Cash and cash equivalents (USD, millions)

Fixed maturity securities, current (USD, millions)

Equity securities, current (USD, millions)

Premium receivables (USD, millions)

Self-funded receivables (USD, millions)

Other receivables, current (USD, millions)

Other current assets (USD, millions)

Assets held for sale, current (USD, millions)

Total current assets (USD, millions)

Fixed maturity securities, long-term (USD, millions)

Other invested assets, long-term (USD, millions)

Property and equipment, net (USD, millions)

Goodwill (USD, millions)

Other intangible assets (USD, millions)

Other noncurrent assets (USD, millions)

Total assets (USD, millions)

Medical claims payable (USD, millions)

Short-term borrowings (USD, millions)

Current portion of long-term debt (USD, millions)

Other current liabilities (USD, millions)

Liabilities held for sale, current (USD, millions)

Total current liabilities (USD, millions)

Long-term debt, less current portion (USD, millions)

Other noncurrent liabilities (USD, millions)

Total liabilities (USD, millions)

Total shareholders’ equity (USD, millions)

Noncontrolling interests (USD, millions)

Total equity (USD, millions)

Total liabilities and equity (USD, millions)

a6d708cb04ef740bcc12771d2b298ed6bf5f94fbcfe2a81c7a8c7200cd365b2d

The documents do not provide a detailed explanation for the lower net income in Q4 2023. They indicate that net income was **$831 million**, which is a **5.2% decrease** vs. Q4 2022, and note that during this period, benefit expenses and operating expenses increased by **3.8%** and **9.5%**, respectively, even as total operating revenue increased by **7.0%**.  **[0001193125-24-013498_d736006dex991.htm:6]** **[0001193125-24-013498_d736006dex991.htm:0]** 

Why was Net income so low in Q4 2023?

The decline in Basic EPS in Q4 2023 was primarily driven by several factors. **Net losses on financial instruments** significantly worsened, with losses increasing to **$336 million** compared to **$111 million** in Q4 2022.  **[0001193125-24-013498_d736006dex991.htm:11]**  **Operating expenses** also rose by **9.5%** year-over-year due to accelerated investments in network quality, value-based care, and customer experience initiatives.  **[ELV_3370674_4]** **[0001193125-24-013498_d736006dex991.htm:1]**  Additionally, while the **benefit expense ratio** improved slightly by **50 basis points** to **89.2%**, the overall benefit expense still increased because of higher premium revenue.  **[0001193125-24-013498_d736006dex991.htm:1]**  Finally, despite a **12.1%** decrease in **amortization of intangible assets**, the expense of **$217 million** remained a significant cost factor impacting net income.  **[0001193125-24-013498_d736006dex991.htm:6]** 

What contributed to the decline in Basic EPS in Q4 2023?

The sharp drop in **Basic EPS** in Q3 2024 was primarily driven by a combination of several factors: **elevated medical costs** in the Medicaid business, which saw the benefit expense ratio spike to **89.5%** due to a timing mismatch between Medicaid rates and the higher acuity of members, and **membership attrition** resulting in the loss of about **85,000 Medicaid members**, both of which substantially pressured profitability.  **[0001156039-24-000119_a3q2024elvearningsrelease.htm:0]** **[ELV_3402953_4]** **[ELV_3402953_1]**  Additionally, the company experienced a **lower operating gain**—dropping from **$1.8 billion to $1.4 billion** (a **19.8% decline**)—and **increased total expenses** by **6.2%** year-over-year, further reducing net income and thereby impacting EPS.  **[0001156039-24-000119_a3q2024elvearningsrelease.htm:0]** **[0001156039-24-000119_a3q2024elvearningsrelease.htm:9]** **[0001156039-24-000119_a3q2024elvearningsrelease.htm:4]** **[0001156039-24-000122_elv-20240930.htm:4]** 

What led to the sharp drop in Basic EPS in Q3 2024?

The surge in **Income before income tax expense** in **Q1 2024** was driven by several factors. **Net investment income** increased by **20.2%**, significantly contributing to the gain. In addition, a **decrease of 0.8% in benefit expense** helped improve profitability, while **product revenue surged by 11.9%** and **service fees grew by 3.5%**, reflecting strong performance across segments. Additionally, **operating expenses** were tightly controlled with only a modest increase of **1.8%**, ensuring that costs did not offset the revenue gains.  **[0001193125-24-099824_d813732dex991.htm:6]** **[0001156039-24-000066_elv-20240331.htm:49]** 

Why did Income before tax surge in Q1 2024?

Based on the documents, **product revenue did not fall in Q1 2024**. In fact, it **increased from $4,022 million in Q1 2023 to $4,499 million in Q1 2024—an 11.9% growth**. This growth was primarily attributed to an increase in the **CarelonRx business** and the inclusion of a **full quarter of revenue from BioPlus**, which was acquired in February 2023.  **[0001193125-24-099824_d813732dex991.htm:6]** **[0001156039-24-000066_elv-20240331.htm:49]** **[0001193125-24-099824_d813732dex991.htm:1]** **[0001156039-24-000066_elv-20240331.htm:50]** 

Why did Product revenue fall in Q1 2024?

00f579c15d0644f4c333e077d8cf910401774b25a95e82279e46794b523d321e

The documents indicate that the decline in operating cash flow in Q4 2023 was primarily driven by the **timing of working capital changes**, the **non-recurrence of a one-time Subscriber Settlement Agreement payment** that had boosted previous cash flows, and impacts from **non-cash business optimization charges** that were recorded in Q3 2023.  **[0001156039-24-000015_elv-20231231.htm:115]**  However, note that while one document shows a negative figure of **(2,971)** million  **[0001156039-24-000015_elv-20231231.htm:131]**  for operating cash flow in Q4 2023, the detailed reasoning provided (which explains a change from **8,399** million in Q4 2022 to **8,061** million in Q4 2023) does not directly account for the negative value. This discrepancy suggests that additional factors or measurement differences might be affecting the reported negative operating cash flow in Q4 2023.

Why was Operating Cash Flow so negative in Q4 2023?

The dramatic drop in Q4 2023 was driven by several factors. **Operating activities** saw a decline in cash due to timing changes in working capital, even though higher net income partially offset this impact. Additionally, **investing activities** resulted in increased cash outflows through the purchases of subsidiaries and investments. Finally, **financing activities**, including repurchase and retirement of common stock, cash dividends, and purchases of property and equipment, significantly contributed to the drop in cash and cash equivalents.  **[0001156039-24-000015_elv-20231231.htm:115]** **[0001156039-24-000015_elv-20231231.htm:131]** 

What drove the dramatic drop in Change in cash and cash equivalents in Q4 2023?

The documents indicate that the positive figure in Q4 2023 reflects a **marked increase in investment activity**. While the exact reasons were not explicitly detailed, the documents suggest that the change could be attributed to factors such as **increased investment activity**, shifts in **market conditions**, and a **strategic reallocation** of the investment portfolio.  **[0001156039-24-000015_elv-20231231.htm:131]**  

Why did Purchases of investments flip to a positive value in Q4 2023?

The documents do not provide a specific reason for the massive negative swing in maturities from investments in Q4 2023. The commentary suggests that the decline could be linked to factors such as **changes in investment strategies**, **market conditions**, **timing differences in maturity schedules**, and the impact of **increasing interest rates** on the fair value of securities, but none of these factors are explicitly stated as the cause for the Q4 2023 swing.  **[0001156039-24-000015_elv-20231231.htm:131]** **[0001156039-24-000066_elv-20240331.htm:17]** 

What caused the massive negative swing in maturities from investments in Q4 2023?

af9feca0abb0eccf6ea94955a27af39ce16c6f880947d0fb49c8f30131d9b921

Net cash provided by operating activities [USD, millions]

Net cash used in investing activities [USD, millions]

Net cash (used in) provided by financing activities [USD, millions]

Change in cash and cash equivalents [USD, millions]

Cash and cash equivalents at beginning of period [USD, millions]

Cash and cash equivalents at end of period [USD, millions]

03d145fa883d982a7219abcd965a06cd254ca935ba072d41978272a90122d284

Total operating revenue (USD, millions)

Cost of products sold (USD, millions)

Operating expense (USD, millions)

Net income (USD, millions)

e43d837de05ace60151b8bc33bdf63fdd9918a768a50dfd2852087b92395eecd

Adjustments for Non-Cash Items

Stock-Based Compensation

Changes in Working Capital

Capital Expenditures (CapEx)

Proceeds from / Repayments of Debt

Share Repurchases

Dividend Payments

Net Change in Cash

a7c8b81dad36bbe8e1e28654414f10b0ae6bf92bc45f041f7712b52b10d06e64

Total Revenue [USD, Millions]

Cost of Goods Sold (COGS) [USD, Millions]

SG&A [USD, Millions]

R&D [USD, Millions]

D&A [USD, Millions]

Interest Expense [USD, Millions]

Operating Income (EBIT) [USD, Millions]

Net Income [USD, Millions]

EPS - Basic [USD]

EPS - Diluted [USD]

ca9f812074ded8e7d8a29feb886c8c8a8fbe408f9acc7921ee028bfc3bbf5854

52d606a1ee6db970ccadc3c7407738235bc985d6d0eac30934c26061c2c724e4

39530d18d49b7fb0869af4dfd8a95fe3b57fc891435012c4a7210e07a1fa6de9

c5f6535be4fc5e1bf82d5653b1b8ced483328312a9fab76fbdbe86a0bd0952bf

Elevance Health (ELV)

Financials