Elevance Health(ELV) - 2025 Q3 - Earnings Call Transcript

Financial Data and Key Metrics Changes - Elevance Health reported third quarter GAAP diluted earnings per share of $5.32 and adjusted diluted earnings per share of $6.30, reflecting enhanced medical cost management and expense discipline [16][17] - Total operating revenue for the quarter was $50.1 billion, up 12% year over year, driven by higher premium yields and growth in Medicare Advantage membership [17][18] - The consolidated benefit expense ratio was 91.3%, aligned with expectations, while the Medicaid operating margin is expected to be modestly negative for the full year 2025 [17][18] Business Line Data and Key Metrics Changes - In Medicaid, performance was pressured by elevated acuity and utilization, leading to a projected decline of at least 125 basis points in margins for 2026 [18][22] - Medicare Advantage costs were marginally better than expected due to disciplined plan design, with approximately 55% of MA members in four-star or higher contracts for the 2027 payment year, up from about 40% for 2026 [8][18] - CarillonRx revenue grew 20% year over year, driven by strong momentum with large clients, while Carillon Services grew by more than 50% [20][21] Market Data and Key Metrics Changes - The ACA market is expected to face significant membership impacts if enhanced subsidies expire, with independent estimates indicating lower enrollment and a higher morbidity risk pool for 2026 [10][54] - The anticipated expiration of enhanced subsidies would significantly impact membership in 2026, with the company prepared to work with states to ensure continued access for consumers [10][54] Company Strategy and Development Direction - The company is focused on lowering the total cost of care and improving member experience through an integrated clinical and benefits approach, leveraging value-based care [5][6] - Capital deployment remains a key lever for long-term earnings growth, with a commitment to disciplined capital allocation and returning capital to shareholders through share repurchases [14][21] - The company is prioritizing durable, long-term performance over near-term expense leverage, with targeted investments in AI and digital tools to enhance member and provider experience [25][41] Management's Comments on Operating Environment and Future Outlook - Management acknowledged the dynamic external environment and emphasized a prudent approach to planning for 2026, with expectations for continued challenges in Medicaid [15][22] - The company expects 2026 to be a low point for Medicaid margins, with a return to a more balanced earnings growth profile anticipated in 2027 [25][84] - Management expressed confidence in the strategy and execution, aiming to drive sustainable value for stakeholders despite external uncertainties [15][25] Other Important Information - The company is integrating recent acquisitions and focusing on operational efficiency to sustain growth and enhance performance across the enterprise [20][21] - The company has made significant investments in technology and operational initiatives to improve star ratings and member engagement [41][42] Q&A Session Summary Question: Medicaid margin expectations and state discussions - Management discussed the challenges in Medicaid margins, indicating a slight negative margin for 2025 and a projected decline of at least 125 basis points for 2026, with constructive conversations with states about improving affordability [27][30][34] Question: Investment spending and its impact - Management clarified that several hundred million dollars in investments are planned for 2026, focusing on technology adoption, Careline investments, and operational initiatives to enhance long-term growth [39][40][41] Question: Impact of enhanced subsidies on ACA membership - Management indicated that if enhanced subsidies expire, a material contraction in the ACA marketplace is expected, leading to lower enrollment and a higher morbidity risk pool for 2026 [50][54] Question: Medicaid membership outlook - Management expects Medicaid membership to decline modestly in 2026 due to ongoing normalization following the redetermination process and state program changes [87][88] Question: Variability in Medicaid performance by state - Management acknowledged variability in Medicaid performance across states and indicated a willingness to exit contracts if financial expectations are not met [70][72]