It's because we're starting year 2 of a 3 year Medicare rate cut and as a company, Optum is completely incapable of increasing bottom line/operating revenue. We say we innovate but really we just terminate people to keep our MLR at 85% and hit our earnings target. When rates go up, we hire more. UNH stock is just a proxy for Medicare reimbursement, and we adjust headcount to manipulate the bottom line since we have no other tricks. In years where reimbursement is good and UHC needs to spend more money to keep MLR at or above 85%, they spend it with Optum, so there's a direct correlation between how UHC earns and how much budget Optum has.
Bumping this up for visibility. Source: @a3+1jja4vrdh