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Elevance Health
Elevance Health (ELV) investor relations material
Elevance Health Q4 2025 earnings summary
Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.Q4 2025 earnings summary28 Jan, 2026
Executive summary
Fourth quarter and full year 2025 operating results were consistent with expectations, with adjusted diluted EPS of $3.33 for Q4 and $30.29 for the year, including $3.75 of non-recurring favorable items, mainly tax-related benefits.
Full year 2025 operating revenue was $197.6B, up 12.8%–13% year-over-year, driven by improved premium yields, acquisitions, and Medicare Advantage growth, partially offset by Medicaid attrition.
2026 is positioned as a year of execution and repositioning, focusing on Medicare margin improvement, managing Medicaid headwinds, and stabilizing ACA performance.
Returned $4.1B to shareholders in 2025 through share repurchases and dividends.
Reaffirmed long-term earnings growth target, aiming for at least 12% adjusted EPS growth in 2027.
Financial highlights
2025 benefit expense ratio increased 150 bps to 90.0%, reflecting higher cost trends across all major lines.
Adjusted operating gain for 2025 was $7.5B, down 20% year-over-year; adjusted operating margin declined to 3.8%.
Operating cash flow for 2025 was $4.3B, a decrease of $1.5B from the prior year and approximately 0.8x GAAP net income.
2025 adjusted operating expense ratio improved to 10.5% due to disciplined expense management.
Q4 2025 net income was $547M, up 31% year-over-year; full year net income was $5.66B, down 5%.
Outlook and guidance
2026 adjusted diluted EPS guidance is at least $25.50; GAAP diluted EPS projected at least $22.30.
2026 operating revenue expected to decline in the low single digits, with benefit expense ratio at 90.2% +/- 50 bps.
2027 adjusted diluted EPS targeted to grow at least 12% from the 2026 baseline.
2026 operating cash flow projected at least $5.5B.
Total medical membership expected to decline to 43.2–43.9 million in 2026.
How will Health Benefits revenue decline be limited?
Impact of reduced prior year claims redundancies?
Path to 12% adjusted EPS growth by 2027?
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Next Elevance Health earnings date
Q1 202621 Apr, 2026
Elevance Health
Next Elevance Health earnings date
Q1 202621 Apr, 2026
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Frequently asked questions
Elevance Health Inc., formerly Anthem, Inc., operates as a health benefits company in the United States. The company operates through Blue Cross and Blue Shield Service Operations, Commercial and Specialty Services, and Individual Commercial segments. It is also involved in the offering of complementary health and wellness products; provision of access to contracted primary care providers through its HMO network; and the joint-ventured accountable care organization that contracts with the government to provide health care services to Medicare Advantage populations and fee-for-service Medicare populations. Anthem, Inc. is based in Indianapolis, Indiana.
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