Elevance Health (ELV) Q3 2025 earnings summary

Executive summary

• Third quarter 2025 operating revenue reached $50.1 billion, up 12% year-over-year, with diluted EPS of $5.32 and adjusted EPS of $6.03, reflecting solid execution and strategic investments in Carelon, AI, and digital innovation.

• Net income for Q3 2025 was $1.19 billion, up 17–17.8% year-over-year, while medical membership declined 0.9%, mainly from BlueCard and Medicaid, partially offset by Medicare Advantage growth.

• Year-to-date, $3.3 billion was returned to shareholders through buybacks and dividends.

• Strategic focus on lowering total cost of care, improving member experience, and leveraging value-based care and digital innovation.

• Disciplined approach to 2026 planning, acknowledging uncertainties and focusing on controllable levers.

Financial highlights

• Q3 2025 GAAP diluted EPS was $5.32; adjusted diluted EPS was $6.03; net investment income was $625 million.

• Total operating revenue for Q3 2025 was $50.1 billion, up 12% year-over-year; nine-month revenue was $148.3 billion, up 13.9%.

• Benefit expense ratio rose to 91.3%, up 180 basis points year-over-year, reflecting higher medical cost trends.

• Operating cash flow for Q3 2025 was $1.1 billion, impacted by a litigation settlement payment; year-to-date cash flow was $4.2 billion.

• Operating margin declined to 2.6–2.7% from 3.1–5.5% year-over-year.

Outlook and guidance

• Full-year 2025 adjusted EPS guidance reaffirmed at approximately $30, with $27 as the baseline excluding non-recurring items; benefit expense ratio guidance maintained at about 90%.

• Medicaid operating margin expected to decline at least 125 basis points year-over-year in 2026, with 2026 seen as the trough.

• Medicare Advantage margins expected to improve slightly in 2025, though below long-term range.

• ACA operating margins expected to decline high single digits year-over-year; higher costs anticipated in Q4.

• Several hundred million dollars of incremental investments planned for 2026, mainly in technology, Carelon, and quality initiatives.