UnitedHealth Group reported Thursday that it earned less than expected this past quarter, citing higher medical costs and pressure on its insurance division at a time when the company is still reeling from the shocking killing of a top executive last month.

Revenues for UnitedHealth Group amounted to $100.8 billion for the fourth quarter, below what analysts had predicted but still 6.8% higher than in the same quarter the year before. The company’s full-year revenue for 2024 rose to $400.3 billion. For UnitedHealthcare, the insurance division, full-year revenue increased to $298.2 billion, up 6% from 2023.

The results were the company’s first since Brian Thompson, CEO of UnitedHealthcare, was gunned down in front of a midtown Manhattan hotel.

The killing unleashed public outrage aimed at big health insurers over lack of access to health care and denials of coverage and insurance claims.

Some shareholders have urged UnitedHealth to issue a report on its practices that “limit or delay access to health care.”

Andrew Witty, UnitedHealth Group’s CEO, said on a call with analysts Thursday that frustrations about claims, including delays in receiving care and coverage, were “key areas for us to work hard at to improve.”

A successor to Thompson has not been named yet. Witty did not share details about filling the post nor did he directly address the recent shareholder campaign.

But he and other executives discussed the loss of Thompson at the top of the call.

“He devoted his time to helping make the health system work better for all of the people we’re privileged to serve,” Witty said.

UnitedHealth’s results, which disappointed Wall Street, in many ways reflected broader trends and lingering issues for the industry. For several quarters, U.S. health insurers have taken hits to their earnings from high medical expenses and a tightening of government payment policies.

John Rex, the company’s chief financial officer, pointed to cutbacks in government rates in the payment system for Medicare Advantage program, the private insurance arm of federal coverage for people 65 and older. UnitedHealth has substantial business in these Medicare private plans.

Medicare Advantage performance has declined throughout the industry recently, partly because of regulatory changes meant to prevent overcharging and following increased health spending among some older populations.

Witty also said there were costs associated with changes in Medicaid, the federal-state insurance program for the poor.

The company’s medical cost ratio, a measure of the cost of providing care, came in higher than expected in the most recent quarter, which could add fuel to investors’ concerns that increased costs for delivery of care might linger, said John Boylan, an analyst at Edward Jones, an investment firm.

UnitedHealth, however, kept its full-year guidance for 2025 intact, unaltered by recent pressure. Analysts at Morgan Stanley said in a research note that the company had set “reasonably prudent targets” for this year.

“Overall, our view is that United is well positioned to navigate the evolving health care landscape due to its diversified business model,” Boylan said.

UnitedHealth’s stock fell more than 4% in Thursday morning trading as investors digested the weaker-than-expected results. UnitedHealth’s results, often seen as a bellwether for performance across the industry, pushed down shares of its rivals, including CVS Health, which is the parent of the insurer Aetna.