Elevance Health Reports Fourth Quarter and Full Year 2022 Results

Sample article from our Health Care Sector

INDIANAPOLIS, Indiana , January 25, 2023 (press release) –

  • Fourth quarter and full year GAAP net income was $3.93 and $24.81 per share
     
  • Fourth quarter and full year adjusted net income was $5.23* and $29.07* per share
     
  • Full year operating revenue grew 13.7% year-over-year to $156 billion
     
  • Full year operating gain grew 12.9% year-over-year to $8.5 billion
     
  • Medical enrollment increased 2.2 million members year-over-year to 47.5 million members
     
  • Quarterly dividend increased by 16% to $1.48 per share
 

Elevance Health, Inc. (NYSE: ELV) reported fourth quarter and full year 2022 results reflecting strong financial performance, including double-digit growth in revenue, operating earnings, and adjusted earnings per share.

“We made considerable progress in our transformation to become a lifetime, trusted health partner in 2022,” said Gail K. Boudreaux, President and CEO.“ Through strategic advancements we are making to optimize our health benefits businesses, invest in high growth opportunities, and accelerate capabilities and services, we are delivering on our commitments to our communities and all of our stakeholders. Additionally, we look forward to welcoming Blue Cross and Blue Shield of Louisiana to Elevance Health to further this commitment within a 15th Blue state. Last year marked the fifth consecutive year in which we met or exceeded our long-term adjusted earnings per share growth target, and we are well-positioned to do it again in 2023.”

The Company expects GAAP net income to be greater than $29.80 per share in 2023, and adjusted net income to be greater than $32.60 per share.

*Refer to GAAP reconciliation tables on page 14.

Consolidated Highlights

Earnings Per Share: GAAP net income was $3.93 per share in the fourth quarter, including net negative adjustment items of $1.30 per share. Adjusted net income was $5.23* per share.  Full year GAAP net income was $24.81 per share, including net negative adjustment items of $4.26 per share.  Adjusted net income was $29.07* per share.

*Please refer to the GAAP reconciliation tables on page 14.

Membership: Medical membership totaled approximately 47.5 million as of December 31, 2022, an increase of 2.2 million, or 4.8 percent year-over-year. Government Business membership increased by 1.1 million year-over-year driven primarily by growth in the Medicaid business and organic growth in Medicare Advantage. Commercial & Specialty Business membership increased by 1.1 million year-over-year, driven primarily by strong sales to fee-based employers.

During the fourth quarter of 2022, medical membership increased by 248 thousand driven by organic growth in Medicaid, which we attribute primarily to the suspension of eligibility recertification, as well as the acquisition of Vivida Health, which added 29 thousand Medicaid members.

Operating Revenue: Operating revenue was $39.7 billion in the fourth quarter of 2022, an increase of $3.6 billion, or 10.1 percent year-over-year. Operating revenue was $155.7 billion for the full year, representing 13.7 percent growth over 2021.  The increase in both the quarter and the full year was driven by higher premium revenue due to membership growth in Medicaid, growth in Medicare Advantage, as well as premium rate increases to cover overall cost trends.  The increase in operating revenue was further attributable to growth in pharmacy product revenue within CarelonRx driven by growth in consumers served and higher utilization of prescription drugs.

Benefit Expense Ratio: The benefit expense ratio was 89.4 percent in the fourth quarter of 2022, a decrease of 10 basis points year-over-year. The decrease was driven by the realignment of certain quality improvement costs to match recent regulatory clarifications.  Excluding the realignment, our benefit expense ratio would have increased, driven by the non-recurrence of favorable out of period adjustment items in Medicaid in the prior year quarter, partially offset by improved medical underwriting performance in our Commercial & Specialty business.  The benefit expense ratio was 87.4 percent for the full year of 2022, a decrease of 10 basis points year-over-year.  The decrease was primarily driven by the realignment of certain quality improvement costs.  Excluding the realignment, the full year benefit expense ratio would have increased, driven by a shift in business mix toward Medicaid, which carries a higher benefit expense ratio than our commercial and Medicare health plans.

Medical claims reserves established at December 31, 2021 developed in line with the Company’s expectations as of the fourth quarter of 2022.

Days in Claims Payable: Days in Claims Payable was 47.7 days as of December 31, 2022, unchanged from September 30, 2022 and an increase of 2.5 days compared to December 31, 2021.

SG&A Expense Ratio: The SG&A expense ratio was 11.5 percent in the fourth quarter of 2022, a decrease of 20 basis points from 11.7 percent in the fourth quarter of 2021. For the full year of 2022, the SG&A expense ratio was 11.4 percent, a decrease of 20 basis points from 11.6 percent in 2021.  The decrease for both the quarter and the full year was primarily driven by operating expense leverage associated with growth in operating revenue and lower business optimization charges taken in 2022 as compared to 2021, partially offset by increased spend to support growth in operations and the realignment of certain quality improvement expenses previously reported in benefit expense in the prior year periods.

Operating Cash Flow: Operating cash flow was a use of $1.5 billion, or (1.6) times net income in the fourth quarter of 2022, a decrease of $3.2 billion as compared to the prior year quarter. The year-on-year decrease was driven by the early receipt of premium payments from the Centers for Medicare and Medicaid in third quarter of 2022, which were received during the fourth quarter in 2021.  For the full year 2022, operating cash flow was $8.4 billion, or 1.4 times net income.

Share Repurchase Program: During the fourth quarter of 2022, the Company repurchased 1.1 million shares of its common stock for $567 million, at a weighted average price of $497.24. For the full year of 2022, the Company repurchased 4.8 million shares of its common stock for $2.3 billion, at a weighted average price of $478.99.  As of December 31, 2022, the Company had approximately $1.9 billion of Board-approved share repurchase authorization remaining.

On January 24, 2023, our Audit Committee, pursuant to authorization granted by the Board of Directors, authorized a $5.0 billion increase to the common stock repurchase program.  The Company intends to utilize this authorization over a multi-year period, subject to market and industry conditions.

Cash Dividend: During the fourth quarter of 2022, the Company paid a quarterly dividend of $1.28 per share, representing a distribution of cash totaling $305 million.

On January 24, 2023, the Audit Committee of the Company's Board of Directors declared a first quarter 2023 dividend to shareholders of $1.48 per share, an increase of 16 percent from the quarterly dividend payment in the fourth quarter.  On an annualized basis, the new quarterly dividend equates to $5.92 per share.  The first quarter dividend is payable on March 24, 2023, to shareholders of record at the close of business on March 10, 2023.

Investment Portfolio & Capital Position: During the fourth quarter of 2022, the Company recorded net losses of $111 million. During the fourth quarter of 2021, the Company recorded net gains of $211 million. These amounts are excluded from adjusted earnings per share.

As of December 31, 2022, the Company’s net unrealized loss position in the investment portfolio was $2.3 billion, consisting primarily of fixed maturity securities. As of December 31, 2022, cash and investments at the parent company totaled approximately $1.2 billion.

 

Reportable Segments

Elevance Health has four reportable segments: Commercial & Specialty Business (comprised of Individual, Group risk-based, Group fee-based, and BlueCard businesses); Government Business (comprised of the Medicaid, Medicare, and Federal Health Products & Services businesses); CarelonRx; and Other (comprised of the Carelon companies, formerly known as our Diversified Business Group, and corporate expenses not allocated to our other reportable segments).

Elevance Health, Inc.

Reportable Segment Highlights

(Unaudited)

 

(In millions)

 

Three

Months Ended December 31

Twelve Months Ended December 31

 

2022

2021

Change

2022

2021

Change

Operating Revenue

 

 

 

 

 

 

Commercial & Specialty Business

$10,350

$9,905

4.5 %

$41,674

$38,809

7.4 %

Government Business

24,646

21,912

12.5 %

96,810

82,919

16.8 %

CarelonRx

7,523

6,801

10.6 %

28,526

25,431

12.2 %

Other

3,410

2,693

26.6 %

13,294

10,250

29.7 %

Eliminations

(6,262)

(5,293)

18.3 %

(24,644)

(20,466)

20.4 %

Total Operating Revenue1

$39,667

$36,018

10.1 %

$155,660

$136,943

13.7 %

 

 

 

 

 

 

 

Operating Gain (Loss)2

 

 

 

 

 

 

Commercial & Specialty Business

$260

$74

251.4 %

$2,933

$2,753

6.5 %

Government Business

644

748

(13.9) %

3,297

3,061

7.7 %

CarelonRx

475

427

11.2  %

1,868

1,684

10.9 %

Other

(11)

(61)

NM

354

(9)

NM

Total Operating Gain1

$1,368

$1,188

15.2 %

$8,452

$7,489

12.9 %

 

 

 

 

 

 

 

Operating Margin

 

 

 

 

 

 

Commercial & Specialty Business

2.5 %

0.7 %

180 bp

7.0 %

7.1 %

(10) bp

Government Business

2.6 %

3.4 %

(80) bp

3.4 %

3.7 %

(30) bp

CarelonRx

6.3 %

6.3 %

— bp

6.5 %

6.6 %

(10) bp

Total Operating Margin1

3.4 %

3.3 %

10 bp

5.4 %

5.5 %

(10) bp

 

 

 

 

 

 

 

  1. See “Basis of Presentation” on page 6 herein.
  1. Operating gain for the three and twelve months ended December 31, 2022 included $39 of charges related to business optimization plans; including $20 for Commercial & Specialty Business; $16 for the Government Business; and $3 for the Other segment.  Operating gain for the three and twelve months ended December 31, 2021 included $187 of charges related to business optimization plans; including $106 for Commercial & Specialty Business; $47 for the Government Business; $2 for CarelonRx; and $32 for the Other segment.  
 

Commercial & Specialty Business: Operating gain in the Commercial & Specialty Business segment totaled $260 million in the fourth quarter of 2022, an increase of $186 million from $74 million in the fourth quarter of 2021. The increase was primarily driven by improved medical underwriting performance in our commercial risk-based business and lower business optimization expenses in the fourth quarter of 2022 as compared to the fourth quarter of 2021. 

Government Business: Operating gain in the Government Business segment was $644 million in the fourth quarter of 2022, a decrease of $104 million from $748 million in the fourth quarter of 2021. The decrease was primarily driven by the non-recurrence of certain favorable out of period rate actions in Medicaid in the prior year quarter partially offset by increased gross profit in our Medicare health plans and lower business optimization expenses in the fourth quarter of 2022 as compared to the fourth quarter of 2021.

CarelonRx: Operating gain was $475 million in the fourth quarter of 2022, an increase of $48 million from $427 million in the fourth quarter of 2021. The increase was driven by higher prescription volumes associated with growth in integrated medical and standalone pharmacy customers.

Other: The Company reported an operating loss of $11 million in the Other segment for the fourth quarter of 2022, an improvement of $50 million from an operating loss of $61 million in the prior year quarter, driven by growth in Carelon's affiliated and unaffiliated earnings.

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 selling, general and administrative 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 the GAAP reconciliation tables.

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

Conference Call and Webcast

Management will host a conference call and webcast today at 8:30 a.m. Eastern Daylight Time (“EDT”) to discuss the company’s third quarter 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)
  • 312-470-0178 (International)
  • 800-396-1242 (Domestic Replay)
  • 203-369-3272 (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 24, 2023. 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.

Elevance Health Contacts: 

Investor Relations:
Stephen Tanal
Stephen.Tanal@ElevanceHealth.com

Media Contact:
Leslie Porras
Leslie.Porras@ElevanceHealth.com

About Elevance Health, Inc.

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 approximately 119 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 Twitter and Elevance Health on LinkedIn. 

 

Elevance Health, Inc.

Membership Summary

(Unaudited and in Thousands)

 

 

 

 

Change From

Medical Membership

December 31, 2022

December 31, 2021

September 30, 2022

December 31,
2021

September 30, 2022

Commercial & Specialty Business

 

 

 

 

 

Individual

789

759

800

4.0 %

(1.4) %

Group Risk-Based

3,988

4,006

3,988

(0.4) %

—  %

Commercial Risk-Based

4,777

4,765

4,788

0.3 %

(0.2) %

BlueCard®

6,462

6,178

6,453

4.6 %

0.1 %

Group Fee-Based

20,174

19,395

20,184

4.0 %

—  %

Commercial Fee-Based

26,636

25,573

26,637

4.2 %

—  %

Total Commercial & Specialty Business

31,413

30,338

31,425           

3.5 %

—  %

Government Business

 

 

 

 

 

Medicare Advantage

1,977

1,859

              1,969             

6.3 %

0.4 %

Medicare Supplement

947

952

945       

(0.5) %

0.2 %

Total Medicare

2,924

2,811

2,914             

4.0 %

0.3 %

Medicaid

11,571

10,600

            11,319           

9.2 %

2.2 %

Federal Employees Health Benefits

1,623

1,625

1,625    

(0.1) %

(0.1) %

Total Government Business

16,118

15,036

15,858

7.2 %

1.6 %

Total Medical Membership

47,531

45,374

47,283

4.8 %

0.5 %

Other Membership

 

 

 

 

 

Life and Disability Members

4,834

4,782

4,796             

1.1 %

0.8 %

Dental Members

6,692

6,674

6,655             

0.3 %

0.6 %

Dental Administration Members

1,586

1,491

1,577             

6.4 %

0.6 %

Vision Members

9,813

8,031

9,628             

22.2 %

1.9 %

Medicare Part D Standalone Members

271

438

274

(38.1) %

(1.1) %

 

Elevance Health, Inc.

Consolidated Statements of Income

(Unaudited)

(In millions, except per share data)

 

 

Three Months Ended  

December 31

 

 

2022

2021

Change

Revenues

 

 

 

Premiums

$33,646

$30,769

9.4  %

Product revenue

4,137

3,525

17.4  %

Administrative fees and other revenue

1,884

1,724

9.3  %

Total operating revenue

39,667

36,018

10.1  %

Net investment income

373

352

6.0  %

Net (losses) gains on financial instruments

(111)

211

(152.6) %

Total revenues

39,929

36,581

9.2  %

 

 

 

 

Expenses

 

 

 

Benefit expense

30,091

27,538

9.3  %

Cost of products sold

3,646

3,070

18.8  %

Selling, general and administrative expense

4,562

4,222

8.1  %

Interest expense

229

200

14.5  %

Amortization of other intangible assets

247

135

83.0  %

Loss on extinguishment of debt

16

(100.0) %

Total expenses

38,775

35,181

10.2  %

Income before income tax expense

1,154

1,400

(17.6) %

Income tax expense

193

275

(29.8) %

Net income

961

1,125

(14.6) %

Net (income) loss attributable to noncontrolling interests

(12)

12

NM

 

 

 

 

Shareholders' net income

$ 949

$ 1,137

(16.5) %

 

 

 

 

Shareholders' net income per diluted share

$ 3.93

$ 4.63

(15.1) %

 

 

 

 

Diluted shares

241.2

245.5

(1.8) %

 

 

 

 

Benefit expense as a percentage of premiums

89.4 %

89.5 %

               (10)               bp

Selling, general and administrative expense as a percentage of total operating revenue

11.5  %

11.7  %

               (20)               bp

Income before income tax expense as a percentage of total revenue

2.9 %

3.8 %

               (90)               bp

"NM" = calculation not meaningful

 

Elevance Health, Inc.

Consolidated Statements of Income

(Unaudited)

(In millions, except per share data)

Twelve Months Ended 

 December 31

 

 

2022

2021

Change

Revenues

 

 

 

Premiums

$ 133,229

$ 117,373

13.5  %

Product revenue

14,978

12,657

18.3  %

Administrative fees and other revenue

7,453

6,913

7.8  %

Total operating revenue

155,660

136,943

13.7  %

Net investment income

1,485

1,378

7.8  %

Net (losses) gains on financial instruments

(550)

318

(273.0) %

Total revenues

156,595

138,639

13.0  %

Expenses

 

 

 

Benefit expense

116,487

102,645

13.5  %

Cost of products sold

13,035

10,895

19.6  %

Selling, general and administrative expense

17,686

15,914

11.1  %

Interest expense

851

798

6.6  %

Amortization of other intangible assets

767

441

73.9  %

Loss on extinguishment of debt

21

(100.0) %

Total expenses

148,826

130,714

13.9  %

Income before income tax expense

7,769

7,925

(2.0) %

Income tax expense

1,750

1,830

(4.4) %

Net income

6,019

6,095

(1.2) %

Net loss attributable to noncontrolling interests

6

9

NM

Shareholders' net income

$ 6,025

$ 6,104

(1.3) %

 

 

 

 

Shareholders' net income per diluted share

$ 24.81

$ 24.73

0.3  %

 

 

 

 

Diluted shares

242.8

246.8

(1.6) %

 

 

 

 

Benefit expense as a percentage of premiums

87.4 %

87.5 %

               (10)               bp

Selling, general and administrative expense as a percentage of total operating revenue

11.4  %

11.6  %

               (20)               bp

Income before income tax expense as a percentage of total revenue

5.0 %

5.7 %

               (70)               bp

"NM" = calculation not meaningful

 

Elevance Health, Inc.

Consolidated Balance Sheets

(In millions)

December 31,
2022

December 31,
2021

Assets

(Unaudited)

 

Current assets:

 

 

Cash and cash equivalents

$ 7,387

$ 4,880

Fixed maturity securities

25,952

26,267

Equity securities

953

1,881

Premium receivables

7,083

5,681

Self-funded receivables

4,663

4,010

Other receivables

4,298

3,749

Other current assets

5,281

4,654

Total current assets

55,617

51,122

 

 

 

Long-term investments:

 

 

Fixed maturity securities

752

632

Other invested assets

5,685

5,225

Property and equipment, net

4,316

3,919

Goodwill

24,383

24,228

Other intangible assets

10,315

10,615

Other noncurrent assets

1,704

1,719

Total assets

$ 102,772

$ 97,460

 

 

 

Liabilities and equity

 

 

Liabilities

 

 

Current liabilities:

 

 

Medical claims payable

$ 15,596

$ 13,518

Other policyholder liabilities

6,505

5,521

Unearned income

1,112

1,153

Accounts payable and accrued expenses

5,035

4,970

Short-term borrowings

265

275

Current portion of long-term debt

1,500

1,599

Other current liabilities

9,683

7,849

Total current liabilities

39,696

34,885

 

 

 

Long-term debt, less current portion

22,349

21,157

Reserves for future policy benefits

737

802

Deferred tax liabilities, net

2,034

2,805

Other noncurrent liabilities

1,562

1,683

Total liabilities

66,378

61,332

 

 

 

Shareholders’ equity

 

 

Common stock

2

2

Additional paid-in capital

9,084

9,148

Retained earnings

29,724

27,088

Accumulated other comprehensive loss

(2,503)

(178)

Total shareholders’ equity

36,307

36,060

Noncontrolling interests

87

68

Total equity

36,394

36,128

Total liabilities and equity

$ 102,772

$ 97,460

 

Elevance Health, Inc.

Consolidated Statements of Cash Flows

(Unaudited)

(In millions)

Twelve Months Ended December 31

 

2022

2021

Operating activities

 

 

Net income

$6,019

$6,095

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

 

 

Net losses (gains) on financial instruments

550

(318)

Equity in net earnings of other invested assets

(293)

(562)

Depreciation and amortization

1,675

1,302

Deferred income taxes

(76)

326

Impairment of property and equipment

7

73

Share-based compensation

264

255

Changes in operating assets and liabilities:

 

 

Receivables, net

(2,510)

(2,138)

Other invested assets

11

(70)

Other assets

120

37

Policy liabilities

2,826

2,597

Unearned income

(42)

(113)

Accounts payable and other liabilities

252

719

Income taxes

(338)

140

Other, net

(66)

21

Net cash provided by operating activities

8,399

8,364

 

 

 

Investing activities

 

 

Purchases of investments

(24,946)

(18,669)

Proceeds from sale of investments

11,988

10,269

Maturities, calls and redemptions from investments

10,620

4,344

Changes in securities lending collateral

(301)

(956)

Purchases of subsidiaries, net of cash acquired

(649)

(3,476)

Purchases of property and equipment

(1,152)

(1,087)

Other, net

(120)

(63)

Net cash used in investing activities

(4,560)

(9,638)

 

 

 

Financing activities

 

 

Net (repayments of) proceeds from commercial paper borrowings

(300)

50

Net proceeds from (repayments of) short-term borrowings

(10)

275

Net proceeds from long-term borrowings

1,172

2,394

Changes in securities lending payable

302

956

Changes in bank overdrafts

933

(376)

Repurchase and retirement of common stock

(2,316)

(1,900)

Cash dividends

(1,229)

(1,104)

Proceeds from issuance of common stock under employee stock plans

182

203

Taxes paid through withholding of common stock under employee stock plans

(93)

(102)

Other, net

41

27

Net cash (used in) provided by financing activities

(1,318)

423

 

 

 

Effect of foreign exchange rates on cash and cash equivalents

(14)

(10)

Change in cash and cash equivalents

2,507

(861)

Cash and cash equivalents at beginning of period

4,880

5,741

Cash and cash equivalents at end of period

$7,387

$4,880

 

Elevance Health, Inc.

Reconciliation of Medical Claims Payable

 

 

Years Ended December 31

 

2022

2021

2020

(In millions)

(Unaudited)

 

 

 

 

 

 

Gross medical claims payable, beginning of year

$ 13,282

$ 11,135

$ 8,647

Ceded medical claims payable, beginning of year

(21)

(46)

(33)

Net medical claims payable, beginning of year

13,261

11,089

8,614

 

 

 

 

Business combinations and purchase adjustments

133

420

339

 

 

 

 

Net incurred medical claims:

 

 

 

Current year

113,414

100,440

85,094

Prior years redundancies(1)

(869)

(1,703)

(637)

Total net incurred medical claims

112,545

98,737

84,457

 

 

 

 

Net payments attributable to:

 

 

 

Current year medical claims

98,997

88,156

74,629

Prior years medical claims

11,600

8,829

7,692

Total net payments

110,597

96,985

82,321

 

 

 

 

Net medical claims payable, end of year

15,342

13,261

11,089

Ceded medical claims payable, end of year

6

21

46

Gross medical claims payable, end of year*

$ 15,348

$ 13,282

$ 11,135

 

 

 

 

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

87.3 %

87.8 %

87.7 %

 

 

 

 

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

7.0 %

18.1 %

8.0 %

 

 

 

 

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

0.9 %

2.0 %

0.8 %

 

 

 

 

* Excludes insurance lines other than short duration.

 

 

 

 

Elevance Health, Inc.

GAAP Reconciliation

(Unaudited)

Elevance Health, Inc. has referenced “Adjusted Net Income” and “Adjusted Net Income Per Share,” which are non-GAAP measures, in this document. These non-GAAP measures are not intended to be alternatives to any measure calculated in accordance with GAAP. In addition to these non-GAAP measures, references are made to the measures “Operating Revenue” and “Operating Gain.” Each of these measures is provided to further aid investors in understanding and analyzing the company’s core operating results and comparing Elevance Health, Inc.’s 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.

 

Three Months Ended December 31

 

Twelve Months Ended December 31

 

(In millions, except per share data)

2022

2021

Change

2022

2021

Change

Shareholders' net income

$        949

$     1,137

(16.5) %

$     6,025

$     6,104

(1.3) %

Add / (Subtract):

 

 

 

 

 

 

Net losses (gains) on financial instruments

          111

        (211)

 

          550

        (318)

 

Amortization of other intangible assets

          247

          135

 

          767

          441

 

Loss on extinguishment of debt

           —

           16

 

           —

           21

 

Business optimization charges

           39

          187

 

           39

          187

 

BCBSA litigation settlement

          (20)

           —

 

          (44)

           —

 

Transaction and integration related costs

           36

           19

 

           72

           54

 

Litigation expenses

             1

           27

 

           12

           42

 

Tax impact of non-GAAP adjustments

     

   (102)

          (49)

 

        (363)

        (120)

 

Net adjustment items

        

  312

          124

 

       1,033

          307

 

Adjusted shareholders' net income

$     1,261

$     1,261

— %

$     7,058

$     6,411

 

10.1 %

 

 

 

 

 

 

 

Shareholders' net income per diluted share

$       3.93

$       4.63

(15.1) %

$     24.81

$     24.73

0.3 %

Add / (Subtract):

 

 

 

 

 

 

Net losses (gains) on financial instruments

         0.46

       (0.86)

 

         2.27

       (1.29)

 

Amortization of other intangible assets

         1.02

         0.55

 

         3.16

         1.79

 

Loss on extinguishment of debt

           —

         0.07

 

           —

         0.09

 

Business optimization charges

         0.16

         0.76

 

         0.16

         0.76

 

BCBSA litigation settlement

       (0.08)

           —

 

       (0.18)

           —

 

Transaction and integration related costs

         0.15

         0.08

 

         0.30

         0.22

 

Litigation expenses

           —

         0.11

 

         0.05

         0.17

 

Tax impact of non-GAAP adjustments

       (0.42)

       (0.20)

 

       (1.50)

       (0.49)

 

Rounding impact

       

  0.01

           —

 

           —

           —

 

Net adjustment items

       

  1.30

         0.51

 

         4.26

         1.25

 

 

Adjusted shareholders' net income per diluted share

     5.23

$       5.14

1.8 %

$     29.07

$     25.98

11.9 %

 

 

 

 

Full Year 2023 Outlook

Shareholders' net income per diluted share

 

Greater than $29.80

Add / (Subtract):

 

 

Amortization of other intangible assets

 

Approximately $3.63

Tax impact of non-GAAP adjustments

 

Approximately $(0.83)

Net adjustment items

 

Approximately $2.80

Adjusted shareholders' net income per diluted share

 

Greater than $32.60

 

 

 

Three Months Ended               December 31

 

Twelve Months Ended               December 31

 

(In millions)

2022

2021

Change

2022

2021

Change

Income before income tax expense

$     1,154

$     1,400

(17.6) %

$     7,769

$     7,925

(2.0) %

Net investment income

        (373)

        (352)

 

     (1,485)

     (1,378)

 

Net losses (gains) on financial instruments

          111

        (211)

 

          550

        (318)

 

Interest expense

          229

          200

 

          851

          798

 

Amortization of other intangible assets

          247

          135

 

          767

          441

 

Loss on extinguishment of debt

          —

           16

 

          —

           21

 

Reportable segments operating gain

$     1,368

$     1,188

15.2 %

$     8,452

$     7,489

12.9 %

 

2022 Quarterly & Annual Results - Pro-Forma for New Reportable Segments

Beginning in 2023, Elevance Health will have four reportable segments: Health Benefits, the combination of our existing Commercial & Specialty Business and Government Business (comprised of Individual, Group risk-based, Group fee-based, BlueCard businesses, Medicaid, Medicare, and Federal Health Products & Services businesses); CarelonRx (formerly IngenioRx); Carelon Services, carved out from our existing Other segment (formerly known as Diversified Business Group); 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, Inc.

Reportable Segment Highlights

(Unaudited)

(In millions)

1Q 2022

2Q 2022

3Q 2022

4Q 2022

2022

 

 

 

 

 

 

Operating Revenue

 

 

 

 

 

Health Benefits

$34,027

$34,396

$35,065

$34,996

$138,484

Carelon2

9,631

10,054

10,403

10,715

40,803

Corporate & Other

273

315

211

218

1,017

Eliminations

(6,045)

(6,283)

(6,054)

(6,262)

(24,644)

Total Operating Revenue1

$37,886

$38,482

$39,625

$39,667

$155,660

 

 

 

 

 

 

Operating Gain  (Loss)3

 

 

 

 

 

Health Benefits

$1,871

$1,802

$1,653

$904

$6,230

Carelon2

598

592

641

492

2,323

Corporate & Other

(22)

(27)

(24)

(28)

(101)

Total Operating Gain1

$2,447

$2,367

$2,270

$1,368

$8,452

 

 

 

 

 

 

Operating Margin

 

 

 

 

 

Health Benefits

5.5 %

5.2 %

4.7 %

2.6 %

4.5 %

Carelon

6.2 %

5.9 %

6.2 %

4.6 %

5.7 %

Total Operating Margin1

6.5 %

6.2 %

5.7 %

3.4 %

5.4 %

 

 

 

 

 

 

(In millions)

1Q 2022

2Q 2022

3Q 2022

4Q 2022

2022

Carelon Services - Consumers Served

104.0

104.7

105.3

105.0

105.0

CarelonRx Adjusted Scripts

73.0

76.4

76.9

82.0

308.3

 

 

 

 

 

 

 

1. See “Basis of Presentation” on page 6 herein.

2. Operating Revenue and Operating Gain for Carelon for the three months ended March 31, 2022 included $6,683 and $398 for CarelonRx; $2,948 and $200 for Carelon Services, respectively. Operating Revenue and Operating Gain for Carelon for the three months ended June 30, 2022 included $7,071 and $479 for CarelonRx; $2,983 and $113 for Carelon Services, respectively. Operating Revenue and Operating Gain for Carelon for the three months ended September 30, 2022 included $7,249 and $516 for CarelonRx; $3,154 and $125 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; $3,192 and $17 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; $12,277 and $455 for Carelon Services, respectively.

3. Operating Gain for the three and twelve months ended December 31, 2022 included $39 of charges related to business optimization plans; including $36 for Health Benefits; $5 for Carelon Services; and a ($2) benefit for the Corporate & Other segment.

 

Elevance Health, Inc.

Financial Guidance Summary

(Unaudited)

 

Full Year 2022 Actual

Full Year 2023 Outlook

Approximate Change

Year-End Medical Enrollment

 

 

 

Fee-Based

26,651

27,100 - 27,400

449k -749k

Risk-Based

20,880

20,300 - 21,100

(580k)-220k

Total

47,531

47,400 - 48,500

(131k) - 969k

 

 

 

 

Operating Revenue

$155.7 billion

$164 billion

Approximately $8.3 billion or 5.4%

 

 

 

 

Premium Revenue

$133.2 billion

$140 billion

Approximately $6.8 billion or 5.1%

 

 

 

 

Benefit Expense Ratio

87.4%

87.2% +/- 50 bps

(20) bps +/- 50 bps

 

 

 

 

SG&A Expense Ratio

11.4%

11.2% +/- 50 bps

(20) bps +/- 50 bps

 

 

 

 

Operating Gain

$8.5 billion

Greater than $9.35 billion

Greater than $850 million or 10.6%

 

 

 

 

Other Pre-Tax Items:

 

 

 

Net Investment income

$1,485 million

$1,600 million

$115 million

Interest Expense

($851) million

($1,000) million

($149) million

Amortization of Intangible Assets

($767) million

($869) million

($102) million

Net Pre-Tax Expense

($133) million

($269) million

($136) million

 

 

 

 

Effective Tax Rate

22.5%

22.0% - 24.0%

(0.5%) - 1.5%

 

 

 

 

GAAP EPS

$24.81

Greater than $29.80

20.1% or better

 

 

 

 

Adjusted EPS

$29.07

Greater than $32.60

12.1% or better

 

 

 

 

Diluted Shares

242.8 million

239 - 240 million

(1.6%) - (1.2%)

 

 

 

 

Operating Cash Flow

$8.4 billion

Greater than $7.6 billion

($0.8) billion or better

 

 

 

 

Segment Level Guidance Metrics

 

 

 

Operating Revenue Growth Rate

 

 

 

Health Benefits

 

Mid to upper single digit

 

CarelonRx

 

Upper single digit

 

Carelon Services

 

Low double digit

 

Segment Operating Margin vs. 2022

 

 

 

Health Benefits

 

Up 25-50 bps

 

CarelonRx

 

Unchanged

 

Carelon Services

 

Up 25-50 bps

 

 

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 undertake to 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 healthcare laws and regulations, 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 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 pharmacy benefit management (“PBM”), healthcare and other diversified products and services, including medical malpractice or professional liability claims and non-compliance by any party with the PBM 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.

 

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