Elevance Health reported operating revenue of $49.3 billion for the fourth quarter of 2025, a 10 percent increase versus the prior year driven by higher premium yields, contributions from acquisitions and growth in Medicare Advantage membership. Operating gain narrowed to $0.3 billion in Q4 from $0.7 billion a year ago, while adjusted operating gain fell to $0.4 billion from $0.8 billion. Benefit expense ratio climbed 110 basis points to 93.5 percent, reflecting elevated medical cost trends in Affordable Care Act plans and seasonal Medicare Part D impacts. For the full year, operating revenue rose 13 percent to $197.6 billion, adjusted operating margin declined to 3.8 percent from 5.3 percent, and the benefit expense ratio expanded by 150 basis points to 90.0 percent.

In the Health Benefits segment, Q4 operating revenue was $41.8 billion, up 11 percent year-over-year, while adjusted operating loss was $0.2 billion compared with a $0.2 billion gain in the prior period; full-year adjusted operating gain totaled $4.2 billion, down from $6.3 billion a year earlier. Medical membership stood at 45.2 million, down 1 percent year-over-year due to Medicaid attrition. Carelon posted Q4 revenue of $18.7 billion, a 27 percent increase driven by CarelonRx and risk-based services expansion, with adjusted operating gain flat at $0.6 billion. Full-year Carelon revenue grew 33 percent to $71.7 billion, and adjusted operating gain rose 10 percent to $3.4 billion.

For fiscal 2026, Elevance Health issued a profit forecast below consensus as it anticipates persistent medical cost pressures and moderating premium growth. Operating cash flow was $4.3 billion in 2025, 0.8 times GAAP net income, and parent-company cash and investments totaled $2.6 billion at year-end. In Q4 the company repurchased 1.4 million shares for $471 million and paid $377 million in dividends ($1.71 per share), leaving $6.7 billion of share repurchase authorization. The Board declared a first-quarter 2026 dividend of $1.72 per share payable March 25 to holders of record on March 10.

CEO Gail Boudreaux emphasized disciplined execution and pricing discipline to drive affordability and ease of access for members. Investments will focus on scaling Carelon capabilities and accelerating technology adoption across the enterprise. The company reaffirmed its goal to return to at least 12 percent adjusted EPS growth in 2027, underpinned by a diversified platform spanning individual, group, Medicare, Medicaid and pharmacy services.