UnitedHealth's Last Three Years: From 'Balanced Growth' to a Guidance Collapse — and Back

The story

January 2024: total confidence

On the Q4 FY2023 earnings call, CEO Andrew Witty called 2023 "the year of balanced, sustainable growth" and reaffirmed a long-term target of 13–16% annual adjusted EPS growth. Nine months later, on the October 2024 call, he stood by that framing even through a Medicare rate cut and the February 2024 Change Healthcare cyberattack, saying the company could "still finish within the guidance range we first gave in November 2023" and that management remained "highly optimistic for the future." The FY2023 10-K's own language matched the mood: "diluted earnings per share increased 13% to $23.86."

Two shocks, three months apart

On December 4, 2024, UnitedHealthcare CEO Brian Thompson was killed — a tragedy Witty acknowledged at the opening of the Q4 FY2024 call the following month, where the company also issued FY2025 adjusted EPS guidance of $29.50–$30.00, calling it "a strong outlook" to start the year. Just three months later, the Q1 FY2025 call cut that guidance to $26.00–$26.50, with Witty calling the results "an overall performance that was frankly unusual and unacceptable." On May 13, 2025, the company withdrew guidance entirely, and Witty stepped down; Stephen Hemsley, who had led the company from 2006 to 2017, returned as CEO.

A different way of talking

Hemsley's first call as CEO, in July 2025, reset guidance to "at least $16" — nearly half the original figure — in a tone that had changed completely. "Humility," "we've made pricing and operational mistakes," and "a fundamental cultural shift in how we work with regulators" were the phrases that recurred. The 10-K's language shifted in step: the FY2023 filing's confident "increased 13%" framing gave way, in FY2024, to a flatter "diluted earnings per share was $15.51, impacted by the loss on sale of subsidiary" — a number with no growth comparison, plus an excuse. By FY2025 it had flattened further still: "diluted earnings per share was $13.23," with no comparison language left at all. A "return on equity was 27.0%" bullet, present in the FY2023 10-K's highlights, disappeared entirely starting FY2024 — right as ROE itself fell from 27.0% to 15.9% to 12.8% over the following two years.

Where it stands now

By the October 2025 call, Hemsley was still cautious, saying only that the company would "provide our 2026 plans in January." When January 2026 arrived, FY2025 adjusted EPS closed at $16.35 — just above the reset "at least $16" target, but 45% below the original $29.50–$30.00 promised the year before. FY2026 guidance was set at "$17.75 or more," and by the July 2026 call it had been raised again, to $19.50–$20.00, alongside an expanded buyback plan (from $2.5B to more than $5B). Hemsley described it as "continuing progress toward more consistent and dependable performance."

Guidance scorecard

Against the original December 2024 promise, actual FY2025 results ($16.35) missed by 45%. But against the far more conservative target reset after the crisis, the company slightly exceeded its own bar — and has repeated a similar "issue guidance, then raise it mid-year" pattern in FY2026. The pattern reads as: lower the bar sharply, then rebuild credibility within the new, lower range.

Source: SEC 8-K investor guidance filing (Dec 3, 2024); Q4 FY2024, Q1 FY2025, Q2 FY2025, Q4 FY2025, and Q2 FY2026 earnings calls.

Timeline

• Jan 12, 2024Q4 2023 earnings: "the year of balanced, sustainable growth"; 13–16% long-term growth target reaffirmed.
• Feb 2024Change Healthcare cyberattack — 10-K mentions jump from 1 to 13 the following year.
• Dec 4, 2024UnitedHealthcare CEO Brian Thompson killed — not named in any subsequent 10-K.
• Jan 16, 2025FY2025 guidance reaffirmed at $29.50–$30.00; "we begin 2025 with a strong outlook."
• Apr 17, 2025Q1 2025 earnings shock: guidance cut to $26.00–$26.50; "unusual and unacceptable."
• May 13, 2025Guidance withdrawn entirely; Andrew Witty steps down; Stephen Hemsley returns as CEO.
• Jul 29, 2025Guidance reset to "at least $16"; Hemsley's first call as CEO leans on "humility."
• Jan 27, 2026FY2025 closes at $16.35, slightly above the reset target; FY2026 guidance issued at $17.75+.
• Jul 16, 2026FY2026 guidance raised to $19.50–$20.00; buyback plan expanded past $5B.

Our read

The clearest way to read this is a company rebuilding trust by keeping deliberately lowered promises rather than by returning to its old ones. After missing badly against its original 2025 target, UnitedHealth set a far more conservative bar and has now cleared it twice — first for FY2025, then with an early FY2026 raise following the same "issue low, then raise" pattern. Whether that reflects genuine operational recovery or simply an easier bar to clear is something only the next two or three quarters can really answer.

What we still don't know

• The actual status and likely conclusion of the 2025 DOJ criminal investigation isn't disclosed anywhere in the company's filings or earnings calls.
• Whether slightly beating the reset "at least $16" target reflects real business normalization or simply a conveniently lowered bar needs more of 2026 and 2027's results to judge.
• Any specific security or risk-management changes made after the CEO's killing aren't detailed in public disclosures.