UNH · Forward model · Bear case

The Bear case, 20 quarters out

Model as of 2026-08-27

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.

Where each case comes from

From cash flow to fair value

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.

The projected path

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.

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.