By Anna Wilde Mathews

UnitedHealth Group reported fourth-quarter results and issued 2026 earnings guidance that were in line with lowered Wall Street expectations, as the company said it was making progress on its financial turnaround.

Chief Executive Stephen Hemsley, who began his second stint as CEO last May after UnitedHealth suffered an earnings shortfall that helped spark a share meltdown, said the healthcare giant "confronted challenges directly and finished 2025 as a stronger company."

Shares of UnitedHealth and some of its competitors dropped sharply in after-hours trading Monday after the federal Medicare agency proposed payment rates for 2027 that were well below what Wall Street had expected. Hemsley and his fellow insurance CEOs also recently faced down testy members of Congress in two House hearings, taking a critical strafing from lawmakers of both parties.

UnitedHealth was recently down 11% at $310 in premarket trading.

For the fourth quarter of 2025, UnitedHealth reported net income of $10 million, or 1 cent per share, after a fourth-quarter charge that totaled $1.6 billion, or $1.78 a share. That compared with net income of $5.54 billion, or $5.98 a share, in the year-earlier quarter.

The charges in the fourth quarter of 2025 included costs related to a major cyberattack on UnitedHealth's Change Healthcare unit, as well as restructuring. The company has said it is divesting some holdings.

Revenue for the fourth quarter of 2025 was $113.2 billion, up from $100.8 billion in the same quarter of 2024.

On an adjusted basis, UnitedHealth reported fourth-quarter earnings of $2.11 a share, close to the $2.10 projected by a FactSet analyst consensus. Adjusted earnings for the fourth quarter of 2024 were $6.81 a share.

UnitedHealth projected 2026 revenue of more than $439 billion--a potential decline from the 2025 figure of $447.6 billion. The dropoff is unusual for a company long characterized by constant growth and unrelenting acquisitions. UnitedHealth, which is the parent of the largest U.S. health insurer as well as doctor groups and other assets, has said it is retrenching across a number of its businesses, as it seeks to bolster margins.

The company said it expects net earnings per share of more than $17.10 in 2026, or more than $17.75 on an adjusted basis. The FactSet adjusted earnings projection for the year is for $17.74 a share.

Net earnings per share for 2025 totaled $13.23, while adjusted earnings per share were $16.35.

Write to Anna Wilde Mathews at Anna.Mathews@wsj.com

(END) Dow Jones Newswires

January 27, 2026 06:10 ET (11:10 GMT)

Copyright (c) 2026 Dow Jones & Company, Inc.