Elevance Health (ELV) reported better-than-expected fourth-quarter results on Thursday, while the health insurer anticipates its 2025 earnings and revenue to rise year over year.

The company anticipates adjusted earnings to be in a range of $34.15 to $34.85 per share for the ongoing year, compared with the $33.04 it recorded in 2024. Operating revenue is pegged to grow by high-single to low-double digits versus last year's revenue of $175.2 billion. The current consensus on FactSet is for EPS of $34.52 and sales of $189.59 billion.

The company forecasts low-double-digit gains in premium revenue and low-single-digit growth in product revenue. It also sees total year-end medical enrollment in a 45.8 million to 46.6 million range, compared with 45.7 million in 2024.

For the three-month period ended December, the insurer's adjusted EPS dropped about 32% year over year to $3.84, but topped the Street's view of $3.81. Operating revenue increased to $44.99 billion from $42.45 billion in the prior-year quarter, just above analysts' $44.92 billion estimate. Elevance shares rose 3.7% in premarket activity.

"Our fourth-quarter results demonstrate tangible progress in improving our operations in response to the dynamic environment facing the industry," Chief Executive Gail Boudreaux said in a statement.

Total medical membership declined 2.3% year over year to 45.7 million, impacted by a 15% fall in the Medicaid business, partially offset by gains in Affordable Care Act health plans and employer group fee-based memberships, according to the company. Within its commercial risk-based business, individual membership climbed 26%, while employer group decreased 1.1%. Sequentially, consolidated membership edged down 0.1%.

Overall premiums inclined 3.2% to $36.25 billion. Product revenue advanced about 25%, while service fees rose 5.6%. By segment, health benefits revenue increased 2.8% to $37.58 billion while its Carelon division, composed of CarelonRx and Carelon Services, jumped 19% to $14.7 billion.

The benefit-expense ratio rose by 320 basis points to 92.4% for the fourth quarter. The increase was driven by higher Medicaid medical cost trends, according to the company.