Abstract
Elevance Health will report fourth-quarter 2025 results on January 28, 2026 Pre-Market; expectations center on resilient premium growth, disciplined medical cost management, and steady adjusted EPS performance into year-end.
Market Forecast
Market participants expect Elevance Health’s fourth-quarter revenue to reach USD 49.82 billion, with adjusted EPS around USD 3.10 and EBIT at USD 1.12 billion, based on the company’s latest forecast dataset; year-over-year forecasts imply revenue growth of 11.04%, adjusted EPS down 18.40%, and EBIT down 11.01%. Forecast margin signals point to normalized profitability after elevated prior-quarter results, with emphasis on medical cost containment; company-level gross margin and net profit margin forecasts were not disclosed alongside the quarterly guidance. The company’s main business remains premium and services revenue from its operations segment, with growth continuing to be supported by membership retention and pricing discipline. Care management and services solutions are positioned as the strongest growth contributor, with operational revenue of USD 50.09 billion last quarter and double-digit YoY growth of 12.00%.
Last Quarter Review
Elevance Health’s third-quarter 2025 results featured revenue of USD 50.09 billion, a gross profit margin of 24.79%, GAAP net profit attributable to the parent company of USD 1.19 billion, a net profit margin of 2.34%, and adjusted EPS of USD 6.03, with year-over-year growth of 12.00% for revenue and a 27.96% decline for adjusted EPS. A notable highlight was stronger-than-expected topline driven by premium dynamics and membership mix, alongside a better-than-estimate adjusted EPS print. The operations segment generated USD 50.09 billion in revenue, while net investment income contributed USD 0.63 billion; realized investment income was slightly negative at USD -0.00 billion.
Current Quarter Outlook
Operations (Premiums, Services, and Membership Economics)
The core operations segment is expected to anchor fourth-quarter results, with revenue projected near USD 49.82 billion and year-over-year growth of 11.04%. Pricing discipline and risk score normalization are likely to sustain premium yields while supporting the medical loss ratio within targeted ranges. Membership stability across commercial and government programs should help protect the run-rate revenue base, even as seasonality in utilizations may lean higher late in the year. With the prior quarter’s gross margin at 24.79%, investors will watch whether gross margin holds close to the mid-20.00% range, given the forecast headwinds to EBIT and EPS. Management focus on benefits design, pharmacy trend management, and negotiated provider rates can mitigate utilization drift. The quarter-on-quarter net income trend showed a decline of 31.78% last quarter, which frames expectations for conservative margin assumptions into year-end, especially with mix shifts in government programs.
Care Management and Services Solutions (Largest Growth Potential)
Elevance Health’s services capabilities—spanning care management, integrated pharmacy, analytics, and provider enablement—remain a structural growth vector. The interplay of value-based arrangements and longitudinal care programs can elevate per-member value while limiting costly acute episodes. Last quarter’s operations revenue of USD 50.09 billion and 12.00% year-over-year growth signaled the scale Elevance Health can leverage to expand services penetration within its insured base. The current quarter’s revenue forecast implies continued double-digit growth tailwinds, with room for margin accretion over time as utilization management, site-of-care optimization, and specialty pharmacy programs interact to lower unit costs. Investors will look for updates on services attachment rates and any incremental contribution from technology-enabled care pathways, which collectively influence adjusted EPS resilience even as headline medical trends oscillate.
Key Stock Price Drivers This Quarter
Share performance into the print will be most sensitive to medical cost trends, particularly the medical loss ratio trajectory relative to internal targets. Any deviation from expected utilization—especially in outpatient surgeries, behavioral health, and specialty drugs—can sway margins and EBIT versus the forecast USD 1.12 billion. Pharmacy benefit dynamics, including rebates and specialty pipeline mix, also affect gross margin sustainability after the 24.79% level seen last quarter. Membership mix shifts between commercial and government lines can influence premium yields and risk adjustment dynamics; updates on retention rates and open enrollment outcomes will help the market assess run-rate revenue durability. Finally, realized investment income, slightly negative last quarter, may be a modest swing factor to net margin given the reported net profit margin of 2.34%, though operational performance will remain the primary determinant of EPS around USD 3.10.
Analyst Opinions
The prevailing analyst stance is constructive heading into the fourth quarter, with a majority emphasizing stable revenue growth and manageable medical cost trends relative to 2025 baselines. Several high-profile institutions highlight a favorable setup for revenue growth near USD 49.82 billion and adjusted EPS consistency around USD 3.10, acknowledging year-over-year compression due to lapping elevated prior-year factors. Consensus commentary points to resilient membership, firm pricing, and disciplined care management programs supporting earnings quality, while cautioning that utilization volatility could cap EBIT upside relative to the USD 1.12 billion forecast. The bullish view argues Elevance Health’s scale advantages and data-driven programs should underpin revenue growth of 11.04% and steady margin execution, sustaining investor confidence through the Pre-Market release on January 28, 2026.Disclaimer: Investing carries risk. This is not financial advice. The above content should not be regarded as an offer, recommendation, or solicitation on acquiring or disposing of any financial products, any associated discussions, comments, or posts by author or other users should not be considered as such either. It is solely for general information purpose only, which does not consider your own investment objectives, financial situations or needs. TTM assumes no responsibility or warranty for the accuracy and completeness of the information, investors should do their own research and may seek professional advice before investing.
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