• GAAP Diluted EPS (Q4 2024): $1.81
• Adjusted Diluted EPS (Q4 2024): $3.84
• Full-Year Adjusted Diluted EPS (2024): $33.04
• Total Operating Revenue (2024): $175.2 billion, up approximately 3% year-over-year
• Consolidated Benefit Expense Ratio (Q4 2024): 92.4%
• Full-Year Benefit Expense Ratio (2024): 88.5%
• Adjusted Operating Expense Ratio (Q4 2024): 9.9%
• Full-Year Operating Expense Ratio (2024): 10.6%
• Operating Cash Flow (2024): $5.8 billion
• Membership (End of 2024): 45.7 million, a decrease of 1.1 million year-over-year
• Share Repurchases (Q4 2024): 4.5 million shares for $1.8 billion
• Full-Year Share Repurchases (2024): $2.9 billion
• Dividend Increase: 5% increase to $1.71 per share
• 2025 Adjusted EPS Guidance: $34.15 to $34.85
• 2025 Projected Operating Revenue Growth: High single to low double-digit percent range
• 2025 Projected Medical Membership: 45.8 million to 46.6 million
• 2025 Projected Operating Cash Flow: Approximately $8 billion

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Release Date: January 23, 2025

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

Positive Points

• Elevance Health Inc (NYSE:ELV) reported fourth-quarter adjusted diluted earnings per share of $3.84, consistent with prior expectations.
• The company achieved strong member retention in its Medicare Advantage business, with anticipated membership growth of 7% to 9% for 2025.
• Elevance Health's commercial businesses performed well in 2024, with record retention in national accounts and strong growth in individual exchange business.
• The acquisition of CareBridge is expected to bolster home- and community-based services, aligning with the company's focus on whole health.
• Elevance Health plans to allocate approximately $2.3 billion towards share repurchases in 2025, demonstrating a commitment to returning capital to shareholders.

Negative Points

• Elevance Health experienced elevated cost trends in its Medicaid business, which remain a challenge due to insufficient rates to cover costs.
• The company reported a decrease of 1.1 million members year over year, primarily due to Medicaid redeterminations and geographic changes.
• Medicaid cost trends are expected to remain elevated in the first half of 2025, impacting margins until rate adjustments are fully reflected.
• The operating margin for health benefits is expected to decline by 25 to 50 basis points year over year in 2025.
• Elevance Health's Medicare Advantage margins are expected to remain below long-term targets despite anticipated stability in 2025.

Q & A Highlights

Q: Can you provide more details on your Medicare Advantage enrollment and margin expectations for 2025? A: Gail Boudreaux, President and CEO, stated that they are confident in their Medicare Advantage enrollment guidance, which aligns with their expectations. Felicia Norwood, President of the Government Business Division, added that the annual enrollment period performance was strong, driven by member retention and stability in offerings. They expect Medicare Advantage membership growth of 7% to 9% and are positioned for margin stability in 2025 through disciplined cost management and strong retention.

Q: What are the trends in utilization and cost assumptions for 2025 across different products like Medicare Advantage and commercial? A: Mark Kaye, CFO, noted that cost trends in the fourth quarter were stable across lines of business. Medicaid trends remained elevated, particularly in behavioral health and inpatient services. Medicare trends were manageable, with notable drivers in post-acute care services. Commercial performance was strong, and they expect elevated trends to persist in the first half of 2025, particularly in Medicaid.

Q: Can you elaborate on the Medicaid cost trends and margin expectations for 2025? A: Mark Kaye explained that Medicaid cost trends remained elevated in the fourth quarter, consistent with prior expectations. They expect these trends to persist into the first half of 2025. Current rates have not fully caught up to these cost trends, so they are maintaining a prudent stance on Medicaid margins, expecting improvement in the second half of the year as rate adjustments take effect.

Q: What impact will the Part D redesign have on your Medical Loss Ratio (MLR) and CarelonRx's performance in 2025? A: Mark Kaye stated that the MLR is expected to increase by approximately 60 basis points due to strategic growth in Medicare, including Part D changes, recent acquisitions, and a prudent view towards medical cost trends. Peter Haytaian, President of Carelon and CarelonRx, highlighted strong growth in Carelon, with over 50% growth expected in services, driven by both organic growth and the acquisition of CareBridge.

Q: Can you clarify your Medicare Advantage membership growth expectations for 2025 and the impact of the annual enrollment period? A: Felicia Norwood confirmed that their annual enrollment period growth was strong, particularly in group membership, and aligned with expectations. They anticipate 7% to 9% growth in Medicare Advantage membership for 2025, with minimal growth expected for the rest of the year, supported by strong retention.

For the complete transcript of the earnings call, please refer to the full earnings call transcript.