Elevance Health (NYSE:ELV) Q4 2025 Earnings call January 28, 2026 08:30 AM ET Speaker18Ladies and gentlemen, thank you for standing by, and welcome to the Elevance Health Fourth Quarter Earnings Conference Call. At this time, all participants are in a listen-only mode. Later, we will conduct a question-and-answer session, where participants are encouraged to present a single question. If you wish to ask a question, please press star then one on your telephone keypad. You will hear a prompt that you have bee ...

Core Insights - U.S. managed healthcare insurers are undergoing significant transformation due to rising medical costs, increased regulatory scrutiny, and a surge in investments in data and value-based care [1] - Scale, diversification, and disciplined capital allocation are crucial for payers to protect margins and sustain long-term growth [1] - UnitedHealth Group (UNH) and Elevance Health, Inc. (ELV) are two major players in the health insurance and managed care sector [1] UnitedHealth Group (UNH) - UNH, with a market cap of nearly $298 billion, is the largest health insurer in the U.S. and operates beyond traditional insurance through its Optum healthcare services unit [4] - The company serves 50.1 million people as of September 30, 2025, reflecting a 1.6% year-over-year growth [5] - Total revenues increased by 11.6% year-over-year in the first nine months of 2025, with UnitedHealthcare growing by 15% and Optum by 6.6% [6] - UNH is divesting assets, including a $1 billion sale of its South American operation, Banmedica, to streamline operations and address regulatory challenges [7] - The company ended Q3 2025 with $30.6 billion in cash and short-term investments, with a total debt-to-capital ratio of 41.6% [8] - Rising medical costs have pressured profit margins, with the medical care ratio increasing to 88.1% in Q3 2025 from 84.9% the previous year [10] Elevance Health, Inc. (ELV) - ELV, with a market cap of $77.4 billion, is a diversified managed care organization focusing on growth and operational efficiency [11] - The Carelon division, which integrates care delivery and data analytics, saw operating revenues rise by 35.4% year-over-year [12] - Total revenues for ELV increased by 13.9% year-over-year in the first nine months of 2025, supported by strong growth in premiums and product revenues [13] - Strategic acquisitions have strengthened ELV's portfolio, while divesting underperforming segments allows for resource reallocation [14] - Total expenses rose by 15% year-over-year in the first nine months of 2025, with the benefit expense ratio deteriorating to 88.9% [15] Comparative Analysis - Both UNH and ELV face unfavorable earnings estimates for 2025 due to rising costs, with UNH expected to see a 41.1% decline in EPS while ELV anticipates a 9.2% decline [16] - Valuation analysis shows ELV is more attractive, trading at a forward P/E of 12.68X compared to UNH's 18.69X [17] - In the past three months, UNH shares declined by 4.8% due to concerns over medical costs and investigations, while ELV shares increased by 7.8% [19] Conclusion - Both companies are navigating a challenging managed care environment with rising medical costs and regulatory pressures [22] - UNH has significant scale and the Optum platform but faces short-term margin pressures [22] - ELV appears to be in a stronger position with strategic market exits and a growing Carelon platform, offering a better near-term risk-reward profile [23]

Core Insights - Pelican Bay Capital Management (PBCM) reported a 7.8% return for its Concentrated Value Strategy in Q3 2025, outperforming the Russell 1000 Value Index which returned 5.3% [1] - Year-to-date, PBCM's fund returned 11.2%, slightly below the index's 11.6% [1] Company Overview: Elevance Health, Inc. (NYSE:ELV) - Elevance Health, Inc. is a health benefits company with over 45 million members, operating under brands like Anthem Blue Cross Blue Shield and Wellpoint [3] - The company has a competitive advantage through its in-house pharmacy benefit manager, Carelon [3] Stock Performance - Elevance Health's stock experienced a one-month return of -10.04% and a 52-week decline of 24.81% [2] - As of November 7, 2025, Elevance Health's stock closed at $317.78, with a market capitalization of $70.623 billion [2] Financial Performance - In Q3 2025, Elevance Health reported operating revenue of $50.1 billion, marking a 12% year-over-year increase [4] - Despite the revenue growth, the stock is not favored among hedge funds, with a decrease in holdings from 75 to 67 portfolios [4] Investment Perspective - While Elevance Health is recognized for its potential, the company is compared unfavorably to certain AI stocks that are perceived to offer greater upside potential and lower downside risk [4]

Core Insights - Elevance Health, Inc. (ELV) is scheduled to report its Q3 2025 results on October 21, 2025, with earnings estimated at $4.97 per share and revenues of $49.5 billion [1][6] Earnings Estimates - The earnings estimate for Q3 2025 has seen one upward revision and two downward revisions, indicating a year-over-year decline of 40.6% [2] - The revenue estimate for Q3 2025 suggests a year-over-year increase of 10.7% [2] - For the full year 2025, the revenue consensus is $197.36 billion, reflecting a 12.6% year-over-year rise, while the EPS consensus is $29.96, indicating a 9.3% year-over-year decrease [3] Earnings Performance - Elevance's earnings have beaten the consensus estimate in two of the last four quarters, with an average surprise of negative 2.3% [3] Earnings Prediction Model - The current Earnings ESP for Elevance is +3.36%, but it holds a Zacks Rank of 4 (Sell), making an earnings beat uncertain [4] Revenue Drivers - The consensus estimate for product revenues indicates a 7.7% growth from the previous year's $5.9 billion, while premiums are expected to increase by 11.5% year-over-year [5][6] Cost and Expense Outlook - Elevated costs and benefit expenses are anticipated to impact profit margins negatively, with total expenses expected to rise around 9% year-over-year in Q3 [9] - The benefit expense ratio is estimated at 91.6, higher than the previous year's 89.5 [9] Segment Performance - The Health Benefits segment's operating income is projected to decrease by 45.5% year-over-year, with declining Medicaid memberships affecting premium growth [10]

Core Insights - UnitedHealth Group Incorporated (UNH) and Elevance Health, Inc. (ELV) are facing significant challenges due to rising medical costs, regulatory pressures, and declining investor confidence, leading to substantial stock declines in 2025 [1][22] - UNH's stock has decreased by 40.7% year-to-date, while ELV has seen a 16% decline, against a broader industry slump of 31.6% [2][22] Group 1: Company Comparisons - UnitedHealth has a market capitalization of $275.5 billion, significantly larger than Elevance's $70.3 billion, and a stronger debt-to-EBITDA ratio of 2.03 compared to Elevance's 2.47 [5][22] - UNH's operational model includes vertical integration through UnitedHealthcare and Optum, allowing for better cost control and negotiation power [6][22] - Despite recent pressures, UNH has maintained robust cash flow, enabling continued investment in growth, although it has lowered its outlook after missing estimates [7][22] Group 2: Financial Performance - Elevance achieved a 15.5% growth in premiums in the first half of 2025, surpassing UNH's 12.6% growth [12][22] - Elevance's benefit expense ratio increased to 88.9% in Q2 2025, indicating a significant portion of premium revenue is directed towards claims rather than profitability, with expectations to reach 90% for the full year [13][22] - UNH's medical care ratio rose to 89.4% in Q2 2025, suggesting stronger profitability compared to Elevance [14][22] Group 3: Shareholder Returns and Valuation - Elevance returned over $2 billion to shareholders in the first half of 2025, while UNH returned $9.5 billion, with UNH's dividend yield at 2.95% compared to Elevance's 2.21% [15][22] - Investors are willing to pay a premium for UNH, reflected in its forward P/E ratio of 17.23X versus Elevance's 9.72X [21][22] Group 4: Future Outlook - Both companies are facing unfavorable earnings estimates for 2025 due to rising costs, with UNH's EPS expected to decline by 40.1% year-over-year, while Elevance's is projected to decline by 8.8% [17][20][22] - The acquisition of Amedisys by UNH is expected to enhance its integrated care model and reduce medical costs by minimizing hospitalizations [9][22] - Elevance's Carelon platform is driving growth through digital and AI-enabled solutions, although it still lags behind UNH in profitability and capital efficiency [11][16][22]

Core Insights - UnitedHealth Group (UNH) is expected to report its second-quarter earnings on July 29, with a focus on its Optum platform, which may provide stability amid regulatory challenges and margin pressures in the health insurance sector [1][8] Optum Performance - Optum's diverse business model, encompassing pharmacy services, data analytics, and value-based care, positions UNH advantageously. In Q2 2025, Optum's revenues are projected to increase by 7.3% year-over-year, building on a 12% growth in 2024 and a 4.6% growth in Q1 2025 [2][8] - OptumHealth is enhancing its value-based care model, which aims to improve health outcomes while controlling costs, thereby mitigating the impact of rising claims in the sector [3] - OptumInsight is leveraging technology and data-driven services to enhance operational efficiencies for both external clients and UNH itself [3] Competitive Landscape - Elevance Health Inc (ELV) reported a 36.1% year-over-year increase in operating revenues for its Carelon services brand in Q2 2025, while overall operating revenues rose by 14.3% [5] - Cigna's health services division, Evernorth, saw adjusted revenues climb by 16% year-over-year in Q1 2025, with its second-quarter results expected on July 31 [6] Valuation and Earnings Estimates - UNH shares have declined by 44.5% year-to-date, compared to a 36.7% decline in the industry [7] - The forward price-to-earnings ratio for UNH is 12.2, above the industry average of 11.2, with a Value Score of A [9] - The Zacks Consensus Estimate for UNH's 2025 earnings is $21.15 per share, indicating a 23.5% decrease from the previous year [10]

Core Insights - Elevance Health reported revenue of $49.42 billion for the quarter ended June 2025, reflecting a 14.3% increase year-over-year, and an EPS of $8.84, down from $10.12 in the same quarter last year [1] - The revenue exceeded the Zacks Consensus Estimate of $48.15 billion by 2.64%, while the EPS fell short of the consensus estimate of $9.16 by 3.49% [1] Financial Performance Metrics - Benefit Expense Ratio was reported at 88.9%, slightly above the average estimate of 88.4% from 16 analysts [4] - Medical Membership - Commercial Risk-Based stood at 4.96 million, below the estimated 5 million [4] - Medical Membership - Commercial Fee-Based was reported at 27.15 million, slightly below the estimate of 27.22 million [4] - Service fees revenue was $2.11 billion, lower than the $2.23 billion estimate, representing a year-over-year decline of 7.4% [4] - Product revenue reached $6.04 billion, slightly below the $6.14 billion estimate, but showed a 9.3% increase year-over-year [4] - Net investment income was $486 million, exceeding the estimate of $464.67 million, but down 4.3% from the previous year [4] - Premiums revenue was reported at $41.27 billion, surpassing the estimate of $39.64 billion, with a year-over-year increase of 16.5% [4] - Total operating revenue from Health Benefits was $41.58 billion, above the estimate of $40.84 billion, reflecting an 11.9% year-over-year increase [4] - Total operating revenue from Carelon was $18.08 billion, exceeding the estimate of $16.86 billion, with a significant year-over-year increase of 35.8% [4] - Total operating revenue from Carelon Services was $7.44 billion, above the estimate of $6.8 billion, representing a remarkable 63.7% increase year-over-year [4] - Total operating revenue from CarelonRx was $10.64 billion, surpassing the estimate of $10.05 billion, with a year-over-year increase of 21.3% [4] Stock Performance - Elevance Health's shares have returned -8.3% over the past month, contrasting with the Zacks S&P 500 composite's increase of 4.2% [3] - The stock currently holds a Zacks Rank 3 (Hold), indicating expected performance in line with the broader market in the near term [3]