UnitedHealth's high medical costs and lower-than-expected revenue in the fourth quarter underscored persistent challenges at its insurance unit, sending the healthcare conglomerate's shares down about 4% before the bell on Thursday.

The company’s shares fell in premarket trading following the healthcare firms first earnings since the killing of executive Brian Thompson.

UnitedHealth beat fourth-quarter earnings forecast, though revenue fell short and medical costs ran high, hitting the Dow Jones component.

UnitedHealth posted a better-than-expected fourth-quarter profit, but a nagging rise in medical costs and care utilization surprised Wall Street.

UnitedHealth Group reported $14.4 billion in 2024 profits as its UnitedHealthcare health insurance and Optum provider services overcame rising costs and a cyberattack.