Elevance Health Reports Fourth Quarter and Full Year 2024 Results; Sets Full Year 2025 Outlook

Indianapolis, IN -- January 23, 2025 - Elevance Health, Inc. (NYSE: ELV) reported fourth quarter and full year 2024 results.

“As part of our commitment to elevating whole health and advancing health beyond healthcare, we deliver value to the members and care providers we serve by ensuring simple, affordable, and accessible care. Our fourth quarter results demonstrate tangible progress in improving our operations in response to the dynamic environment facing the industry. As we look to 2025, we remain resolute in our goal to simplify the healthcare experience, deepen the impact of Carelon, and deploy innovative care models, positioning us to achieve sustainable growth over the long run.”

Gail K. Boudreaux
President and Chief Executive Officer

*Earnings per diluted share ("EPS")
**Refer to GAAP reconciliation tables.

Consolidated Enterprise Highlights

Operating revenue was $45.0 billion in the fourth quarter of 2024, an increase of $2.5 billion, or 6 percent compared to the prior year quarter. Operating revenue was $175.2 billion in 2024, an increase of $5.0 billion, or 3 percent. The increase in revenue for the quarter and year was driven by higher premium yields in our Health Benefits segment, acquisitions completed in 2024, and growth in CarelonRx product revenue, partially offset by membership attrition in our Medicaid business. 

The benefit expense ratio was 92.4 percent in the fourth quarter, an increase of 320 basis points compared to the prior year period, and 88.5 percent for the full year, an increase of 150 basis points year over year. The increases were driven primarily by higher Medicaid medical cost trends. Days in Claims Payable was 42.9 days as of December 31, 2024, a slight increase of 0.1 days from September 30, 2024, and a decrease of 4.4 days compared to December 31, 2023.

The operating expense ratio was 10.7 percent in the fourth quarter and 11.4 percent for the full year. On an adjusted basis, the corresponding operating expense ratios were 9.9 percent and 10.6 percent. The improvements in the adjusted operating expense ratio over prior year periods of 170 basis points and 70 basis points, respectively, reflect disciplined cost management and enhanced efficiency. 

Cash Flow & Balance Sheet

Operating cash flow was $5.8 billion in 2024, approximately 1.0 times GAAP net income. As of December 31, 2024, cash and investments at the parent company totaled approximately $2.4 billion. 

During the fourth quarter of 2024, the Company repurchased 4.5 million shares of its common stock for $1.8 billion, at a weighted average price of $401.29, and paid a quarterly dividend of $1.63 per share, representing a distribution of cash totaling $373 million. As of December 31, 2024, the Company had approximately $9.3 billion of Board approved share repurchase authorization remaining.

Reportable Segment Highlights

Health Benefits is comprised of Individual, Employer Group risk-based, Employer Group fee-based, BlueCard® , Medicare, Medicaid, and Federal Employee Program businesses.

Health Benefits segment operating revenue was $37.6 billion in the fourth quarter of 2024, an increase of $1.0 billion, or 3 percent compared to the fourth quarter of 2023. Operating revenue was $150.3 billion in 2024, an increase of $1.7 billion, or 1 percent. The increases for the quarter and year were driven primarily by higher premium yields, partially offset by membership attrition in our Medicaid business.

Operating gain totaled $0.2 billion in the fourth quarter of 2024 and $6.2 billion for the full year. On an adjusted basis, operating gain was $0.3 billion in the fourth quarter of 2024 and $6.3 billion for the full year. Adjusted operating gain in both periods was impacted primarily by higher cost trend in Medicaid related to redeterminations.

Medical membership totaled approximately 45.7 million as of December 31, 2024, a decrease of 1.1 million, or 2 percent year over year, driven by attrition in our Medicaid business, partially offset by growth in Employer Group fee-based and Affordable Care Act health plan membership. 

Carelon is comprised of CarelonRx and Carelon Services.

Operating revenue for Carelon was $14.7 billion in the fourth quarter of 2024, an increase of $2.3 billion, or 19 percent compared to the prior year period. Operating revenue was $53.9 billion in 2024, an increase of $5.9 billion, or 12 percent. The increases for the quarter and the year were driven by the launch and growth of risk-based capabilities in Carelon Services and acquisitions completed in 2024.

Operating gain for Carelon totaled $0.6 billion in the fourth quarter, effectively flat year over year; however, on an adjusted basis, operating gain was $0.8 billion, an increase of $0.2 billion, or 32 percent. The increase for the fourth quarter of 2024 was driven by higher pharmacy product revenue. On a full year basis, operating gain was $2.9 billion in 2024, an increase of $0.2 billion, or 9 percent. Similarly, on an adjusted basis, operating gain was $3.1 billion, an increase of $0.4 billion, or 17 percent.

Quarterly Dividend

On January 22, 2025, the Audit Committee of the Company's Board of Directors declared a first quarter 2025 dividend to shareholders of $1.71 per share. The first quarter dividend is payable on March 25, 2025, to shareholders of record at the close of business on March 10, 2025.

About Elevance Health

Elevance Health is a lifetime, trusted health partner whose purpose is to improve the health of humanity. The company supports consumers, families, and communities across the entire healthcare journey – connecting them to the care, support, and resources they need to lead better lives. Elevance Health’s companies serve approximately 112 million consumers through a diverse portfolio of industry-leading medical, pharmacy, behavioral, clinical, home health, and complex care solutions. For more information, please visit www.elevancehealth.com or follow us @ElevanceHealth on X and Elevance Health on LinkedIn.

Conference Call and Webcast

Management will host a conference call and webcast today at 8:30 a.m. Eastern Standard Time (“EST”) to discuss the company’s fourth quarter and full year 2024 results and 2025 outlook. The conference call should be accessed at least 15 minutes prior to the start of the call with the following numbers: 

• 888-947-9963 (Domestic)
• 866-405-7292 (Domestic Replay)
• 312-470-0178 (International)
• 203-369-0604 (International Replay)

The access code for today's conference call is 3972058. There is no access code for the replay. The replay will be available from 11:30 a.m. EST today, until the end of the day on February 21, 2025. The call will also be available through a live webcast at www.elevancehealth.com under the “Investors” link. A webcast replay will be available following the call.

Basis of Presentation

1.      Operating revenue and operating gain/loss are the key measures used by management to evaluate performance in each of its reporting segments, allocate resources, set incentive compensation targets and to forecast future operating performance. Operating gain/loss is calculated as total operating revenue less benefit expense, cost of products sold and operating expense. It does not include net investment income, net gains/losses on financial instruments, interest expense, amortization of other intangible assets, gains/losses on extinguishment of debt or income taxes, as these items are managed in a corporate shared service environment and are not the responsibility of operating segment management. Refer to the GAAP reconciliation tables.

2.      Operating margin is defined as operating gain divided by operating revenue.

Elevance Health Contacts

Investor Relations:
Nathan Rich
Investor.Relations@elevancehealth.com

Media Contact:
Leslie Porras
Leslie.Porras@elevancehealth.com

Forward-Looking Statements

This document contains certain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward looking statements reflect our views about future events and financial performance and are generally not historical facts. Words such as “expect,” “feel,” “believe,” “will,” “may,” “should,” “anticipate,” “intend,” “estimate,” “project,” “forecast,” “plan” and similar expressions are intended to identify forward-looking statements. These statements include, but are not limited to: financial projections and estimates and their underlying assumptions; statements regarding plans, objectives and expectations with respect to future operations, products and services; and statements regarding future performance. Such statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond our control, that could cause actual results to differ materially from those expressed in, or implied or projected by, the forward-looking statements. You are cautioned not to place undue reliance on these forward-looking statements that speak only as of the date hereof. You are also urged to carefully review and consider the various risks and other disclosures discussed in our reports filed with the U.S. Securities and Exchange Commission from time to time, which attempt to advise interested parties of the factors that affect our business. Except to the extent required by law, we do not update or revise any forward-looking statements to reflect events or circumstances occurring after the date hereof. These risks and uncertainties include, but are not limited to: trends in healthcare costs and utilization rates; reduced enrollment; our ability to secure and implement sufficient premium rates; the impact of large scale medical emergencies, such as public health epidemics and pandemics, and other catastrophes; the impact of new or changes in existing federal, state and international laws or regulations, including laws and regulations impacting healthcare, insurance, pharmacy services and other diversified products and services, or their enforcement or application; the impact of cyber-attacks or other privacy or data security incidents or our failure to comply with any privacy, data or security laws or regulations, including any investigations, claims or litigation related thereto; failure to effectively maintain and modernize our information systems, or failure of our information systems or technology, including artificial intelligence, to operate as intended; failure to effectively maintain the availability and integrity of our data; changes in economic and market conditions, as well as regulations that may negatively affect our liquidity and investment portfolios; competitive pressures and our ability to adapt to changes in the industry and develop and implement strategic growth opportunities; risks and uncertainties regarding Medicare and Medicaid programs, including those related to non-compliance with the complex regulations imposed thereon; our ability to maintain and achieve improvement in Centers for Medicare and Medicaid Services Star Ratings and other quality scores and funding risks with respect to revenue received from participation therein; a negative change in our healthcare product mix; costs and other liabilities associated with litigation, government investigations, audits or reviews; our ability to contract with providers on cost-effective and competitive terms; risks associated with providing healthcare, pharmacy and other diversified products and services, including medical malpractice or professional liability claims and non-compliance by any party with the pharmacy services agreement between us and CaremarkPCS Health, L.L.C.; the effects of any negative publicity related to the health benefits industry in general or us in particular; risks associated with mergers, acquisitions, joint ventures and strategic alliances; possible impairment of the value of our intangible assets if future results do not adequately support goodwill and other intangible assets; possible restrictions in the payment of dividends from our subsidiaries and increases in required minimum levels of capital; our ability to repurchase shares of our common stock and pay dividends on our common stock due to the adequacy of our cash flow and earnings and other considerations; the potential negative effect from our substantial amount of outstanding indebtedness and the risk that increased interest rates or market volatility could impact our access to or further increase the cost of financing; a downgrade in our financial strength ratings; events that may negatively affect our licenses with the Blue Cross and Blue Shield Association; intense competition to attract and retain employees; risks associated with our international operations; and various laws and provisions in our governing documents that may prevent or discourage takeovers and business combinations.