EX-99.1 2 d418386dex991.htm EX-99.1 EX-99.1

Exhibit 99.1

 

PRESS RELEASE

 

LOGO

ELEVANCE HEALTH REPORTS FOURTH QUARTER

AND FULL YEAR 2022 RESULTS

 

   

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

Indianapolis, Ind. - January 25, 2023 - 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.

 

1


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.

 

2


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.

 

3


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 (formerly IngenioRx); 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.

2.

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.

 

4


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.

 

5


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 page 14 for 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 fourth 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)

   800-396-1242 (Domestic Replay)

312-470-0178 (International)

   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    Media
Stephen Tanal    Leslie Porras
Stephen.Tanal@elevancehealth.com    Leslie.Porras@elevancehealth.com

 

6


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.

 

7


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 )% 

 

8


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

 

9


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

 

10


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  
  

 

 

   

 

 

 

 

11


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  
  

 

 

   

 

 

 

 

12


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

 

(1) 

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

*

Excludes insurance lines other than short duration.

 

13


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
  

 

 

   

 

 

     

 

 

   

 

 

   

 

14


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.

 

15


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  

 

16


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.

 

17