dispositions and changes in AARP balances:
Accounts receivable(6,162)(4,306)
Other assets(1,927)(1,875)
Medical costs payable2,069 2,467 
Accounts payable and other liabilities(231)1,796 
Unearned revenues9 11,402 
Cash flows from operating activities1,144 16,327 
Investing activities
Purchases of investments(4,798)(4,894)
Sales of investments2,976 456 
Maturities of investments2,314 2,119 
Cash paid for acquisitions, net of cash assumed(3,006)(7,826)
Purchases of property, equipment and capitalized software(743)(760)
Other, net(3,083)(115)
Cash flows used for investing activities(6,340)(11,020)
Financing activities
Common share repurchases(3,072)(2,000)
Cash dividends paid(1,729)(1,537)
Proceeds from common stock issuances486 344 
Repayments of long-term debt(750)(1,375)
Proceeds from short-term borrowings, net6,189 7,349 
Proceeds from issuance of long-term debt5,925 6,401 
Customer funds administered1,745 5,012 
Other, net(563)(1,004)
Cash flows from financing activities8,231 13,190 
Effect of exchange rate changes on cash and cash equivalents(48)51 
Increase in cash and cash equivalents2,987 18,548 
Cash and cash equivalents, beginning of period25,427 23,365 
Cash and cash equivalents, end of period$28,414 $41,913 
See Notes to the Condensed Consolidated Financial Statements
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UnitedHealth Group
Notes to the Condensed Consolidated Financial Statements
(Unaudited)
1.    Basis of Presentation
UnitedHealth Group Incorporated (individually and together with its subsidiaries, “UnitedHealth Group” and the “Company”) 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. The Company’s two distinct, yet complementary businesses — Optum and UnitedHealthcare — are working to help build a modern, high-performing health system through improved access, affordability, outcomes and experiences for the individuals and organizations the Company is privileged to serve.
The Company has prepared the Condensed Consolidated Financial Statements according to U.S. Generally Accepted Accounting Principles (GAAP) and has included the accounts of UnitedHealth Group and its subsidiaries. The year-end condensed consolidated balance sheet was derived from audited financial statements, but does not include all disclosures required by GAAP. In accordance with the rules and regulations of the U.S. Securities and Exchange Commission (SEC), the Company has omitted certain footnote disclosures that would substantially duplicate the disclosures contained in its annual audited Consolidated Financial Statements. Therefore, these Condensed Consolidated Financial Statements should be read together with the Consolidated Financial Statements and the Notes included in Part II, Item 8, “Financial Statements and Supplementary Data” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 as filed with the SEC (2023 10-K). The accompanying Condensed Consolidated Financial Statements include all normal recurring adjustments necessary to present the interim financial statements fairly.
Use of Estimates
These Condensed Consolidated Financial Statements include certain amounts based on the Company’s best estimates and judgments. The Company’s most significant estimates relate to estimates and judgments for medical costs payable and goodwill. Certain of these estimates require the application of complex assumptions and judgments, often because they involve matters that are inherently uncertain and will likely change in subsequent periods. The impact of any change in estimates is included in earnings in the period in which the estimate is adjusted.
Revenues - Products and Services
As of March 31, 2024 and December 31, 2023, accounts receivable related to products and services were $10.3 billion and $8.6 billion, respectively. As of March 31, 2024, revenue expected to be recognized in any future year related to remaining performance obligations, excluding revenue pertaining to contracts having an original expected duration of one year or less, contracts where revenue is recognized as invoiced and contracts with variable consideration related to undelivered performance obligations, was $14.3 billion, of which approximately half is expected to be recognized in the next three years.
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2.    Investments
A summary of debt securities by major security type is as follows:
(in millions)Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
March 31, 2024
Debt securities - available-for-sale:
U.S. government and agency obligations$4,730 $1 $(262)$4,469 
State and municipal obligations7,228 7 (357)6,878 
Corporate obligations22,756 20 (1,225)21,551 
U.S. agency mortgage-backed securities9,395 7 (850)8,552 
Non-U.S. agency mortgage-backed securities2,901 1 (220)2,682 
Total debt securities - available-for-sale47,010 36 (2,914)44,132 
Debt securities - held-to-maturity:
U.S. government and agency obligations510  (5)505 
State and municipal obligations28  (3)25 
Corporate obligations59   59 
Total debt securities - held-to-maturity597  (8)589 
Total debt securities$47,607 $36 $(2,922)$44,721 
December 31, 2023
Debt securities - available-for-sale:
U.S. government and agency obligations$4,674 $3 $(234)$4,443 
State and municipal obligations7,636 39 (322)7,353 
Corporate obligations23,136 67 (1,186)22,017 
U.S. agency mortgage-backed securities8,982 22 (708)8,296 
Non-U.S. agency mortgage-backed securities3,023 3 (240)2,786 
Total debt securities - available-for-sale47,451 134 (2,690)44,895 
Debt securities - held-to-maturity:
U.S. government and agency obligations506 1 (6)501 
State and municipal obligations28  (2)26 
Corporate obligations69   69 
Total debt securities - held-to-maturity603 1 (8)596 
Total debt securities$48,054 $135 $(2,698)$45,491 
The Company held $4.1 billion and $4.9 billion of equity securities as of March 31, 2024 and December 31, 2023, respectively. The Company’s investments in equity securities primarily consist of venture investments and employee savings plan related investments. Additionally, the Company’s investments included $1.4 billion of equity method investments primarily in operating businesses in the health care sector as of March 31, 2024 and December 31, 2023. The allowance for credit losses on held-to-maturity securities at March 31, 2024 and December 31, 2023 was not material.
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The amortized cost and fair value of debt securities as of March 31, 2024, by contractual maturity, were as follows:
Available-for-SaleHeld-to-Maturity
(in millions)Amortized
Cost
Fair
Value
Amortized
Cost
Fair
Value
Due in one year or less$4,430 $4,398 $336 $334 
Due after one year through five years14,686 14,061 219 216 
Due after five years through ten years10,690 9,813 24 23 
Due after ten years4,908 4,626 18 16 
U.S. agency mortgage-backed securities9,395 8,552 — — 
Non-U.S. agency mortgage-backed securities2,901 2,682 — — 
Total debt securities$47,010 $44,132 $597 $589 
The fair value of available-for-sale debt securities with gross unrealized losses by major security type and length of time that individual securities have been in a continuous unrealized loss position were as follows:
 Less Than 12 Months12 Months or Greater Total
(in millions)Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
March 31, 2024
Debt securities - available-for-sale:
U.S. government and agency obligations
$2,005 $(18)$2,053 $(244)$4,058 $(262)
State and municipal obligations1,736 (18)4,334 (339)6,070 (357)
Corporate obligations4,046 (33)13,881 (1,192)17,927 (1,225)
U.S. agency mortgage-backed securities2,686 (46)5,197 (804)7,883 (850)
Non-U.S. agency mortgage-backed securities
159 (1)2,265 (219)2,424 (220)
Total debt securities - available-for-sale$10,632 $(116)$27,730 $(2,798)$38,362 $(2,914)
December 31, 2023
Debt securities - available-for-sale:
U.S. government and agency obligations
$1,270 $(7)$2,077 $(227)$3,347 $(234)
State and municipal obligations907 (7)4,063 (315)4,970 (322)
Corporate obligations1,826 (17)14,696 (1,169)16,522 (1,186)
U.S. agency mortgage-backed securities1,337 (12)5,069 (696)6,406 (708)
Non-U.S. agency mortgage-backed securities
279 (6)2,202 (234)2,481 (240)
Total debt securities - available-for-sale$5,619 $(49)$28,107 $(2,641)$33,726 $(2,690)
The Company’s unrealized losses from debt securities as of March 31, 2024 were generated from approximately 32,000 positions out of a total of 39,000 positions. The Company believes that it will timely collect the principal and interest due on its debt securities that have an amortized cost in excess of fair value. The unrealized losses were primarily caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities which impacted the Company’s assessment on collectability of principal and interest. At each reporting period, the Company evaluates available-for-sale debt securities for any credit-related impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the expected cash flows, the underlying credit quality and credit ratings of the issuers, noting no significant credit deterioration since purchase. As of March 31, 2024, the Company did not have the intent to sell any of the available-for-sale debt securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary. The allowance for credit losses on available-for-sale debt securities at March 31, 2024 and December 31, 2023 was not material.
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3.    Fair Value
Certain assets and liabilities are measured at fair value in the Condensed Consolidated Financial Statements or have fair values disclosed in the Notes to the Condensed Consolidated Financial Statements. These assets and liabilities are classified into one of three levels of a hierarchy defined by GAAP.
For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see Note 4 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements and Supplementary Data” in the 2023 10-K.
The following table presents a summary of fair value measurements by level and carrying values for items measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions)Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair and Carrying
Value
March 31, 2024
Cash and cash equivalents$28,367 $47 $ $28,414 
Debt securities - available-for-sale:
U.S. government and agency obligations4,275 194  4,469 
State and municipal obligations 6,878  6,878 
Corporate obligations28 21,324 199 21,551 
U.S. agency mortgage-backed securities 8,552  8,552 
Non-U.S. agency mortgage-backed securities 2,682  2,682 
Total debt securities - available-for-sale4,303 39,630 199 44,132 
Equity securities1,640 16 69 1,725 
Assets under management 1,636 1,876 107 3,619 
Total assets at fair value$35,946 $41,569 $375 $77,890 
Percentage of total assets at fair value46 %53 %%100 %
December 31, 2023
Cash and cash equivalents$25,345 $82 $ $25,427 
Debt securities - available-for-sale:
U.S. government and agency obligations4,167 276  4,443 
State and municipal obligations 7,353  7,353 
Corporate obligations15 21,800 202 22,017 
U.S. agency mortgage-backed securities 8,296  8,296 
Non-U.S. agency mortgage-backed securities 2,786  2,786 
Total debt securities - available-for-sale4,182 40,511 202 44,895 
Equity securities2,468 16 69 2,553 
Assets under management 1,505 2,140 110 3,755 
Total assets at fair value$33,500 $42,749 $381 $76,630 
Percentage of total assets at fair value44 %55 %%100 %
There were no transfers in or out of Level 3 financial assets or liabilities during the three months ended March 31, 2024 or 2023.
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The following table presents a summary of fair value measurements by level and carrying values for certain financial instruments not measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions)Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair
Value
Total Carrying Value
March 31, 2024
Debt securities - held-to-maturity$522 $67 $ $589 $597 
Long-term debt and other financing obligations$ $63,489 $ $63,489 $66,299 
December 31, 2023
Debt securities - held-to-maturity$524 $72 $ $596 $603 
Long-term debt and other financing obligations$ $59,851 $ $59,851 $61,449 
Nonfinancial assets and liabilities or financial assets and liabilities that are measured at fair value on a nonrecurring basis are subject to fair value adjustments only in certain circumstances, such as when the Company records an impairment. There were no significant fair value adjustments for these assets and liabilities recorded during the three months ended March 31, 2024 or 2023.
4.    Medical Costs Payable
The following table shows the components of the change in medical costs payable for the three months ended March 31:
(in millions)20242023
Medical costs payable, beginning of period$32,395 $29,056 
Acquisitions (dispositions), net(687)1 
Reported medical costs:
Current year66,045 60,315 
Prior years(310)(470)
Total reported medical costs65,735 59,845 
Medical payments:
Payments for current year
(38,652)(35,087)
Payments for prior years(24,759)(22,006)
Total medical payments(63,411)(57,093)
Medical costs payable, end of period$34,032 $31,809 
For the three months ended March 31, 2024 and 2023, prior years’ medical cost reserve development included no individual factors that were significant. Medical costs payable included reserves for claims incurred by consumers but not yet reported to the Company of $25.3 billion and $22.3 billion at March 31, 2024 and December 31, 2023, respectively.
5.    Short-Term Borrowings and Long-Term Debt
In March 2024, the Company issued $6.0 billion of senior unsecured notes consisting of the following:
(in millions, except percentages)Par Value
4.600% notes due April 2027
$500 
4.700% notes due April 2029
400 
4.900% notes due April 2031
1,000 
5.000% notes due April 2034
1,250 
5.375% Notes due April 2054
1,750 
5.500% Notes due April 2064
1,100 
As of March 31, 2024, the Company had $7.3 billion of commercial paper outstanding, with a weighted-average annual interest rate of 5.4%.
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For more information on the Company’s short-term borrowings, debt covenants and long-term debt, see Note 8 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements and Supplementary Data” in the 2023 10-K.
6.    Commitments and Contingencies
Pending Acquisitions
As of March 31, 2024, the Company has entered into agreements to acquire companies in the health care sector, subject to regulatory approval and other customary closing conditions. The total anticipated consideration required for these acquisitions, excluding the payoff of acquired indebtedness, is approximately $4 billion.
Legal Matters
The Company is frequently made party to a variety of legal actions and regulatory inquiries, including class actions and suits brought by members, care providers, consumer advocacy organizations, customers and regulators, relating to the Company’s businesses, including management and administration of health benefit plans and other services. These matters include medical malpractice, employment, intellectual property, antitrust, privacy and contract claims and claims related to health care benefits coverage and other business practices.
The Company records liabilities for its estimates of probable costs resulting from these matters where appropriate. Estimates of costs resulting from legal and regulatory matters involving the Company are inherently difficult to predict, particularly where the matters: involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or represent a shift in regulatory policy; involve a large number of claimants or regulatory bodies; are in the early stages of the proceedings; or could result in a change in business practices. Accordingly, the Company is often unable to estimate the losses or ranges of losses for those matters where there is a reasonable possibility or it is probable a loss may be incurred.
Government Investigations, Audits and Reviews
The Company has been involved or is currently involved in various governmental investigations, audits and reviews. These include routine, regular and special investigations, audits and reviews by the Centers for Medicare and Medicaid Services (CMS), state insurance and health and welfare departments, state attorneys general, the Office of the Inspector General, the Office of Personnel Management, the Office of Civil Rights, the Government Accountability Office, the Federal Trade Commission, U.S. Congressional committees, the U.S. Department of Justice (DOJ), the SEC, the Internal Revenue Service, the U.S. Drug Enforcement Administration, the U.S. Department of Labor, the Federal Deposit Insurance Corporation, the Consumer Financial Protection Bureau (CFPB), the Defense Contract Audit Agency and other governmental authorities. Similarly, the Company’s international businesses are also subject to investigations, audits and reviews by applicable foreign governments. The Company has also been responding to subpoenas, information requests and investigations from governmental entities. The Company can provide no assurance as to the scope and outcome of these matters and no assurance as to whether its business, financial condition or results of operations will be materially adversely affected. Certain of the Company’s businesses have been reviewed or are currently under review, including for, among other matters, compliance with coding and other requirements under the Medicare risk-adjustment model. CMS has selected certain of the Company’s local plans for risk adjustment data validation (RADV) audits to validate the coding practices of and supporting documentation maintained by health care providers and such audits may result in retrospective adjustments to payments made to the Company’s health plans.
On February 14, 2017, the DOJ announced its decision to pursue certain claims within a lawsuit initially asserted against the Company and filed under seal by a whistleblower in 2011. The whistleblower’s complaint, which was unsealed on February 15, 2017, alleges the Company made improper risk adjustment submissions and violated the False Claims Act. On February 12, 2018, the court granted in part and denied in part the Company’s motion to dismiss. In May 2018, the DOJ moved to dismiss the Company’s counterclaims, which were filed in March 2018, and moved for partial summary judgment. In March 2019, the court denied the government’s motion for partial summary judgment and dismissed the Company’s counterclaims without prejudice. The Company cannot reasonably estimate the outcome which may result from this matter given its procedural status.
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7.    Disposition
On February 6, 2024, the Company completed the sale of its Brazil operations. During the three months ended March 31, 2024, the Company recorded a loss of $7.1 billion within the Consolidated Statement of Operations, of which $4.1 billion related to the impact of cumulative foreign currency translation losses previously included in accumulated other comprehensive loss.
The assets and liabilities of the disposal group as of the date of the sale were as follows:
(in millions)
Assets
Cash and cash equivalents$778 
Accounts receivable and other current assets515 
Long-term investments788 
Property, equipment and capitalized software1,052 
Deferred tax assets1,035 
Other intangible assets317 
Other long-term assets439 
Total assets4,924 
Liabilities
Medical costs payable701 
Accounts payable and other current liabilities834 
Other long-term liabilities136 
Total liabilities$1,671 
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8.    Segment Financial Information
The Company’s four reportable segments are UnitedHealthcare, Optum Health, Optum Insight and Optum Rx. For more information on the Company’s segments, see Part I, Item I, “Business” and Note 14 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements and Supplementary Data” in the 2023 10-K.
The following tables present reportable segment financial information:
  Optum  
(in millions)UnitedHealthcareOptum HealthOptum InsightOptum RxOptum EliminationsOptumCorporate and
Eliminations
Consolidated
Three Months Ended March 31, 2024
Revenues - unaffiliated customers:
Premiums$72,293 $5,695 $ $ $ $5,695 $ $77,988 
Products 59 41 11,809  11,909  11,909 
Services2,529 3,970 1,702 687  6,359  8,888 
Total revenues - unaffiliated customers
74,822 9,724 1,743 12,496  23,963  98,785 
Total revenues - affiliated customers
 16,617 2,731 18,281 (1,016)36,613 (36,613) 
Investment and other income
535 390 28 58  476  1,011 
Total revenues$75,357 $26,731 $4,502 $30,835 $(1,016)$61,052 $(36,613)$99,796 
Earnings from operations$4,395 $1,899 $490 $1,147 $ $3,536 $ $7,931 
Interest expense      (844)(844)
Loss on sale of subsidiary(7,086)      (7,086)
Earnings before income taxes
$(2,691)$1,899 $490 $1,147 $ $3,536 $(844)$1 
Three Months Ended March 31, 2023
Revenues - unaffiliated customers:
Premiums$67,458 $5,328 $ $ $ $5,328 $ $72,786 
Products 44 40 10,183  10,267  10,267 
Services2,555 3,089 1,926 510  5,525  8,080 
Total revenues - unaffiliated customers
70,013 8,461 1,966 10,693  21,120  91,133 
Total revenues - affiliated customers
 14,266 2,510 16,679 (859)32,596 (32,596) 
Investment and other income
455 277 20 46  343  798 
Total revenues$70,468 $23,004 $4,496 $27,418 $(859)$54,059 $(32,596)$91,931 
Earnings from operations$4,343 $1,776 $907 $1,060 $ $3,743 $ $8,086 
Interest expense      (754)(754)
Earnings before income taxes
$4,343 $1,776 $907 $1,060 $ $3,743 $(754)$7,332 

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ITEM 2.    MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following discussion should be read together with the accompanying Condensed Consolidated Financial Statements and Notes and with our 2023 10-K, including the Consolidated Financial Statements and Notes included in Part II, Item 8, “Financial Statements and Supplementary Data” in that report. Unless the context indicates otherwise, references to the terms “UnitedHealth Group,” the “Company,” “we,” “our” or “us” used throughout this Management’s Discussion and Analysis of Financial Condition and Results of Operations refer to UnitedHealth Group Incorporated and its consolidated subsidiaries.
Readers are cautioned that the statements, estimates, projections or outlook contained in this Management's Discussion and Analysis of Financial Condition and Results of Operations, including discussions regarding financial prospects, economic conditions, trends and uncertainties contained in this Item 2, may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (PSLRA). These forward-looking statements involve risks and uncertainties that may cause our actual results to differ materially from the results discussed or implied in the forward-looking statements. A description of some of the risks and uncertainties is set forth in Part I, Item 1A, “Risk Factors” in our 2023 10-K and in the discussion below.
EXECUTIVE OVERVIEW
General
UnitedHealth Group 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. Our two distinct, yet complementary businesses — Optum and UnitedHealthcare — are working to help build a modern, high-performing health system through improved access, affordability, outcomes and experiences for the individuals and organizations we are privileged to serve.
We have four reportable segments:
Optum Health;
Optum Insight;
Optum Rx; and
UnitedHealthcare, which includes UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement and UnitedHealthcare Community & State.
Further information on our business is presented in Part I, Item 1, “Business” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2023 10-K and additional information on our segments can be found in this Item 2 and in Note 8 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Change Healthcare Cyberattack
As previously announced, on February 21, 2024, we identified that cybercrime threat actors had gained access to certain Change Healthcare information technology systems. Upon detection of this outside threat, we isolated the impacted systems to protect our partners and customers.
We have made substantial progress in mitigating the impact to consumers and care providers of the unprecedented cyberattack on the U.S. health system and certain Change Healthcare services. To support care providers, we accelerated funding and provided interest-free loans of approximately $3.9 billion through March 31, 2024, which has increased to over $6.5 billion through April 30, 2024. For the three months ended March 31, 2024, we incurred $593 million of direct response costs, including network restoration and increased medical care expenditures, as we suspended some care management activities to help care providers with their workflow processes. Optum Insight also experienced estimated business disruption impacts of $279 million for the three months ended March 31, 2024, reflecting lost revenue while maintaining full readiness of the affected Change Healthcare services. We expect to continue to incur direct response costs and experience business disruption impacts over the remainder of the year, including costs to continue to restore Change Healthcare’s services and the impact of suspended care management activities.
In April 2024, we also announced that based on initial targeted data sampling to date, we have found files containing protected health information (PHI) or personally identifiable information (PII), which could cover a substantial proportion of people in America. The investigation of impacted data is ongoing. It is possible that future risks and uncertainties resulting from the Change Healthcare cyberattack, including risks related to impacted data, litigation, reputational harm, and regulatory actions could adversely affect our financial condition or results of operations.

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Business Trends
Our businesses participate in the United States and certain other international health markets. We expect overall spending on health care to continue to grow in the future, due to inflation, medical technology and pharmaceutical advancement, regulatory requirements, demographic trends in the population and national interest in health and well-being. The rate of market growth may be affected by a variety of factors, including macroeconomic conditions and regulatory changes, which could impact our results of operations, including our continued efforts to control health care costs.
Pricing Trends. To price our health care benefits, products and services, we start with our view of expected future costs, including medical cost trends, inflation and labor market dynamics. We frequently evaluate and adjust our approach in each of the local markets we serve, considering all relevant factors, such as product positioning, price competitiveness and environmental, competitive, legislative and regulatory considerations, including minimum medical loss ratio thresholds and similar revenue adjustments. We will continue seeking to balance growth and profitability across all these dimensions.
The commercial risk market remains highly competitive in the small group, large group and individual segments. We expect broad-based competition to continue as the industry adapts to individual and employer needs.
Government programs in the community and senior sector tend to receive lower rates of increase than the commercial market due to governmental budget pressures and lower cost trends.
Medical Cost Trends. Our medical cost trends primarily relate to changes in unit costs, care activity and prescription drug costs. As expected and contemplated in our benefits design, during the first quarter we continued to observe increased care patterns, primarily related to outpatient procedures for seniors, which may continue in future periods. We endeavor to mitigate those increases by engaging physicians and consumers with information and helping them make clinically sound choices, with the objective of helping them achieve quality, affordable care.
In the first quarter 2024, as a result of the Change Healthcare cyberattack, we incurred $340 million of medical costs related to the temporary suspension of some care management activities, impacting our UnitedHealthcare and Optum Health businesses, to help care providers with their workflow processes. Early in the second quarter we have resumed these activities. Additionally, the business disruption impacted claims receipt timing for payer customers, including UnitedHealthcare, which could potentially result in increased variability to our medical cost reserve development in future periods.
Medicaid Redeterminations. Medicaid redeterminations have continued to impact the number of people served through our Medicaid offerings, partially offset by an increase in consumers served through our commercial offerings as we endeavor to ensure that people and families have continued access to care.
Regulatory Trends and Uncertainties
Medicare Advantage Rates. Medicare Advantage rate notices over the years have at times resulted in industry base rates well below industry forward medical trend. For example, the Final Notices for 2024 and 2025 rates resulted in an industry base rate decrease, both well short of an increasing industry forward medical cost trend, creating continued pressure in the Medicare Advantage program. Further, substantial revisions to the risk adjustment model, which serves to adjust rates to reflect a patient’s health status and care resource needs, will result in reduced funding and potentially benefits for people, especially those with some of the greatest health and social challenges.
As a result of ongoing Medicare funding pressures, there are adjustments we can make to partially offset these rate pressures and reductions for a particular period. For example, we can seek to intensify our medical and operating cost management, make changes to the size and composition of our care provider networks, adjust member benefits and implement or increase the member premiums supplementing the monthly payments we receive from the government. Additionally, we decide annually on a county-by-county basis where we will offer Medicare Advantage plans.
SELECTED OPERATING PERFORMANCE AND OTHER SIGNIFICANT ITEMS
The following summarizes select first quarter 2024 year-over-year operating comparisons to first quarter 2023 and other financial results.
Consolidated revenues grew 9%, UnitedHealthcare revenues grew 7% and Optum revenues grew 13%.
UnitedHealthcare served 1.6 million more people domestically, driven by growth in commercial and Medicare offerings.
Consolidated earnings from operations of $7.9 billion compared to $8.1 billion last year, impacted by the Change Healthcare cyberattack.
Diluted loss per common share was $1.53, impacted by the loss on the sale of our Brazil operations and the Change Healthcare cyberattack.
Cash flows from operations for the three months ended March 31, 2024 were $1.1 billion.
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RESULTS SUMMARY
The following table summarizes our consolidated results of operations and other financial information:
(in millions, except percentages and per share data)Three Months Ended
March 31,
Increase/(Decrease)
202420232024 vs. 2023
Revenues:
Premiums$77,988 $72,786 $5,202 %
Products11,909 10,267 1,642 16 
Services8,888 8,080 808 10 
Investment and other income1,011 798 213 27 
Total revenues99,796 91,931 7,865 
Operating costs:
Medical costs65,735 59,845 5,890 10 
Operating costs14,077 13,625 452 
Cost of products sold11,056 9,405 1,651 18 
Depreciation and amortization997 970 27 
Total operating costs91,865 83,845 8,020 10 
Earnings from operations7,931 8,086 (155)(2)
Interest expense(844)(754)(90)12 
Loss on sale of subsidiary(7,086)— (7,086)nm
Earnings before income taxes7,332 (7,331)nm
Provision for income taxes(1,222)(1,558)336 (22)
Net (loss) earnings(1,221)5,774 (6,995)nm
Earnings attributable to noncontrolling interests(188)(163)(25)15 
Net (loss) earnings attributable to UnitedHealth Group common shareholders$(1,409)$5,611 $(7,020)nm
Diluted (loss) earnings per share attributable to UnitedHealth Group common shareholders $(1.53)$5.95 $(7.48)
Medical care ratio (a)84.3 %82.2 %2.1 %
Operating cost ratio14.1 14.8 (0.7)
Operating margin7.9 8.8 (0.9)
Tax rate nm21.2  nm
Net earnings margin (b)(1.4)6.1 (7.5)
Return on equity (c) nm28.2 % nm
nm = not meaningful
(a)Medical care ratio (MCR) is calculated as medical costs divided by premium revenue.
(b)Net earnings margin attributable to UnitedHealth Group shareholders.
(c)Return on equity is calculated as annualized net earnings attributable to UnitedHealth Group common shareholders divided by average shareholders’ equity. Average shareholders’ equity is calculated using the shareholders’ equity balance at the end of the preceding year and the shareholders’ equity balances at the end of each of the quarters in the year presented.
2024 RESULTS OF OPERATIONS COMPARED TO 2023 RESULTS OF OPERATIONS
Consolidated Financial Results
Revenues
The increases in revenues were primarily driven by growth in the number of people served through Medicare Advantage and domestic commercial offerings, pricing trends and growth in Optum Health and Optum Rx.
Medical Costs and MCR
Medical costs increased primarily due to growth in people served through Medicare Advantage and domestic commercial offerings. The MCR increased as a result of the revenue effects of the Medicare funding reductions, incremental medical costs for accommodations made to care providers as a result of the Change Healthcare cyberattack and decreased favorable reserve development.
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Operating Cost Ratio
The operating cost ratio decreased primarily due to operating cost management, partially offset by the impact of our direct response efforts to the Change Healthcare cyberattack, business mix and investments to support future growth.
Loss on Sale of Subsidiary
On February 6, 2024, the Company completed the sale of its Brazil operations. During the three months ended March 31, 2024, we recorded a loss of $7.1 billion, of which $4.1 billion related to the impact of cumulative foreign currency translation losses previously included in accumulated other comprehensive loss. As a result of the loss, which was non-deductible for income tax purposes, the income tax rate and return on equity were not meaningful for the three months ended March 31, 2024.
Reportable Segments
See Note 8 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report for more information on our segments. We utilize various metrics to evaluate and manage our reportable segments, including people served by UnitedHealthcare by major market segment and funding arrangement, people served by Optum Health and adjusted scripts for Optum Rx. These metrics are the main drivers of revenue, earnings and cash flows at each business. The metrics also allow management and investors to evaluate and understand business mix, including the level and scope of services provided to people, and pricing trends when comparing the metrics to revenue by segment.
The following table presents a summary of the reportable segment financial information:
 Three Months Ended
March 31,
Increase/
(Decrease)
(in millions, except percentages)202420232024 vs. 2023
Revenues
UnitedHealthcare$75,357 $70,468 $4,889 %
Optum Health26,731 23,004 3,727 16 
Optum Insight4,502 4,496 — 
Optum Rx30,835 27,418 3,417 12 
Optum eliminations(1,016)(859)(157)18 
Optum61,052 54,059 6,993 13 
Eliminations(36,613)(32,596)(4,017)12 
Consolidated revenues$99,796 $91,931 $7,865 %
Earnings from operations
UnitedHealthcare$4,395 $4,343 $52 %
Optum Health1,899 1,776 123 
Optum Insight490 907 (417)(46)
Optum Rx1,147 1,060 87 
Optum3,536 3,743 (207)(6)
Consolidated earnings from operations$7,931 $8,086 $(155)(2)%
Operating margin
UnitedHealthcare5.8 %6.2 %(0.4)%
Optum Health7.1 7.7 (0.6)
Optum Insight10.9 20.2 (9.3)
Optum Rx3.7 3.9 (0.2)
Optum5.8 6.9 (1.1)
Consolidated operating margin7.9 %8.8 %(0.9)%
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UnitedHealthcare
The following table summarizes UnitedHealthcare revenues by business:
 Three Months Ended
March 31,
Increase/
(Decrease)
(in millions, except percentages)202420232024 vs. 2023
UnitedHealthcare Employer & Individual - Domestic$17,839 $16,544 $1,295 %
UnitedHealthcare Employer & Individual - Global1,532 2,163 (631)(29)
UnitedHealthcare Employer & Individual - Total19,371 18,707 664 
UnitedHealthcare Medicare & Retirement35,486 33,006 2,480 
UnitedHealthcare Community & State20,500 18,755 1,745 
Total UnitedHealthcare revenues$75,357 $70,468 $4,889 %
The following table summarizes the number of people served by our UnitedHealthcare businesses, by major market segment and funding arrangement:
March 31,Increase/(Decrease)
(in thousands, except percentages)202420232024 vs. 2023
Commercial - Domestic:
Risk-based8,545 8,025 520 %
Fee-based20,870 19,325 1,545 
Total Commercial - Domestic29,415