Global health company The Cigna Group (NYSE: CI) today reported strong first quarter 2023 results reflecting growth and focused execution across our diversified portfolio of businesses.
“Our strong results in the first quarter demonstrate how our company continues to execute well, while also introducing innovative, market-leading solutions that improve clinical outcomes, affordability and transparency for the benefit of those we serve,” said David M. Cordani, chairman and chief executive officer.
Shareholders’ net income for first quarter 2023 was $1.3 billion, or $4.24 per share, and compares with $1.2 billion, or $3.73 per share, for first quarter 20223.
The Cigna Group’s adjusted income from operations1 for first quarter 2023 was $1.6 billion, or $5.41 per share, compared with $1.9 billion, or $6.06 per share, for first quarter 20223, primarily reflecting the absence of income from divested businesses4 as well as lower net investment income, as anticipated.
A reconciliation of shareholders’ net income to adjusted income from operations1 is provided on the following page and on Exhibit 1 of this earnings release.
CONSOLIDATED HIGHLIGHTS
The following table includes highlights of results and reconciliations of total revenues to adjusted revenues5 and shareholders’ net income to adjusted income from operations1:View News Release Full Screen
| Consolidated Financial Results (dollars in millions): | |||
| Three Months Ended | |||
| March 31, | December 31, | ||
| 2023 | 20223 | 20223 | |
| Total Revenues | $ 46,517 | $ 44,006 | $ 45,753 |
| Net Realized Investment Losses (Gains) from Equity Method Investments5 | (38) | 103 | (8) |
| Adjusted Revenues5 | $ 46,479 | $ 44,109 | $ 45,745 |
| Consolidated Earnings, net of taxes | |||
| Shareholders’ Net Income | $ 1,267 | $ 1,197 | $ 1,193 |
| Net Realized Investment Losses (Gains)1 | 6 | 358 | (17) |
| Amortization of Acquired Intangible Assets1 | 344 | 356 | 284 |
| Special Items1 | 1 | 37 | 73 |
| Adjusted Income from Operations1 | $ 1,618 | $ 1,948 | $ 1,533 |
| Shareholders’ Net Income, per share | $ 4.24 | $ 3.73 | $ 3.91 |
| Adjusted Income from Operations1, per share | $ 5.41 | $ 6.06 | $ 5.02 |
- Total revenues for first quarter 2023 increased 6% from first quarter 2022. Adjusted revenues5 for first quarter 2023 increased 5% from first quarter 2022, reflecting strong contributions from Evernorth Health Services and Cigna Healthcare, partially offset by the absence of revenues from divested businesses4.
- Shareholders’ Net Income for first quarter 2023 increased 6% from first quarter 2022 reflecting improved realized investment results, partially offset by lower adjusted income from operations1.
- Adjusted income from operations1 for first quarter 2023 decreased 17% from first quarter 2022, reflecting the absence of income from divested businesses4 and lower net investment income, as anticipated.
- The SG&A expense ratio6 on a GAAP basis was 7.6% for first quarter 2023 compared to 7.4% for first quarter 2022. The adjusted SG&A expense ratio6 was 7.6% for first quarter 2023 compared to 7.3% for first quarter 2022, reflecting increased expenses to support business growth and expand our capabilities, partially offset by the absence of divested businesses4.
- The debt-to-capitalization ratio was 42.2% at March 31, 2023, elevated from fourth quarter 2022, reflecting bond offerings in the first quarter of 2023, the proceeds of which will be used to repay debt securities, including bonds maturing later in 2023.
- Year to date through May 4, 2023, the Company repurchased 3.7 million shares of common stock for approximately $1.1 billion.
CUSTOMER RELATIONSHIPS
The following table summarizes The Cigna Group’s medical customers and overall customer relationships:
| Customer Relationships (in thousands): | |||
| As of the Periods Ended | |||
| March 31, | December 31, | ||
| 2023 | 2022 | 2022 | |
| Total Pharmacy Customers8 | 98,749 | 94,388 | 93,905 |
| U.S. Commercial | 16,026 | 14,621 | 14,852 |
| U.S. Government | 1,843 | 1,402 | 1,354 |
| International Health | 1,604 | 1,756 | 1,798 |
| Total Medical Customers8 | 19,473 | 17,779 | 18,004 |
| Behavioral Care | 26,890 | 44,078 | 44,841 |
| Dental | 18,731 | 18,169 | 18,397 |
| Medicare Part D | 2,541 | 2,904 | 2,874 |
| Total Customer Relationships8 | 166,384 | 177,318 | 178,021 |
- Total pharmacy customer base8 at first quarter 2023 increased by 5% from December 31, 2022 to 98.7 million due to new sales and the continued expansion of relationships.
- The total medical customer base8 at first quarter 2023 grew 8% to 19.5 million, an increase of 1.5 million customers from December 31, 2022, primarily driven by growth in fee-based customers as well as growth in Individual and Medicare Advantage customers.
- Customer relationships8 were impacted by the non-renewal of a supplemental behavioral coverage contract with New York Life that was not significant to total revenues or adjusted income from operations1. Excluding the impact of this contract8, behavioral care and total customer relationships8 at first quarter 2023 increased 9% and 5%, respectively from December 31, 2022.
HIGHLIGHTS OF SEGMENT RESULTS
See Exhibit 1 for a reconciliation of adjusted income (loss) from operations1 to shareholders’ net income.
Evernorth Health Services
This segment includes a broad range of coordinated and point solution health services and capabilities, as well as those from partners across the health care system, in Pharmacy Benefits, Home Delivery Pharmacy, Specialty Pharmacy, Distribution and Care Delivery and Management Solutions to health plans, employers, government organizations and health care providers. Express Scripts, the pharmacy benefits management business of Evernorth, is launching a new microsite at: ExpressScriptsFacts.com. The site has information about the Express Scripts model and additional disclosures.
| Financial Results (dollars in millions): | |||
| Three Months Ended | |||
| March 31, | December 31, | ||
| 2023 | 2022 | 2022 | |
| Adjusted Revenues5 | $ 36,179 | $ 33,586 | $ 36,188 |
| Adjusted Income from Operations, Pre-Tax1 | $ 1,320 | $ 1,302 | $ 1,725 |
| Adjusted Margin, Pre-Tax9 | 3.6 % | 3.9 % | 4.8 % |
- First quarter 2023 adjusted revenues5 increased 8% relative to first quarter 2022, reflecting strong organic growth in specialty pharmacy services as well as care delivery and management solutions.
- First quarter 2023 adjusted income from operations, pre-tax1, increased 1% relative to first quarter 2022 reflecting growth in specialty pharmacy, partially offset by increased strategic investments to support business growth and continued advancement of our capabilities.
Cigna Healthcare
This segment includes U.S. Commercial, U.S. Government and International Health businesses, which provide comprehensive medical benefits and coordinated solutions to clients and customers. U.S. Commercial products and services include medical, pharmacy, behavioral health, dental, and other products and services for insured and self-insured clients. U.S. Government solutions include Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors, and individual health insurance plans. International Health solutions include health care coverage in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.
| Financial Results (dollars in millions): | |||
| Three Months Ended | |||
| March 31, | December 31, | ||
| 2023 | 20223 | 20223 | |
| Adjusted Revenues5,10 | $ 12,718 | $ 11,393 | $ 11,132 |
| Adjusted Income from Operations, Pre-Tax1 | $ 1,115 | $ 1,297 | $ 517 |
| Adjusted Margin, Pre-Tax9 | 8.8 % | 11.4 % | 4.6 % |
- First quarter 2023 adjusted revenues5,10 grew 12% over first quarter 2022, reflecting customer growth in U.S. Government and U.S. Commercial, increased specialty contributions, including stop loss, and premium increases to cover underlying medical cost trends, partially offset by lower net investment income.
- First quarter 2023 adjusted income from operations, pre-tax1 decreased 14% relative to first quarter 2022, reflecting a higher adjusted expense ratio, including increased investments, and lower net investment income, partially offset by a lower medical care ratio.
- The Cigna Healthcare MCR6 of 81.3% for first quarter 2023 compares to 81.5% for first quarter 2022, reflecting effective pricing execution and favorable cost trends, inclusive of lower COVID-19 costs.
- Cigna Healthcare net medical costs payable11 was $4.74 billion at March 31, 2023, $4.29 billion at March 31, 2022, and $3.96 billion at December 31, 2022. Favorable prior year reserve development on a gross pre-tax basis was $144 million and $276 million for the first quarter 2023 and 2022, respectively.
Corporate and Other Operations
Corporate reflects interest expense, as well as amounts not allocated to operating segments and includes intersegment eliminations. Additionally, this discussion includes items reported in Other Operations which is comprised of Corporate Owned Life Insurance (“COLI”) and the Company’s run-off operations.
| Financial Results (dollars in millions): | |||
| Three Months Ended | |||
| March 31, | December 31, | ||
| 2023 | 20223 | 20223 | |
| Adjusted (Loss) from Operations, Pre-Tax1 | $ (399) | $ (114) | $ (375) |
- First quarter 2023 adjusted loss from operations, pre-tax1 of $399 million was greater than first quarter 2022 primarily due to the absence of income from divested businesses4.
2023 OUTLOOK2
The Cigna Group’s outlook2 for full year 2023 adjusted revenues2,5 increased to at least $188.0 billion. The Cigna Group’s outlook2 for full year 2023 consolidated adjusted income from operations1,2 increased to at least $7.36 billion, or at least $24.70 per share2. Additionally, this outlook includes the impact of expected future share repurchases and anticipated 2023 dividends.View News Release Full Screen
| (dollars in millions, except where noted and per share amounts) | ||
| 2023 Consolidated Metrics | Projection for Full Year EndingDecember 31, 2023 | Change from Prior Projection |
| Adjusted Revenues2,5 | at least $188,000 | +$1,000 |
| Adjusted Income from Operations1,2 | at least $7,360 | +$30 |
| Adjusted Income from Operations, per share1,2 | at least $24.70 | +$0.10 |
| Adjusted SG&A Expense Ratio2,6 | ~7.3% | |
| Adjusted Effective Tax Rate2,7 | 21.0% to 21.5% | |
| Cash Flow from Operations2 | at least $9,000 | |
| Weighted Average Shares Outstanding (millions)2 | 296 to 300 | |
| 2023 Evernorth Metrics | ||
| Adjusted Income from Operations, Pre-Tax1,2 | at least $6,400 | |
| 2023 Cigna Healthcare Metrics | ||
| Adjusted Income from Operations, Pre-Tax1,2 | at least $4,425 | +$25 |
| Medical Care Ratio2,6 | 81.5% to 82.3% | -10 bps at the midpoint |
| Total Medical Customer Growth (lives)2,8 | at least 1,300,000 | +100,000 |
The foregoing statements represent the Company’s current estimates of The Cigna Group’s 2023 consolidated and segment adjusted income from operations1,2 and other key metrics as of the date of this release. Actual results may differ materially depending on a number of factors. Investors are urged to read the Cautionary Note Regarding Forward-Looking Statements included in this release. Management does not assume any obligation to update these estimates.
This quarterly earnings release and the Quarterly Financial Supplement are available on The Cigna Group’s website in the Investor Relations section (https://investors.thecignagroup.com/overview/default.aspxThis link will open in a new tab.). Management will be hosting a conference call to review first quarter 2023 results and discuss full year 2023 outlook beginning today at 8:30 a.m. ET. A link to the conference call is available in the Investor Relations section of The Cigna Group’s website located at https://investors.thecignagroup.com/events-and-presentations/default.aspxThis link will open in a new tab..
The call-in numbers for the conference call are as follows:
Live Call
(888) 455-5036 (Domestic)
(773) 799-3981 (International)
Passcode: 5052023
Replay
(888) 282-0036 (Domestic)
(203) 369-3022 (International)
It is strongly suggested you dial in to the conference call by 8:15 a.m. ET.
About The Cigna Group
The Cigna Group (NYSE: CI) is a global health company committed to creating a better future built on the vitality of every individual and every community. We relentlessly challenge ourselves to partner and innovate solutions for better health. The Cigna Group includes products and services marketed under Evernorth Health Services, Cigna Healthcare, or its subsidiaries. The Cigna Group maintains sales capabilities in more than 30 countries and jurisdictions, and has more than 165 million customer relationships around the world.
