UnitedHealth Group quietly sold minority stakes in several business units to private-equity firms at the end of 2024, booking about $3.3 billion in gains that allowed it to narrowly top Wall Street’s fourth-quarter and full-year earnings targets and extend a 15-year streak of earnings beats. The windfall lifted adjusted earnings per share to $6.81 in the quarter, roughly $3.50 of which came from the transactions. Warburg Pincus acquired a majority holding in Epic Hearing Healthcare and another subrogation-services unit, while KKR bought into a senior-fitness program, according to people familiar with the matter and corporate filings. The deals, completed just before the books closed on 2024, include options that could oblige UnitedHealth to repurchase the stakes within a few years for up to $3.4 billion. The company counted the proceeds as operating revenue and in adjusted earnings but excluded a separate $7.1 billion loss tied to its exit from Brazil. Accounting specialists said the treatment is permissible under U.S. rules but unusual, and it highlights how the insurer is relying on one-off gains as rising medical costs and tighter government reimbursement squeeze its core health-care margins. Without the asset sales, analysts estimate UnitedHealth would have fallen short of consensus profit forecasts for the first time since 2009. The maneuver comes as the $273 billion insurer faces a criminal investigation into its Medicare billing practices, heightened antitrust scrutiny of acquisitions and the financial impact of higher Medicare Advantage costs. UnitedHealth posted its first quarterly miss in early 2025, withdrew guidance and replaced Chief Executive Officer Andrew Witty with former CEO Stephen Hemsley in May; the shares now hover near a five-year low.