UnitedHealth posted a better-than-expected profit in the final quarter of 2024, but revenue fell short as challenges like Medicare funding cuts and a Medicaid enrollment drop hurt.

Shares of the health care giant slid early Thursday after it released its first financial report since the brazen shooting of one of its executives outside a New York City hotel touched a national nerve and brought to the surface American frustration over health care access.

UnitedHealth earned $5.5 billion in the quarter, as adjusted results totaled $6.81 per share. The company's revenue climbed about 7% to $100.8 billion.

Analysts expected earnings of $6.73 per share in the fourth quarter on $101.6 billion in revenue, according to the data firm FactSet.

UnitedHealth operates the nation's largest health insurer, UnitedHealthcare, which covers more than 49 million people in the United States. It also operates a large pharmacy benefit manager that runs prescription drug coverage and a growing business that delivers care and provides technical support.

UnitedHealth's Medicaid enrollment tumbled by about 400,000 people compared to the previous year's quarter, as states went through a lengthy process to determine who was still eligible for the government program after the COVID-19 pandemic.

The company says it also dealt with increased prescribing of expensive specialty drugs and other cost pressures.

The company on Thursday also reaffirmed a forecast it laid last month for 2025 adjusted earnings ranging between $29.50 to $30 per share.

Analysts expect earnings per share of $29.83.

Company shares slid about 5% to $515 in premarket trading Thursday.