Elevance Health (ELV) Q3 2026 earnings summary

Executive summary

• Q3 operating revenue was $50.440B, up 0.7% YoY; adjusted diluted EPS was $6.99, including $0.50/share of operating outperformance and a $1.85/share net non-operating benefit.

• 2026 adjusted EPS guidance rose to at least $29; management expects at least 12% adjusted EPS growth in 2027 from a baseline of at least $26.75.

• Nine-month operating revenue grew 1.0% to $149.760B, while shareholders’ net income fell 10.2% to $4.592B; a $935M Medicare risk-adjustment accrual weighed on results.

Financial highlights

• Q3 diluted EPS was $6.27, up 17.9% YoY; shareholders’ net income rose 14.8% to $1.365B and adjusted shareholders’ net income rose 12.7% to $1.520B.

• Q3 total revenues were $51.429B, up 1.4% YoY; net investment income increased to $1.037B from $625M.

• Adjusted operating gain was $1.337B, down 0.5% YoY; adjusted operating margin was 2.7%, unchanged.

• Operating cash flow was $1.3B in Q3; nine-month operating cash flow rose to $7.512B from $4.206B, primarily due to favorable working capital.

• Medical membership was 44.882M, down 1.1% YoY, mainly from Medicaid eligibility redeterminations and lower Medicare Advantage and other risk-based enrollment.

Outlook and guidance

• 2026 adjusted diluted EPS guidance increased to at least $29.00; diluted EPS guidance rose to at least $22.00.

• The 2026 earnings baseline increased to at least $26.75 from $26.00, excluding non-recurring investment income and other non-operating items, plus targeted one-time investments.

• 2026 operating cash flow guidance increased to at least $6.5B.

• 2027 adjusted EPS growth is expected to be at least 12%, supported by Health Benefits margin improvement, Carelon growth, efficiency and disciplined capital deployment.

• Medicaid margins are expected to improve in 2027 after a 2026 trough; the long-term target remains 2%-4%. Medicare Advantage margin is expected to reach at least 2% in 2026 and improve toward a 3%-5% long-term target.