Alan Kral , CFA, CIC UnitedHealth Group Inc UNH-N DON'T BUY Apr 21, 2009

Down today, so an opportunity. The largest health insurer can do anything it wants under this presidency.

Has plunged 22% since reporting last Thursday and dragged the sector down. What in the world happened? They missed top and bottom lines, but worse they cut their full-year earnings forecast by 12%, citing high medical costs in its Medicare plans. The health profiles of many patients has been inaccurate., especially in their managed care business. Their medical care ratio was 84.8% in Q1 2025, but they guided full year at 87.5%. However, UNH's peers are faring better. UNH is having execution problems and is no longer best of breed.

Fallen angel. Disappointing quarter, severely lowered guidance for 2025. 80% of its business is healthcare insurance. Taking market share in every segment they operate in. Funding pressure on government-funded healthcare insurance is curtailing short-term profitability; but this is building long-term value for shareholders. Secular trends of demographics and morbidity in the US are tailwinds. 

Fortress-like balance sheet, A+ credit rating. Buying back shares prolifically with FCF. Trading at 15x PE vs. the 5-year average of 19.5x. Yield is 1.97%.

It will be under pressure for some time and he's been very negative on this stock, but at $400 you can start a position on it.

Good entry point for long-term hold; potential generational buying opportunity. Reason for the drop is that they were classifying clinic patients as less sick than they actually were. Resulted in recouping less revenue, to the tune of ~$500 per month per patient, amounting to ~$3+B. Keep an eye on how quickly this amount is recovered. Yield is 2.1%.

Be mindful that this doesn't turn into a bigger problem of something fundamentally changing in the ever-evolving US healthcare system. Facts could change.

Major leader in the Medicare space. Recent rare miss on earnings, and he sold just before. Shares now well below 200-day MA, which is starting to trend down a little bit. Earnings growth rate now 6-7% going forward, at 14x forward PE.

Very oversold, around 25 RSI. At some point, shares will bottom and move higher. Be careful, shares seem to be in freefall right now. Doesn't see any major support levels. Wait for an opportunity, once it starts swinging up for real.

Historical bastion of consistency. Last quarter it became inconsistent, with a 12% guidance down on EPS because utilization rates went up (they were unable, for some reason, to calculate this accurately). Just a small improvement in these metrics will boost the stock. 20 years of excellent execution, so this hiccup is a great time to buy. Yield is 2.2%.

A few weeks ago they warned they wouldn't meet their numbers. Today, they said they wouldn't meet their guidance. US insurance is changing with regulatory policy demands and medical loss ratios are staying high as people are using their plans more and more as an echo of Covid. The problem is UNH's concentration in the Medicare/Medicaid space

There was a lot of insider buying today, so why would their execs buy if they felt they would have a problem with the US Justice Dept? But he isn't happy with this stock, down 50% in the last month. Sell on this strength.

Under lots of pressure. He's bought in recent weeks. Rare miss on Q1, lowered guidance. Medical loss ratios expected to be elevated for a few quarters; should recoup when premiums reprice in 2026. Recent CEO departure rattled investors further. Unconfirmed story of DOJ investigation for Medicare fraud. 

Brand tarnished, but not irreparably. Not an immediate fix, but worth the wait. Long-term sustainable growth rate of 13-16%, trading at 12-13x PE. Market's overreacted, shares undervalued. Largest healthcare company in US. Healthcare sector is secularly advantaged by demographics and morbidity trends.