Name: UnitedHealth Group Inc. (NYSE:UNH) | Cash Flow Statement
Creator: Stock Analysis on Net

Cash Flow Statement

The cash flow statement provides information about a company cash receipts and cash payments during an accounting period, showing how these cash flows link the ending cash balance to the beginning balance shown on the company balance sheet.

The cash flow statement consists of three parts: cash flows provided by (used in) operating activities, cash flows provided by (used in) investing activities, and cash flows provided by (used in) financing activities.

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UnitedHealth Group Inc., consolidated cash flow statement

US$ in millions

12 months ended:	Dec 31, 2025	Dec 31, 2024	Dec 31, 2023	Dec 31, 2022	Dec 31, 2021
Net earnings	12,807)	15,242)	23,144)	20,639)	17,732)
Depreciation and amortization	4,361)	4,099)	3,972)	3,400)	3,103)
Deferred income taxes	(1,752)	(296)	(245)	(673)	130)
Share-based compensation	971)	1,018)	1,059)	925)	800)
Loss on sale of subsidiary and subsidiaries held for sale	265)	8,310)	—)	—)	—)
Net gains on dispositions and other strategic transactions	(910)	(3,333)	(489)	(588)	—)
Other, net	1,673)	(28)	(16)	257)	(944)
Noncash items	4,608)	9,770)	4,281)	3,321)	3,089)
Accounts receivable	(764)	(1,437)	(3,114)	(2,523)	(1,000)
Other assets	(4,606)	(4,140)	(2,444)	(1,374)	(1,031)
Medical costs payable	5,824)	2,503)	3,482)	4,053)	2,701)
Accounts payable and other liabilities	1,665)	2,463)	3,516)	1,964)	1,162)
Unearned revenues	163)	(197)	203)	126)	(310)
Net change in other operating items, net of effects from acquisitions and dispositions	2,282)	(808)	1,643)	2,246)	1,522)
Cash flows from operating activities	19,697)	24,204)	29,068)	26,206)	22,343)
Purchases of investments	(17,373)	(27,308)	(18,314)	(18,825)	(17,139)
Sales of investments	9,288)	18,514)	7,307)	5,907)	7,045)
Maturities of investments	8,446)	9,319)	9,230)	6,081)	8,251)
Cash paid for acquisitions and other transactions, net of cash assumed	(4,509)	(13,408)	(10,136)	(21,458)	(4,821)
Purchases of property, equipment and capitalized software	(3,622)	(3,499)	(3,386)	(2,802)	(2,454)
Loans to care providers, cyberattack	—)	(9,033)	—)	—)	—)
Repayments of care provider loans, cyberattack	1,680)	4,514)	—)	—)	—)
Cash received from dispositions and other strategic transactions, net	561)	2,041)	685)	3,414)	15)
Originations and purchases of loans	(4,795)	(2,477)	(1,664)	—)	—)
Repayments and maturities of loans	1,980)	908)	613)	—)	—)
Other, net	(341)	(98)	91)	(793)	(1,269)
Cash flows used for investing activities	(8,685)	(20,527)	(15,574)	(28,476)	(10,372)
Common share repurchases	(5,545)	(9,000)	(8,000)	(7,000)	(5,000)
Cash dividends paid	(7,916)	(7,533)	(6,761)	(5,991)	(5,280)
Proceeds from common stock issuances	827)	1,846)	1,353)	1,253)	1,355)
Repayments of long-term debt	(3,050)	(3,000)	(2,125)	(3,015)	(3,150)
Proceeds from (repayments of) short-term borrowings, net	807)	(151)	11)	732)	(1,302)
Proceeds from issuance of long-term debt	2,969)	17,811)	6,394)	14,819)	6,933)
Customer funds administered	366)	(1,560)	(521)	5,548)	622)
Purchases of redeemable noncontrolling interests	(165)	(280)	(730)	(176)	(1,338)
Other, net	63)	(1,645)	(1,150)	(1,944)	(295)
Cash flows from (used for) financing activities	(11,644)	(3,512)	(11,529)	4,226)	(7,455)
Effect of exchange rate changes on cash and cash equivalents	40)	(61)	97)	34)	(62)
Increase (decrease) in cash and cash equivalents, including cash within businesses held for sale	(592)	104)	2,062)	1,990)	4,454)
Net increase in cash within businesses held for sale	(355)	(219)	—)	—)	—)
Net increase (decrease) in cash and cash equivalents	(947)	(115)	2,062)	1,990)	4,454)
Cash and cash equivalents, beginning of period	25,312)	25,427)	23,365)	21,375)	16,921)
Cash and cash equivalents, end of period	24,365)	25,312)	25,427)	23,365)	21,375)

Based on: 10-K (reporting date: 2025-12-31), 10-K (reporting date: 2024-12-31), 10-K (reporting date: 2023-12-31), 10-K (reporting date: 2022-12-31), 10-K (reporting date: 2021-12-31).

Overall cash flow performance demonstrates variability across the five-year period. While operating activities consistently generate substantial cash inflows, investing and financing activities exhibit significant fluctuations, impacting the net change in cash and cash equivalents.

Operating Activities: Cash flows from operating activities generally increased from US$22.343 billion in 2021 to US$29.068 billion in 2023, before declining to US$19.697 billion in 2025. This initial growth was driven by increases in net earnings, coupled with noncash items like depreciation and share-based compensation. However, the decline in 2024 and 2025 is linked to a decrease in net earnings and changes in working capital components, particularly accounts receivable and other assets. Medical costs payable and accounts payable demonstrate positive contributions to cash flow, with notable increases in 2022 and 2025 respectively.
Investing Activities: Investing activities consistently represent a significant cash outflow. Purchases of investments are the primary driver of this outflow, remaining substantial throughout the period, although increasing significantly in 2024. Sales of investments provide some offset, with a particularly large contribution in 2024. Cash paid for acquisitions also represents a considerable outflow, peaking in 2022. A substantial outflow related to a cyberattack and associated loans occurred in 2024, partially offset by repayments in 2025. Originations and purchases of loans also contribute to cash outflows in later years.
Financing Activities: Financing activities show considerable volatility. Common share repurchases and cash dividends paid consistently represent significant cash outflows. Proceeds from the issuance of long-term debt are a major inflow, particularly in 2022 and 2024. Customer funds administered show a large inflow in 2022, followed by outflows in subsequent years. Purchases of redeemable noncontrolling interests also contribute to cash outflows. Overall, financing activities were positive in 2022 but negative in all other years, with a substantial negative impact in 2025.
Net Cash Flow & Key Trends: The net increase in cash and cash equivalents was positive in 2021, 2022, and 2023, but turned negative in 2024 and 2025. The decrease in net earnings, coupled with increased investment in acquisitions and a shift in financing activities, contributed to the negative cash flow in the later years. Deferred income taxes show a consistent negative impact, increasing in magnitude over time. Noncash items generally increased, contributing positively to operating cash flow, but were insufficient to offset the declines in net earnings and the impact of working capital changes.

The company’s ability to generate cash from operations remains strong, but is increasingly impacted by strategic investments, financing decisions, and fluctuations in net income. The significant changes in investing and financing cash flows warrant further investigation to understand the underlying drivers and potential implications for future financial performance.

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