Elevance Health (ELV) Q2 2026 earnings summary

Executive summary

• Second quarter 2026 operating revenue reached $49.8 billion, up 0.8% year-over-year, driven by higher premium yields and CarelonRx product growth, partially offset by declines in Medicare Advantage, Medicaid, and Employer Group risk membership.

• Adjusted diluted EPS was $7.45, supported by favorable benefit expense performance and a net below-the-line benefit of approximately $0.80 per share.

• Net income for Q2 2026 was $1.46 billion, down 16.1% from Q2 2025, primarily due to higher medical costs, increased operating expenses, and a loss contingency accrual for Medicare Advantage risk adjustment data.

• Full-year 2026 guidance for adjusted diluted EPS raised to at least $27.00, reflecting strong Q2 results and ongoing investments in cost management and operational efficiency.

• Medical membership was approximately 44.9 million as of June 30, 2026, down 1.5% year-over-year, mainly due to commercial fee-based customer transitions and attrition in Individual ACA and Medicaid.

Financial highlights

• Q2 2026 operating gain was $1.8 billion, down from $2.4 billion in Q2 2025; adjusted operating margin declined to 3.6%.

• Operating revenue increased 0.8% to $49.8 billion; total revenues for Q2 2026 were $50.5 billion, up 1.4% year-over-year.

• Net investment income rose 44.9% to $704 million in Q2 2026.

• Operating cash flow for Q2 2026 was $1.9 billion; first half of 2026 operating cash flow was $6.25 billion.

• Benefit expense ratio increased to 89.7% in Q2 2026 from 88.9% in Q2 2025.

Outlook and guidance

• FY 2026 adjusted diluted EPS guidance raised to at least $27.00, with expectations of at least 12% adjusted EPS growth in 2027.

• FY 2026 operating cash flow guidance increased to at least $6.0 billion.

• Management expects continued pressure on medical cost trends, especially in Medicaid and Medicare, due to higher acuity and utilization.

• Ongoing investments in technology, workforce, and regulatory/litigation matters are expected to impact operating expenses.

• Third quarter adjusted EPS expected to represent about 17% of full-year guidance.