UnitedHealth Group Q4 Earnings Preview: First Report Since Insurance CEO's Murder Comes With Questions On Company's Future

Investors and analysts could turn attention to how UnitedHealth Group UNH will replace its insurance unit CEO Brian Thompson, who was fatally shot in December, and how the company will keep public trust as the sector comes under increased scrutiny when the company reports fourth-quarter financial results before market open Thursday.

Earnings Estimates: Analysts expect UnitedHealth to report fourth-quarter revenue of $101.75 billion, up from $94.43 billion in last year's fourth quarter, according to data from Benzinga Pro.

The company has missed analyst revenue estimates in two straight quarters, while beating estimates in eight of the last 10 quarters.

Analysts expect the company to report fourth-quarter earnings per share of $6.73, up from $6.16 in last year's fourth quarter. The company has beaten analyst estimates for earnings per share in nine of the last 10 quarters.

Key Items to Watch: Thursday's earnings report marks the first quarterly report from UnitedHealth since the company lost Thompson.

Thompson, who was the CEO of UnitedHealthcare, was shot and killed on Dec. 4 in New York City. Luigi Mangione was arrested for the murder and is facing state and federal charges that include first degree murder. Mangione faces potential sentences of life in prison without parole and the possibility of the death penalty if found guilty.

Analysts and investors may be ready to hear if UnitedHealth will address the challenges of replacing Thompson and moving forward after his passing. Sources told Bloomberg the company is not ready to immediately replace Thompson.

UnitedHealth Group CEO Andrew Witty recently reportedly told executives the company will hit financial records in the current fiscal year, which could put the company and stock back in the spotlight a month after Thompson's death.

The company's revenue through the first nine months is $299 billion, a company record, and up from $277 billion through the first nine months of 2023.

Health insurance companies like UnitedHealth have come under increased attention and pressure after Thompson's death. A notebook found on Mangione at the time of his arrest mentioned how insurance companies were focused on profits over the public's health.

An entry in the notebook dated Aug. 15 said: "The details are finally coming together." The entry said procrastination had allowed Mangione to learn more about the company he was targeting; the name of the company was redacted.

"The target is insurance…it checks every box," was also written in the notebook alleged to belong to Mangione, according to the federal complaint against him.

Despite being on trial for murder, Mangione has gained a level of public support, with Thompson's death becoming a rallying cry for critics of the health insurance industry, often accused of denying medical claims.

Along with navigating the fallout from Thompson's death and the increased attention on insurance claims, UnitedHealth has found itself a target of incoming President Donald Trump, who recently spoke out about pharmacy benefit managers.

Trump said he would "knock out" PBMs from the industry, referring to them as drug middlemen, a role they are commonly associated with.

"You know the middleman, right? The horrible middleman that makes more money frankly than the drug companies, and they don't do anything except they're a middleman. We're going to knock out the middleman," Trump said.

UnitedHealth is also facing bipartisan pressure from Congress to push for the breakup of health care conglomerates over PBM practices.

The insurance company also faces scrutiny from the Department of Justice, which has blocked United's $3.3 billion deal to acquire Amedisys Inc AMED.

Along with any commentary on how the new White House administration and public pressure could impact the company's future growth and operations, investors and analysts may be looking for an update on guidance.

UnitedHealth shared 2025 revenue guidance of $450 billion to $455 billion and earnings per share guidance of $28.15 to $28.65 ahead of Thompson's death in December.

UNH, DIA Price Action: UnitedHealth stock trades at $544.11 versus a 52-week trading range of $436.38 to $630.73. UnitedHealth stock is up 4.8% over the last year, but has fallen around 11% since Thompson's death.

The SPDR Dow Jones Industrial Average ETF DIA and other ETFs that track the Dow Jones Industrial Average will also be in the spotlight Thursday after UnitedHealth's report. United is the second largest component of the Dow Jones Index due to its price-weighted methodology.

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