UnitedHealth Group Inc. (NYSE:UNH)

Reported net earnings attributable to UnitedHealth Group common shareholders exhibited an increasing trend from 2021 to 2023, followed by substantial declines in both 2024 and 2025. Conversely, adjusted net earnings attributable to UnitedHealth Group common shareholders demonstrate a more moderate pattern, with an initial decrease in 2022, followed by growth through 2023, and then declines similar to the reported net earnings in the subsequent two years. The difference between reported and adjusted net earnings suggests the presence of significant mark-to-market adjustments related to available-for-sale securities.

Trend in Reported Net Earnings

Reported net earnings increased from US$17,285 million in 2021 to US$20,120 million in 2022, representing a growth of approximately 16.4%. Further growth was observed in 2023, reaching US$22,381 million. However, a significant decrease occurred in 2024, with reported net earnings falling to US$14,405 million, and continued to decline in 2025 to US$12,056 million.

Trend in Adjusted Net Earnings

Adjusted net earnings decreased from US$16,372 million in 2021 to US$16,919 million in 2022, a slight increase. A substantial increase was then observed in 2023, reaching US$23,188 million. Similar to reported net earnings, adjusted net earnings decreased in 2024 to US$14,150 million and further to US$13,204 million in 2025.

Impact of Adjustments

The difference between reported and adjusted net earnings was US$913 million in 2021, increasing to US$3,201 million in 2022. In 2023, the difference narrowed to US$807 million, indicating a smaller adjustment. However, the difference widened considerably in 2024 to US$255 million and then to US$1,148 million in 2025. This suggests that mark-to-market adjustments, specifically losses, had a more pronounced negative impact on reported net earnings in 2024 and 2025.

The convergence of the downward trends in both reported and adjusted net earnings in 2024 and 2025, coupled with the increasing magnitude of the adjustment, indicates that fluctuations in the value of available-for-sale securities are playing an increasingly significant role in the company’s overall financial performance. Further investigation into the nature of these securities and the reasons for the mark-to-market adjustments is warranted.

The adjusted profitability ratios demonstrate fluctuating performance over the five-year period. While reported profitability metrics initially showed stability, a noticeable decline emerges in later years, with adjusted figures mirroring this trend. The differences between reported and adjusted values suggest the impact of mark-to-market adjustments on available-for-sale securities.

Net Profit Margin

Both reported and adjusted net profit margins exhibited relative stability between 2021 and 2023, fluctuating around the 6% and 5.7% marks, respectively. However, a significant downward trend is observed from 2023 onwards. Reported net profit margin decreased from 6.09% in 2023 to 2.72% in 2025, while the adjusted net profit margin followed a similar pattern, declining from 6.31% to 2.98% over the same period. The convergence of reported and adjusted margins indicates that the adjustments are consistently impacting the overall profitability picture.

Return on Equity (ROE)

Reported ROE peaked at 25.87% in 2022 before experiencing a substantial decrease to 12.81% by 2025. Adjusted ROE mirrored this trajectory, starting at 21.75% in 2022 and falling to 14.03% in 2025. The magnitude of the decline in ROE is considerable, suggesting a diminishing ability to generate profits from shareholder equity. The gap between reported and adjusted ROE remained relatively consistent, indicating a stable impact from the mark-to-market adjustments.

Return on Assets (ROA)

Reported ROA followed a similar pattern to ROE, remaining relatively stable around 8.15% - 8.19% from 2021 to 2023, then declining to 3.89% in 2025. Adjusted ROA exhibited a comparable trend, decreasing from 7.72% in 2021 to 4.27% in 2025. The decline in ROA suggests a decreasing efficiency in utilizing assets to generate profits. The adjustments consistently lowered the ROA figures, though the difference remained relatively contained.

Overall, the analysis reveals a clear deterioration in adjusted profitability metrics from 2023 to 2025. The consistent impact of mark-to-market adjustments on available-for-sale securities appears to be a contributing factor to this decline, as evidenced by the parallel trends observed between reported and adjusted ratios. The decreasing ROE and ROA suggest a weakening ability to generate returns for both shareholders and from asset utilization.

The period between 2021 and 2025 demonstrates fluctuating performance in net profitability, as measured by both reported and adjusted metrics. While adjusted net earnings generally track reported earnings, discrepancies exist, indicating the impact of certain adjustments made to reported figures. A notable divergence emerges in the later years of the observed period.

Reported Net Profit Margin

The reported net profit margin initially increased from 6.06% in 2021 to 6.25% in 2022, before stabilizing at 6.09% in 2023. A significant decline is then observed, falling to 3.65% in 2024 and further decreasing to 2.72% in 2025. This represents a substantial downward trend over the final three years of the period.

Adjusted Net Profit Margin

The adjusted net profit margin exhibited a decrease from 5.74% in 2021 to 5.25% in 2022. A subsequent increase to 6.31% occurred in 2023, followed by declines mirroring the reported margin, reaching 3.58% in 2024 and 2.98% in 2025. The pattern of decline in 2024 and 2025 is consistent with the reported margin, though the adjusted margin values are consistently lower than the reported margin throughout the period.

The convergence of the reported and adjusted net profit margins in the decline from 2023 to 2025 suggests that the adjustments made to net earnings are having a proportionally similar impact as the underlying changes in reported earnings. The consistent decrease in both margins during this period warrants further investigation to determine the underlying drivers, such as increased costs, decreased revenues, or specific accounting adjustments.

Relationship between Reported and Adjusted Earnings

The difference between reported and adjusted net earnings attributable to UnitedHealth Group common shareholders remained relatively small in 2021 and 2022. However, the gap widened considerably in 2023, with adjusted earnings exceeding reported earnings by a larger margin. This difference diminished in 2024 and 2025 as both earnings figures decreased, but the adjusted earnings remained consistently below the reported earnings.

The observed trends indicate a weakening of profitability towards the end of the analyzed period. The consistent decline in both reported and adjusted net profit margins from 2023 to 2025 suggests a systemic shift in the company’s financial performance, requiring further scrutiny to understand the root causes and potential implications.

The period under review demonstrates fluctuating performance in both reported and adjusted net earnings, which consequently impacts reported and adjusted return on equity (ROE). A general trend of increasing earnings through 2023 is followed by declines in both 2024 and 2025.

Reported Net Earnings

Reported net earnings attributable to UnitedHealth Group common shareholders increased from US$17,285 million in 2021 to US$20,120 million in 2022, and further to US$22,381 million in 2023. However, a significant decrease is observed in 2024, falling to US$14,405 million, with a further decline to US$12,056 million in 2025.

Adjusted Net Earnings

Adjusted net earnings attributable to UnitedHealth Group common shareholders show a similar pattern, rising from US$16,372 million in 2021 to US$16,919 million in 2022, and then increasing substantially to US$23,188 million in 2023. Like reported earnings, adjusted earnings then decrease to US$14,150 million in 2024 and US$13,204 million in 2025.

Reported ROE

Reported ROE initially increased from 24.09% in 2021 to 25.87% in 2022, before slightly decreasing to 25.22% in 2023. A substantial decline is then evident, with ROE falling to 15.55% in 2024 and further to 12.81% in 2025. This mirrors the decline in reported net earnings.

Adjusted ROE

Adjusted ROE follows a comparable trend, moving from 22.81% in 2021 to 21.75% in 2022, then increasing to 26.13% in 2023. A decrease is observed in 2024 to 15.27%, followed by a further decline to 14.03% in 2025. The adjusted ROE generally tracks the adjusted net earnings, though the magnitudes of change are slightly different than those observed in the reported figures.

The convergence of reported and adjusted ROE in 2024 and 2025 suggests that adjustments to net earnings have a diminishing impact on the overall ROE calculation during these periods. The consistent downward trend in both reported and adjusted ROE from 2023 to 2025 warrants further investigation into the underlying causes of the earnings declines.

The period under review demonstrates fluctuating performance in both reported and adjusted net earnings, which consequently impacts reported and adjusted return on assets. A general observation is that while adjusted net earnings initially increased, they experienced a decline in the later years of the period. This pattern is reflected in the corresponding return on assets metrics.

Reported Net Earnings & ROA

Reported net earnings attributable to UnitedHealth Group common shareholders increased from US$17,285 million in 2021 to US$20,120 million in 2022, and further to US$22,381 million in 2023. However, a significant decrease is observed in 2024, falling to US$14,405 million, and continuing to decline to US$12,056 million in 2025. This earnings trend directly correlates with the reported return on assets. Reported ROA peaked at 8.19% in 2022, remained relatively stable at 8.18% in 2023, and then experienced a substantial decline to 4.83% in 2024 and 3.89% in 2025.

Adjusted Net Earnings & ROA

Adjusted net earnings attributable to UnitedHealth Group common shareholders show a different trajectory. While increasing from US$16,372 million in 2021 to US$16,919 million in 2022, and then significantly to US$23,188 million in 2023, they also decreased in 2024 to US$14,150 million and further to US$13,204 million in 2025. The adjusted return on assets mirrors this pattern. Adjusted ROA increased to 8.47% in 2023 before declining to 4.74% in 2024 and 4.27% in 2025. The adjusted ROA consistently remains below the reported ROA throughout the period.

ROA Comparison

The difference between reported and adjusted ROA is relatively small in the earlier years (2021-2023), but becomes more pronounced in 2024 and 2025. This suggests that adjustments to net earnings have a greater impact on the calculated ROA during periods of lower overall earnings. The consistent decline in both reported and adjusted ROA in the final two years of the period indicates a weakening in the company’s profitability relative to its assets.

In summary, the company experienced a period of growth in net earnings and ROA through 2023, followed by a marked decline in both metrics in 2024 and 2025. The adjusted ROA provides a slightly different perspective due to the impact of adjustments made to net earnings, but the overall trend of declining profitability remains consistent across both measures.