Elevance Health (ELV) Q1 2025 earnings summary

Executive summary

• Q1 2025 operating revenue reached $48.8B, up 15.4% year-over-year, driven by premium yields, acquisitions, and growth in Medicare Advantage and ACA membership, partially offset by Medicaid attrition.

• Adjusted diluted EPS was $11.97, up 10.5% year-over-year; diluted EPS was $9.61, up 0.2%, with net income at $2.18B, down 2.9% due to higher costs and lower Health Benefits gain.

• Returned $1.3B to shareholders via dividends and share repurchases; 2.2M shares repurchased for $880M.

• Strategic focus on digital innovation, value-based care, and Carelon platform expansion.

• Recognized for workplace excellence and innovation, reflecting a strong organizational culture.

Financial highlights

• Operating revenue: $48.8B (up 15.4% year-over-year); adjusted operating gain: $3.3B (up 4.1%); net income: $2.18B (down 2.9%).

• Adjusted diluted EPS: $11.97 (up 10.5%); diluted EPS: $9.61 (up 0.2%).

• Medical membership ended at 45.8M, down 0.5% year-over-year, with growth in Medicare Advantage and ACA offset by Medicaid attrition.

• Benefit expense ratio was 86.4% (up 80 bps year-over-year), mainly due to higher Medicaid costs.

• Operating cash flow was $1.0B, down $1.0B year-over-year due to working capital timing.

Outlook and guidance

• Full-year 2025 adjusted diluted EPS guidance reaffirmed at $34.15–$34.85.

• Expect more than 60% of adjusted EPS to be realized in the first half of the year.

• Operating cash flow outlook remains at approximately $8B for 2025.

• Anticipate ACA membership attrition in mid-single digits in Q2, with stabilization thereafter.

• Medicaid margin recovery expected in H2 2025 as rate updates take effect.