false 0001156039 0001156039 2024-01-24 2024-01-24

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

FORM 8-K

 

 

CURRENT REPORT

Pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934

January 24, 2024

Date of Report (Date of earliest event reported)

 

 

Elevance Health, Inc.

(Exact name of registrant as specified in its charter)

 

 

 

Indiana   001-16751   35-2145715

(State or other jurisdiction of

incorporation or organization)

  (Commission
File Number)
  (I.R.S. Employer
Identification Number)

 

220 Virginia Ave
Indianapolis, IN 46204
(Address of principal executive offices and zip code)

(833) 401-1577

(Registrant’s telephone number, including area code)

 

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class

 

Trading
Symbol

 

Name of each exchange
on which registered

Common Stock, Par Value $0.01   ELV   NYSE

Indicate by check mark whether the registrant is an emerging growth company as defined Rule 405 of the Securities Act (§230.405 of this chapter) or Rule 12b-2 of the Exchange Act (§240.12b-2 of this chapter).

Emerging growth company

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.

 

 

 


Item 2.02 Results of Operations and Financial Condition.

On January 24, 2024, Elevance Health, Inc. issued a press release reporting its financial results for the quarter ended December 31, 2023. A copy of the press release is furnished as Exhibit 99.1 to this report and incorporated herein by reference.

None of the information furnished in Item 2.02 or Exhibit 99.1 hereto shall be deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended. Unless expressly set forth by specific reference in such filings, none of the information furnished in this report shall be incorporated by reference in any filing under the Securities Act of 1933, as amended, whether made before or after the date hereof and regardless of any general incorporation language in such filings.

Item 9.01 Financial Statements and Exhibits.

(d) Exhibits.

 

   

Exhibit

No.

  

Exhibit

  99.1    Press Release, dated January 24, 2024, reporting Elevance Health, Inc. financial results for the quarter ended December 31, 2023.
  104    Cover Page Interactive Data File (embedded within the Inline XBRL document)

FORWARD-LOOKING STATEMENTS

This document contains certain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements reflect our views about future events and financial performance and are generally not historical facts. Words such as “expect,” “feel,” “believe,” “will,” “may,” “should,” “anticipate,” “intend,” “estimate,” “project,” “forecast,” “plan” and similar expressions are intended to identify forward-looking statements. These statements include, but are not limited to: financial projections and estimates and their underlying assumptions; statements regarding plans, objectives and expectations with respect to future operations, products and services; and statements regarding future performance. Such statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond our control, that could cause actual results to differ materially from those expressed in, or implied or projected by, the forward-looking statements. You are cautioned not to place undue reliance on these forward-looking statements that speak only as of the date hereof. You are also urged to carefully review and consider the various risks and other disclosures discussed in our reports filed with the U.S. Securities and Exchange Commission from time to time, which attempt to advise interested parties of the factors that affect our business. Except to the extent required by law, we do not update or revise any forward-looking statements to reflect events or circumstances occurring after the date hereof. These risks and uncertainties include, but are not limited to: trends in healthcare costs and utilization rates; reduced enrollment; our ability to secure and implement sufficient premium rates; the impact of large scale medical emergencies, such as public health epidemics and pandemics, including COVID-19, and other catastrophes; the impact of new or changes in existing federal, state and international laws or regulations, including laws and regulations impacting healthcare, insurance, pharmacy services and other diversified products and services, or their enforcement or application; the impact of cyber-attacks or other privacy or data security incidents or breaches or our failure to comply with any privacy, data or security laws or regulations, including any investigations, claims or litigation related thereto; information technology disruptions; changes in economic and market conditions, as well as regulations that may negatively affect our liquidity and investment portfolios; competitive pressures and our ability to adapt to changes in the industry and develop and implement strategic growth opportunities; risks and uncertainties regarding Medicare and Medicaid programs, including those related to non-compliance with the complex regulations imposed thereon; our ability to maintain and achieve improvement in Centers for Medicare and Medicaid Services Star ratings and other quality scores and funding risks with respect to revenue received from participation therein; a negative change in our healthcare product mix; costs and other liabilities associated with litigation, government investigations, audits or reviews; our ability to contract with providers on cost-effective and competitive terms; failure to effectively maintain and modernize our information systems; risks associated with providing healthcare, pharmacy and other diversified products and services, including medical malpractice or professional liability claims and non-compliance by any party with the pharmacy services agreement between us and


CaremarkPCS Health, L.L.C.; risks associated with mergers, acquisitions, joint ventures and strategic alliances; possible impairment of the value of our intangible assets if future results do not adequately support goodwill and other intangible assets; possible restrictions in the payment of dividends from our subsidiaries and increases in required minimum levels of capital; our ability to repurchase shares of our common stock and pay dividends on our common stock due to the adequacy of our cash flow and earnings and other considerations; the potential negative effect from our substantial amount of outstanding indebtedness and the risk that increased interest rates or market volatility could impact our access to or further increase the cost of financing; a downgrade in our financial strength ratings; the effects of any negative publicity related to the health benefits industry in general or us in particular; events that may negatively affect our licenses with the Blue Cross and Blue Shield Association; intense competition to attract and retain employees; risks associated with our international operations; and various laws and provisions in our governing documents that may prevent or discourage takeovers and business combinations.


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

Dated: January 24, 2024

 

ELEVANCE HEALTH, INC.
By:  

/s/ Kathleen S. Kiefer

Name:   Kathleen S. Kiefer
Title:   Chief Governance Officer and Corporate Secretary

Exhibit 99.1

E A R N I N G S R E L E A S E

 

LOGO

ELEVANCE HEALTH REPORTS RESULTS FOR FOURTH QUARTER

AND FULL YEAR 2023; SETS FULL YEAR 2024 OUTLOOK

 

   

4Q 2023 operating revenue of $42.5 billion, up 7.0% from 4Q 2022; FY 2023 operating revenue of $170 billion, up 9.3% from FY 2022

 

   

4Q 2023 GAAP diluted EPS1 of $3.63, up 1.1% from 4Q 2022 and adjusted diluted EPS2 of $5.62, up 15.2%; FY 2023 GAAP diluted EPS of $25.22, up 3.9% from FY 2022 and adjusted diluted EPS2 of $33.14, up 16.2%

 

   

Projected FY 2024 GAAP diluted EPS and adjusted diluted EPS2 of greater than $34.29 and $37.10 per share, respectively

 

   

Quarterly dividend increased by 10.1% to $1.63 per share

Indianapolis, IN - January 24, 2024 - Elevance Health, Inc. (NYSE: ELV) reported fourth quarter and full year 2023 results.

“We are pleased to have delivered another year of strong performance in 2023, enabled by our relentless focus on customer experience and affordability, and continued investments in growth and innovation. The balance and resilience of our business coupled with the focused execution of our enterprise strategy supports our confidence in our outlook for 2024, as we continue to optimize the foundation, and scale our flywheel for sustained growth of the enterprise over the long term.”

Gail K. Boudreaux

President and Chief Executive Officer

 

  1.

Earnings per diluted share (“EPS”)

 

  2.

Refer to GAAP reconciliation tables on pages 13 and 14 herein for reconciliation of GAAP to adjusted measures.

 

1


LOGO

Elevance Health

Consolidated Enterprise Highlights

(Unaudited)

 

(In billions)    Three Months Ended     Twelve Months Ended  
     December 31,
2023
    December 31,
2022
    September 30,
2023
    December 31,
2023
    December 31,
2022
 

Operating Revenue1

   $ 42.5     $ 39.7     $ 42.5     $ 170.2     $ 155.7  

Operating Gain1,2,3

   $ 1.3     $ 1.3     $ 1.8     $ 8.5     $ 8.3  

Operating Margin1

     3.0     3.2     4.1     5.0     5.3

 

1.

See “Basis of Presentation” on page 5 herein.

2.

Operating Gain for the three and twelve months ended December 31, 2023 and December 31, 2022 include items that are excluded from adjusted shareholders’ net income. See “GAAP Reconciliation” on pages 13 and 14 herein.

3.

Operating Gain for the three and twelve months ended December 31, 2022 have been restated. See “GAAP Reconciliation” on pages 13 and 14 herein.

Operating revenue was $42.5 billion in the fourth quarter of 2023, an increase of $2.8 billion, or 7 percent compared to fourth quarter 2022. Operating revenue was $170.2 billion in 2023, an increase of $14.5 billion, or 9 percent. The increase in the quarter and year was driven by higher premium revenue in our Health Benefits segment and growth in pharmacy product revenue in CarelonRx.

The benefit expense ratio was 89.2 percent in the fourth quarter, an improvement of 50 basis points compared to fourth quarter 2022, and 87.0 percent for the full year, an improvement of 60 basis points year-over-year. The improvement in the quarter and year was driven by premium rate adjustments to cover medical cost trend. Days in Claims Payable was 47.3 days as of December 31, 2023, a decrease of 1.3 days from September 30, 2023, and a decrease of 0.2 days compared to December 31, 2022.

The operating expense ratio was 11.8 percent both in the fourth quarter and for the full year of 2023, an increase of 30 basis points as compared to the fourth quarter of 2022 and an increase of 40 basis points year-over-year. The increase in the quarter was driven by an acceleration of investments for growth and the increase for the full year was driven by business optimization charges recorded in 2023.

Cash Flow & Balance Sheet

Operating cash flow for 2023 was $8.1 billion, or 1.3 times GAAP net income. As of December 31, 2023, cash and investments at the parent company totaled approximately $1.6 billion.

During the fourth quarter of 2023, the Company repurchased 2.0 million shares of its common stock for $929 million, at a weighted average price of $465.63. For the full year of 2023, the Company repurchased 5.8 million shares of its common stock for $2.7 billion, at a weighted average price of $463.53. As of December 31, 2023, the Company had approximately $4.2 billion of Board approved share repurchase authorization remaining. During the fourth quarter of 2023, the Company paid a quarterly dividend of $1.48 per share, representing a distribution of cash totaling $346 million.

 

2


LOGO    LOGO

Health Benefits is comprised of Individual, Employer Group risk-based, Employer Group fee-based, BlueCard, Medicare, Medicaid, and Federal Health Products & Services businesses.

Health Benefits

Reportable Segment Highlights

(Unaudited)

 

(In billions)    Three Months Ended     Twelve Months Ended  
     December 31,
2023
    December 31,
2022
    September 30,
2023
    December 31,
2023
    December 31,
2022
 

Operating Revenue1

   $ 36.5     $ 35.0     $ 36.7     $ 148.6     $ 138.5  

Operating Gain1,2

   $ 0.8     $ 0.8     $ 1.8     $ 6.9     $ 6.0  

Operating Margin1

     2.1     2.2     5.0     4.6     4.3

 

1.

See “Basis of Presentation” on page 5 herein.

2.

Operating Gain for the three and twelve months ended December 31, 2022 and three months ended September 30, 2023 have been restated for the realignment of Carelon Global Solutions. See footnote 4 to the Reportable Segment Highlight Details table on page 11 for more detail.

Operating revenue was $36.5 billion in the fourth quarter of 2023, an increase of $1.5 billion, or 4 percent compared to fourth quarter 2022. Operating revenue was $148.6 billion in 2023, an increase of $10.1 billion, or 7 percent. The increase was primarily driven by higher premium revenue in our Commercial Health Benefits business.

Operating gain totaled $767 million in the fourth quarter of 2023, a decline of 2 percent compared to the fourth quarter of 2022. This was primarily driven by investments made in the quarter to support long-term growth. Operating gain totaled $6.9 billion in 2023, an increase of $866 million, or 14 percent year-over-year. This was primarily driven by premium rate adjustments to reflect medical cost trends.

Medical membership totaled approximately 47.0 million as of December 31, 2023, a decrease of 570 thousand, or 1 percent year-over-year. This was driven by attrition in our Medicaid business associated with the resumption of eligibility redeterminations in the second quarter of 2023 and declines in our Employer Group risk-based business. These membership losses were partially offset by growth in BlueCard, Affordable Care Act health plans, and Medicare Advantage.

During the fourth quarter of 2023, medical membership declined by 364 thousand driven by Medicaid membership attrition associated with redeterminations, partially offset by growth in commercial fee-based members.

 

3


LOGO

Carelon is comprised of CarelonRx and Carelon Services.

Carelon

Reportable Segment Highlights

(Unaudited)

 

(In billions)    Three Months Ended     Twelve Months Ended  
     December 31,
2023
    December 31,
2022
    September 30,
2023
    December 31,
2023
    December 31,
2022
 

Operating Revenue1,2,3

   $ 12.4     $ 10.9     $ 12.0     $ 48.0     $ 41.4  

Operating Gain1,2,3

   $ 0.6     $ 0.5     $ 0.7     $ 2.7     $ 2.4  

Operating Margin1

     4.8     4.7     5.6     5.5     5.8

 

1.

See “Basis of Presentation” on page 5 herein.

2.

Operating Revenue and Operating Gain for Carelon in millions for the three months ended December 31, 2023 included $8,827 and $490 for CarelonRx; and $3,574 and $102 for Carelon Services, respectively. Operating Revenue and Operating Gain for Carelon for the three months ended December 31, 2022 included $7,523 and $475 for CarelonRx; and $3,342 and $39 for Carelon Services, respectively. Operating Revenue and Operating Gain for Carelon for the twelve months ended December 31, 2023 included $33,835 and $1,975 for CarelonRx; and $14,147 and $680 for Carelon Services, respectively. Operating Revenue and Operating Gain for Carelon for the twelve months ended December 31, 2022 included $28,526 and $1,868 for CarelonRx; and $12,860 and $535 for Carelon Services, respectively.

3.

Operating Revenue and Operating Gain for the three and twelve months ended December 31, 2022 and three months ended September 30, 2023 have been restated for the realignment of Carelon Global Solutions. See footnote 4 to the Reportable Segment Highlight Details table on page 11 for more detail.

Operating revenue in the Carelon segments was $12.4 billion in the fourth quarter of 2023, an increase of $1.5 billion, or 14 percent from fourth quarter 2022. Operating revenue was $48.0 billion in 2023, an increase of $6.6 billion, or 16 percent. The increases for the quarter and the year were driven by growth in pharmacy product revenue in CarelonRx associated with growth in both external pharmacy members served and the acquisition of the BioPlus specialty pharmacy.

Operating gain in the Carelon segments was $592 million in the fourth quarter of 2023, an increase of $78 million, or 15 percent from fourth quarter 2022. The increase in the quarter was primarily driven by improved performance in our Carelon Services businesses. Operating gain was $2.7 billion in 2023, an increase of $252 million, or 10 percent year-over-year. The increase for the full year was primarily driven by higher prescription volumes in CarelonRx associated with growth in external pharmacy members served, the acquisition of the BioPlus specialty pharmacy, and improved performance across our Carelon Services businesses, along with the continued expansion of our post-acute care management business.

 

4


About Elevance Health

Elevance Health is a lifetime, trusted health partner fueled by its purpose to improve the health of humanity. The company supports consumers, families, and communities across the entire care journey – connecting them to the care, support, and resources they need to lead healthier lives. Elevance Health’s companies serve more than 115 million people through a diverse portfolio of industry-leading medical, digital, pharmacy, behavioral, clinical, and complex care solutions. For more information, please visit www.elevancehealth.com or follow us @ElevanceHealth on X and Elevance Health on LinkedIn.

Conference Call and Webcast

Management will host a conference call and webcast today at 8:30 a.m. Eastern Standard Time (“EST”) to discuss the company’s fourth quarter and full year results and outlook. The conference call should be accessed at least 15 minutes prior to the start of the call with the following numbers:

 

888-947-9963 (Domestic)    800-568-3942 (Domestic Replay)
312-470-0178 (International)    203-369-3812 (International Replay)

The access code for today’s conference call is 3972058. There is no access code for the replay. The replay will be available from 11:30 a.m. EDT today, until the end of the day on February 23, 2024. The call will also be available through a live webcast at www.elevancehealth.com under the “Investors” link. A webcast replay will be available following the call.

Basis of Presentation

 

1.

Operating revenue and operating gain/loss are the key measures used by management to evaluate performance in each of its reporting segments, allocate resources, set incentive compensation targets and to forecast future operating performance. Operating gain/loss is calculated as total operating revenue less benefit expense, cost of products sold and operating expense. It does not include net investment income, net gains/losses on financial instruments, interest expense, amortization of other intangible assets, gains/losses on extinguishment of debt or income taxes, as these items are managed in a corporate shared service environment and are not the responsibility of operating segment management. Refer to pages 13 and 14 for the GAAP reconciliation tables.

 

2.

Operating margin is defined as operating gain divided by operating revenue.

 

Elevance Health Contacts:   
Investor Relations    Media
Stephen Tanal    Leslie Porras
Stephen.Tanal@elevancehealth.com    Leslie.Porras@elevancehealth.com

 

5


Elevance Health

Earnings Release Financial Schedules and Supplementary Information

Quarter and Year Ended December 31, 2023

 

   

Membership and Other Metrics

 

   

Quarterly & Full-Year Consolidated Statements of Income

 

   

Condensed Consolidated Balance Sheet

 

   

Condensed Consolidated Statement of Cash Flows

 

   

Supplemental Financial Information - Reportable Segments

 

   

Supplemental Financial Information - Reconciliation of Medical Claims Payable

 

   

Reconciliation of Non-GAAP Financial Measures

 

   

Financial Guidance Summary

 

6


Elevance Health

Membership and Other Metrics

(Unaudited)

 

                          Change from  

Medical Membership (in thousands)

   December 31,
2023
     December 31,
2022
     September 30,
2023
     December 31,
2022
    September 30,
2023
 

Individual

     1,025        789        999        29.9     2.6

Employer Group Risk-Based

     3,756        3,988        3,754        (5.8 )%      0.1
  

 

 

    

 

 

    

 

 

      

Commercial Risk-Based

     4,781        4,777        4,753        0.1     0.6

BlueCard®

     6,838        6,462        6,756        5.8     1.2

Employer Group Fee-Based

     20,227        20,174        20,166        0.3     0.3
  

 

 

    

 

 

    

 

 

      

Commercial Fee-Based

     27,065        26,636        26,922        1.6     0.5

Medicare Advantage

     2,047        1,977        2,064        3.5     (0.8 )% 

Medicare Supplement

     923        947        928        (2.5 )%      (0.5 )% 
  

 

 

    

 

 

    

 

 

      

Total Medicare

     2,970        2,924        2,992        1.6     (0.7 )% 

Medicaid

     10,503        11,571        11,018        (9.2 )%      (4.7 )% 

Federal Employees Health Benefits

     1,642        1,623        1,640        1.2     0.1
  

 

 

    

 

 

    

 

 

      

Total Medical Membership

     46,961        47,531        47,325        (1.2 )%      (0.8 )% 
  

 

 

    

 

 

    

 

 

      

Other Membership (in thousands)

             

Life and Disability Members

     4,629        4,834        4,611        (4.2 )%      0.4

Dental Members

     6,820        6,692        6,775        1.9     0.7

Dental Administration Members

     1,729        1,586        1,708        9.0     1.2

Vision Members

     9,944        9,813        9,861        1.3     0.8

Medicare Part D Standalone Members

     260        271        261        (4.1 )%      (0.4 )% 

Other Metrics (in millions)

             

CarelonRx Quarterly Adjusted Scripts

     78.0        82.0        77.3        (4.9 )%      0.9

Carelon Services Consumers Served

     103.3        105.0        104.8        (1.6 )%      (1.4 )% 

 

7


Elevance Health

Consolidated Statements of Income

(Unaudited)

 

(In millions, except per share data)    Three Months Ended
December 31
    Twelve Months Ended
December 31
 
     2023     2022     Change     2023     2022     Change  

Revenues

            

Premiums

   $ 35,138     $ 33,646       4.4   $ 142,854     $ 133,229       7.2

Product revenue

     5,394       4,137       30.4     19,452       14,978       29.9

Service fees

     1,922       1,884       2.0     7,903       7,453       6.0
  

 

 

   

 

 

     

 

 

   

 

 

   

Total operating revenue

     42,454       39,667       7.0     170,209       155,660       9.3

Net investment income

     529       373       41.8     1,825       1,485       22.9

Net losses on financial instruments

     (336     (111     NM       (694     (550     NM  
  

 

 

   

 

 

     

 

 

   

 

 

   

Total revenues

     42,647       39,929       6.8     171,340       156,595       9.4

Expenses

            

Benefit expense

     31,334       30,195       3.8     124,330       116,642       6.6

Cost of products sold

     4,837       3,646       32.7     17,293       13,035       32.7

Operating expense

     4,999       4,567       9.5     20,087       17,700       13.5

Interest expense

     259       229       13.1     1,030       851       21.0

Amortization of other intangible assets

     217       247       (12.1 )%      885       767       15.4
  

 

 

   

 

 

     

 

 

   

 

 

   

Total expenses

     41,646       38,884       7.1     163,625       148,995       9.8

Income before income tax expense

     1,001       1,045       (4.2 )%      7,715       7,600       1.5

Income tax expense

     170       168       1.2     1,724       1,712       0.7
  

 

 

   

 

 

     

 

 

   

 

 

   

Net income

     831       877       (5.2 )%      5,991       5,888       1.7

Net loss (income) attributable to noncontrolling interests

     25       (12     NM       (4     6       NM  
  

 

 

   

 

 

     

 

 

   

 

 

   

Shareholders’ net income

   $ 856     $ 865       (1.0 )%    $ 5,987     $ 5,894       1.6
  

 

 

   

 

 

     

 

 

   

 

 

   

Shareholders’ earnings per diluted share

   $ 3.63     $ 3.59       1.1   $ 25.22     $ 24.28       3.9
  

 

 

   

 

 

     

 

 

   

 

 

   

Diluted shares

     235.8       241.2       (2.2 )%      237.4       242.8       (2.2 )% 

Benefit expense as a percentage of premiums

     89.2     89.7     (50 )bp      87.0     87.6     (60 )bp 

Operating expense as a percentage of total operating revenue

     11.8     11.5     30 bp      11.8     11.4     40 bp 

Income before income tax expense as a percentage of total revenue

     2.3     2.6     (30 )bp      4.5     4.9     (40 )bp 

“NM” = calculation not meaningful

 

8


Elevance Health

Condensed Consolidated Balance Sheet

 

(In millions)    December 31,
2023
    December 31,
2022
 

Assets

     (Unaudited)    

Current assets:

    

Cash and cash equivalents

   $ 6,526     $ 7,387  

Fixed maturity and equity securities

     29,843       26,905  

Premium and other receivables

     17,865       16,044  

Other current assets

     5,795       5,281  
  

 

 

   

 

 

 

Total current assets

     60,029       55,617  

Long-term investments

     6,983       6,437  

Property and equipment, net

     4,359       4,316  

Goodwill and other intangible assets

     35,590       34,698  

Other noncurrent assets

     1,967       1,687  
  

 

 

   

 

 

 

Total assets

   $ 108,928     $ 102,755  
  

 

 

   

 

 

 

Liabilities and equity

    

Liabilities

    

Current liabilities:

    

Medical claims payable

   $ 16,111     $ 15,596  

Short-term borrowings

     225       265  

Current portion of long-term debt

     1,649       1,500  

Other current liabilities

     23,806       22,335  
  

 

 

   

 

 

 

Total current liabilities

     41,791       39,696  

Long-term debt, less current portion

     23,246       22,349  

Other noncurrent liabilities

     4,486       4,380  
  

 

 

   

 

 

 

Total liabilities

     69,523       66,425  
  

 

 

   

 

 

 

Total shareholders’ equity

     39,306       36,243  

Noncontrolling interests

     99       87  
  

 

 

   

 

 

 

Total equity

     39,405       36,330  
  

 

 

   

 

 

 

Total liabilities and equity

   $ 108,928     $ 102,755  
  

 

 

   

 

 

 

 

9


Elevance Health

Condensed Consolidated Statement of Cash Flows

(Unaudited)

 

(In millions)    Twelve Months Ended
December 31
 
     2023     2022  

Operating activities

    

Net income

   $ 5,991     $ 5,888  

Adjustments to reconcile net income to net cash provided by operating activities:

    

Depreciation and amortization

     1,745       1,675  

Share-based compensation

     289       264  

Changes in operating assets and liabilities

     (534     423  

Other non-cash items

     570       149  
  

 

 

   

 

 

 

Net cash provided by operating activities

     8,061       8,399  

Investing activities

    

Purchases of investments, net of sales and maturities

     (2,700     (2,338

Purchases of subsidiaries, net of cash acquired

     (1,552     (649

Purchases of property and equipment

     (1,296     (1,152

Other, net

     (24     (421
  

 

 

   

 

 

 

Net cash used in investing activities

     (5,572     (4,560

Financing activities

    

Net change in short-term and long-term borrowings

     626       862  

Repurchase and retirement of common stock

     (2,676     (2,316

Cash dividends

     (1,395     (1,229

Other, net

     96       1,365  
  

 

 

   

 

 

 

Net cash used in financing activities

     (3,349     (1,318

Effect of foreign exchange rates on cash and cash equivalents

     (1     (14
  

 

 

   

 

 

 

Change in cash and cash equivalents

     (861     2,507  

Cash and cash equivalents at beginning of period

     7,387       4,880  
  

 

 

   

 

 

 

Cash and cash equivalents at end of period

   $ 6,526     $ 7,387  
  

 

 

   

 

 

 

 

10


REPORTABLE SEGMENTS

Elevance Health has four reportable segments: Health Benefits (comprised of Individual, Employer Group risk-based, Employer Group fee-based, BlueCard, Medicare, Medicaid, and Federal Health Products & Services businesses); CarelonRx; Carelon Services; and Corporate & Other (comprised of businesses that do not individually meet the quantitative thresholds for an operating division as well as corporate expenses not allocated to our other reportable segments).

Elevance Health

Reportable Segment Highlight Details

(Unaudited)

 

(In millions)    Three Months Ended December 31     Twelve Months Ended December 31  
     2023     2022     Change     2023     2022     Change  

Operating Revenue

            

Health Benefits

   $ 36,547     $ 34,996       4.4   $ 148,571     $ 138,484       7.3

Carelon2,4

     12,401       10,865       14.1     47,982       41,386       15.9

Corporate & Other4

     181       58       212.1     479       399       20.1

Eliminations4

     (6,675     (6,252     6.8     (26,823     (24,609     9.0
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Revenue1

   $ 42,454     $ 39,667       7.0   $ 170,209     $ 155,660       9.3
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating Gain (Loss)

            

Health Benefits3,4

   $ 767     $ 785       (2.3 )%    $ 6,888     $ 6,022       14.4

Carelon2,3,4

     592       514       15.2     2,655       2,403       10.5

Corporate & Other1,3,4

     (75     (40     NM 5      (1,044     (142     NM 5 
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total Operating Gain1

   $ 1,284     $ 1,259       2.0   $ 8,499     $ 8,283       2.6
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating Margin

            

Health Benefits

     2.1     2.2     (10 )bp      4.6     4.3     30 bp 

Carelon

     4.8     4.7     10 bp      5.5     5.8     (30 )bp 

Total Operating Margin1

     3.0     3.2     (20 )bp      5.0     5.3     (30 )bp 

 

1.

See “Basis of Presentation” on page 5 herein.

2.

Operating Revenue and Operating Gain for Carelon for the three months ended December 31, 2023 included $8,827 and $490 for CarelonRx; and $3,574 and $102 for Carelon Services, respectively. Operating Revenue and Operating Gain for Carelon for the three months ended December 31, 2022 included $7,523 and $475 for CarelonRx; and $3,342 and $39 for Carelon Services, respectively. Operating Revenue and Operating Gain for Carelon for the twelve months ended December 31, 2023 included $33,835 and $1,975 for CarelonRx; and $14,147 and $680 for Carelon Services, respectively. Operating Revenue and Operating Gain for Carelon for the twelve months ended December 31, 2022 included $28,526 and $1,868 for CarelonRx; and $12,860 and $535 for Carelon Services, respectively.

3.

Operating Gain for the three and twelve months ended December 31, 2023 and December 31, 2022 included items adjusted out of adjusted shareholders’ net income. See “GAAP Reconciliation” on page 13 and 14 herein.

4.

Operating Revenue and Operating Gain for the three and twelve months ended December 31, 2022 are restated for the realignment of Carelon Global Solutions. For the three and twelve months ended December 31, 2022, $150 and $583 of Operating Revenue was realigned to Carelon Services, $160 and $618 of Operating Revenue was realigned away from the Corporate & Other segment, and $10 and $35 of Operating Revenue were realigned to Eliminations. For the three and twelve months ended December 31, 2022, $22 and $80 of Operating Gain was realigned to Carelon Services, $10 and $39 of Operating Gain was realigned away from the Health Benefits segment, and $12 and $41 of Operating Gain was realigned away from Corporate & Other. For the three months ended September 30, 2023, $135 of Operating Revenue was realigned to Carelon Services, $147 of Operating Revenue was realigned away from the Corporate & Other segment, and $12 of Operating Revenue were realigned to Eliminations. For the three months ended September 30, 2023, $19 of Operating Gain was realigned to Carelon Services, $13 of Operating Gain was realigned away from the Health Benefits segment, and $6 was realigned away from Corporate & Other.

5.

“NM” = calculation not meaningful.

 

11


Elevance Health

Reconciliation of Medical Claims Payable

 

     Years Ended December 31  
     2023     2022     2021  
(In millions)    (Unaudited)              

Gross medical claims payable, beginning of year

   $ 15,348     $ 13,282     $ 11,135  

Ceded medical claims payable, beginning of year

     (6     (21     (46
  

 

 

   

 

 

   

 

 

 

Net medical claims payable, beginning of year

     15,342       13,261       11,089  
  

 

 

   

 

 

   

 

 

 

Business combinations and purchase adjustments

     —         133       420  

Net incurred medical claims:

      

Current year

     121,798       113,414       100,440  

Prior years redundancies1

     (1,571     (869     (1,703
  

 

 

   

 

 

   

 

 

 

Total net incurred medical claims

     120,227       112,545       98,737  
  

 

 

   

 

 

   

 

 

 

Net payments attributable to:

      

Current year medical claims

     107,146       98,997       88,156  

Prior years medical claims

     12,565       11,600       8,829  
  

 

 

   

 

 

   

 

 

 

Total net payments

     119,711       110,597       96,985  
  

 

 

   

 

 

   

 

 

 

Net medical claims payable, end of year

     15,858       15,342       13,261  

Ceded medical claims payable, end of year

     7       6       21  
  

 

 

   

 

 

   

 

 

 

Gross medical claims payable, end of year2

   $ 15,865     $ 15,348     $ 13,282  
  

 

 

   

 

 

   

 

 

 

Current year medical claims paid as a percentage of current year net incurred medical claims

     88.0     87.3     87.8

Prior year redundancies in the current year as a percentage of prior year net medical claims payable less prior year redundancies in the current year

     11.4     7.0     18.1

Prior year redundancies in the current year as a percentage of prior year net incurred medical claims

     1.4     0.9     2.2

 

1.

Negative amounts reported for net incurred medical claims related to prior years result from claims being settled for amounts less than originally estimated.

2.

Excludes insurance lines other than short duration.

 

12


Elevance Health

GAAP Reconciliation

(Unaudited)

This document references non-GAAP measures, including “Adjusted Shareholders’ Net Income,” “Adjusted Shareholders’ Net Income Per Share,” “Adjusted EPS”, “Adjusted Operating Gain”, “Adjusted Operating Expense” and “Adjusted Operating Expense Ratio”, which are non-GAAP measures. These non-GAAP measures are intended to aid investors when comparing Elevance Health’s financial results among periods and are not intended to be alternatives to any measure calculated in accordance with GAAP. Reconciliations of these non-GAAP measures to the most directly comparable measures calculated in accordance with GAAP are available below. In addition to these non-GAAP measures, references are made to the measures “Operating Revenue” and “Operating Gain/Loss,” “Operating Margin” and “Adjusted EPS”. Operating revenue and operating gain/loss are the key measures used by management to evaluate performance in each of its reporting segments, allocate resources, set incentive compensation targets and to forecast future operating performance. Operating gain/loss is calculated as total operating revenue less benefit expense, cost of products sold and operating expense. It does not include net investment income, net gains/losses on financial instruments, interest expense, amortization of other intangible assets and gains/losses on extinguishment of debt or income taxes, as these items are managed in a corporate shared service environment and are not the responsibility of operating segment management. Each of these measures is provided to further aid investors in understanding and analyzing Elevance Health’s operating and financial results. A reconciliation of Operating Revenue to Total Revenue is set forth in the Consolidated Statements of Income herein. A reconciliation of the non-GAAP measures to the most directly comparable measures calculated in accordance with GAAP, together with a reconciliation of reportable segments operating gain to income before income tax expense, is reported below. Prior amounts may be grouped differently to conform to current presentation.Net adjustment items per share may not sum due to rounding. A reconciliation of Operating Revenue to Total Revenue is set forth in the Consolidated Statements of Income herein.

 

     Three Months Ended
December 31
          Twelve Months Ended
December 31
       
(In millions, except per share data)    2023     2022     Change     2023     2022     Change  

Shareholders’ net income - As reported

   $ 856     $ 949       (9.8 )%    $ 5,987     $ 6,025       (0.6 )% 

Impact of Accounting Standards Update 2018-12 Adoption

     —         (84       —         (131  

Shareholders’ net income - Restated

   $ 856     $ 865       (1.0 )%    $ 5,987     $ 5,894       1.6

Add / (Subtract):

            

Net losses on financial instruments

     336       111         694       550    

Amortization of other intangible assets

     217       247         885       767    

Transaction and integration related costs

     59       36         213       72    

Business optimization charges

     22       39         719       39    

Litigation expenses

     1       1         6       12    

BCBSA litigation settlement

     (8     (20       (8     (44  

Tax impact of non-GAAP adjustments

     (158     (102       (628     (363  
  

 

 

   

 

 

     

 

 

   

 

 

   

Net adjustment items

     469       312         1,881       1,033    
  

 

 

   

 

 

     

 

 

   

 

 

   

Adjusted shareholders’ net income

   $ 1,325     $ 1,177       12.6   $ 7,868     $ 6,927       13.6
  

 

 

   

 

 

     

 

 

   

 

 

   

Shareholders’ earnings per diluted share - As reported

   $ 3.63     $ 3.93       (7.6 )%    $ 25.22     $ 24.81       1.7

Impact of Accounting Standards Update 2018-12 Adoption

     —         (0.34       —         (0.53  

Shareholders’ earnings per diluted share - Restated

     3.63       3.59       1.1     25.22       24.28       3.9

Add / (Subtract):

            

Net losses on financial instruments

     1.42       0.46         2.92       2.27    

Amortization of other intangible assets

     0.92       1.02         3.73       3.16    

Transaction and integration related costs

     0.25       0.15         0.90       0.30    

Business optimization charges

     0.09       0.16         3.03       0.16    

Litigation expenses

     —         —           0.03       0.05    

BCBSA litigation settlement

     (0.03     (0.08       (0.03     (0.18  

Tax impact of non-GAAP adjustments

     (0.67     (0.42       (2.65     (1.50  
  

 

 

   

 

 

     

 

 

   

 

 

   

Net adjustment items

     1.99       1.29         7.92       4.25    
  

 

 

   

 

 

     

 

 

   

 

 

   

Adjusted shareholders’ earnings per diluted share

   $ 5.62     $ 4.88       15.2   $ 33.14     $ 28.53       16.2
  

 

 

   

 

 

     

 

 

   

 

 

   

 

13


Elevance Health

GAAP Reconciliation

(Unaudited)

 

     Three Months Ended
December 31
          Twelve Months Ended
December 31
       
(In millions)    2023     2022     Change     2023     2022     Change  

Operating expense - As reported

   $ 4,999     $ 4,562       9.6   $ 20,087     $ 17,686       13.6

Impact of Accounting Standards Update 2018-12 Adoption

     —         5         —         14    

Operating expense - Restated

   $ 4,999     $ 4,567       9.5   $ 20,087     $ 17,700       13.5

Add / (Subtract):

            

Transaction and integration related costs

     (59     (36       (213     (72  

Business optimization charges

     (22     (39       (719     (39  

Litigation expenses

     (1     (1       (6     (12  

BCBSA litigation settlement

     8       20         8       44    
  

 

 

   

 

 

     

 

 

   

 

 

   

Net adjustment items

     (74     (56       (930     (79  
  

 

 

   

 

 

     

 

 

   

 

 

   

Adjusted operating expense

   $ 4,925     $ 4,511       9.2   $ 19,157     $ 17,621       8.7
  

 

 

   

 

 

     

 

 

   

 

 

   

Operating revenue

   $ 42,454     $ 39,667       7.0   $ 170,209     $ 155,660       9.3

Operating expense ratio

     11.8     11.5     30 bp      11.8     11.4     40 bp 

Adjusted operating expense ratio

     11.6     11.4     20 bp      11.3     11.3     bp 
     Three Months Ended
December 31
          Twelve Months Ended
December 31
       
(In millions)    2023     2022     Change     2023     2022     Change  

Income before income tax expense

   $ 1,001     $ 1,045       (4.2 )%    $ 7,715     $ 7,600       1.5

Net investment income

     (529     (373       (1,825     (1,485  

Net losses on financial instruments

     336       111         694       550    

Interest expense

     259       229         1,030       851    

Amortization of other intangible assets

     217       247         885       767    
  

 

 

   

 

 

     

 

 

   

 

 

   

Reportable segments operating gain

   $ 1,284     $ 1,259       2.0   $ 8,499     $ 8,283       2.6
  

 

 

   

 

 

     

 

 

   

 

 

   

Adjustment items

     74       56         930       79    
  

 

 

   

 

 

     

 

 

   

 

 

   

Reportable segments adjusted operating gain

   $ 1,358     $ 1,315       3.3   $ 9,429     $ 8,362       12.8
  

 

 

   

 

 

     

 

 

   

 

 

   
     Full Year 2024 Outlook                          

Shareholders’ earnings per diluted share

     Greater than $34.29          

Add / (Subtract):

          

Amortization of other intangibles

     $1.93          

Net losses on financial instruments

     $1.35          

Transaction and integration related costs

     $0.31          

Litigation expenses

     $0.03          

Tax impact of non-GAAP adjustments

     Approximately $(0.81)          
  

 

 

         

Net adjustment items

     $2.81          
  

 

 

         

Adjusted shareholders’ earnings per diluted share

     Greater Than $37.10          
  

 

 

         

 

 

14


Elevance Health

Financial Guidance Summary

(Unaudited)

 

     Full Year 2023 Actual      Full Year 2024 Outlook  

Year-End Medical Enrollment (in millions)

     

Fee-Based

     27.1        27.4 - 27.6  

Risk-Based

     19.9        18.4 - 19.0  
  

 

 

    

 

 

 

Total

     47.0        45.8 - 46.6  

Premium Revenue

     $142.9 billion        Approximately flat  

Product Revenue

     $19.5 billion        Mid-single digit growth  

Service Fees

     $7.9 billion        Low double-digit growth  
  

 

 

    

 

 

 

Total Operating Revenue

     $170.2 billion        Flat to low-single digit growth  

Benefit Expense Ratio

     87.0%        87.0% +/- 50 bps  

Adjusted Operating Expense Ratio

     11.3%        11.1% +/- 50 bps  

Adjusted Operating Gain

     $9.4 billion        Greater than $10.3 billion  

Other Pre-Tax Items:

     

Net Investment income

     $1,825 million        $1,900 million  

Interest Expense

     ($1,030) million        ($1,100) million  

Amortization of Intangible Assets

     ($885) million        ($450) million  
  

 

 

    

 

 

 

Net Pre-Tax Expense

     ($90) million        $350 million  

Adjusted Effective Tax Rate

     23.0%        22.0% - 24.0%  

GAAP Diluted EPS

     $25.22        Greater than $34.29  

Adjusted Diluted EPS

     $33.14        Greater than $37.10  

Diluted Shares

     237.4 million        233 - 234 million  

Operating Cash Flow

     $8.1 billion        Greater than $8.1 billion  

Segment Level Guidance Metrics

     

Operating Revenue Growth Rate

     

Health Benefits

     $148.6 billion        Approximately flat  

CarelonRx

     $33.8 billion        Low-single digit  

Carelon Services

     $14.1 billion        High-teens to low-twenties  

Operating Margin vs. 2023

     

Health Benefits

     4.6%        25 - 50 bps  

CarelonRx

     5.8%        40 - 60 bps  

Carelon Services

     4.8%        (30) - 0 bps  

 

15


Forward-Looking Statements

This document contains certain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements reflect our views about future events and financial performance and are generally not historical facts. Words such as “expect,” “feel,” “believe,” “will,” “may,” “should,” “anticipate,” “intend,” “estimate,” “project,” “forecast,” “plan” and similar expressions are intended to identify forward-looking statements. These statements include, but are not limited to: financial projections and estimates and their underlying assumptions; statements regarding plans, objectives and expectations with respect to future operations, products and services; and statements regarding future performance. Such statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond our control, that could cause actual results to differ materially from those expressed in, or implied or projected by, the forward-looking statements. You are cautioned not to place undue reliance on these forward-looking statements that speak only as of the date hereof. You are also urged to carefully review and consider the various risks and other disclosures discussed in our reports filed with the U.S. Securities and Exchange Commission from time to time, which attempt to advise interested parties of the factors that affect our business. Except to the extent required by law, we do not update or revise any forward-looking statements to reflect events or circumstances occurring after the date hereof. These risks and uncertainties include, but are not limited to: trends in healthcare costs and utilization rates; reduced enrollment; our ability to secure and implement sufficient premium rates; the impact of large scale medical emergencies, such as public health epidemics and pandemics, including COVID-19, and other catastrophes; the impact of new or changes in existing federal, state and international laws or regulations, including laws and regulations impacting healthcare, insurance, pharmacy services and other diversified products and services, or their enforcement or application; the impact of cyber-attacks or other privacy or data security incidents or breaches or our failure to comply with any privacy, data or security laws or regulations, including any investigations, claims or litigation related thereto; information technology disruptions; changes in economic and market conditions, as well as regulations that may negatively affect our liquidity and investment portfolios; competitive pressures and our ability to adapt to changes in the industry and develop and implement strategic growth opportunities; risks and uncertainties regarding Medicare and Medicaid programs, including those related to non-compliance with the complex regulations imposed thereon; our ability to maintain and achieve improvement in Centers for Medicare and Medicaid Services Star ratings and other quality scores and funding risks with respect to revenue received from participation therein; a negative change in our healthcare product mix; costs and other liabilities associated with litigation, government investigations, audits or reviews; our ability to contract with providers on cost-effective and competitive terms; failure to effectively maintain and modernize our information systems; risks associated with providing healthcare, pharmacy and other diversified products and services, including medical malpractice or professional liability claims and non-compliance by any party with the pharmacy services agreement between us and CaremarkPCS Health, L.L.C.; risks associated with mergers, acquisitions, joint ventures and strategic alliances; possible impairment of the value of our intangible assets if future results do not adequately support goodwill and other intangible assets; possible restrictions in the payment of dividends from our subsidiaries and increases in required minimum levels of capital; our ability to repurchase shares of our common stock and pay dividends on our common stock due to the adequacy of our cash flow and earnings and other considerations; the potential negative effect from our substantial amount of outstanding indebtedness and the risk that increased interest rates or market volatility could impact our access to or further increase the cost of financing; a downgrade in our financial strength ratings; the effects of any negative publicity related to the health benefits industry in general or us in particular; events that may negatively affect our licenses with the Blue Cross and Blue Shield Association; intense competition to attract and retain employees; risks associated with our international operations; and various laws and provisions in our governing documents that may prevent or discourage takeovers and business combinations.

 

16

v3.23.4
Document and Entity Information
Jan. 24, 2024
Cover [Abstract]  
Amendment Flag false
Entity Central Index Key 0001156039
Document Type 8-K
Document Period End Date Jan. 24, 2024
Entity Registrant Name Elevance Health, Inc.
Entity Incorporation State Country Code IN
Entity File Number 001-16751
Entity Tax Identification Number 35-2145715
Entity Address, Address Line One 220 Virginia Ave
Entity Address, City or Town Indianapolis
Entity Address, State or Province IN
Entity Address, Postal Zip Code 46204
City Area Code (833)
Local Phone Number 401-1577
Written Communications false
Soliciting Material false
Pre Commencement Tender Offer false
Pre Commencement Issuer Tender Offer false
Security 12b Title Common Stock, Par Value $0.01
Trading Symbol ELV
Security Exchange Name NYSE
Entity Emerging Growth Company false

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