UnitedHealth continues to lead the way on insurer profits in Q3. Here's how its competitors fared

UnitedHealth Group continues to lead the pack in profitability, according to the latest earnings reports for major national insurers.

The company's massive profits certainly aren't going unnoticed. The ongoing expansion of the company's Optum subsidiary, which has been a significant growth engine over multiple quarters, is a blueprint that competitors are starting to follow.

In the third quarter, UHG reported $5.3 billion in profit. It's next-closest competitor, Cigna, posted $2.8 billion in profit. UnitedHealth is also comfortably out in front on profit through the first three quarters of the year, with the healthcare giant reporting $15.35 billion in profit through the first nine months of 2022.

Cigna also reported the second-highest profit through the first nine months of this year, posting $5.5 billion.

UnitedHealth Group edges out CVS Health for the highest revenue through the first three quarters of 2022, reporting $241.4 billion. CVS Health posted $238.6 billion in revenue through Sept. 30 of this year.

CVS, however, wins the revenue battle for Q3, reporting $81.6 billion in revenue. UHG brought in $80.9 billion in revenue in the third quarter.

While CVS pulled ahead in revenue for the quarter, the pharmacy giant did stumble on profit as it faced a $5 billion charge to settle ongoing allegations related to its role in the opioid epidemic. The settlement costs led CVS to post a $3.4 billion loss in the quarter. The company remains profitable through three quarters, however, with $1.9 billion in profit.

UnitedHealth's continued expansion is built largely on the back of ongoing double-digit growth at Optum, particularly Optum Health, which shows no signs of slowing down. Optum has been active in the merger space throughout the year and just days into the fourth quarter closed its biggest and most controversial deal of the year: its acquisition of Change Healthcare.

UHG executives have circled Optum as a growth engine moving forward, with CEO Andrew Witty saying last year that he sees "untapped potential" in the subsidiary's business lines. The company is also seeking new ways to synergize the strengths of Optum and its massive health plan, UnitedHealthcare, to drive growth and lower health costs.

Cigna lands in third place for third-quarter revenue with $45.3 billion as well as across the first three quarters with $134.9 billion.

The insurer is on a similar journey as UnitedHealth Group as it looks to build out its Evernorth subsidiary, which houses multiple key business including Express Scripts, one of the country's largest pharmacy benefit managers; MDLive, a telehealth arm; and eviCore, which provides data analytics services. Evernorth accounts for a growing portion of Cigna's revenue and earnings, and CEO David Cordani said Cigna is similarly looking for ways to align Evernorth with its Cigna Healthcare health plan arm.

Elevance Health, formerly Anthem, is fourth in revenue among the six insurers we analyzed, posting $39.9 billion in revenue for the third quarter and $116.7 billion through three quarters. The company finalized its corporate rebrand earlier this year and is now investing to build out its Carelon business, which includes its new in-house PBM IngenioRx, as well as provider services and digital health tools.

Centene posted $35.9 billion in revenue in the third quarter and $109 billion in revenue through three quarters. Aside from CVS' loss, Centene posted the lowest profits in the quarter with $738 million and is the least profitable insurer through three quarters with $1.4 billion.

The government market-focused insurer has spent much of the last year on its value-creation plan, which aims to reinvest in its core businesses. CEO Sarah London has spearheaded the effort, and the insurer redesigned its office of the CEO to reflect growing segments.

Humana has the lowest revenue for the quarter but beats Centene in profitability. The insurer reported $22.8 billion in revenue and $1.2 billion in profit for the third quarter and $70.4 billion in revenue and $2.8 billion in profit through the first nine months of the year. Similar to its competitors, earlier this year Humana reorganized into two segments, one focused on its health insurance business and then CenterWell, which houses its senior-focused primary care and other provider health services.

Humana is now the country's largest provider of home healthcare services, following its acquisition of Kindred at Home earlier this year, and is investing heavily in its primary care benefits.