← UnitedHealth Group Incorporated

UNH · Forward model · Bear case

The Bear case, 20 quarters out

Each segment is projected from its own operating driver, rolled up into consolidated cash flow, and discounted back to a fair value per share. The assumptions below are editable — change them and every number on this page moves with them.

UnitedHealth reports four segments - UnitedHealthcare, Optum Health, Optum Insight, Optum Rx - plus a disclosed elimination line, and this model copies all five. Gross segment revenue less Optum eliminations less corporate eliminations equals consolidated revenue to the dollar in all thirteen quarters here (2023 Q2 - 2026 Q2), so the negative eliminations vertical is a reported line, not a plug; it is kept separate because UNH publishes no external-revenue split by segment and any allocation back into the four would be invented. Nothing below segment level is disclosed: no segment D&A, no segment capex, no PMPM. Vertical EBITDA margins are the 16 July 2026 guided full-year operating margin plus 0.68pp, the consolidated $4,400M of 2026 D&A allocated pro rata to gross segment revenue at the 2026 Q2 mix - which understates Optum Insight, the segment carrying most of the group's acquired intangibles. All capex is carried as one corporate programme because it is not disclosed by segment. Corporate overhead is zero: the four segments' operating earnings sum exactly to the consolidated $7,991M in 2026 Q2, so there is no unallocated line. Two things the engine cannot express, both disclosed: UnitedHealth's earnings are roughly two-thirds first-half (UnitedHealthcare ~75%, nearly all of Optum Health, Optum Insight and Optum Rx ~55% second-half), and the model glides margin smoothly, so every projected quarter carries a full-year-average margin rather than the intra-year shape; and the 1 January premium reset arrives as an even ARPU drift rather than a first-quarter step. Free cash flow here is EBITDA less capex less tax, which understates the cash UnitedHealth reports - 2026 Q2 operating cash flow was $11,052M against $7,991M of operating earnings, and full-year operating cash flow is guided at ~$24,000M - because insurance float is not in this model. Optum Insight excludes Alegeus, which closed on 2 July 2026 with no disclosed price or revenue contribution. Two history caveats: the 1 January 2026 Optum Financial realignment moved about $1.9B of annual revenue from Optum Health to Optum Insight and was recast only back to 2025 Q1, so the 2023-2024 quarters of those two lines sit on the old basis; and UnitedHealthcare membership moved from a total to a domestic basis in 2025. Consolidated revenue is unaffected in every quarter. Net debt is cash and short-term investments less total debt; the $57.7B of long-term investments is deliberately excluded because it backs medical costs payable and other insurance liabilities inside regulated subsidiaries - including it would show UnitedHealth in net cash and lift equity value by roughly $64 a share. Guidance check on the two projected 2026 quarters, added to first-half actuals: FY2026 consolidated revenue $446.4B against the > $439.0B January floor, UnitedHealthcare $342.7B against > $335.0B, Optum Health $92.4B against > $91.0B, Optum Insight $21.4B against > $21.0B with Alegeus excluded, Optum Rx $152.8B against > $150.5B on 1,541 million adjusted scripts against the > 1.52 billion floor, and eliminations $162.9B against the ~$158.5B guided - 27.0% of gross segment revenue, inside the 26.1-28.8% band of the last thirteen quarters. Every line sits above its floor, which is what floors set in January against a larger guided membership decline should do; the revenue guide was not raised on 16 July, only the earnings guide was.

Membership attrition does not stop at 46 million and commercial cost trend keeps rising, so the margin recovery is paid for out of a shrinking revenue base for longer than one year and Optum Health's fourth quarter turns negative again. Revenue is tilted down 0.35% a quarter across every line, each segment gives back 0.5-1.2pp of EBITDA margin, and the exit strikes at 10.5x.

UNH REVENUE MODEL

Latest: $115.10B (2031Q2E)

Period Value
2023Q2 $92.90B
2023Q3 $92.36B
2023Q4 $94.43B
2024Q1 $99.80B
2024Q2 $98.86B
2024Q3 $100.82B
2024Q4 $100.81B
2025Q1 $109.58B
2025Q2 $111.62B
2025Q3 $113.16B
2025Q4 $113.22B
2026Q1 $111.72B
2026Q2 $112.03B
2026Q3E $110.87B
2026Q4E $110.66B
2027Q1E $107.58B
2027Q2E $108.63B
2027Q3E $109.30B
2027Q4E $110.29B
2028Q1E $107.98B
2028Q2E $109.57B
2028Q3E $110.58B
2028Q4E $111.82B
2029Q1E $109.62B
2029Q2E $111.32B
2029Q3E $112.41B
2029Q4E $113.70B
2030Q1E $111.47B
2030Q2E $113.21B
2030Q3E $114.32B
2030Q4E $115.63B
2031Q1E $113.33B
2031Q2E $115.10B

What drives each segment

UnitedHealthcare

Subscribers × ARPU
Basis quarter$86.02B
Final quarter$89.15B
Implied CAGR+1%
Share of revenue, final quarter77%
PV of segment cash flow$54.43B

A risk-bearing benefits business whose revenue is people served times premium per member per month, reset every 1 January. It does not grow by selling more to the same member; it grows by adding members and by the rate reset, and in 2026 management is deliberately shedding members to reprice. Membership fell 525,000 in the basis quarter and Medicare Advantage is down 965,000 since year-end 2025.

Last four quarters
2025 Q3 $87.07B Reported
2025 Q4 $87.11B Reported
2026 Q1 $86.27B Reported
2026 Q2 $86.02B Reported
Employer & Individual (domestic and global)Medicare & RetirementCommunity & State
Subscribers 48.5M 97.5% of a 49.8M addressable base 48,525k medical members at 30 June 2026, down 525k in the quarter (2Q26 UnitedHealthcare Customer Profile).
Addressable subscribers 49.8M the S-curve ceiling 49.76m is the year-end 2025 base implied by the January outlook. A scaling artefact the driver needs, not a researched TAM.
Net adds 0/qtr ramping toward 0/qtr, throttled as the base approaches the TAM
Net-add ceiling 0/qtr what supply can deliver at full rate
ARPU $590.88/mo drifting +0.8% per quarter, floor $0.00 $590.88 = 2Q26 revenue $86,017M / 48,525k members / 3 months. Blended and derived; UNH discloses no PMPM.
Non-subscriber revenue $0/qtr growing +0.0% per quarter Zero. Every dollar of UnitedHealthcare revenue sits inside the member-times-premium identity.
UnitedHealthcare

Latest: $89.15B (2031Q2E)

Period Value
2023Q2 $70.23B
2023Q3 $69.85B
2023Q4 $70.81B
2024Q1 $75.36B
2024Q2 $73.87B
2024Q3 $74.85B
2024Q4 $74.13B
2025Q1 $84.62B
2025Q2 $86.10B
2025Q3 $87.07B
2025Q4 $87.11B
2026Q1 $86.27B
2026Q2 $86.02B
2026Q3E $85.05B
2026Q4E $84.48B
2027Q1E $84.19B
2027Q2E $84.10B
2027Q3E $84.15B
2027Q4E $84.29B
2028Q1E $84.51B
2028Q2E $84.77B
2028Q3E $85.07B
2028Q4E $85.39B
2029Q1E $85.73B
2029Q2E $86.09B
2029Q3E $86.45B
2029Q4E $86.83B
2030Q1E $87.21B
2030Q2E $87.59B
2030Q3E $87.98B
2030Q4E $88.37B
2031Q1E $88.76B
2031Q2E $89.15B

Assumptions & reasoning

  • 4.26% is the guided full-year 2026 operating margin - $12,000M of operating earnings on the $335,000M revenue floor, 3.58% - plus 0.68pp of pro-rata D&A. It is deliberately not the 2026 Q2 print of 4.6% operating: management has said UnitedHealthcare earnings are weighted about 75% to the first half, so the second-half quarters this model projects earn far less than the basis quarter did.
  • Terminal 5.30% EBITDA is 4.62% operating, which is the level UnitedHealthcare actually printed in 2026 Q2 - the base case is that the strong quarter becomes the full-year average by 2031, not that margin keeps climbing past it.
  • Membership is disclosed every quarter and is on a consistent domestic basis only from 2025; the 2023-2024 counts include South American businesses now held for sale. Revenue reconciles exactly to the three disclosed sub-lines in every quarter.
  • The driver is left aseasonal on purpose. UnitedHealthcare revenue shows a Q1 lift of about 3% but the Q4 window spread of 6.0% is wider than the whole 5.7% amplitude, and the Q1 lift is the 1 January enrolment and rate reset that member-times-premium already carries.

Optum Health

Subscribers × ARPU
Basis quarter$23.47B
Final quarter$21.41B
Implied CAGR-2%
Share of revenue, final quarter19%
PV of segment cash flow$10.93B

Care delivery under value-based arrangements: revenue follows the number of patients the business is accountable for and the rate it is paid for them. It is shrinking on purpose while margin is rebuilt - 2026 Q2 revenue fell 5% year-over-year on about 700,000 fewer value-based-care patients, and the January outlook guides consumers served down to roughly 84 million.

Last four quarters
2025 Q3 $25.42B Reported
2025 Q4 $25.07B Reported
2026 Q1 $24.11B Reported
2026 Q2 $23.47B Reported
Value-based care (fully accountable patients)Primary and specialist careAmbulatory surgeryHome health (incl. Amedisys)HouseCalls
Subscribers 93.0M 93.0% of a 100.0M addressable base 93 million consumers served at 30 June 2026, recast for the Optum Financial realignment, against 95 million a year earlier.
Addressable subscribers 100.0M the S-curve ceiling 100m is a round scaling base the driver requires. The number doing the work is the attach ceiling below it.
Net adds 0/qtr ramping toward 0/qtr, throttled as the base approaches the TAM
Net-add ceiling 0/qtr what supply can deliver at full rate
ARPU $84.13/mo drifting +0.4% per quarter, floor $0.00 $84.13 a month is $252.39 a quarter - 2Q26 revenue over consumers served. The rate has run $252-273 for six quarters.
Non-subscriber revenue $0/qtr growing +0.0% per quarter Zero. Consumers served times the derived rate is the whole line; no separate non-consumer revenue is disclosed.
Optum Health

Latest: $21.41B (2031Q2E)

Period Value
2023Q2 $23.92B
2023Q3 $23.86B
2023Q4 $24.53B
2024Q1 $26.73B
2024Q2 $27.05B
2024Q3 $25.92B
2024Q4 $25.66B
2025Q1 $24.84B
2025Q2 $24.73B
2025Q3 $25.42B
2025Q4 $25.07B
2026Q1 $24.11B
2026Q2 $23.47B
2026Q3E $22.57B
2026Q4E $22.04B
2027Q1E $21.72B
2027Q2E $21.54B
2027Q3E $21.43B
2027Q4E $21.37B
2028Q1E $21.34B
2028Q2E $21.32B
2028Q3E $21.32B
2028Q4E $21.32B
2029Q1E $21.32B
2029Q2E $21.33B
2029Q3E $21.34B
2029Q4E $21.35B
2030Q1E $21.36B
2030Q2E $21.37B
2030Q3E $21.38B
2030Q4E $21.39B
2031Q1E $21.40B
2031Q2E $21.41B

Assumptions & reasoning

  • 3.18% is the guided full-year 2026 reported operating margin - $2,275M of operating earnings on the $91,000M revenue floor, 2.50% - plus 0.68pp of pro-rata D&A. Reported, not adjusted: the segment carries $405M of loss-contract amortisation in reported earnings that adjusted strips out, and the revenue guidance is on the reported basis too.
  • Terminal 5.20% EBITDA is 4.52% operating, below the 5.1% the segment printed in 2026 Q2. Management has said nearly all of Optum Health's earnings land in the first half, with modest fourth-quarter losses, so the Q2 print is not a run rate and the base case does not assume it becomes one.
  • Consumers served is a much looser measure than the true economic driver. Fully accountable patients - guided at about 4.1 million for 2026 - are disclosed only as an approximate annual figure, so the quarterly driver has to rest on consumers served and the derived rate per consumer is published as a trace so the looseness is visible.
  • The metric was recast for the 1 January 2026 Optum Financial realignment: 31 December 2025 reads 95 million in the 4Q25 release and 92 million in the 1Q26 recast table. The 2026 basis is used. Revenue for 2023-2024 is as originally reported and still reconciles exactly, because each quarter's elimination line comes from the same release.
  • Left aseasonal: the measured amplitude of 1.2% sits an order of magnitude inside its own 2.7-5.1% window spreads, and the series straddles both the realignment and the August 2025 Amedisys close.

Optum Insight

Growth path
Basis quarter$5.40B
Final quarter$6.20B
Implied CAGR+3%
Share of revenue, final quarter5%
PV of segment cash flow$21.87B

Technology, analytics and revenue-cycle services sold to payers and providers on multi-year contracts, plus Optum Financial and Optum Bank since 1 January 2026. Revenue is contract backlog converting into recognised revenue - but the company stopped publishing backlog in 2026, and no backlog-to-revenue conversion rate has ever been disclosed, so a sequential growth rate is the honest driver rather than a manufactured capacity model.

Last four quarters
2025 Q3 $5.32B Reported
2025 Q4 $5.46B Reported
2026 Q1 $5.12B Reported
2026 Q2 $5.40B Reported
Revenue-cycle managementPayer and provider technologyAI-enabled coding and prior-authorisation toolsOptum Financial / Optum Bank (from 1 January 2026)Alegeus (from 2 July 2026, not modelled)
Sequential growth +0.6%/qtr decaying toward +1.4% 0.6% a quarter holds 2H26 near $10.9B against the ~$10.5B the January floor implies, before any Alegeus contribution.
Optum Insight

Latest: $6.20B (2031Q2E)

Period Value
2023Q2 $4.67B
2023Q3 $4.98B
2023Q4 $4.79B
2024Q1 $4.50B
2024Q2 $4.54B
2024Q3 $4.93B
2024Q4 $4.78B
2025Q1 $5.03B
2025Q2 $5.23B
2025Q3 $5.32B
2025Q4 $5.46B
2026Q1 $5.12B
2026Q2 $5.40B
2026Q3E $5.42B
2026Q4E $5.43B
2027Q1E $5.45B
2027Q2E $5.48B
2027Q3E $5.51B
2027Q4E $5.54B
2028Q1E $5.57B
2028Q2E $5.61B
2028Q3E $5.65B
2028Q4E $5.69B
2029Q1E $5.74B
2029Q2E $5.78B
2029Q3E $5.83B
2029Q4E $5.88B
2030Q1E $5.93B
2030Q2E $5.98B
2030Q3E $6.04B
2030Q4E $6.09B
2031Q1E $6.15B
2031Q2E $6.20B

Assumptions & reasoning

  • 24.13% is the guided full-year 2026 operating margin - the 16 July raise to $4,925M of operating earnings on the $21,000M revenue floor, 23.45% - plus 0.68pp of pro-rata D&A. The pro-rata allocation understates this segment specifically: Optum Insight carries most of the group's acquired intangibles, and group intangible amortisation alone is guided at about $1,345M for 2026.
  • Alegeus closed on 2 July 2026, two days into the first projected quarter, and no purchase price or revenue contribution has been disclosed. It is deliberately left out of the driver rather than guessed at, so this line is understated by an unknown amount from 2026 Q3 onward. Revisit at the 2026 Q3 print.
  • Contract revenue backlog was $31.1 billion at 31 December 2025 and was dropped from the Optum Performance Metrics table in both 2026 releases. It was rejected as a capacity driver because using it would require inventing a conversion rate the company has never published.
  • The 2023-2024 quarters predate the Optum Financial realignment and therefore exclude Optum Bank: FY2024 recast revenue is $20,356M against $18,757M as reported, so those quarters sit roughly 8-9% below the 2026 basis. UnitedHealth published no recast quarterly figures before 2025 Q1.
  • Left aseasonal: the 4.5% measured amplitude sits inside a 5.4% Q4 window spread, and what looks like a second-half lift is contract timing over a cyberattack-distorted 2024.

Optum Rx

Units × price
Basis quarter$38.29B
Final quarter$41.34B
Implied CAGR+2%
Share of revenue, final quarter36%
PV of segment cash flow$28.08B

Pharmacy care services: revenue is adjusted scripts times revenue per script, both disclosed or directly derivable, and the two guided 2026 floors are internally consistent at $99.01 per script. Script volume follows the membership it serves, which is falling - 387 million scripts in the basis quarter against 414 million a year earlier - while revenue per script follows drug mix, which is rising.

Last four quarters
2025 Q3 $39.68B Reported
2025 Q4 $41.46B Reported
2026 Q1 $35.74B Reported
2026 Q2 $38.29B Reported
Pharmacy benefit managementHome delivery, specialty and community pharmacyPrivate label / specialty genericsFee-based transparent pricing model
Units 388940000/qtr growing -0.6% per quarter 387m scripts reported in 2Q26 divided by the 0.995 Q2 factor; with seasonality on, the driver runs deseasonalised.
Price per unit $99 drifting +0.7% per quarter $98.95 = 2Q26 revenue $38,292M / 387m scripts. The two guided 2026 floors imply $99.01, within 0.1%.
Optum Rx

Latest: $41.34B (2031Q2E)

Period Value
2023Q2 $28.65B
2023Q3 $28.86B
2023Q4 $31.17B
2024Q1 $30.84B
2024Q2 $32.41B
2024Q3 $34.21B
2024Q4 $35.77B
2025Q1 $35.13B
2025Q2 $38.46B
2025Q3 $39.68B
2025Q4 $41.46B
2026Q1 $35.74B
2026Q2 $38.29B
2026Q3E $38.79B
2026Q4E $39.53B
2027Q1E $36.95B
2027Q2E $38.20B
2027Q3E $38.88B
2027Q4E $39.77B
2028Q1E $37.30B
2028Q2E $38.67B
2028Q3E $39.45B
2028Q4E $40.43B
2029Q1E $37.98B
2029Q2E $39.42B
2029Q3E $40.26B
2029Q4E $41.30B
2030Q1E $38.83B
2030Q2E $40.33B
2030Q3E $41.21B
2030Q4E $42.30B
2031Q1E $39.78B
2031Q2E $41.34B

Assumptions & reasoning

  • 4.83% is the guided full-year 2026 operating margin - $6,250M of operating earnings on the $150,500M revenue floor, 4.15% - plus 0.68pp of pro-rata D&A. Terminal 4.95% barely moves, because the move to monthly per-member fees with full PBM and GPO fee transparency and 100% rebate pass-through changes what a script is worth and argues against extrapolating margin expansion here.
  • This is the only vertical carrying a seasonality array, and the only one where the shape survives its own noise: revenue factors [0.9635, 0.9950, 1.0106, 1.0309] have an amplitude of 6.7% against window spreads of 1.3-2.3% for Q1-Q3 and 5.0% for Q4, Q1 is the trough and Q4 the peak in every window, and the disclosed script counts corroborate it independently at [0.987, 0.991, 0.994, 1.028].
  • Because the driver is unit-based, the engine's deseasonalisation of the basis quarter does not reach it - that step only divides the growth driver's base. The script count entered here is therefore deseasonalised by hand: 387 million divided by the normalised Q2 factor of 0.995.
  • Revenue amplitude (6.7%) is larger than script amplitude (4.1%); the excess is fourth-quarter drug mix and cost per script, which is why the seasonal factors sit on revenue while the script trace stays smooth.
  • Adjusted scripts are the only volume metric UnitedHealth discloses every quarter on an unbroken basis, and every value in the thirteen-quarter series appears in at least two consecutive releases with the overlaps agreeing.

Intersegment eliminations

Growth path
Basis quarter-$41.15B
Final quarter-$43.00B
Share of revenue, final quarter-37%
PV of segment cash flow$0

Optum sells pharmacy care and care delivery to UnitedHealthcare, and the elimination is not an accounting residual to be hidden: at $41.2B it is 27% of gross segment revenue, and UnitedHealth discloses both the Optum-level and the corporate-level component in footnote (a) of every release. It is modelled as its own negative line because there is no disclosed external-revenue split by segment, so pushing it back into the four segments would mean inventing one.

Last four quarters
2025 Q3 -$44.33B Reported
2025 Q4 -$45.88B Estimated
2026 Q1 -$39.51B Reported
2026 Q2 -$41.15B Reported
Optum eliminations (within Optum)Corporate eliminations (Optum to UnitedHealthcare)
Sequential growth -0.1%/qtr decaying toward +1.1% -0.1%: the elimination tracks gross segment revenue, which dips through 2H26 as membership and scripts fall.
Intersegment eliminations

Latest: -$43.00B (2031Q2E)

Period Value
2023Q2 -$34.56B
2023Q3 -$35.19B
2023Q4 -$36.87B
2024Q1 -$37.63B
2024Q2 -$39.02B
2024Q3 -$39.09B
2024Q4 -$39.54B
2025Q1 -$40.04B
2025Q2 -$42.90B
2025Q3 -$44.33B
2025Q4 -$45.88B
2026Q1 -$39.51B
2026Q2 -$41.15B
2026Q3E -$40.97B
2026Q4E -$40.83B
2027Q1E -$40.74B
2027Q2E -$40.69B
2027Q3E -$40.67B
2027Q4E -$40.69B
2028Q1E -$40.73B
2028Q2E -$40.81B
2028Q3E -$40.90B
2028Q4E -$41.02B
2029Q1E -$41.15B
2029Q2E -$41.30B
2029Q3E -$41.47B
2029Q4E -$41.66B
2030Q1E -$41.85B
2030Q2E -$42.06B
2030Q3E -$42.28B
2030Q4E -$42.51B
2031Q1E -$42.75B
2031Q2E -$43.00B

Assumptions & reasoning

  • This vertical's revenue is negative, which the engine handles: a growth driver compounds a negative base without special-casing and the spec imposes no positivity constraint on actuals. It carries no seasonality array, both because the validator requires positive factors and because deseasonalising a negative base would be meaningless.
  • Zero margin and zero capex are the right answers rather than placeholders: the four segments' operating earnings sum exactly to consolidated earnings from operations in 2026 Q2 ($3,942M + $1,190M + $1,369M + $1,490M = $7,991M), so consolidated EBITDA is the sum of the four segments' EBITDA with nothing left over for the elimination to carry.
  • The stable feature of this line is not a calendar shape but its ratio to gross segment revenue, which has sat between 26.1% and 28.8% across all thirteen quarters and matches the 26.5% implied by the January 2026 guidance ($158,500M of eliminations against $597,500M of gross segment revenue).
  • The risk that matters here is a re-cut of intersegment volume - if Optum Rx's fee-based model changes how internal pharmacy revenue is booked, the ratio could step, and a model holding it flat would mis-state consolidated revenue by tens of billions.
  • The 2025 Q4 point is the only estimated cell in the whole history: the Optum-level elimination of $1,645M is read from the 1Q26 recast table rather than the 4Q25 release, and the corporate-level $44,231M is derived as UnitedHealthcare $87,113M plus Optum $70,333M less consolidated $113,215M. The total still reconciles exactly to reported consolidated revenue.
Scenarios

Where each case comes from

Bear case — primary sources

The primary sources this case is built from — filings, calls and posts. Where they are claims by an interested party rather than disclosures, every number in the Bear column is what happens if they are taken at face value.

Valuation

From cash flow to fair value

Present value of free cash flow, 20 quarters$80.73B
Terminal-year revenue$458.38B
Terminal-year EBITDA$31.00B
Exit multiple, on ebitda10.5x
Terminal value$325.48B
Discounted at 8.5% a year, terminal value becomes$216.46B
Enterprise value$297.19B
Net cash-$41.86B
Equity value$255.33B
Shares0.90B
Fair value per share$284.46
Against the current price of $395.05-28%

Exit on EBITDA, not revenue. UnitedHealth trades at 0.91x guided 2026 revenue, where 100bp of group operating margin disappears into a rounding error, and the whole equity story here is margin: each 10bp of group operating margin on $439B is $439M of operating earnings, about $0.40 of adjusted EPS. Enterprise value is $399.8B today - $358.0B of market capitalisation at $398.76 on 897,594,847 shares plus $41.9B of net debt - which is 13.4x guided 2026 EBITDA of $29,850M (>$25,450M of operating earnings plus ~$4,400M of D&A), 20.2x the adjusted EPS midpoint and 21.3x the GAAP midpoint. The 12x exit is assumed and deliberately below today's 13.4x, so the model banks no multiple expansion; it is a sensitivity, not a researched comparable, because no peer multiple set was verified against a primary source. The 8.5% discount rate is a round WACC for an A-rated, low-beta business at 41.2% debt-to-capital, with room for regulatory risk. Net debt excludes the $57.7B of long-term investments, which back medical costs payable and other insurance liabilities inside regulated subsidiaries; netting them would flip UnitedHealth to net cash and add roughly $64 a share. Sensitivity, computed on this model: holding everything else at base, an exit of 10.5x gives $361.16 a share and 13.0x gives $431.76, about $28 a turn. The Bear case's fall from $403.52 to $284.46 is roughly $85 operating - the margin deltas and the -0.35%/qtr revenue tilt - and the remaining $34 the multiple, so the operating assumptions on this page matter more than the exit, not less.

Read the other way round: at $395.05 the market is paying 15.3x terminal-year revenue, holding every other assumption on this page fixed. That is the number to argue about.

Capital programmes

Capex outside the verticals

Each vertical's capex is a share of its own revenue, which is the right shape for capacity that scales with sales. These are not that: fixed-size programmes with their own schedule that spend whether or not any segment grows. They are added on top, and they are why free cash flow dips in the years below.

Group capital expenditure

2026 Q3 → 2031 Q2
Programme total$20.00B
Cash out$1.00B/qtr

UnitedHealth does not disclose capex by segment, so the whole programme is carried here and every vertical's capex intensity is zero. $20,000M over twenty quarters is $1,000M a quarter, a little above the ~$3,800M guided for 2026 (2026 Q1 was $763M and Q2 $799M, so the guide itself implies a second-half step up). At 0.87% of guided 2026 revenue this is an asset-light business whose real capital is regulatory capital, not plant.

Quarter by quarter

The projected path

Quarter UnitedHealthcareOptum HealthOptum InsightOptum RxIntersegment eliminations Revenue YoY EBITDA Capex FCF R40 PV of FCF
2026 Q3E $85.05B$22.57B$5.42B$38.79B-$40.97B $110.87B -2% $6.47B $1.00B $4.46B +2 $4.37B
2026 Q4E $84.48B$22.04B$5.43B$39.53B-$40.83B $110.66B -2% $6.55B $1.00B $4.52B +2 $4.34B
2027 Q1E $84.19B$21.72B$5.45B$36.95B-$40.74B $107.58B -4% $6.50B $1.00B $4.48B +0 $4.22B
2027 Q2E $84.10B$21.54B$5.48B$38.20B-$40.69B $108.63B -3% $6.63B $1.00B $4.58B +1 $4.23B
2027 Q3E $84.15B$21.43B$5.51B$38.88B-$40.67B $109.30B -1% $6.73B $1.00B $4.67B +3 $4.22B
2027 Q4E $84.29B$21.37B$5.54B$39.77B-$40.69B $110.29B +0% $6.84B $1.00B $4.76B +4 $4.21B
2028 Q1E $84.51B$21.34B$5.57B$37.30B-$40.73B $107.98B +0% $6.81B $1.00B $4.73B +5 $4.10B
2028 Q2E $84.77B$21.32B$5.61B$38.67B-$40.81B $109.57B +1% $6.94B $1.00B $4.84B +5 $4.11B
2028 Q3E $85.07B$21.32B$5.65B$39.45B-$40.90B $110.58B +1% $7.05B $1.00B $4.93B +6 $4.10B
2028 Q4E $85.39B$21.32B$5.69B$40.43B-$41.02B $111.82B +1% $7.16B $1.00B $5.02B +6 $4.10B
2029 Q1E $85.73B$21.32B$5.74B$37.98B-$41.15B $109.62B +2% $7.13B $1.00B $4.99B +6 $3.99B
2029 Q2E $86.09B$21.33B$5.78B$39.42B-$41.30B $111.32B +2% $7.26B $1.00B $5.10B +6 $3.99B
2029 Q3E $86.45B$21.34B$5.83B$40.26B-$41.47B $112.41B +2% $7.36B $1.00B $5.19B +6 $3.98B
2029 Q4E $86.83B$21.35B$5.88B$41.30B-$41.66B $113.70B +2% $7.48B $1.00B $5.28B +6 $3.97B
2030 Q1E $87.21B$21.36B$5.93B$38.83B-$41.85B $111.47B +2% $7.43B $1.00B $5.24B +6 $3.86B
2030 Q2E $87.59B$21.37B$5.98B$40.33B-$42.06B $113.21B +2% $7.56B $1.00B $5.35B +6 $3.86B
2030 Q3E $87.98B$21.38B$6.04B$41.21B-$42.28B $114.32B +2% $7.66B $1.00B $5.43B +6 $3.84B
2030 Q4E $88.37B$21.39B$6.09B$42.30B-$42.51B $115.63B +2% $7.77B $1.00B $5.52B +6 $3.82B
2031 Q1E $88.76B$21.40B$6.15B$39.78B-$42.75B $113.33B +2% $7.72B $1.00B $5.48B +7 $3.72B
2031 Q2E $89.15B$21.41B$6.20B$41.34B-$43.00B $115.10B +2% $7.85B $1.00B $5.58B +7 $3.71B

Every row is projected. A year-over-year change is shown only where the quarter it compares against exists — an em dash means there is no comparable quarter, not a flat year.

Track record

Model revisions

Assumptions are marked to reality as each quarter prints. Every change is appended here, with the fair value the model produced at the time, so the model's own history stays visible.

DateChangedFair value thenNote
2026-08-27 all $403.52 First published. Five verticals from the disclosed Revenues by Business schedule, basis 2026 Q2, margins set to the 16 July 2026 guided full-year averages rather than the second-quarter print.