Elevance health reports fourth quarter and full year 2022 results
Indianapolis--(business wire)--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. 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. 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 (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.” 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. 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 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. 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 % (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. 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.” 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.
