Elevance Health (ELV) Q2 2025 earnings summary

Executive summary

• Operating revenue for Q2 2025 reached $49.4 billion, up 14.3% year-over-year, driven by higher premium yields, acquisitions, and Medicare Advantage growth, partially offset by Medicaid attrition.

• Adjusted diluted EPS was $8.84, with GAAP diluted EPS at $7.72; full-year 2025 adjusted EPS guidance revised to approximately $30.00 due to elevated medical cost trends in ACA and slower Medicaid rate alignment.

• Net income for Q2 2025 was $1.74 billion, down 24.2% year-over-year, mainly due to higher medical costs and lower Health Benefits margins.

• Returned $2.0 billion to shareholders year-to-date through share repurchases and dividends.

• Strategic focus remains on cost management, targeted investments, and operational discipline to stabilize margins and support long-term growth.

Financial highlights

• Benefit expense ratio increased to 88.9% in Q2 2025, up 260 bps year-over-year, reflecting higher medical costs in Medicaid and ACA plans.

• Operating expense ratio improved to 10.1% (adjusted: 10.0%), down 140–160 bps year-over-year.

• Operating margin was 4.9%, down from 6.4% year-over-year; adjusted operating margin at 5.0%.

• Operating cash flow year-to-date was $3.1 billion, up $0.6 billion year-over-year; $6 billion expected for the full year.

• Net investment income for Q2 2025 was $486 million, down 4.3% year-over-year.

Outlook and guidance

• Full-year 2025 adjusted EPS guidance revised to approximately $30.00, reflecting persistent elevated trends in ACA and Medicaid.

• Benefit expense ratio forecasted at ~90% for 2025.

• More earnings expected in Q3 than Q4, with Q4 impacted by anticipated utilization surge if enhanced subsidies expire.

• 2026 rate filings incorporate current morbidity and risk pool deterioration from potential subsidy expiration.

• Management expects to maintain strong liquidity and capital resources, with cash, equivalents, and investments totaling $35.9 billion at June 30, 2025.