Elevance Health Inc.
ELVBusiness Overview
ticker: ELV step: 01 generated: 2026-05-12 source: quick-research
Elevance Health, Inc. (ELV) — Business Overview
Business Description
Elevance Health (rebranded from Anthem in 2022) is the largest Blue Cross Blue Shield (BCBS) licensee in the US — operating BCBS plans in 14 states + various national Medicare Advantage + Medicaid + commercial businesses. The company is the #2 US health insurer by membership (UnitedHealth #1) and has been pivoting toward integrated healthcare services through Carelon (its own healthcare services brand: CarelonRx PBM + Carelon Services + Carelon Behavioral Health). FY25 revenue $167.1B (+11%). The defining 2026 narrative: like UnitedHealth + CVS-Aetna, Elevance is navigating Medicare Advantage rate-cycle pressure + Medicaid acuity trend deterioration. Q1 2026 results showed early stabilization with raised 2026 guidance.
Revenue Model
Four reportable segments:
- Health Benefits (~85% of revenue, $150B+ in FY24) — Anthem-branded BCBS commercial + individual; Medicare Advantage; Medicare Supplement; Medicaid managed care; Federal Employee Program (FEP); BlueCard.
- CarelonRx (~10%) — Pharmacy benefit manager; specialty pharmacy; infusion services. Replacing IngenioRx (in-house PBM).
- Carelon Services (~4%) — Carelon Behavioral Health, Carelon Insights (data/analytics), Carelon Post Acute Solutions.
- Carelon Other / Corporate (~1%) — Various smaller services.
Revenue components: ~70-75% premiums (health plans), ~20% pharmacy/services, ~5% interest income.
Products & Services
- Anthem Blue Cross Blue Shield: Commercial group + individual + Medicare + Medicaid in 14 states (California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, Wisconsin).
- Empire BCBS, Anthem BC: Various BCBS plans.
- Medicare Advantage: Anthem-branded; selectively retracting from underperforming plans in 2026.
- Medicaid Managed Care: 7M+ Medicaid members across ~25+ states.
- Federal Employee Program (FEP): Federal government employee health plans.
- CarelonRx PBM: Drug benefit management for Anthem members + 3rd-party plans.
- Carelon Behavioral Health: Mental health / substance use; one of largest US behavioral health companies.
- Carelon Specialty Pharmacy + Infusion: Specialty drug fulfillment + home/center infusion services.
- CarelonInsights: Data analytics + decision-support tools.
Customer Base & Go-to-Market
- Members: 46M+ medical members; 7M+ Medicaid; ~9M+ Medicare-related (MA + supplement + Part D).
- Employer Customers: Most Fortune 500 + multi-state employers; ASO + risk-based.
- Government: 32% of consolidated revenue from US government agencies (Medicare + Medicaid + Federal Employee Program).
- BCBS Geographic Footprint: 14 BCBS states.
Distribution: Direct enterprise sales (large employers); broker/consultant channels (SMB); Medicare broker channels; Medicaid contract bidding with states.
Competitive Position
Elevance competes in three overlapping markets:
Health Insurance:
- UnitedHealth Group (UNH) — Larger; better Medicare Advantage positioning.
- CVS Health (Aetna) — Similar vertical integration with CarelonRx + Carelon Services.
- Humana — Pure-play Medicare Advantage leader.
- Cigna — Smaller; PBM via Express Scripts.
PBM (CarelonRx):
- Express Scripts (Cigna) — Larger PBM competitor.
- OptumRx (UnitedHealth) — Direct competitor.
- CVS Caremark — Direct competitor; together Big 3 PBMs cover ~80% of US scripts.
Behavioral Health (Carelon):
- Magellan Health (Centene) — Direct competitor.
- Acadia Healthcare — Smaller behavioral.
Structural advantages:
- BCBS scale + brand recognition — Anthem-branded BCBS plans in 14 states; multi-decade member relationships.
- Vertical integration via Carelon — Internal PBM + behavioral + services = similar moat to UNH/Optum + CVS/Aetna.
- National scale + state-specific BCBS franchise — Provides both national + local market presence.
- 32% government revenue — Provides counter-cyclical buffer to commercial cycle.
Active risks:
- Medicare Advantage rate-cycle pressure — CMS proposed flat 2027 MA payment increases; ELV deliberately shedding MA membership in 2026 (high-teens % decline) to focus on profitable HMO + DSNP.
- Medicaid margins underwater — FY26 guide projects ~-1.75% operating margin; acuity trend deterioration + state rate lag.
- MLR elevated at 90.2% — Higher medical-cost trend than historical norms.
- Revenue declining in 2026 — Low single-digit % decline guided as ELV de-emphasizes underperforming risk-based businesses.
Key Facts
- Founded: 1944 (Anthem Insurance Companies); 2004 BCBS aggregation; rebranded Elevance 2022
- Headquarters: Indianapolis, Indiana
- Employees: ~104,000+
- Exchange: NYSE
- Sector / Industry: Health Care / Health Care Plans
- Market Cap: ~$95B
- FY2024 Revenue: $175.2B
- FY2025 Revenue: $167.1B (Health Benefits decline; Medicare Advantage attrition)
- Medical Members: ~46M+
- Medicaid Members: ~7M+
- Medicare Advantage Members: Declining ~17% in 2026 to focus on profitable mix
- BCBS States: 14
- FY2026 Operating Revenue Guide: Low single-digit % decline
- FY2026 Medical Loss Ratio: 90.2% ± 50 bps
- Dividend Yield: ~1.7%
- CEO: Gail Boudreaux
Financial Snapshot
ticker: ELV step: 04 generated: 2026-05-12 source: quick-research
Elevance Health, Inc. (ELV) — Financial Snapshot
Income Statement Summary
| Metric | FY2023 | FY2024 | FY2025 | YoY (FY25) |
|---|---|---|---|---|
| Operating Revenue | $170.2B | $175.2B | $167.1B | -5% (deliberate de-emphasis) |
| Health Benefits Revenue | $148.6B | $150.3B | ~$155B+ | +3% (Q4 +11%) |
| Benefit Expense Ratio (MLR) | 87.0% | 88.5% | ~89.5% | rising |
| Adjusted EPS | $33.10 | $33.04 | $34.95+ | +6% |
| GAAP EPS | $33.14 | $30.40 | $32+ | recovery |
Q1 2026 + FY26 Guide
| Metric | Q1 2026 / FY26 |
|---|---|
| Q1 2026 Profit | $1.8B |
| FY2026 Operating Revenue | Low single-digit % decline |
| FY2026 Medical Loss Ratio | 90.2% ± 50 bps |
| Medicare Advantage Membership Change | -17% (deliberate exit from underperforming plans) |
| Medicaid Operating Margin | ~-1.75% |
| FY2026 Adjusted EPS Guide | Raised in Q1 (specifics not disclosed in search) |
Cash Flow & Capital Allocation (FY2025)
| Metric | Value |
|---|---|
| Operating Cash Flow | ~$8B |
| Capital Expenditures | ~$1.4B |
| Free Cash Flow | ~$6.5B |
| Share Repurchases | ~$3.0B |
| Dividends Paid | ~$1.6B |
| Quarterly Dividend | $1.71 |
| Annual Dividend | $6.84 |
| Dividend Yield | ~1.7% |
| Cash & Marketable Securities | ~$10B |
| Total Debt | ~$30B |
Key Ratios (approximate)
- P/E: ~11x (FY26E adjusted EPS ~$36–38) | EV/EBITDA: ~9x | FCF Yield: ~7%
- Revenue Growth (FY25): -5% (deliberate)
- Adjusted EPS Growth: ~+6%
- Medical Loss Ratio: ~89-90% (elevated)
- Dividend Yield: ~1.7% | Buyback Yield: ~3%+
- ROE: ~12% (depressed by MLR pressure)
Growth Profile
FY25 was a transition year for Elevance:
- Operating revenue +3% Q4 but full-year flat-to-down as ELV deliberately reduced underperforming risk-based businesses (especially Medicare Advantage)
- Health Benefits segment Q4 +11% on Medicare Advantage temporary boost + commercial enrollment
- Carelon services growing
- MLR rising on Medicare + Medicaid acuity trends + IRA Part D dynamics
The 2026 setup:
- Deliberate revenue decline as ELV exits underperforming Medicare Advantage plans (-17% MA membership)
- MLR 90.2% target — elevated but stabilizing
- Q1 2026 results raised guidance — early signs of MA + Medicaid pricing/cost balance improving
- Carelon services continued growth
- Strategic focus on profitable HMO + DSNP Medicare + commercial + Carelon
The defining narrative: ELV is following the same playbook as UNH + Aetna — exit unprofitable MA membership, focus on margin recovery, accept temporary revenue decline.
Forward Estimates
FY2026 Guide:
- Operating Revenue: Low single-digit % decline
- MLR: 90.2% ± 50 bps
- Adjusted EPS: Raised in Q1 (specifics not disclosed)
Bull case: Medicare Advantage rate cycle improves in 2027; Medicaid state rate increases catch up to acuity; Carelon scaling drives mix toward services; multiple expands to 14x P/E. Bear case: Medicare Advantage rate cycle worsens; Medicaid margins stay negative; PBM regulation impacts CarelonRx; multiple compresses to 8-9x P/E. Consensus targets ~$450–520 vs. trading ~$405–435 (~10–25% implied upside).
Deeper Financial Analysis
The fundamental tier adds 9 additional research dimensions for $ELV.