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Elevance Health Reports First Quarter 2026 Results; Raises Full-Year Guidance

Press Release
April 22, 2026
  • 1Q 2026 operating revenue of $49.5 billion, up 1.5% from 1Q 2025

  • 1Q 2026 diluted EPS* of $8.00; adjusted diluted EPS** of $12.58 driven by strong operating results and ~$1 per share of non-recurring investment income

  • FY 2026 diluted EPS* guidance to be at least $19.85, including the Company's estimate of the financial impact for the CMS matter

  • FY 2026 adjusted diluted EPS** guidance raised to at least $26.75, supported by underlying business strength, actions to reduce medical costs, and increased visibility

  • Reaffirm FY 2026 operating cash flow of at least $5.5 billion, inclusive of potential cash payments for the CMS matter

  • Returned $1.5 billion of capital to shareholders in 1Q 2026

 

Indianapolis, IN - April 22, 2026 - Elevance Health, Inc. (NYSE: ELV) reported first quarter 2026 results ahead of expectations.

"Our first quarter results exceeded expectations, reflecting underlying business strength and improving claims experience. We are raising our full-year adjusted EPS guidance, supported by greater visibility into the balance of the year. Our actions are driving more consistent performance and position Elevance Health for continued improvement over time.”

Gail K. Boudreaux
President and Chief Executive Officer

 

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



Consolidated Enterprise Highlights

Operating revenue was $49.5 billion in the first quarter of 2026, an increase of $0.7 billion, or 1.5 percent compared to the prior year quarter. This was driven by higher premium yields in our Health Benefits segment and growth in CarelonRx product revenue, partially offset by anticipated declines in our Medicare Advantage, Medicaid, and Employer Group risk membership.

The benefit expense ratio was 86.8 percent, an increase of 40 basis points, reflecting expected elevated medical cost trend in our Medicaid business, partially offset by improved performance in Medicare. Days in Claims Payable stood at 46.6 days as of March 31, 2026, an increase of 5.3 days from December 31, 2025 and an increase of 3.8 days year over year.

The operating expense ratio of 12.8 percent included a $935 million accrual representing our current best estimate of the identified potential exposure related to the CMS notice. The Company also recorded a charge of $129 million related to business optimization as we simplify and enhance our organizational structure.

The adjusted operating expense ratio was 10.5 percent, a decrease of 20 basis points, driven by disciplined expense management. We are prioritizing targeted investments across clinical, operational, and administrative workflows to position the enterprise for long-term growth.

Cash Flow & Balance Sheet

Operating cash flow of $4.3 billion in the quarter increased $3.3 billion year over year, reflecting underlying business strength and favorable working capital dynamics. As of March 31, 2026, cash and investments at the parent company totaled approximately $2.2 billion.

During the first quarter of 2026, the Company repurchased 3.7 million shares of its common stock for $1.1 billion, at a weighted average price of $304.68, and paid a quarterly dividend of $1.72 per share, representing a distribution of cash totaling $376 million. As of March 31, 2026, the Company had approximately $5.6 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 $42.5 billion in the first quarter of 2026, an increase of $1.1 billion, or 2.6 percent compared to the prior year quarter, driven primarily by higher premium yields, partially offset by anticipated declines in our Medicare Advantage, Medicaid, and Employer Group risk membership.

Operating gain totaled $2.2 billion, down 2.7 percent from the prior year. Growth in operating revenue was offset by anticipated higher medical costs, primarily in Medicaid.

Medical membership of approximately 45.4 million as of March 31, 2026 increased by 186 thousand from year-end 2025, driven by expansion of our commercial fee-based membership, partially offset by anticipated reductions in our Medicare Advantage and Employer Group risk membership as we took disciplined action to reposition these businesses for sustainable performance.

Carelon is comprised of CarelonRx and Carelon Services.

Operating revenue for Carelon was $18.0 billion in the first quarter of 2026, an increase of $1.3 billion, or 7.9 percent compared to the prior year quarter. Growth was driven by the scaling of Carelon Services risk-based solutions and CarelonRx product revenue.

Operating gain for Carelon totaled $1.1 billion, a decline of 3.8 percent year over year, reflecting the impact of lower health plan membership and continued investment in the expansion of risk-based capabilities in our Carelon Services business. These factors were partly offset by improved profitability in our specialty pharmacy and behavioral health businesses.

Quarterly Dividend

On April 21, 2026, the Audit Committee of the Company's Board of Directors declared a second quarter 2026 dividend to shareholders of $1.72 per share. The second quarter dividend is payable on June 25, 2026, to shareholders of record at the close of business on June 10, 2026.

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 105 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 Daylight Time (“EDT”) to discuss the company’s first quarter results and 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)
  • 800-391-9853 (Domestic Replay)
  • 312-470-0178 (International)
  • 203-369-3269 (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. EDT today, until the end of the day on May 22, 2026. The call will also be available through a live webcast atThe 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,” "potential," "predict" 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 or sentiment 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.