CANADA – 2025/10/01: In this photo illustration, the UnitedHealth Group (United Health) logo is seen displayed on a smartphone screen. (Photo Illustration by Thomas Fuller/SOPA Images/LightRocket via Getty Images)
SOPA Images/LightRocket via Getty Images
UnitedHealth’s stock plummeted from over $600 to approximately $310-$320 (nearly 50% down) over the last year, and it’s not merely market fluctuations. This decline stems from a significant issue centered around one key metric: the Medical Care Ratio (MCR). Additionally, even Optum, the division that was expected to provide stability, is encountering difficulties. Separately, read about the turmoil in Bitcoin: Before Bitcoin Hits $50,000, Ask This One Question.
So, what precisely led to the stock’s decline?
The downfall unfolded in two harsh stages of damage to earnings and a collapse in valuation multiples. Before we delve into the details, if you’re looking for a strategy with less volatility than owning a single stock like UNH, consider the High Quality Portfolio. It has consistently outperformed its benchmark—a combination of the S&P 500, Russell 2000, and S&P MidCap indexes—and has recorded returns exceeding 105% since its launch. Why is that? As a collective, HQ Portfolio stocks have yielded better returns with lower risk compared to the benchmark index; it has provided a smoother investment experience, as illustrated in HQ Portfolio performance metrics. Separately, see – Before Bitcoin Hits $50,000, Ask This One Question
Phase 1: Earnings Were Decimated
- What transpired with the MCR? It surged. The consolidated MCR increased from a stable ~82% in 2022 to about ~88% by late 2025, with certain quarters reaching 89.9%. This marks an approximate 600 basis point spike, eating directly into profits.
- Why was this so significant? Medicare Advantage members began utilizing far more medical services than anticipated. When claims payouts rise significantly and revenue growth cannot keep pace, profitability takes a hit.
- How severe was the damage to earnings? Management had to reduce their 2025 Adjusted EPS guidance from around $29.50-$30.00 to at least $16.25. That represents over $13 per share in expected earnings—simply vanished.
Phase 2: The Valuation Multiple Crashed
What prompted investors to flee? UNH previously commanded a premium valuation (P/E of 24x-26x) because it consistently generated reliable, double-digit earnings growth. The disruption in MCR destroyed that predictability almost instantly.
- P/E Multiple in 2022: ~24x-26x
- P/E Multiple in 2025: ~16x-17x
- The decline: Down 8-10 points
- Stock price effect: What was (High Multiple × High EPS) became (Low Multiple × Low EPS)—a double blow
Investors are now reluctant to pay a premium for earnings that appear uncertain and volatile. The market currently views UNH as a lower-quality, higher-risk enterprise.
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Wait, wasn’t Optum supposed to counter this?
This was the general belief. For years, Optum’s high-growth narrative protected UNH from the fluctuations in the insurance market. That’s no longer the case.
What issues is Optum facing?
- Funding reductions for Medicare are impacting this division as well
- The value-based care model (Optum Health) is encountering the same utilization challenges
- Significant investment costs are squeezing margins
How serious is the situation? Optum’s operating earnings are expected to drop year-over-year in 2025—from ~$16.7 billion in 2024 to somewhere between $12.5 billion and $12.8 billion.
Why is this a major concern? UNH has simultaneously lost both its growth engine and its profit safeguard. There are no remaining safety nets.
What’s next?
Is the stock inexpensive now at 16x-17x earnings? On the surface, yes—it’s trading significantly below its historical average of 25x. Nevertheless, this discount is warranted at this point. Until the MCR stabilizes and Optum rebounds, UNH resembles a low-margin, cyclical insurance firm more than the premium healthcare technology leader it once was.
What must happen for recovery?
Three things:
- MCR stabilization – Clear evidence that medical utilization is returning to normal
- 2026 premium adjustments – Successfully increasing premiums sufficiently to recover lost margins (bids are placed months in advance, so investors are observing closely)
- Optum’s re-acceleration – The growth segment needs to realign
What is the greatest risk? If management misjudges the 2026 pricing or if the MCR remains persistently high, the stock’s current low multiple may persist indefinitely, capping potential upside.
To mitigate this single-stock risk, investors should consider diversified strategies such as the Trefis Reinforced Value (RV) Portfolio. This portfolio has consistently surpassed its all-cap stocks benchmark (a mix of the S&P 500, S&P mid-cap, and Russell 2000 indices), achieving robust returns.
What accounts for the outperformance? The RV Portfolio’s success, as outlined in its performance metrics, is attributed to its quarterly rebalanced blend of large-, mid-, and small-cap stocks. This adaptive approach is crafted to strategically leverage favorable market conditions while simultaneously limiting losses during downturns.
Conclusion
The MCR spike delivered a dual blow: it drastically cut earnings AND obliterated the valuation multiple. A genuine recovery will not be achieved through stabilization alone—it necessitates a credible trajectory back to double-digit growth, which entails resolving the MCR challenge in UnitedHealthcare and reigniting growth in Optum. Until both occur, anticipate ongoing pressure.