Eavesdropping on Power: UnitedHealth’s 2024 Earnings Call with Wall Street

As UnitedHealth executives face Wall Street analysts tomorrow, the stakes are high — not just for the company’s stock price, but for patients, doctors and the future of American health care.

A reminder that at 8:45 am EST tomorrow UnitedHealth executives will hold a call with arguably the most powerful people in health care, certainly the people those execs care most about, and you can listen in.

I’m not talking about members of Congress or even President-elect Trump and his nominees. I’m talking about 17 or so highly paid people who, because they are Wall Street financial analysts at major investment banks, will be able to ask UnitedHealth CEO Andrew Witty a few questions about how much money the company made for rich investors during the last three months of 2024 and how much it expects to make this year. 

Unless you’ve listened in on these quarterly calls, you’ve never heard of these people, unless, of course, you are rich enough to afford the reports they write about UnitedHealth and other big for-profit health insurers for the large institutional investors that own the industry. 

You will hear CEO Andrew Witty and one or two other company executives – including CFO John Rex – field softball questions from these analysts (Rex used to be one of them), all of whom are “bullish” on the company. That means they’re confident that, despite all the bad publicity about the company and the outpouring of rage against it by people enrolled in its health plans, they’re confident UnitedHealth is likely resilient and on a path to become even bigger and more profitable. All of them have a “buy” rating on the company. 

They know that UnitedHealth has already become the 4th largest company on the Fortune 500 list of American companies and that if it continues to grow by buying more and chunks of America’s physician practices and clinics, it is only a matter of time before it leaps over Walmart, Amazon and Apple, the only corporations that are currently larger in terms of annual revenues.

Chances are you’ve never heard of these analysts or know what they do because their names are rarely if ever in the news, and that is by design. What they write is exclusively for the world’s biggest and richest investors, and those investors make decisions on whether to buy, sell or hold shares of an insurer’s stock based on the reports and recommendations those analysts make. And what those analysts say also affects the bank accounts of insurance company executives because the higher up the ladder they climb, the more they are paid in stock grants and options. Ninety percent or more of a CEO’s compensation is paid in stock, so you can understand why CEOs want to meet those analysts’ expectations.

And speaking of expectations, the consensus estimate of analysts is that UnitedHealth will report earning $6.72 per share during the fourth quarter of 2024, which would be a growth of 9.1% over the same quarter in 2023, according to Zacks Investment Research. UnitedHealth’s executives know they must at least report earnings per share that is no less than that. If they miss that estimate by even a penny, many investors will likely sell their shares. The more they “beat” Wall Street analysts’ expectations, the more likely the stock price will climb, and along with it, the net worth of the company’s top executives. 

And as Bloomberg’s John Tozzi is reporting today, the analysts are also expecting UnitedHealth’s 2024 profits to be a record $25.6 billion. 

Investors will be looking to hear how the company will be able to ensure even higher profits this year in the face of increasing scrutiny of its business practices by lawmakers and the media. Almost all of those investors read The Wall Street Journal, and they can’t help but notice that the Journal has been investigating how UnitedHealth in particular has gamed the Medicare Advantage program to boost its bottom line. 

Lawmakers in Washington most certainly have been seeing those and other stories about how insurance company business practices are harming both patients and doctors and hospitals, rural hospitals in particular. And some of UnitedHealth’s biggest critics are Republicans. Rep. Buddy Carter (R-Georgia) the new chair of the House Energy and Commerce Subcommittee on Health, is a fierce critic of UnitedHealth’s pharmacy benefit manager, Optum Rx, and has called for the breakup of the company. And the FTC just released a new report, signed by both Democratic and Republican commissioners, detailing how the PBMs owned by UnitedHealth, Cigna and CVS/Aetna have been hiking prices of many specialty drugs 1000% or more.

The Journal’s reporting clearly put the company on the defensive. Right after one of the most recent stories was published, UnitedHealth put a lengthy rebuttal on its website. The rebuttal cited research conducted or paid for by the company or the health insurance industry which no one should find credible. Among the reports UnitedHealth cited was one published in a JAMA publication that I discovered was written by UnitedHealth employees. Other research cited by the company was funded by the industry and published by the Better Medicare Alliance, a PR and lobbying group that gets its funding from UnitedHealth and the other big Medicare Advantage insurers. 

So much is at stake that I strongly encourage you to eavesdrop on UnitedHealth’s call tomorrow morning with those analysts. I’ll be listening, and I’ll write a report about it on Friday.