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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
__________________________________________________________ 
FORM 10-Q
__________________________________________________________ 
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2023
or
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from _______ to _______
Commission File Number: 1-10864
__________________________________________________________ 
UHG(R)_CMYK.jpg
UnitedHealth Group Incorporated
(Exact name of registrant as specified in its charter)
 __________________________________________________________ 
Delaware 41-1321939
(State or other jurisdiction of
incorporation or organization)
 (I.R.S. Employer
Identification No.)
UnitedHealth Group Center 55343
9900 Bren Road East
Minnetonka,
Minnesota
(Address of principal executive offices) (Zip Code)
(952) 936-1300
(Registrant’s telephone number, including area code)
_________________________________________________________  
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $.01 par valueUNHNew York Stock Exchange
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes No
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes  No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act
Large accelerated filerAccelerated filer
Non-accelerated filer
Smaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes No 
As of October 31, 2023, there were 924,925,293 shares of the registrant’s Common Stock, $.01 par value per share, issued and outstanding.



UNITEDHEALTH GROUP
Table of Contents
 
  Page




PART I
ITEM 1.    FINANCIAL STATEMENTS
UnitedHealth Group
Condensed Consolidated Balance Sheets
(Unaudited)
(in millions, except per share data)September 30,
2023
December 31,
2022
Assets
Current assets:
Cash and cash equivalents$38,915 $23,365 
Short-term investments5,182 4,546 
Accounts receivable, net20,673 17,681 
Other current receivables, net17,752 12,769 
Assets under management3,616 4,087 
Prepaid expenses and other current assets5,767 6,621 
Total current assets91,905 69,069 
Long-term investments45,474 43,728 
Property, equipment and capitalized software, net
11,070 10,128 
Goodwill101,703 93,352 
Other intangible assets, net15,200 14,401 
Other assets16,711 15,027 
Total assets$282,063 $245,705 
Liabilities, redeemable noncontrolling interests and equity
Current liabilities:
Medical costs payable$32,792 $29,056 
Accounts payable and accrued liabilities31,164 27,715 
Short-term borrowings and current maturities of long-term debt5,290 3,110 
Unearned revenues15,311 3,075 
Other current liabilities29,622 26,281 
Total current liabilities114,179 89,237 
Long-term debt, less current maturities58,079 54,513 
Deferred income taxes2,210 2,769 
Other liabilities13,615 12,839 
Total liabilities188,083 159,358 
Commitments and contingencies (Note 7)
Redeemable noncontrolling interests4,416 4,897 
Equity:
Preferred stock, $0.001 par value - 10 shares authorized; no shares issued or outstanding
  
Common stock, $0.01 par value - 3,000 shares authorized; 925 and 934 issued and outstanding
9 9 
Retained earnings93,173 86,156 
Accumulated other comprehensive loss(8,688)(8,393)
Nonredeemable noncontrolling interests
5,070 3,678 
Total equity89,564 81,450 
Total liabilities, redeemable noncontrolling interests and equity$282,063 $245,705 
See Notes to the Condensed Consolidated Financial Statements
1

Table of Contents
UnitedHealth Group
Condensed Consolidated Statements of Operations
(Unaudited)
 Three Months Ended September 30,Nine Months Ended
September 30,
(in millions, except per share data)2023202220232022
Revenues:
Premiums$72,339 $64,491 $217,599 $192,457 
Products10,354 9,190 31,272 28,026 
Services8,671 6,700 25,414 19,717 
Investment and other income997 513 2,910 1,175 
Total revenues92,361 80,894 277,195 241,375 
Operating costs:
Medical costs59,550 52,635 179,663 157,251 
Operating costs13,855 11,663 41,289 34,773 
Cost of products sold9,423 8,306 28,576 25,389 
Depreciation and amortization1,007 828 2,998 2,418 
Total operating costs83,835 73,432 252,526 219,831 
Earnings from operations8,526 7,462 24,669 21,544 
Interest expense(834)(516)(2,416)(1,416)
Earnings before income taxes7,692 6,946 22,253 20,128 
Provision for income taxes(1,654)(1,562)(4,784)(4,397)
Net earnings6,038 5,384 17,469 15,731 
Earnings attributable to noncontrolling interests(197)(122)(543)(372)
Net earnings attributable to UnitedHealth Group common shareholders$5,841 $5,262 16,926 $15,359 
Earnings per share attributable to UnitedHealth Group common shareholders:
Basic$6.31 $5.63 $18.20 $16.37 
Diluted$6.24 $5.55 $18.01 $16.15 
Basic weighted-average number of common shares outstanding926 935 930 938 
Dilutive effect of common share equivalents10 13 10 13 
Diluted weighted-average number of common shares outstanding936 948 940 951 
Anti-dilutive shares excluded from the calculation of dilutive effect of common share equivalents6 3 6 3 
See Notes to the Condensed Consolidated Financial Statements
2

Table of Contents
UnitedHealth Group
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)
 Three Months Ended September 30,Nine Months Ended
September 30,
(in millions)2023202220232022
Net earnings$6,038 $5,384 $17,469 $15,731 
Other comprehensive loss:
Gross unrealized losses on investment securities during the period(893)(1,471)(684)(4,825)
Income tax effect204 340 156 1,109 
Total unrealized losses, net of tax(689)(1,131)(528)(3,716)
Gross reclassification adjustment for net realized losses (gains) included in net earnings7 138 (27)134 
Income tax effect(2)(32)6 (31)
Total reclassification adjustment, net of tax
5 106 (21)103 
Total foreign currency translation (losses) gains (354)(331)254 (89)
Other comprehensive loss(1,038)(1,356)(295)(3,702)
Comprehensive income5,000 4,028 17,174 12,029 
Comprehensive income attributable to noncontrolling interests(197)(122)(543)(372)
Comprehensive income attributable to UnitedHealth Group common shareholders
$4,803 $3,906 $16,631 $11,657 
See Notes to the Condensed Consolidated Financial Statements
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UnitedHealth Group
Condensed Consolidated Statements of Changes in Equity
(Unaudited)
Common StockAdditional Paid-In CapitalRetained EarningsAccumulated Other Comprehensive LossNonredeemable Noncontrolling InterestsTotal
Equity
Three months ended September 30,
(in millions)
SharesAmountNet Unrealized Losses on InvestmentsForeign Currency Translation Losses
Balance at June 30, 2023927 $9 $ $89,994 $(2,643)$(5,007)$5,015 $87,368 
Net earnings
5,841 149 5,990 
Other comprehensive loss(684)(354)(1,038)
Issuances of common stock, and related tax effects
1  395 395 
Share-based compensation
235 235 
Common share repurchases(3) (588)(923)(1,511)
Cash dividends paid on common shares ($1.88 per share)
(1,739)(1,739)
Redeemable noncontrolling interests fair value and other adjustments
(42)(42)
Acquisition and other adjustments of nonredeemable noncontrolling interests
42 42 
Distribution to nonredeemable noncontrolling interests
(136)(136)
Balance at September 30, 2023925 $9 $ $93,173 $(3,327)$(5,361)$5,070 $89,564 
Balance at June 30, 2022935 $10 $ $80,540 $(2,165)$(5,565)$3,385 $76,205 
Net earnings
5,262 99 5,361 
Other comprehensive loss(1,025)(331)(1,356)
Issuances of common stock, and related tax effects
2  294 294 
Share-based compensation
163 163 
Common share repurchases(2) (462)(538)(1,000)
Cash dividends paid on common shares ($1.65 per share)
(1,542)(1,542)
Redeemable noncontrolling interests fair value and other adjustments
5 5 
Acquisition and other adjustments of nonredeemable noncontrolling interests32 32 
Distribution to nonredeemable noncontrolling interests
(98)(98)
Balance at September 30, 2022935 $10 $ $83,722 $(3,190)$(5,896)$3,418 $78,064 
See Notes to the Condensed Consolidated Financial Statements






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UnitedHealth Group
Condensed Consolidated Statements of Changes in Equity
(Unaudited)
Common StockAdditional Paid-In CapitalRetained EarningsAccumulated Other Comprehensive
(Loss) Income
Nonredeemable Noncontrolling InterestsTotal
Equity
Nine months ended September 30,
(in millions)
SharesAmountNet Unrealized (Losses) Gains on InvestmentsForeign Currency Translation (Losses) Gains
Balance at January 1, 2023934 $9 $ $86,156 $(2,778)$(5,615)$3,678 $81,450 
Net earnings
16,926 401 17,327 
Other comprehensive (loss) income(549)254 (295)
Issuances of common stock, and related tax effects
4  963 963 
Share-based compensation
833 833 
Common share repurchases(13) (1,663)(4,886)(6,549)
Cash dividends paid on common shares ($5.41 per share)
(5,023)(5,023)
Redeemable noncontrolling interests fair value and other adjustments
(133)(133)
Acquisition and other adjustments of nonredeemable noncontrolling interests
1,339 1,339 
Distribution to nonredeemable noncontrolling interests
(348)(348)
Balance at September 30, 2023925 $9 $ $93,173 $(3,327)$(5,361)$5,070 $89,564 
Balance at January 1, 2022941 $10 $ $77,134 $423 $(5,807)$3,285 $75,045 
Net earnings
15,359 281 15,640 
Other comprehensive loss(3,613)(89)(3,702)
Issuances of common stock, and related tax effects
6  801 801 
Share-based compensation
639 639 
Common share repurchases(12) (1,679)(4,321)(6,000)
Cash dividends paid on common shares ($4.75 per share)
(4,450)(4,450)
Redeemable noncontrolling interests fair value and other adjustments
239 239 
Acquisition and other adjustments of nonredeemable noncontrolling interests135 135 
Distribution to nonredeemable noncontrolling interests
(283)(283)
Balance at September 30, 2022935 $10 $ $83,722 $(3,190)$(5,896)$3,418 $78,064 
See Notes to the Condensed Consolidated Financial Statements
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UnitedHealth Group
Condensed Consolidated Statements of Cash Flows
(Unaudited)
 Nine Months Ended
September 30,
(in millions)20232022
Operating activities
Net earnings$17,469 $15,731 
Noncash items:
Depreciation and amortization2,998 2,418 
Deferred income taxes(494)(590)
Share-based compensation851 675 
Other, net(59) 
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:
Accounts receivable(2,574)(2,563)
Other assets(2,358)(741)
Medical costs payable3,837 4,192 
Accounts payable and other liabilities2,370 1,416 
Unearned revenues12,221 10,201 
Cash flows from operating activities34,261 30,739 
Investing activities
Purchases of investments(12,998)(14,183)
Sales of investments3,674 5,376 
Maturities of investments6,474 4,740 
Cash paid for acquisitions, net of cash assumed(8,389)(7,154)
Purchases of property, equipment and capitalized software(2,427)(1,936)
Other, net(721)50 
Cash flows used for investing activities(14,387)(13,107)
Financing activities
Common share repurchases(6,500)(6,000)
Cash dividends paid(5,023)(4,450)
Proceeds from common stock issuances1,039 1,084 
Repayments of long-term debt(2,125)(2,100)
Proceeds from (repayments of) short-term borrowings, net1,579 (16)
Proceeds from issuance of long-term debt6,394 5,922 
Customer funds administered2,037 7,028 
Other, net(1,774)(1,634)
Cash flows used for financing activities(4,373)(166)
Effect of exchange rate changes on cash and cash equivalents49 4 
Increase in cash and cash equivalents15,550 17,470 
Cash and cash equivalents, beginning of period23,365 21,375 
Cash and cash equivalents, end of period$38,915 $38,845 
See Notes to the Condensed Consolidated Financial Statements
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UnitedHealth Group
Notes to the Condensed Consolidated Financial Statements
(Unaudited)
1.    Basis of Presentation
UnitedHealth Group Incorporated (individually and together with its subsidiaries, “UnitedHealth Group” and the “Company”) is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone. Our two distinct, yet complementary business platforms — Optum and UnitedHealthcare — are working to help build a modern, high-performing health system through improved access, affordability, outcomes and experiences for the individuals and organizations the Company is privileged to serve.
The Company has prepared the Condensed Consolidated Financial Statements according to U.S. Generally Accepted Accounting Principles (GAAP) and has included the accounts of UnitedHealth Group and its subsidiaries. The year-end condensed consolidated balance sheet was derived from audited financial statements, but does not include all disclosures required by GAAP. In accordance with the rules and regulations of the U.S. Securities and Exchange Commission (SEC), the Company has omitted certain footnote disclosures that would substantially duplicate the disclosures contained in its annual audited Consolidated Financial Statements. Therefore, these Condensed Consolidated Financial Statements should be read together with the Consolidated Financial Statements and the Notes included in Part II, Item 8, “Financial Statements and Supplementary Data” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022 as filed with the SEC (2022 10-K). The accompanying Condensed Consolidated Financial Statements include all normal recurring adjustments necessary to present the interim financial statements fairly.
Use of Estimates
These Condensed Consolidated Financial Statements include certain amounts based on the Company’s best estimates and judgments. The Company’s most significant estimates relate to estimates and judgments for medical costs payable and goodwill. Certain of these estimates require the application of complex assumptions and judgments, often because they involve matters that are inherently uncertain and will likely change in subsequent periods. The impact of any change in estimates is included in earnings in the period in which the estimate is adjusted.
Revenues - Products and Services
As of September 30, 2023 and December 31, 2022, accounts receivable related to products and services were $8.0 billion and $7.1 billion, respectively. As of September 30, 2023, revenue expected to be recognized in any future year related to remaining performance obligations, excluding revenue pertaining to contracts having an original expected duration of one year or less, contracts where revenue is recognized as invoiced and contracts with variable consideration related to undelivered performance obligations, was $11.8 billion, of which approximately half is expected to be recognized in the next three years.
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2.    Investments
A summary of debt securities by major security type is as follows:
(in millions)Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
September 30, 2023
Debt securities - available-for-sale:
U.S. government and agency obligations$5,739 $ $(340)$5,399 
State and municipal obligations7,695 1 (643)7,053 
Corporate obligations23,511 5 (1,857)21,659 
U.S. agency mortgage-backed securities8,632  (1,158)7,474 
Non-U.S. agency mortgage-backed securities3,091  (324)2,767 
Total debt securities - available-for-sale48,668 6 (4,322)44,352 
Debt securities - held-to-maturity:
U.S. government and agency obligations466  (10)456 
State and municipal obligations28  (5)23 
Corporate obligations188   188 
Total debt securities - held-to-maturity682  (15)667 
Total debt securities$49,350 $6 $(4,337)$45,019 
December 31, 2022
Debt securities - available-for-sale:
U.S. government and agency obligations$4,093 $1 $(285)$3,809 
State and municipal obligations7,702 25 (479)7,248 
Corporate obligations23,675 17 (1,798)21,894 
U.S. agency mortgage-backed securities7,379 15 (808)6,586 
Non-U.S. agency mortgage-backed securities3,077 1 (294)2,784 
Total debt securities - available-for-sale45,926 59 (3,664)42,321 
Debt securities - held-to-maturity:
U.S. government and agency obligations578  (14)564 
State and municipal obligations29  (3)26 
Corporate obligations89   89 
Total debt securities - held-to-maturity696  (17)679 
Total debt securities$46,622 $59 $(3,681)$43,000 
The Company held $4.2 billion and $3.7 billion of equity securities as of September 30, 2023 and December 31, 2022, respectively. The Company’s investments in equity securities primarily consist of employee savings plan related investments, venture investments and shares of Brazilian real denominated fixed-income funds with readily determinable fair values. Additionally, the Company’s investments included $1.4 billion and $1.5 billion of equity method investments in operating businesses in the health care sector as of September 30, 2023 and December 31, 2022, respectively. The allowance for credit losses on held-to-maturity securities at September 30, 2023 and December 31, 2022 was not material.
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The amortized cost and fair value of debt securities as of September 30, 2023, by contractual maturity, were as follows:
Available-for-SaleHeld-to-Maturity
(in millions)Amortized
Cost
Fair
Value
Amortized
Cost
Fair
Value
Due in one year or less$5,372 $5,340 $375 $372 
Due after one year through five years15,098 14,183 262 255 
Due after five years through ten years11,256 9,898 25 24 
Due after ten years5,219 4,690 20 16 
U.S. agency mortgage-backed securities8,632 7,474 — — 
Non-U.S. agency mortgage-backed securities3,091 2,767 — — 
Total debt securities$48,668 $44,352 $682 $667 
The fair value of available-for-sale debt securities with gross unrealized losses by major security type and length of time that individual securities have been in a continuous unrealized loss position were as follows:
 Less Than 12 Months12 Months or Greater Total
(in millions)Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
September 30, 2023
Debt securities - available-for-sale:
U.S. government and agency obligations
$2,023 $(34)$2,081 $(306)$4,104 $(340)
State and municipal obligations2,872 (124)4,042 (519)6,914 (643)
Corporate obligations5,563 (149)14,821 (1,708)20,384 (1,857)
U.S. agency mortgage-backed securities2,562 (140)4,867 (1,018)7,429 (1,158)
Non-U.S. agency mortgage-backed securities
480 (21)2,249 (303)2,729 (324)
Total debt securities - available-for-sale$13,500 $(468)$28,060 $(3,854)$41,560 $(4,322)
December 31, 2022
Debt securities - available-for-sale:
U.S. government and agency obligations
$2,007 $(96)$1,290 $(189)$3,297 $(285)
State and municipal obligations4,630 (288)1,178 (191)5,808 (479)
Corporate obligations13,003 (893)6,637 (905)19,640 (1,798)
U.S. agency mortgage-backed securities3,561 (345)2,239 (463)5,800 (808)
Non-U.S. agency mortgage-backed securities
1,698 (128)976 (166)2,674 (294)
Total debt securities - available-for-sale$24,899 $(1,750)$12,320 $(1,914)$37,219 $(3,664)
The Company’s unrealized losses from debt securities as of September 30, 2023 were generated from approximately 37,000 positions out of a total of 41,000 positions. The Company believes that it will timely collect the principal and interest due on its debt securities that have an amortized cost in excess of fair value. The unrealized losses were primarily caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities which impacted the Company’s assessment on collectability of principal and interest. At each reporting period, the Company evaluates available-for-sale debt securities for any credit-related impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the expected cash flows, the underlying credit quality and credit ratings of the issuers, noting no significant credit deterioration since purchase. As of September 30, 2023, the Company did not have the intent to sell any of the available-for-sale debt securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary. The allowance for credit losses on available-for-sale debt securities at September 30, 2023 and December 31, 2022 was not material.
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3.    Fair Value
Certain assets and liabilities are measured at fair value in the Condensed Consolidated Financial Statements or have fair values disclosed in the Notes to the Condensed Consolidated Financial Statements. These assets and liabilities are classified into one of three levels of a hierarchy defined by GAAP.
For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see Note 4 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements and Supplementary Data” in the 2022 10-K.
The following table presents a summary of fair value measurements by level and carrying values for items measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions)Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair and Carrying
Value
September 30, 2023
Cash and cash equivalents$38,880 $35 $ $38,915 
Debt securities - available-for-sale:
U.S. government and agency obligations5,050 349  5,399 
State and municipal obligations 7,053  7,053 
Corporate obligations15 21,462 182 21,659 
U.S. agency mortgage-backed securities 7,474  7,474 
Non-U.S. agency mortgage-backed securities 2,767  2,767 
Total debt securities - available-for-sale5,065 39,105 182 44,352 
Equity securities2,231 31 70 2,332 
Assets under management 1,420 2,094 102 3,616 
Total assets at fair value$47,596 $41,265 $354 $89,215 
Percentage of total assets at fair value53 %46 %%100 %
December 31, 2022
Cash and cash equivalents$23,202 $163 $ $23,365 
Debt securities - available-for-sale:
U.S. government and agency obligations3,505 304  3,809 
State and municipal obligations 7,248  7,248 
Corporate obligations7 21,695 192 21,894 
U.S. agency mortgage-backed securities 6,586  6,586 
Non-U.S. agency mortgage-backed securities 2,784  2,784 
Total debt securities - available-for-sale3,512 38,617 192 42,321 
Equity securities2,043 35 70 2,148 
Assets under management 1,788 2,203 96 4,087 
Total assets at fair value$30,545 $41,018 $358 $71,921 
Percentage of total assets at fair value42 %57 %%100 %
There were no transfers in or out of Level 3 financial assets or liabilities during the nine months ended September 30, 2023 or 2022.
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The following table presents a summary of fair value measurements by level and carrying values for certain financial instruments not measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions)Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair
Value
Total Carrying Value
September 30, 2023
Debt securities - held-to-maturity$593 $74 $ $667 $682 
Long-term debt and other financing obligations$ $55,137 $ $55,137 $60,769 
December 31, 2022
Debt securities - held-to-maturity$577 $102 $ $679 $696 
Long-term debt and other financing obligations$ $53,626 $ $53,626 $56,823 
Nonfinancial assets and liabilities or financial assets and liabilities that are measured at fair value on a nonrecurring basis are subject to fair value adjustments only in certain circumstances, such as when the Company records an impairment. There were no significant fair value adjustments for these assets and liabilities recorded during the nine months ended September 30, 2023 or 2022.
4.    Medical Costs Payable
The following table shows the components of the change in medical costs payable for the nine months ended September 30:
(in millions)20232022
Medical costs payable, beginning of period$29,056 $24,483 
Acquisitions1 177 
Reported medical costs:
Current year180,423 157,601 
Prior years(760)(350)
Total reported medical costs179,663 157,251 
Medical payments:
Payments for current year
(149,671)(130,788)
Payments for prior years(26,257)(22,059)
Total medical payments(175,928)(152,847)
Medical costs payable, end of period$32,792 $29,064 
For the nine months ended September 30, 2023 and 2022, prior years’ medical cost reserve development included no individual factors that were significant. Medical costs payable included reserves for claims incurred by consumers but not yet reported to the Company of $22.7 billion and $20.0 billion at September 30, 2023 and December 31, 2022, respectively.
5.    Short-Term Borrowings and Long-Term Debt
In March 2023, the Company issued $6.5 billion of senior unsecured notes consisting of the following:
(in millions, except percentages)Par Value
4.250% notes due January 2029
$1,250 
4.500% notes due April 2033
1,500 
5.050% notes due April 2053
2,000 
5.200% notes due April 2063
1,750 
As of September 30, 2023, the Company had $2.6 billion of commercial paper outstanding, with a weighted-average annual interest rate of 5.3%.
For more information on the Company’s short-term borrowings, debt covenants and long-term debt, see Note 8 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements and Supplementary Data” in the 2022 10-K.
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6.    Dividends
In June 2023, the Company’s Board of Directors increased the Company’s quarterly cash dividend to shareholders to an annual rate of $7.52 compared to $6.60 per share, which the Company had paid since June 2022. Declaration and payment of future quarterly dividends is at the discretion of the Board of Directors and may be adjusted as business needs or market conditions change.
The following table provides details of the Company’s dividend payments during the nine months ended September 30, 2023:
Payment DateAmount per ShareTotal Amount Paid
(in millions)
March 21$1.65 $1,537 
June 271.88 1,747 
September 191.88 1,739 
7.    Commitments and Contingencies
Pending Acquisitions
As of September 30, 2023, the Company has entered into agreements to acquire companies in the health care sector, subject to regulatory approval and other customary closing conditions. The total anticipated consideration required for these acquisitions, excluding the payoff of acquired indebtedness, is approximately $5 billion.
Legal Matters
The Company is frequently made party to a variety of legal actions and regulatory inquiries, including class actions and suits brought by members, care providers, consumer advocacy organizations, customers and regulators, relating to the Company’s businesses, including management and administration of health benefit plans and other services. These matters include medical malpractice, employment, intellectual property, antitrust, privacy and contract claims and claims related to health care benefits coverage and other business practices.
The Company records liabilities for its estimates of probable costs resulting from these matters where appropriate. Estimates of costs resulting from legal and regulatory matters involving the Company are inherently difficult to predict, particularly where the matters: involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or represent a shift in regulatory policy; involve a large number of claimants or regulatory bodies; are in the early stages of the proceedings; or could result in a change in business practices. Accordingly, the Company is often unable to estimate the losses or ranges of losses for those matters where there is a reasonable possibility or it is probable a loss may be incurred.
Government Investigations, Audits and Reviews
The Company has been involved or is currently involved in various governmental investigations, audits and reviews. These include routine, regular and special investigations, audits and reviews by the Centers for Medicare and Medicaid Services (CMS), state insurance and health and welfare departments, state attorneys general, the Office of the Inspector General, the Office of Personnel Management, the Office of Civil Rights, the Government Accountability Office, the Federal Trade Commission, U.S. Congressional committees, the U.S. Department of Justice (DOJ), the SEC, the Internal Revenue Service, the U.S. Drug Enforcement Administration, the U.S. Department of Labor, the Federal Deposit Insurance Corporation, the Consumer Financial Protection Bureau (CFPB), the Defense Contract Audit Agency and other governmental authorities. Similarly, the Company’s international businesses are also subject to investigations, audits and reviews by applicable foreign governments, including South American and other non-U.S. governmental authorities. Certain of the Company’s businesses have been reviewed or are currently under review, including for, among other matters, compliance with coding and other requirements under the Medicare risk-adjustment model. CMS has selected certain of the Company’s local plans for risk adjustment data validation (RADV) audits to validate the coding practices of and supporting documentation maintained by health care providers and such audits may result in retrospective adjustments to payments made to the Company’s health plans.
On February 14, 2017, the DOJ announced its decision to pursue certain claims within a lawsuit initially asserted against the Company and filed under seal by a whistleblower in 2011. The whistleblower’s complaint, which was unsealed on February 15, 2017, alleges the Company made improper risk adjustment submissions and violated the False Claims Act. On February 12, 2018, the court granted in part and denied in part the Company’s motion to dismiss. In May 2018, the DOJ moved to dismiss the Company’s counterclaims, which were filed in March 2018, and moved for partial summary judgment. In March 2019, the court denied the government’s motion for partial summary judgment and dismissed the Company’s counterclaims without prejudice. The Company cannot reasonably estimate the outcome which may result from this matter given its procedural status.
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8.    Business Combinations
During the nine months ended September 30, 2023, the Company completed several business combinations for total consideration of $8.4 billion.
Acquired assets (liabilities) at acquisition date were:
(in millions)
Cash and cash equivalents$104 
Accounts receivable and other current assets587 
Property, equipment and other long-term assets573 
Other intangible assets1,800 
Total identifiable assets acquired3,064 
Medical costs payable(1)
Accounts payable and other current liabilities(551)
Other long-term liabilities(661)
Total identifiable liabilities acquired(1,213)
Total net identifiable assets1,851 
Goodwill8,073 
Redeemable noncontrolling interests(121)
Nonredeemable noncontrolling interests(1,339)
Net assets acquired$8,464 
The majority of goodwill is not deductible for income tax purposes. The preliminary purchase price allocations for the various business combinations are subject to adjustment as valuation analyses, primarily related to intangible assets and contingent liabilities, are finalized.
The acquisition date fair values and weighted-average useful lives assigned to intangible assets were:
(in millions, except years)Fair ValueWeighted-Average Useful Life
Acquired finite-lived intangible assets:
Customer-related$223 12 years
Trademarks and technology171 5 years
Other42 6 years
Total acquired finite-lived intangible assets436 9 years
Total acquired indefinite-lived intangible assets - operating licenses and certificates1,364 
Total acquired intangible assets$1,800 
The results of operations and financial condition of acquired entities have been included in the Company’s consolidated results and the results of the corresponding operating segment as of the date of acquisition. Through September 30, 2023, acquired entities’ impact on revenues and net earnings was not material.
Unaudited pro forma revenues and net earnings for the nine months ended September 30, 2023 and 2022, as if the business combinations had occurred on January 1, 2022, were immaterial for both periods.
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9.    Segment Financial Information
The Company’s four reportable segments are UnitedHealthcare, Optum Health, Optum Insight and Optum Rx. For more information on the Company’s segments, see Part I, Item I, “Business” and Note 14 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements and Supplementary Data” in the 2022 10-K. Total assets at Optum Health increased to $86.9 billion as of September 30, 2023 compared to $69.0 billion as of December 31, 2022, including an increase to goodwill from business combinations of $7.3 billion.
The following tables present reportable segment financial information:
  Optum  
(in millions)UnitedHealthcareOptum HealthOptum InsightOptum RxOptum EliminationsOptumCorporate and
Eliminations
Consolidated
Three Months Ended September 30, 2023
Revenues - unaffiliated customers:
Premiums$66,709 $5,630 $ $ $ $5,630 $ $72,339 
Products 61 40 10,253  10,354  10,354 
Services2,550 3,629 1,938 554  6,121  8,671 
Total revenues - unaffiliated customers
69,259 9,320 1,978 10,807  22,105  91,364 
Total revenues - affiliated customers
 14,227 2,964 17,999 (961)34,229 (34,229) 
Investment and other income
594 317 35 51  403  997 
Total revenues$69,853 $23,864 $4,977 $28,857 $(961)$56,737 $(34,229)$92,361 
Earnings from operations$4,592 $1,568 $1,109 $1,257 $ $3,934 $ $8,526 
Interest expense      (834)(834)
Earnings before income taxes
$4,592 $1,568 $1,109 $1,257 $ $3,934 $(834)$7,692 
Three Months Ended September 30, 2022
Revenues - unaffiliated customers:
Premiums$59,375 $5,116 $ $ $ $5,116 $ $64,491 
Products 2 37 9,151  9,190  9,190 
Services2,435 2,756 1,067 442  4,265  6,700 
Total revenues - unaffiliated customers
61,810 7,874 1,104 9,593  18,571  80,381 
Total revenues - affiliated customers
 10,302 2,566 15,592 (800)27,660 (27,660) 
Investment and other income
185 287 23 18  328  513 
Total revenues$61,995 $18,463 $3,693 $25,203 $(800)$46,559 $(27,660)$80,894 
Earnings from operations$3,799 $1,575 $1,007 $1,081 $ $3,663 $ $7,462 
Interest expense      (516)(516)
Earnings before income taxes
$3,799 $1,575 $1,007 $1,081 $ $3,663 $(516)$6,946 
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  Optum  
(in millions)UnitedHealthcareOptum HealthOptum InsightOptum RxOptum EliminationsOptumCorporate and
Eliminations
Consolidated
Nine Months Ended September 30, 2023
Revenues - unaffiliated customers:
Premiums$201,214 $16,385 $ $ $ $16,385 $ $217,599 
Products 156 119 30,997  31,272  31,272 
Services7,689 10,259 5,859 1,607  17,725  25,414 
Total revenues - unaffiliated customers
208,903 26,800 5,978 32,604  65,382  274,285 
Total revenues - affiliated customers
 42,947 8,089 52,174 (2,713)100,497 (100,497) 
Investment and other income
1,649 1,038 80 143  1,261  2,910 
Total revenues$210,552 $70,785 $14,147 $84,921 $(2,713)$167,140 $(100,497)$277,195 
Earnings from operations$13,293 $4,869 $2,984 $3,523 $ $11,376 $ $24,669 
Interest expense      (2,416)(2,416)
Earnings before income taxes
$13,293 $4,869 $2,984 $3,523 $ $11,376 $(2,416)$22,253 
Nine Months Ended September 30, 2022
Revenues - unaffiliated customers:
Premiums$178,680 $13,777 $ $ $ $13,777 $ $192,457 
Products 14 135 27,877  28,026  28,026 
Services7,492 8,054 3,075 1,096  12,225  19,717 
Total revenues - unaffiliated customers
186,172 21,845 3,210 28,973  54,028  240,200 
Total revenues - affiliated customers
 30,355 6,885 44,921 (1,941)80,220 (80,220) 
Investment and other income
523 528 99 25  652  1,175 
Total revenues$186,695 $52,728 $10,194 $73,919 $(1,941)$134,900 $(80,220)$241,375 
Earnings from operations$11,447 $4,340 $2,693 $3,064 $ $10,097 $ $21,544 
Interest expense      (1,416)(1,416)
Earnings before income taxes
$11,447 $4,340 $2,693 $3,064 $ $10,097 $(1,416)$20,128 
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ITEM 2.    MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following discussion should be read together with the accompanying Condensed Consolidated Financial Statements and Notes and with our 2022 10-K, including the Consolidated Financial Statements and Notes included in Part II, Item 8, “Financial Statements and Supplementary Data” in that report. Unless the context indicates otherwise, references to the terms “UnitedHealth Group,” the “Company,” “we,” “our” or “us” used throughout this Management’s Discussion and Analysis of Financial Condition and Results of Operations refer to UnitedHealth Group Incorporated and its consolidated subsidiaries.
Readers are cautioned that the statements, estimates, projections or outlook contained in this Management's Discussion and Analysis of Financial Condition and Results of Operations, including discussions regarding financial prospects, economic conditions, trends and uncertainties contained in this Item 2, may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (PSLRA). These forward-looking statements involve risks and uncertainties that may cause our actual results to differ materially from the results discussed or implied in the forward-looking statements. A description of some of the risks and uncertainties is set forth in Part I, Item 1A, “Risk Factors” in our 2022 10-K and in the discussion below.
EXECUTIVE OVERVIEW
General
UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone. Our two distinct, yet complementary business platforms — Optum and UnitedHealthcare — are working to help build a modern, high-performing health system through improved access, affordability, outcomes and experiences for the individuals and organizations we are privileged to serve.
We have four reportable segments:
Optum Health;
Optum Insight;
Optum Rx; and
UnitedHealthcare, which includes UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement and UnitedHealthcare Community & State.
Further information on our business is presented in Part I, Item 1, “Business” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2022 10-K and additional information on our segments can be found in this Item 2 and in Note 9 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Business Trends
Our businesses participate in the United States, South America and certain other international health markets. We expect overall spending on health care to continue to grow in the future due to inflation, medical technology and pharmaceutical advancement, regulatory requirements, demographic trends in the population and national interest in health and well-being. The rate of market growth may be affected by a variety of factors, including macroeconomic conditions and regulatory changes, which could impact our results of operations, including our continued efforts to control health care costs.
Pricing Trends. To price our health care benefits, products and services, we start with our view of expected future costs, including medical cost trends, inflation and labor market dynamics. We frequently evaluate and adjust our approach in each of the local markets we serve, considering all relevant factors, such as product positioning, price competitiveness and environmental, competitive, legislative and regulatory considerations, including minimum medical loss ratio thresholds and similar revenue adjustments. We will continue seeking to balance growth and profitability across all these dimensions.
The commercial risk market remains highly competitive in the small group, large group and individual segments. We expect broad-based competition to continue as the industry adapts to individual and employer needs.
Government programs in the community and senior sector tend to receive lower rates of increase than the commercial market due to governmental budget pressures and lower cost trends.
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Medical Cost Trends. Our medical cost trends primarily relate to changes in unit costs, care activity and prescription drug costs. During the third quarter we continued to observe increased care patterns, primarily related to outpatient procedures for seniors, consistent with the levels observed in the second quarter, and which may continue in future periods. We endeavor to mitigate those increases by engaging physicians and consumers with information and helping them make clinically sound choices, with the objective of helping them achieve quality, affordable care.
Medicaid Redeterminations. The majority of states have resumed Medicaid redeterminations, which have impacted the number of people served through our Medicaid offerings, partially offset by an increase in consumers served through our commercial offerings as we endeavor to ensure that people and families have continued access to benefits.
Regulatory Trends and Uncertainties
Medicare Advantage Rates. Medicare Advantage rate notices over the years have at times resulted in industry base rates well below industry forward medical trend. For example, the Final Notice for 2024 rates resulted in an industry base rate decrease, well short of what is an increasing industry forward medical cost trend, creating continued pressure in the Medicare Advantage program. Further, substantial revisions to the risk adjustment model, which serves to adjust rates to reflect a patient’s health status and care resource needs, will result in reduced funding and potentially benefits for people, especially those with some of the greatest health and social challenges.
As a result of ongoing Medicare funding pressures, there are adjustments we can make to partially offset these rate pressures and reductions for a particular period. For example, we can seek to intensify our medical and operating cost management, make changes to the size and composition of our care provider networks, adjust member benefits and implement or increase the member premiums supplementing the monthly payments we receive from the government. Additionally, we decide annually on a county-by-county basis where we will offer Medicare Advantage plans.
SELECTED OPERATING PERFORMANCE AND OTHER SIGNIFICANT ITEMS
The following summarizes select third quarter 2023 year-over-year operating comparisons to third quarter 2022 and other financial results.
Consolidated revenues grew 14%, UnitedHealthcare revenues grew 13% and Optum revenues grew 22%.
UnitedHealthcare served 1.5 million more people, driven by growth across each of our businesses.
Consolidated earnings from operations of $8.5 billion compared to $7.5 billion last year, including growth of 21% at UnitedHealthcare and 7% at Optum.
Diluted earnings per common share were $6.24.
Cash flows from operations for the nine months ended September 30, 2023 were $34.3 billion.
Return on equity was 28.0%.
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RESULTS SUMMARY
The following table summarizes our consolidated results of operations and other financial information:
(in millions, except percentages and per share data)Three Months Ended
September 30,
Increase/(Decrease)Nine Months Ended
September 30,
Increase/(Decrease)
202320222023 vs. 2022202320222023 vs. 2022
Revenues:
Premiums$72,339 $64,491 $7,848 12 %$217,599 $192,457 $25,142 13 %
Products10,354 9,190 1,164 13 31,272 28,026 3,246 12 
Services8,671 6,700 1,971 29 25,414 19,717 5,697 29 
Investment and other income997 513 484 94 2,910 1,175 1,735 148 
Total revenues92,361 80,894 11,467 14 277,195 241,375 35,820 15 
Operating costs:
Medical costs59,550 52,635 6,915 13 179,663 157,251 22,412 14 
Operating costs13,855 11,663 2,192 19 41,289 34,773 6,516 19 
Cost of products sold9,423 8,306 1,117 13 28,576 25,389 3,187 13 
Depreciation and amortization1,007 828 179 22 2,998 2,418 580 24 
Total operating costs83,835 73,432 10,403 14 252,526 219,831 32,695 15 
Earnings from operations8,526 7,462 1,064 14 24,669 21,544 3,125 15 
Interest expense(834)(516)(318)62 (2,416)(1,416)(1,000)71 
Earnings before income taxes7,692 6,946 746 11 22,253 20,128 2,125 11 
Provision for income taxes(1,654)(1,562)(92)(4,784)(4,397)(387)
Net earnings6,038 5,384 654 12 17,469 15,731 1,738 11 
Earnings attributable to noncontrolling interests(197)(122)(75)61 (543)(372)(171)46 
Net earnings attributable to UnitedHealth Group common shareholders$5,841 $5,262 $579 11 %$16,926 $15,359 $1,567 10 %
Diluted earnings per share attributable to UnitedHealth Group common shareholders $6.24 $5.55 $0.69 $18.01 $16.15 $1.86 
Medical care ratio (a)82.3 %81.6 %0.7 %82.6 %81.7 %0.9 %
Operating cost ratio15.0 14.4 0.6 14.9 14.4 0.5 
Operating margin9.2 9.2 — 8.9 8.9 — 
Tax rate21.5 22.5 (1.0)21.5 21.8 (0.3)
Net earnings margin (b)6.3 6.5 (0.2)6.1 6.4 (0.3)
Return on equity (c)28.0 %28.5 %(0.5)%27.7 %28.1 %(0.4)%
(a)Medical care ratio (MCR) is calculated as medical costs divided by premium revenue.
(b)Net earnings margin attributable to UnitedHealth Group shareholders.
(c)Return on equity is calculated as annualized net earnings attributable to UnitedHealth Group common shareholders divided by average shareholders’ equity. Average shareholders’ equity is calculated using the shareholders’ equity balance at the end of the preceding year and the shareholders’ equity balances at the end of each of the quarters in the year presented.
2023 RESULTS OF OPERATIONS COMPARED TO 2022 RESULTS OF OPERATIONS
Consolidated Financial Results
Revenues
The increases in revenues were primarily driven by growth in the number of people served through Medicare Advantage and Medicaid, pricing trends and growth across the Optum businesses. Revenues also increased due to increased investment income, primarily driven by increased interest rates.
Medical Costs and MCR
Medical costs increased primarily due to growth in people served through Medicare Advantage and Medicaid. The MCR increased as a result of elevated care activity, primarily relating to outpatient care for seniors, and business mix.
Operating Cost Ratio
The operating cost ratio increased primarily due to business mix and investments to support future growth, partially offset by continued productivity advances.
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Reportable Segments
See Note 9 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report for more information on our segments. We utilize various metrics to evaluate and manage our reportable segments, including people served by UnitedHealthcare by major market segment and funding arrangement, people served by Optum Health and adjusted scripts for Optum Rx. These metrics are the main drivers of revenue, earnings and cash flows at each business. The metrics also allow management and investors to evaluate and understand business mix, including the level and scope of services provided to people, and pricing trends when comparing the metrics to revenue by segment.
The following table presents a summary of the reportable segment financial information:
 Three Months Ended
September 30,
Increase/
(Decrease)
Nine Months Ended
September 30,
Increase/
(Decrease)
(in millions, except percentages)202320222023 vs. 2022202320222023 vs. 2022
Revenues
UnitedHealthcare$69,853 $61,995 $7,858 13 %$210,552 $186,695 $23,857 13 %
Optum Health23,864 18,463 5,401 29 70,785 52,728 18,057 34 
Optum Insight4,977 3,693 1,284 35 14,147 10,194 3,953 39 
Optum Rx28,857 25,203 3,654 14 84,921 73,919 11,002 15 
Optum eliminations(961)(800)(161)20 (2,713)(1,941)(772)40 
Optum56,737 46,559 10,178 22 167,140 134,900 32,240 24 
Eliminations(34,229)(27,660)(6,569)24 (100,497)(80,220)(20,277)25 
Consolidated revenues$92,361 $80,894 $11,467 14 %$277,195 $241,375 $35,820 15 %
Earnings from operations
UnitedHealthcare$4,592 $3,799 $793 21 %$13,293 $11,447 $1,846 16 %
Optum Health1,568 1,575 (7)— 4,869 4,340 529 12 
Optum Insight1,109 1,007 102 10 2,984 2,693 291 11 
Optum Rx1,257 1,081 176 16 3,523 3,064 459 15 
Optum3,934 3,663 271 11,376 10,097 1,279 13 
Consolidated earnings from operations$8,526 $7,462 $1,064 14 %$24,669 $21,544 $3,125 15 %
Operating margin
UnitedHealthcare6.6 %6.1 %0.5 %6.3 %6.1 %0.2 %
Optum Health6.6 8.5 (1.9)6.9 8.2 (1.3)
Optum Insight22.3 27.3 (5.0)21.1 26.4 (5.3)
Optum Rx4.4 4.3 0.1 4.1 4.1 — 
Optum6.9 7.9 (1.0)6.8 7.5 (0.7)
Consolidated operating margin9.2 %9.2 %— %8.9 %8.9 %— %
UnitedHealthcare
The following table summarizes UnitedHealthcare revenues by business:
 Three Months Ended September 30,Increase/(Decrease)Nine Months Ended September 30,Increase/(Decrease)
(in millions, except percentages)202320222023 vs. 2022202320222023 vs. 2022
UnitedHealthcare Employer & Individual - Domestic$16,854 $15,929 $925 %$50,157 $47,318 $2,839 %
UnitedHealthcare Employer & Individual - Global2,417 2,120 297 14 6,905 6,500 405 
UnitedHealthcare Employer & Individual - Total19,271 18,049 1,222 57,062 53,818 3,244 
UnitedHealthcare Medicare & Retirement32,022 27,895 4,127 15 97,468 85,620 11,848 14 
UnitedHealthcare Community & State18,560 16,051 2,509 16 56,022 47,257 8,765 19 
Total UnitedHealthcare revenues$69,853 $61,995 $7,858 13 %$210,552 $186,695 $23,857 13 %
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The following table summarizes the number of people served by our UnitedHealthcare businesses, by major market segment and funding arrangement:
September 30,Increase/(Decrease)
(in thousands, except percentages)202320222023 vs. 2022
Commercial - Domestic:
Risk-based8,120 8,055 65 %
Fee-based19,130 18,500 630 
Total Commercial - Domestic27,250 26,555 695 
Medicare Advantage7,645 7,035 610 
Medicaid8,065 8,005 60 
Medicare Supplement (Standardized)4,345 4,370 (25)(1)
Total Community and Senior20,055 19,410 645 
Total UnitedHealthcare - Domestic Medical47,305 45,965 1,340 
Commercial - Global5,475 5,360 115 
Total UnitedHealthcare - Medical52,780 51,325 1,455 %
Supplemental Data:
Medicare Part D stand-alone3,335 3,310 25 %
UnitedHealthcare’s revenues increased due to growth in the number of people served through individual and group Medicare Advantage plans; growth in people served with higher acuity needs partially offset by Medicaid redeterminations; and an increase in the number of people served through commercial offerings. Earnings from operations increased due to increased investment income and the factors impacting revenue, partially offset by elevated care activity, primarily relating to outpatient care for seniors.
Optum
Total revenues and earnings from operations increased due to growth across the Optum businesses. The results by segment were as follows:
Optum Health
Revenues at Optum Health increased primarily due to organic growth in patients served under value-based care arrangements and business combinations. For the nine months ended September 30, 2023, earnings from operations increased, while remaining consistent for the three months ended September 30, 2023, due to cost management initiatives and increased investment income, offset by higher senior outpatient and behavioral health care activity, costs associated with serving newly added patients under value-based care arrangements and decreased asset dispositions. Optum Health served approximately 103 million people as of September 30, 2023 compared to 101 million people as of September 30, 2022.
Optum Insight
Revenues and earnings from operations at Optum Insight increased due to growth in business services as a result of business combinations and growth in technology services.
Optum Rx
Revenues and earnings from operations at Optum Rx increased due to growth in pharmacy offerings and higher script volumes from both new clients and growth in existing clients. Earnings from operations also increased as a result of continued supply chain and operating cost management initiatives. Optum Rx fulfilled 383 million and 359 million adjusted scripts in the third quarters of 2023 and 2022, respectively.
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LIQUIDITY, FINANCIAL CONDITION AND CAPITAL RESOURCES
Liquidity
Summary of our Major Sources and Uses of Cash and Cash Equivalents
 Nine Months Ended September 30,Increase/(Decrease)
(in millions)202320222023 vs. 2022
Sources of cash:
Cash provided by operating activities$34,261 $30,739 $3,522 
Issuances of short-term borrowings and long-term debt, net of repayments5,848 3,806 2,042 
Proceeds from common stock issuances1,039 1,084 (45)
Customer funds administered2,037 7,028 (4,991)
Other— 50 (50)
Total sources of cash43,185 42,707 
Uses of cash:
Common stock repurchases(6,500)(6,000)(500)
Cash paid for acquisitions, net of cash assumed(8,389)(7,154)(1,235)
Purchases of investments, net of sales and maturities (2,850)(4,067)1,217 
Purchases of property, equipment and capitalized software(2,427)(1,936)(491)
Cash dividends paid(5,023)(4,450)(573)
Other(2,495)(1,634)(861)
Total uses of cash(27,684)(25,241)
Effect of exchange rate changes on cash and cash equivalents49 45 
Net increase in cash and cash equivalents$15,550 $17,470 $(1,920)
2023 Cash Flows Compared to 2022 Cash Flows
Increased cash flows provided by operating activities were primarily driven by increased net earnings and the receipt of our October CMS premium payment of $11.9 billion and $9.8 billion in September 2023 and 2022, respectively. Other significant changes in sources or uses of cash year-over-year included increased net issuances of short-term borrowings and long-term debt and decreased net purchases of investments, partially offset by decreased customer funds administered, primarily driven by Medicare Part D timing, and increased cash paid for acquisitions.
Financial Condition
As of September 30, 2023, our cash, cash equivalent, available-for-sale debt securities and equity securities balances of $87.5 billion included approximately $38.9 billion of cash and cash equivalents (of which $1.5 billion was available for general corporate use), $44.4 billion of debt securities and $4.2 billion of investments in equity securities. Given the significant portion of our portfolio held in cash and cash equivalents, we do not anticipate fluctuations in the aggregate fair value of our financial assets to have a material impact on our liquidity or capital position. Our available-for-sale debt securities portfolio had a weighted-average duration of 3.8 years and a weighted-average credit rating of “Double A” as of September 30, 2023. When multiple credit ratings are available for an individual security, the average of the available ratings is used to determine the weighted-average credit rating.
Capital Resources and Uses of Liquidity
In addition to cash flows from operations and cash and cash equivalent balances available for general corporate use, our capital resources and uses of liquidity are as follows:
Cash Requirements. A summary of our cash requirements as of December 31, 2022 was disclosed in Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2022 10-K. During the nine months ended September 30, 2023, there were no material changes to this previously disclosed information outside the ordinary course of business. We believe our capital resources are sufficient to meet future, short-term and long-term, liquidity needs. We continually evaluate opportunities to expand our operations, including through internal development of new products, programs and technology applications and business combinations.
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Short-Term Borrowings. Our revolving bank credit facilities provide liquidity support for our commercial paper borrowing program, which facilitates the private placement of unsecured debt through independent broker-dealers, and are available for general corporate purposes. For more information on our commercial paper and bank credit facilities, see Note 5 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report and Note 8 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements and Supplementary Data” in our 2022 10-K.
Our revolving bank credit facilities contain various covenants, including covenants requiring us to maintain a defined debt to debt-plus-shareholders’ equity ratio of not more than 60%. As of September 30, 2023, our debt to debt-plus-shareholders’ equity ratio, as defined and calculated under the credit facilities, was approximately 38%.
Long-Term Debt. Periodically, we access capital markets and issue long-term debt for general corporate purposes, such as to meet our working capital requirements, to refinance debt, to finance acquisitions or for share repurchases. For more information on our long-term debt, see Note 5 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report and Note 8 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements and Supplementary Data” in our 2022 10-K.
Credit Ratings. Our credit ratings as of September 30, 2023 were as follows:
  
Moody’sS&P GlobalFitchA.M. Best
 RatingsOutlookRatingsOutlookRatingsOutlookRatingsOutlook
Senior unsecured debtA2StableA+StableAStableAStable
Commercial paperP-1n/aA-1n/aF1n/aAMB-1+n/a
The availability of financing in the form of debt or equity is influenced by many factors, including our profitability, operating cash flows, debt levels, credit ratings, debt covenants and other contractual restrictions, regulatory requirements and economic and market conditions. A significant downgrade in our credit ratings or adverse conditions in the capital markets may increase the cost of borrowing for us or limit our access to capital.
Share Repurchase Program. During the nine months ended September 30, 2023, we repurchased approximately 13 million shares at an average price of $485.10 per share. As of September 30, 2023, we had Board of Directors’ authorization to purchase up to 18 million shares of our common stock.
Dividends. In June 2023, the Company’s Board of Directors increased our quarterly cash dividend to shareholders to an annual rate of $7.52 compared to $6.60 per share. For more information on our dividend, see Note 6 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Pending Acquisitions. As of September 30, 2023, we have entered into agreements to acquire companies in the health care sector, subject to regulatory approval and other customary closing conditions. The total anticipated consideration required for these acquisitions, excluding the payoff of acquired indebtedness, is approximately $5 billion.
For additional liquidity discussion, see Note 10 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements and Supplementary Data” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” included in Part II, Item 7 in our 2022 10-K.
RECENTLY ISSUED ACCOUNTING STANDARDS
There are no recently issued accounting standards that are expected to have a material impact on our Condensed Consolidated Financial Statements.
CRITICAL ACCOUNTING ESTIMATES
In preparing our Condensed Consolidated Financial Statements, we are required to make judgments, assumptions and estimates, which we believe are reasonable and prudent based on the available facts and circumstances. These judgments, assumptions and estimates affect certain of our revenues and expenses and their related balance sheet accounts and disclosure of our contingent liabilities. We base our assumptions and estimates primarily on historical experience and consider known and projected trends. On an ongoing basis, we re-evaluate our selection of assumptions and the method of calculating our estimates. Actual results, however, may materially differ from our calculated estimates, and this difference would be reported in our current operations.
Our critical accounting estimates include medical costs payable and goodwill. For a detailed description of our critical accounting estimates, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” included in Part II, Item 7 in our 2022 10-K. For a detailed discussion of our significant accounting policies, see Note 2 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements and Supplementary Data” in our 2022 10-K.
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FORWARD-LOOKING STATEMENTS
The statements, estimates, projections, guidance or outlook contained in this document include “forward-looking” statements which are intended to take advantage of the “safe harbor” provisions of the federal securities law. The words “believe,” “expect,” “intend,” “estimate,” “anticipate,” “forecast,” “outlook,” “plan,” “project,” “should” and similar expressions identify forward-looking statements. These statements may contain information about financial prospects, economic conditions and trends and involve risks and uncertainties. Actual results could differ materially from those that management expects, depending on the outcome of certain factors including: our ability to effectively estimate, price for and manage medical costs; new or changes in existing health care laws or regulations, or their enforcement or application; reductions in revenue or delays to cash flows received under government programs; changes in Medicare, the CMS star ratings program or the application of risk adjustment data validation audits; the DOJ’s legal action relating to the risk adjustment submission matter; our ability to maintain and achieve improvement in quality scores impacting revenue; failure to maintain effective and efficient information systems or if our technology products do not operate as intended; cyberattacks, other privacy/data security incidents, or our failure to comply with related regulations; risks and uncertainties associated with our businesses providing pharmacy care services; competitive pressures, including our ability to maintain or increase our market share; changes in or challenges to our public sector contract awards; failure to achieve targeted operating cost productivity improvements; failure to develop and maintain satisfactory relationships with health care payers, physicians, hospitals and other service providers; the impact of potential changes in tax laws and regulations; increases in costs and other liabilities associated with litigation, government investigations, audits or reviews; failure to complete, manage or integrate strategic transactions; risks associated with public health crises arising from large-scale medical emergencies, pandemics, natural disasters and other extreme events; failure to attract, develop, retain, and manage the succession of key employees and executives; our investment portfolio performance; impairment of our goodwill and intangible assets; failure to protect proprietary rights to our databases, software and related products; downgrades in our credit ratings; and our ability to obtain sufficient funds from our regulated subsidiaries or from external financings to fund our obligations, maintain our debt to total capital ratio at targeted levels, maintain our quarterly dividend payment cycle, or continue repurchasing shares of our common stock.
This above list is not exhaustive. We discuss these matters, and certain risks that may affect our business operations, financial condition and results of operations, more fully in our filings with the SEC, including our reports on Forms 10-K, 10-Q and 8-K. By their nature, forward-looking statements are not guarantees of future performance or results and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Actual results may vary materially from expectations expressed or implied in this document or any of our prior communications. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made. We do not undertake to update or revise any forward-looking statements, except as required by law.
ITEM 3.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
We manage exposure to market interest rates by diversifying investments across different fixed-income market sectors and debt across maturities, as well as by matching a portion of our floating-rate assets and liabilities, either directly or through the use of interest rate swap contracts. Unrealized gains and losses on investments in available-for-sale debt securities are reported in comprehensive income.
The following table summarizes the impact of hypothetical changes in market interest rates across the entire yield curve by 1% point or 2% points as of September 30, 2023 on our investment income and interest expense per annum, and the fair value of our investments and debt (in millions, except percentages):
September 30, 2023
Increase (Decrease) in Market Interest RateInvestment
Income Per
Annum
Interest
Expense Per
Annum
Fair Value of
Financial Assets
Fair Value of
Financial Liabilities
2 %$971 $419 $(3,408)$(7,067)
1486 209 (1,758)(3,846)
(1)(486)(193)1,858 4,635 
(2)(971)(386)3,800 10,274 
Note: The impact of hypothetical changes in interest rates may not reflect the full 100 or 200 basis point change on interest income and interest expense or on the fair value of financial assets and liabilities as the rates are assumed to not fall below zero.
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ITEM 4.    CONTROLS AND PROCEDURES
EVALUATION OF DISCLOSURE CONTROLS AND PROCEDURES
We maintain disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934 (Exchange Act) that are designed to provide reasonable assurance that information required to be disclosed by us in reports that we file or submit under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in SEC rules and forms; and (ii) accumulated and communicated to our management, including our principal executive officer and principal financial officer, as appropriate to allow timely decisions regarding required disclosure.
In connection with the filing of this quarterly report on Form 10-Q, management evaluated, under the supervision and with the participation of our Chief Executive Officer and Chief Financial Officer, the effectiveness of the design and operation of our disclosure controls and procedures as of September 30, 2023. Based upon that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective at the reasonable assurance level as of September 30, 2023.
CHANGES IN INTERNAL CONTROL OVER FINANCIAL REPORTING
There have been no changes in our internal control over financial reporting during the quarter ended September 30, 2023 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
PART II. OTHER INFORMATION
ITEM 1.    LEGAL PROCEEDINGS
A description of our legal proceedings is included in and incorporated by reference to Note 7 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
ITEM 1A.    RISK FACTORS
In addition to the other information set forth in this report, you should carefully consider the factors discussed in Part I, Item 1A, “Risk Factors” of our 2022 10-K, which could materially affect our business, financial condition or future results. The risks described in our 2022 10-K are not the only risks facing us. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial also may materially adversely affect our business, financial condition or future results.
There have been no material changes to the risk factors as disclosed in our 2022 10-K.
ITEM 2.    UNREGISTERED SALE OF EQUITY SECURITIES, USE OF PROCEEDS, AND ISSUER PURCHASES OF EQUITY SECURITIES
Issuer Purchases of Equity Securities (a)
Third Quarter 2023
For the Month EndedTotal Number of Shares PurchasedAverage Price Paid Per ShareTotal Number of Shares Purchased as Part of Publicly Announced Plans or ProgramsMaximum Number of Shares That May Yet Be Purchased Under The Plans or Programs
(in millions)(in millions)(in millions)
July 31, 20231.2 $481.19 1.2 19.6
August 31, 20231.0 501.09 1.0 18.6
September 30, 20230.9 488.62 0.9 17.7
Total3.1 $489.56 3.1 
(a)    In November 1997, our Board of Directors adopted a share repurchase program, which the Board of Directors evaluates periodically. In June 2018, the Board of Directors renewed our share repurchase program with an authorization to repurchase up to 100 million shares of our common stock in open market purchases or other types of transactions (including prepaid or structured repurchase programs). There is no established expiration date for the program.
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ITEM 5.    OTHER INFORMATION
Trading Arrangements

During the quarter ended September 30, 2023, none of the Company’s directors or officers (as defined in Rule 16a-1(f) under the Exchange Act) adopted or terminated any contract, instruction or written plan for the purchase or sale of Company securities intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act or any non-Rule 10b5-1 trading arrangement.

ITEM 6.    EXHIBITS*
The following exhibits are filed or incorporated by reference herein in response to Item 601 of Regulation S-K. The Company files Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q and Current Reports on Form 8-K pursuant to the Securities Exchange Act of 1934 under Commission File No. 1-10864.
101.INSXBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.
101.SCHInline XBRL Taxonomy Extension Schema Document.
101.CALInline XBRL Taxonomy Extension Calculation Linkbase Document.
101.DEFInline XBRL Taxonomy Extension Definition Linkbase Document.
101.LABInline XBRL Taxonomy Extension Label Linkbase Document.
101.PREInline XBRL Taxonomy Extension Presentation Linkbase Document.
104 Cover Page Interactive Data File (formatted as Inline XBRL and embedded within Exhibit 101).
 ________________
*Pursuant to Item 601(b)(4)(iii) of Regulation S-K, copies of instruments defining the rights of certain holders of long-term debt are not filed. The Company will furnish copies thereof to the SEC upon request.
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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
 
UNITEDHEALTH GROUP INCORPORATED
 
/s/ ANDREW WITTY
Chief Executive Officer
(principal executive officer)
Dated:November 6, 2023
Andrew Witty  
/s/ JOHN REX
Executive Vice President and
Chief Financial Officer
(principal financial officer)
Dated:November 6, 2023
John Rex  
/s/ THOMAS ROOS
Senior Vice President and
Chief Accounting Officer
(principal accounting officer)
Dated:November 6, 2023
Thomas Roos  
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