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.

UnitedHealth Group Inc., consolidated cash flow statement

US$ in millions

12 months ended:	Dec 31, 2024	Dec 31, 2023	Dec 31, 2022	Dec 31, 2021	Dec 31, 2020
Net earnings	15,242)	23,144)	20,639)	17,732)	15,769)
Depreciation and amortization	4,099)	3,972)	3,400)	3,103)	2,891)
Deferred income taxes	(296)	(245)	(673)	130)	(8)
Share-based compensation	1,018)	1,059)	925)	800)	679)
Loss on sale of subsidiary and subsidiaries held for sale	8,310)	—)	—)	—)	—)
Gains on dispositions and other strategic transactions	(3,333)	(489)	(588)	—)	—)
Other, net	(28)	(16)	257)	(944)	(52)
Noncash items	9,770)	4,281)	3,321)	3,089)	3,510)
Accounts receivable	(1,437)	(3,114)	(2,523)	(1,000)	(688)
Other assets	(4,140)	(2,444)	(1,374)	(1,031)	(2,195)
Medical costs payable	2,503)	3,482)	4,053)	2,701)	152)
Accounts payable and other liabilities	2,463)	3,516)	1,964)	1,162)	5,348)
Unearned revenues	(197)	203)	126)	(310)	278)
Net change in other operating items, net of effects from acquisitions and dispositions	(808)	1,643)	2,246)	1,522)	2,895)
Cash flows from operating activities	24,204)	29,068)	26,206)	22,343)	22,174)
Purchases of investments	(27,308)	(18,314)	(18,825)	(17,139)	(16,577)
Sales of investments	18,514)	7,307)	5,907)	7,045)	6,489)
Maturities of investments	9,319)	9,230)	6,081)	8,251)	7,252)
Cash paid for acquisitions and other transactions, net of cash assumed	(13,408)	(10,136)	(21,458)	(4,821)	(7,139)
Purchases of property, equipment and capitalized software	(3,499)	(3,386)	(2,802)	(2,454)	(2,051)
Loans to care providers, cyberattack	(9,033)	—)	—)	—)	—)
Repayments of care provider loans, cyberattack	4,514)	—)	—)	—)	—)
Cash received from dispositions and other strategic transactions, net	2,041)	685)	3,414)	15)	221)
Other, net	(1,667)	(960)	(793)	(1,269)	(727)
Cash flows used for investing activities	(20,527)	(15,574)	(28,476)	(10,372)	(12,532)
Common share repurchases	(9,000)	(8,000)	(7,000)	(5,000)	(4,250)
Cash dividends paid	(7,533)	(6,761)	(5,991)	(5,280)	(4,584)
Proceeds from common stock issuances	1,846)	1,353)	1,253)	1,355)	1,440)
Repayments of long-term debt	(3,000)	(2,125)	(3,015)	(3,150)	(3,150)
Proceeds from (repayments of) short-term borrowings, net	(151)	11)	732)	(1,302)	872)
Proceeds from issuance of long-term debt	17,811)	6,394)	14,819)	6,933)	4,864)
Customer funds administered	(1,560)	(521)	5,548)	622)	1,677)
Purchases of redeemable noncontrolling interests	(280)	(730)	(176)	(1,338)	—)
Other, net	(1,645)	(1,150)	(1,944)	(295)	(459)
Cash flows from (used for) financing activities	(3,512)	(11,529)	4,226)	(7,455)	(3,590)
Effect of exchange rate changes on cash and cash equivalents	(61)	97)	34)	(62)	(116)
Increase (decrease) in cash and cash equivalents, including cash within businesses held for sale	104)	2,062)	1,990)	4,454)	5,936)
Cash within businesses held for sale	(219)	—)	—)	—)	—)
Net increase (decrease) in cash and cash equivalents	(115)	2,062)	1,990)	4,454)	5,936)
Cash and cash equivalents, beginning of period	25,427)	23,365)	21,375)	16,921)	10,985)
Cash and cash equivalents, end of period	25,312)	25,427)	23,365)	21,375)	16,921)

Based on: 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), 10-K (reporting date: 2020-12-31).

Net Earnings and Noncash Items: Net earnings displayed consistent growth from 2020 through 2023, increasing from $15.8 billion to $23.1 billion, followed by a significant decrease to $15.2 billion in 2024. Noncash items similarly increased over the first four years, peaking sharply in 2024 at $9.8 billion. This indicates a notable rise in adjustments not involving actual cash flow in the latest period.
Depreciation, Amortization, and Share-Based Compensation: Depreciation and amortization expenses steadily increased each year, from $2.9 billion in 2020 to $4.1 billion in 2024. Share-based compensation likewise rose annually until 2023, peaking at $1.06 billion, then slightly declined to $1.02 billion in 2024. These trends point to ongoing investments in assets and employee incentives over time.
Deferred Income Taxes and Gains/Losses on Transactions: Deferred income taxes fluctuated with minor values and showed mostly negative amounts from 2022 onwards. Gains on dispositions and other strategic transactions showed losses starting in 2022, worsening substantially in 2024 at -$3.3 billion. Additionally, a large one-time loss on sale of subsidiaries was recorded in 2024 for $8.3 billion, significantly impacting that year's financial results.
Changes in Working Capital Items: Accounts receivable experienced growing negative changes from 2020 through 2023, suggesting increasing collections or reduction in receivables, but reversed partially in 2024. Other assets showed a consistently negative trend, indicating utilization or reduction of assets. Medical costs payable increased sharply in 2021 and 2022, then declined steadily, reflecting fluctuations in payables.
Cash Flows from Operating Activities: Operating cash flow grew from $22.2 billion in 2020 to a peak of $29.1 billion in 2023, but receded to $24.2 billion in 2024. This pattern parallels net earnings trends but with less volatility.
Investing Activities: Significant volatility characterized investing cash flows. Purchases of investments rose consistently from $16.6 billion in 2020 to $27.3 billion in 2024. Sales of investments fluctuated markedly, with a large surge to $18.5 billion in 2024. Cash paid for acquisitions peaked considerably in 2022 at $21.5 billion before declining. Purchases of property, equipment, and software steadily increased, indicating ongoing capital expenditure. The impact of cyberattacks on loans was notable in 2024, with large loans extended and partial repayments recorded. Overall, cash flows used for investing activities increased sharply in 2022 and remained high, reflecting heavy investment and acquisition activity.
Financing Activities: The company consistently repurchased common shares, increasing the amount annually to $9 billion in 2024. Cash dividends likewise rose steadily from $4.6 billion to $7.5 billion over the period. Debt issuance activities showed substantial long-term debt issuance peaking in 2022 and again significantly increasing in 2024. Repayments of long-term debt decreased over time but picked up slightly in 2024. Net cash flows from financing fluctuated, with net outflows in most years except 2022, where inflows were recorded due to debt issuances exceeding repurchases and dividends. This indicates an active balance sheet management strategy combining shareholder returns and financing.
Liquidity and Cash Position: Cash and cash equivalents rose steadily from $10.9 billion at the start of 2020 to $25.4 billion at the end of 2023, before slightly decreasing to $25.3 billion in 2024. Increases in cash generally aligned with operating cash flow growth but were tempered by increased investing and financing outflows in the most recent year. Effects from exchange rate changes on cash were minor and sporadic.
Overall Assessment: The company showed robust growth in net earnings and operating cash flows up to 2023, supported by steady depreciation and capital expenditures. The year 2024 marked a notable shift, with net earnings dropping sharply, large noncash adjustments, and significant losses from strategic transactions and sales of subsidiaries. Investing activities intensified with record purchases of investments and substantial acquisition payments impacted by cybersecurity issues. Financing activities reflected a strong commitment to returning capital to shareholders through dividends and repurchases, balanced against increased debt issuance. The overall liquidity position remained strong despite the challenges observed in 2024.

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UnitedHealth Group Inc. (NYSE:UNH)

Cash Flow Statement