Elevance Health Reports Q4 and Full Year 2024 Results, 2025 Outlook
Elevance Health, Inc. (NYSE: ELV) reported strong results for the fourth quarter and full year of 2024, showcasing continued growth and operational improvements despite the challenges facing the healthcare industry.
“As part of our commitment to elevating whole health and advancing health beyond healthcare, we deliver value to the members and care providers we serve by ensuring simple, affordable, and accessible care,” said Gail K. Boudreaux, President and CEO of Elevance Health. “Our fourth-quarter results demonstrate tangible progress in improving our operations in response to the dynamic environment. Looking ahead to 2025, we remain focused on simplifying the healthcare experience, enhancing Carelon’s impact, and deploying innovative care models to achieve sustainable long-term growth.”
Consolidated Enterprise Highlights
Elevance Health reported operating revenue of $45.0 billion in Q4 2024, marking an increase of $2.5 billion or 6% compared to Q4 2023. For the full year, operating revenue totaled $175.2 billion, an increase of $5.0 billion, or 3%. These increases were driven by higher premium yields in the Health Benefits segment, acquisitions made in 2024, and growth in CarelonRx product revenue. However, membership attrition in the Medicaid business partially offset these gains.
The company’s benefit expense ratio for Q4 was 92.4%, a 320-basis point increase from the previous year, and 88.5% for the full year, up 150 basis points. The increases were primarily due to higher Medicaid medical cost trends. Days in Claims Payable stood at 42.9 days as of December 31, 2024, a slight increase of 0.1 days from the previous quarter, but a decrease of 4.4 days from the year before.
Operating expenses were 10.7% of revenue in Q4 and 11.4% for the full year. On an adjusted basis, operating expenses were 9.9% in Q4 and 10.6% for the full year, reflecting a disciplined approach to cost management and enhanced operational efficiency. The company improved its adjusted operating expense ratio by 170 basis points in Q4 and 70 basis points for the full year compared to 2023.
Cash Flow and Balance Sheet
Operating cash flow for 2024 was $5.8 billion, roughly 1.0 times GAAP net income. As of December 31, 2024, Elevance Health had $2.4 billion in cash and investments at the parent company.
In Q4 2024, the company repurchased 4.5 million shares of its common stock for $1.8 billion, at an average price of $401.29 per share. It also paid a quarterly dividend of $1.63 per share, totaling $373 million in cash distribution. By year-end 2024, the company had approximately $9.3 billion remaining in its Board-approved share repurchase authorization.
Segment Highlights
Health Benefits Segment
The Health Benefits segment, which includes Individual, Employer Group risk-based and fee-based, BlueCard®, Medicare, Medicaid, and Federal Employee Program businesses, generated operating revenue of $37.6 billion in Q4 2024, a 3% increase compared to the same period in 2023. Full-year revenue for the segment was $150.3 billion, up 1% from 2023.
The revenue increase was primarily driven by higher premium yields, partially offset by membership attrition in Medicaid. Operating gain for the Health Benefits segment was $0.2 billion in Q4 2024, and $6.2 billion for the full year. On an adjusted basis, operating gain was $0.3 billion for Q4 and $6.3 billion for the year. The adjusted operating gain in both periods was impacted by higher Medicaid cost trends related to redeterminations.
Medical membership stood at approximately 45.7 million as of December 31, 2024, reflecting a decline of 1.1 million, or 2%, year-over-year. The decrease was primarily driven by attrition in Medicaid membership, although growth was seen in Employer Group fee-based and Affordable Care Act health plans.
Carelon Segment
Carelon, which consists of CarelonRx and Carelon Services, reported operating revenue of $14.7 billion in Q4 2024, a 19% increase compared to the prior year. Full-year revenue for Carelon was $53.9 billion, up 12% from 2023. The growth was driven by the launch and expansion of risk-based capabilities in Carelon Services and acquisitions in 2024.
Carelon’s operating gain was $0.6 billion for Q4 2024, which was flat year-over-year. However, on an adjusted basis, operating gain was $0.8 billion, an increase of 32%. For the full year, Carelon’s operating gain was $2.9 billion, a 9% increase, and the adjusted operating gain was $3.1 billion, up 17%.
Quarterly Dividend
On January 22, 2025, the Audit Committee of Elevance Health’s Board of Directors declared a first-quarter 2025 dividend of $1.71 per share. The dividend is payable on March 25, 2025, to shareholders of record as of March 10, 2025.
About Elevance Health
Elevance Health is dedicated to improving the health of humanity by supporting consumers, families, and communities throughout their healthcare journey. The company connects members to the care, support, and resources they need to live better lives. Elevance Health serves approximately 112 million consumers through a broad portfolio of medical, pharmacy, behavioral, clinical, home health, and complex care solutions.
In conclusion, Elevance Health demonstrated solid financial results for 2024 and is well-positioned for sustainable growth in 2025, with a continued focus on simplifying healthcare and enhancing member care through innovation.
