The corporations on our annual list of the world's 500 largest companies combined to generate $41.7 trillion in revenue over the past year.

Fortune Global 500

Almost $20 trillion in revenue—and a record-breaking $1.87 trillion in profits. Introducing the 2025 Fortune 500, the definitive list of the biggest companies in America.

Fortune 500

The top companies on our list have one thing in common: Staff largely trust leadership to see them as well-rounded people and reward them for a job well done.

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Employees say: "I find it unique that my company helps us when we're experiencing financial setbacks. It makes me feel like I don't have to go outside of the company for anything. I really appreciate the childcare reimbursement. The fact that the company gives us options for a food card, childcare, or transportation speaks volumes! Who does that? They all want us to succeed and be happy not only at work, but at home as well! I love it here and I plan to be here for a long time!"

Fortune 100 Best Companies to Work For

The 300 companies on this year’s list brought in over $12.6 trillion in revenue for the latest 12 months, with the median revenue figure at $22 billion.

America's Most Innovative Companies

Leaders in all industries rely more than ever on Big Tech—and appreciate the giants that deliver, at scale, without drama.

World's Most Admired Companies

The companies on this annual list make a conscious effort to be supportive, inclusive workplaces.

GPTW_Women_Large_2024-Elevance Health_US1__20240830224000_1

Employees say:"I feel this company pays fairly and has great benefits. I'm treated well and feel like I'm listen to and heard. I feel accomplished when allowed to manage our team, make changes, and drive success. We are allowed to mentor and develop others."

100 Best Large Workplaces for Women

See which workplaces made this year's list.

© Robert Deitchler / Gensler

Employees say:"I love the emphasis and support for work/life balance as well as mental health. The opportunity for growth both through education and career advancement makes this a wonderful environment to foster success. The management team has been the best that I have ever worked for. I feel that management truly cares about me as a person and appreciates my value and contributions to the team and its success."

Best Large Workplaces in Health Care

The corporations on our annual list posted aggregate revenues of $41 trillion for the second year in a row.

Fortune partners with global people analytics firm Great Place to Work to analyze survey feedback representing employees from companies across the U.S.

GPTW-Millennials-Large-2024-Elevance-Health

Employees say:"I love the emphasis and support for work-life balance as well as mental health. The opportunity for growth both through education and career advancement makes this a wonderful environment to foster success. The management team has been the best that I have ever worked for. I feel that management truly cares about me as a person and appreciates my value and contributions to the team and its success."

100 Best Large Workplaces for Millennials

Industries included in the sector are insurance and managed care, medical products and facilities, pharmacy services, and pharmaceutical companies.

Fortune Sector Leaders: Health Care

The Fortune 500, in its 70th year in 2024, ranks the biggest U.S. companies by revenue.

Creating a more empathetic workplace looks like staying loyal to workers, emphasizing D&I initiatives, and paying well.

100 Best Companies 2024-Elevance Health

Elevance, formerly Anthem, calls itself the <a href="https://www.healthcaredive.com/news/elevance-health-us-largest-insurer-unitedhealthcare/634501/">largest</a> commercial insurer in the U.S., and contains the core brands of Anthem Blue Cross and Blue Shield, Carelon, and Wellpoint.The company developed its employee assistance program into the concierge service Associate CARE Service, which provides customized care for employees and their households, including support for mental illness, family distress, grief counseling, and substance abuse, all as part of associates’ benefits and at no extra cost.&nbsp;In 2022, the Elevance Health Foundation invested more than $84 million in grants and sponsorships, and associates volunteered 135,199 hours and generated an additional $12.5 million in community support. The foundation made a three-year commitment to invest $90 million in partnerships and programs addressing racial inequity in maternal-child health, substance abuse disorders, and food as medicine.

The 200 companies on this list are transforming industries from the inside out.

The 26th edition of the list shows how much esteem Big Tech giants command among other business leaders.

The 25th Fortune World’s Most Admired Companies list suggests that tech giants’ peers respect them as much as ever.

Building a culture of trust and transparency is essential to help everyone thrive, especially in rocky economic times.

100-best-companies-2023-elevance-health

Elevance Health, which says it’s the <a href="https://www.healthcaredive.com/news/elevance-health-us-largest-insurer-unitedhealthcare/634501/">largest commercial insurer in the U.S.</a> as of 2022, is known for having a culture that recognizes that it’s people who make the company great. 
<ul> 
 	<li>Elevance Health underwent a <a href="https://providers.anthem.com/docs/gpp/IN_CAID_ElevanceIntro.pdf?v=202206241915">corporate rebrand</a> in June 2022, after being previously known as Anthem.</li> 
 	<li>In 2022 the company laid off 642 employees, roughly 0.8% of its workforce.</li> 
 	<li>Recognizing that different employees have different needs and preferences, Elevance Health devised a hybrid strategy that features four distinct “flex workstyles” that managers and direct reports can use based on their individual team needs.</li> 
 	<li>In partnership with the She-Suite Brand Leadership Institute, Elevance Health launched a new program to advance high-potential women more quickly within the company.</li> 
 	<li>Elevance encourages employees to celebrate each other through the IMPACT recognition program. Colleagues can give out the Go Above award and the Go Beyond award for stellar performance.</li> 
</ul> 
 
 
&nbsp;

The corporations on our annual list of the world’s largest companies delivered a record $41 trillion in aggregate revenues.

G500-2023-Elevance-Health

The 300 companies on this list are transforming industries from the inside out.

Fortune collaborated with the Diligent Institute to rank the most innovative boards of directors among S&P 500.

Modern Board 2023-Elevance Health

The health insurance provider’s board, including experts in the medical field and a who’s who of finance executives, also scores strongly in gender, racial, and age diversity. Its chair, Elizabeth Tallett, is a health care consultant and previously the CEO of pharmaceutical firm Transcell Technologies. Other board members include Elevance CEO Gail Boudreaux and Robert L. Dixon, former CIO of PepsiCo. Elevance’s stock is down 8% year to date, but the company plans to expand several care management programs and product offerings. Elevance hit a first-quarter profit of $2 billion, adding 1.3 million new members.

Fortune Modern Board 25

GPTW Health Care Large 2023-Elevance Health

Employees say: 
 
"Elevance Health has a significant focus on culture, and the company's approach to culture is one of the primary reasons I love working here. Additionally, the flexibility that the company provides with work-at-home options is very desirable and contributes to a good work-life balance. I find the company to be very competitive with pay, and the company does a great job for rewarding associates based on performance."

GPTW Women 2023-Elevance Health

Fortune partnered with Great Place to Work to analyze survey feedback representing nearly half a million U.S. employees.

GPTW Millennial Large 2023-Elevance Health

Employees say: 
 
"Management and executives are very understanding and empathetic—willing to accommodate life (things that come up like childcare, pickup, etc.) They promote good work- life balance, and that means the world to employees and engenders loyalty to the company."

The Fortune 500, in its 69th year in 2023, ranks the biggest U.S. companies by revenue.

Elevance Health continued its brisk recent pace of growth in 2022, boosted by acquisitions and by pandemic-related spending. Revenues rose 13% to $156.6 billion. 
<ul> 
 	<li>Elevance ended 2022 with 47.5 million members on its various health insurance plans. In the first quarter of 2023 it added another 1.3 million.</li> 
 	<li>The health insurance giant agreed to purchase Blue Cross and Blue Shield of Louisiana for a reported $2.5 billion in December 2022, adding roughly 1.9 million patients to its books.</li> 
 	<li>In June 2022 Elevance consolidated all of its health care services divisions, including prescriptions fulfillment, behavioral health, and at-home care, under the new Carelon brand.</li> 
</ul>

Just as it dominates our economy, Big Tech now dominates Fortune’s annual ranking of corporate reputation.

When it comes to supporting employees, flexibility, diversity, and a few extra paid days off go a long way.

100 Best 2022 Anthem,-Inc.

When the pandemic hit, insurance giant Anthem held listening sessions and developed fresh ways to support associates. The Associate CARE Community of Service was an online community—complete with 24/7 concierge service—that assisted employees in need of food, transportation, childcare, and more. (It has since been discontinued and replaced with other wellness benefits.) Anthem also realizes the value of self-care; during Mental Health Awareness Month in 2021, employees tallied 500,000 #MeMinutes—time spent doing things like meditating, listening to podcasts, or chatting with friends. Anthem’s interest in employee input doesn’t end with COVID-era programs. The company’s IdeaHub site allows staffers to share innovative ideas for the future. “The organization as a whole is transformational,” says one employee. “They are open to new ideas, and there is no discrimination based on who the idea comes from. This fosters a great work environment and allows everyone to be heard.”

Aggregate sales hit $37.8 trillion last year—an increase of 19%, the highest annual growth rate in the list’s history.

Elevance Health, formerly known as Anthem, experienced rapid growth during the public-health crisis created by COVID-19. In 2021, its profits increased by 33.5% compared with the prior year’s, and the company announced in early 2022 that it expects medical costs to remain at a high level in the near future owing to the pandemic. Meanwhile, the health insurer added about 30% more Medicare Advantage customers in 2021 than it did the previous year, enrolling 431,000 new members in the plans.

Employees say: 
 
“What makes this company a great place of work is that we all have a relationship as if we're one big family. Everyone is so kind, caring and helpful etc. My team members and managers are very responsive and always available help is needed. And for that, it makes everyone happy and the company flourish.”

GPTW Women 2022-Elevane Health

Employees say: 
 
“Having a CEO who is both a woman and an academic All-American athlete is highly inspirational, and her empathy and concern for our members and us, the Anthem associates, come across as very genuine. Gail also ensures her hiring practices for executive leadership are inclusive of women and people of color. On a separate note, Anthem worked hard to help us get through the pandemic, especially at the beginning stages, and supported both our physical and mental health. One thing that was especially helpful during that time, and that they have since continued, is our office fitness center vendor EXOS began leading video movement and stretch breaks: 15 minutes in the morning and 15 minutes in the afternoon, respectively.”

This year’s Fortune 500 marks the 68th running of the list.

F500 2022 Anthem

Health-insurance provider Elevance Health experienced rapid growth during the public-health crisis created by COVID-19. In 2021, its profits increased by 33.5% compared with the prior year’s, and the company announced in early 2022 that it expects medical costs to remain at a high level in the near future owing to COVID. Meanwhile, Elevance Health added about 30% more Medicare Advantage customers in 2021 than it did the previous year, enrolling 431,000 new members in the plans.

After a year in which humanity leaned more heavily than ever on tech giants, see which companies topped Fortune's ranking of corporate reputation.

Our 2021 list of the 100 best companies to work for, as ranked by their employees. See which companies made the list.

100 Best Companies 2021-72-Anthem,-Inc.

A new addition to Fortune’s Best Companies list, health care insurance provider Anthem is no stranger to medical care crises. As the pandemic reared its ugly head, the company moved aggressively to help its employees work through the global shutdown. It offered 80 hours of additional paid leave to those who were ill or had children, and also paid for the cost of COVID testing and treatment in full.

Total revenue for the world’s biggest companies fell 4.8% to $31.7 trillion this year—the first decline in half a decade.

G500-2021-050-Anthem

America’s largest for-profit health insurance federation continues to roll on unabated, and, as with other industry titans, vertical integration has been its key to success in a tumultuous year. Controlling the length of a supply chain provides a bit of security in uncertain times, and Anthem’s pharmacy benefits arm IngenioRx has helped it do just that. The company’s 2020 revenue was just shy of $121 billion, a 17% increase over the previous year, assisted by a massive surge in Anthem’s Medicare Advantage business. The unit encompassing IngenioRx helped fuel a 9.3% year-over-year spike in first-quarter 2021 sales and is one of the company’s main focus areas going forward.

These companies foster supportive cultures, where employees find opportunities for growth with help from their colleagues.

Best Large Workplaces New York 2021-Anthem

Employees say: 
 
“One of the greatest perks of the company is the ability to work at home. I have worked at home my entire time with Anthem and the new technology such as Webex and Teams has allowed for connecting on a more personal level.”

35 Best Large Workplaces in New York

The best workplaces in financial services and insurance acted as generous corporate citizens amid a year of multiple crises.

Best-Workplaces-Financial-Services-Large-2021-Anthem,-Inc

Employees say: 
 
“As a female, I feel that equal pay, benefits, and advancements are better than most. I love the flexibility and work-from-home capabilities. I also appreciate the consistent yearly raises and bonuses, and I've always felt very appreciated by that.”

Best Large Workplaces in Financial Services and Insurance

This year’s Fortune 500 marks the 67th running of the list.

F500-2021-23-Anthem

For an astounding 13th straight year, Apple claims the top spot in Fortune’s annual ranking of corporate reputation, based on a survey of almost 3,800 executives, directors, and analysts.

This year's Fortune Global 500 generated $33.3 trillion in revenues and $2.1 trillion in profits.

G500-2020-068-Anthem

Anthem is the largest for-profit health insurer in the sprawling Blue Cross Blue Shield federation—a compendium that includes 36 independent and locally operated companies. In 2019, the company seized on a growth opportunity by officially launching its new pharmacy benefits arm, IngenioRx. Anthem president and CEO Gail Boudreaux, who was appointed to the top perch in late 2017, has emphasized the importance of that move, citing it as the main driver for the firm’s nearly 13% increase in year-over-year operating revenue. However, as with most major health insurers, a special tax waiver for 2019 boosted Anthem’s numbers. The company has about 41 million insured members across more than two dozen states.

This year's Fortune 500 marks the 66th running of the list.

F500-2020-029-Anthem

Anthem is the largest for-profit health insurer in the sprawling Blue Cross Blue Shield federation—a compendium that includes 36 independent and locally-operated companies. In 2019, the company seized on a growth opportunity by officially launching its new pharmacy benefits arm, IngenioRx. Anthem president and CEO Gail Boudreaux, who was appointed to the top perch in late 2017, has emphasized the importance of that move, citing it as the main driver for the firm’s nearly 13% increase in year-over-year operating revenue. However, as with most major health insurers, a special tax waiver for 2019 boosted Anthem’s numbers. The company has about 41 million insured members across more than two dozen states.

Here are the World's Most Admired Companies for 2019 as ranked in their industries. See who made the list.

This year's Fortune Global 500 generated $27.7 trillion in revenues and $1.5 trillion in profits.

This year's Fortune 500 marks the 65th running of the list.

This year's Fortune 500 marks the 64th running of the list.

This year's Fortune 500 marks the 63rd running of the list.

Here are the World's Most Admired Companies for 2016 as ranked in their industries. See who made the list.

This year's Fortune Global 500 generated $27.6 trillion in revenues and $1.5 trillion in profits.

This year's Fortune 500 marks the 62nd running of the list.

Business insiders have spoken: Asked which companies they most admire, more than 4,100 executives, directors, and analysts chose these top 50 All-Stars.

The world's 500 largest companies generated $31.2 trillion in revenues and $1.7 trillion in profits in 2014. Together, this year's Fortune Global 500 employ 65 million people worldwide and are represented by 36 countries.

This year's Fortune 500 marks the 61st running of the list. Wal-Mart claims the top spot again. See who made the list.

Wal-Mart stayed on top as its sales crept closer to half-a-trillion dollars. Apple moved into the top five. And UnitedHealth Group continued its steady climb. 

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Elevance Health is a health benefits provider, offering health care coverage and specialty insurance, such as dental, vision, and life. It also operates a pharmacy service and prescription delivery business. Elevance Health was formerly known as Anthem, Inc., and does business under its Anthem Blue Cross and Blue Shield, Wellpoint, and Carelon brands. It was the seventh-largest U.S. health care company by revenue as of 2023.

Q2 2025

Q1 2025

Q4 2024

Elevance Health (ELV): Company Profile, Stock Price, News, Rankings

legacy

Elevance Health

elevance health

Ladies and gentlemen, thank you for standing by, and welcome to the Eleventh Health Fourth Quarter Earnings Conference Call. At this time, all participants are in a listen only mode. Later, we will conduct a question and answer session where participants are encouraged to present a single question. Questions. As a reminder, today's conference is being recorded.

I would now like to turn the conference over to the company's management. Please go ahead.

Good morning, and welcome to Elavance Health's Q4 2024 Earnings Call. My name is Nathan Rich, Vice President of Investor Relations. With us this morning on the earnings call are Gail Boudreaux, President and CEO Mark Kaye, our CFO Peter Haitayan, President of Carillon Morgan Kendrick, President of our Commercial Health Benefits Business and Felicia Norwood, President of our Government Health Benefits Business. Gail will begin the call with a review of the progress we've made against our strategic initiatives and a

the quarter and our 2025 outlook. Mark will then discuss our financial results and guidance in greater detail. After our prepared remarks, the team will be available for Q and A. During the call, we will reference certain non GAAP measures. Reconciliations of these non GAAP measures to the most directly comparable GAAP measures are available on our website, elevancehealth.com.

We will also be making some forward looking statements on this call. Listeners are cautioned that these statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond the control of Elavant's health. These risks and uncertainties can cause actual results to differ materially from our expectations. We advise listeners to carefully review the risk factors discussed in today's press release and in our quarterly filings with the SEC. I will now turn the call over to Gail.

Thank you, Nate, and good morning, everyone. Before we begin, I'd like to extend our deepest sympathies to the millions of people affected by the Southern California wildfires. With over 9,000,000 members and over 6,000 Elavance Health Associates in the State of California, we are especially grateful to the 1st responders who are working tirelessly to support the ongoing recovery efforts. At Elevance Health, our teams quickly mobilized to facilitate access to essential health resources and provide much needed aid to the communities impacted by this devastating event. This moment underscores our shared humanity, reminding us that above all, we are a community dedicated to supporting people's health and well-being.

Our purpose as a company of improving the health of humanity remains resolute and we will demonstrate steadfast leadership in healthcare marked by compassion, dedication and a profound commitment to improving the lives of the people we serve. For our members, we play a critical role in ensuring simple, affordable and accessible care. We recognize that the healthcare ecosystem is grappling with significant challenges, including rising costs, administrative complexity and disparities in access to care. These issues are compounded by evolving consumer expectations and the need for a more integrated approach to physical, behavioral and social health. In collaboration with our partners across the industry, we're addressing these challenges with great urgency, focusing on streamlining processes, reducing costs and improving the overall experience for our members.

We are reimagining how we connect with consumers to personalized experiences, tailor recommendations to meet their specific needs and simplify the healthcare journey. Targeted digital interactions through our Sydney app closed critical gaps in care and save members an estimated 1,500,000 hours in 2024 time they would have otherwise spent trying to find the care they needed. Health insurers play a vital role in keeping healthcare affordable by ensuring our members have access to high quality care at reasonable costs and designing benefit structures that encourage preventative care and early intervention. Through the value based partnerships we have with care providers, we reduce inefficiencies, drive better health outcomes and lower overall costs for members. In our Medicare Advantage portfolio for 2025, 90% of our plans have no monthly premium and nearly all plans offer $0 co pays for primary care visits and access to supplemental benefits.

These innovative plan designs demonstrate how we align affordability with improved member health. Our data demonstrates that dually eligible members who utilize supplemental benefits are 40% more likely to access preventative services and nearly 15% less likely to have an inpatient admission. Solutions like our Total Health, Total You advocacy program enable personalized outreach through digital channels and address whole person care before complex health needs arise. Employers recognize the value this program brings reflected in a net promoter score of 82. For our care providers, we create a real impact on health by going beyond the contract and we strive to be an active partner in the care of our members.

Our value based programs account for nearly 2 thirds of care today with over 35% taking downside risk compared to less than 20% just 3 years ago. Over the past year, we broadened our capabilities through the launch of Mosaic Health in partnership with CD and R. Mosaic Health serves nearly 1,000,000 consumers across 19 states and provides the foundation for us to expand our advanced primary care and physician enablement solutions to serve a growing number of people in the years to come. We have invested significant resources in partnering with hospitals and physicians to provide real time insights and tools that ease administrative burdens and allow care providers to devote more time to caring for patients. In cases where we have aligned data sharing with a health system, we have nearly eliminated claims denied due to incorrect or incomplete information significantly easing the administrative burden for these systems.

We are making good progress in expanding this solution to more partners. When health plans and care providers have access to the same information, we make the same decision. We are working in concert with our many vital partners across the healthcare ecosystem to promote solutions that enhance outcomes and empower healthier communities. With this unified voice, we can more effectively advocate for holistic solutions that address the physical, behavioral and social drivers of health. We are on a promising path and we'll work tirelessly in the coming years to achieve our bold purpose to improve the health of humanity.

Now turning to our results. Today, we reported 4th quarter GAAP diluted earnings per share of $1.81 and adjusted diluted earnings per share of $3.84 consistent with the expectations we shared back in October. These results reflect the immediate actions we took in response to unprecedented cost trends in our Medicaid business. Our Medicaid business serves as a cornerstone in advancing health outcomes for individuals managing chronic and complex conditions. Our complex care management programs provide the support of a dedicated care team and digital resources that have led to a reduction in inpatient admissions by 7%.

We are uniquely equipped to drive better health outcomes through complementary capabilities of our integrated health benefits and Carillon platforms. 4th quarter Medicaid cost trend remained elevated at levels aligned to the outlook we provided last quarter. We are grateful for the continuous and constructive collaboration of our state partners. While rates today remain insufficient to cover the elevated level of cost trend we are experiencing, we remain confident that rates will ultimately reflect the underlying acuity of our Medicaid membership over time. In Medicare, benefit reductions and market exits in 2024 create a strong foundation for profitable growth.

During annual open enrollment this year, seniors value the stability in our benefit offerings, evidenced by improved retention. We anticipate Medicare Advantage membership growth in the range of 7% to 9%, consistent with our prior expectations and inclusive of new wins in Group MA. We remain confident in our ability to balance growth and margin performance in 2025. We are pleased with the performance of our commercial businesses in 2024. Our integrated medical and pharmacy offering is resonating in the market.

We welcomed 18 new national accounts who chose Elevance Health for 2025, including several who selected us as the sole source provider to manage their medical and pharmacy benefits, continuing a trend we have seen in the last few years. We also saw record retention in our national accounts business for 2025, a testament to the differentiated value we provide the market's largest and most sophisticated clients who value simplicity and affordability. Our individual exchange business experienced strong growth of more than 30% in 2024. We delivered innovative affordable products that resonated with consumers and as we enter 2025, we anticipate another year of strong growth in this market. Turning to Carillon.

In 2024, we made progress against our strategy to further scale our enterprise flywheel for growth. In the Q4, we closed on the acquisition of CareBridge, which will bolster our home and community based services for chronic and complex members and serve as a foundation for Carillon's home health business. CareBridge's innovative approach aligns well with our enterprise focus on whole health, utilizing technology and comprehensive clinical support to improve care quality and efficiency while enhancing patient outcomes and independence. The expanding breadth and diversity of our pharmacy, advanced primary care and home and community based solutions will serve members and drive greater alignment with our health plans. Caroline Services experienced impressive internal and external growth in 2024 And we are positioned for revenue growth above our long term target range for this segment in the year ahead.

Shifting to our expectations for 2025. We are providing guidance for adjusted diluted earnings per share to be in the range of $34.15 to $34.85 We will navigate 2025 with the same focus and discipline that has been central to the long term success of Elavance Health. We will continue to manage cost trend for our clients, deepen the impact of our Carillon assets and execute on the growth opportunities ahead of us. The actions we are taking now will enhance the long term earnings power of our enterprise and underscore our confidence in returning to at least 12% adjusted EPS growth annually on average over time. Finally, I would like to express my deepest gratitude to our extraordinary team of over 100,000 associates and their unwavering efforts during this dynamic period for the industry.

Our associates went above and beyond last year, logging over 280,000 hours of volunteer time in our communities, setting a record for Elevance Health. This remarkable dedication underscores our collective commitment to improving the health of humanity by making a tangible positive impact on the people we are privileged to serve and the communities we call home. As we advance our mission, we remain focused on being our members' lifetime trusted health partner and ensuring our work elevates health beyond healthcare. I'll now hand over the call to our CFO, Mark Kay, who will provide more details on our financial results and guidance.

Thank you, Gail, and good morning, everyone. As Gail noted, we reported 4th quarter adjusted diluted earnings per share of $3.84 and full year adjusted diluted earnings per share of $33.04 with 4th quarter results consistent with our October expectations. Our disciplined operational execution helped us navigate an elevated cost environment, primarily within our Medicaid business. We concluded the year with 45,700,000 members, a decrease of 1,100,000 year over year, but roughly flat sequentially.

This annual decline was driven by membership reductions stemming from Medicaid redeterminations and changes in our geographic footprints, partially offset by continued growth in our employer group fee based offerings and our ACA health plan products. These areas of growth demonstrate our ability to deliver compelling value in competitive market segments. Turning to revenue. We generated $175,200,000,000 in total operating revenue for 2024, up approximately 3% from the prior year. This top line growth reflects premium rate adjustments in recognition of higher cost trends as well as expanding customer relationships within our Calon businesses, partially offset by lower Medicaid membership.

We also benefited from acquisitions that further our goals in pharmacy services and home health, enhancing our enterprise flywheel. A priority for the coming year will be integrating these assets to unlock greater value for the members we're privileged to serve, particularly as we drive ambitious growth in Kelon. Our consolidated benefit expense ratio for the Q4 was 92.4%, bringing our full year ratio to 88.5%, in line with our guidance. As noted previously, we continue to see elevated cost trends within the Medicaid population, which remains stable at the levels we experienced exiting the Q3. We are encouraged by the rate adjustments from our state partners, which are helping to better align premiums with current care costs.

As these adjustments become more fully reflected, we expect Medicaid margins to improve over the course of 2025. Elavance Health's adjusted operating expense ratio stood at 9.9% for the 4th quarter and 10.6% for the full year, an improvement of 170 basis points and 70 basis points respectively versus the prior year. This reflects our continued focus on disciplined expense management and operating efficiencies. For the year, operating cash flow was $5,800,000,000 or approximately 1x GAAP net income. Our year end days in claims payable was 42.9 days, essentially flat compared to the 3rd quarter and aligns with our long term target range in the low 40s.

In the 4th quarter, we opportunistically repurchased 4,500,000 shares for a total of $1,800,000,000 bringing full year repurchases to $2,900,000,000 and exceeding our initial full cost. We remain committed to returning capital to shareholders while also investing in our strategic initiatives. Looking ahead to 2025, we are introducing a range for our adjusted diluted earnings per share of $34.15 to $34.85 to provide greater specificity around our view of expected performance for the year. We project total medical membership of $45,800,000 to $46,600,000 by year end 2025, driven by expected growth in our commercial fee based membership, ACA exchange plans and Medicare Advantage. Following an annual enrollment period in line with our expectations, we anticipate ending 2025 with Medicare Advantage membership of $2,200,000 to $2,250,000 reflecting planned growth in group MA and high single digit expansion in individual MA.

Elevance Health (ELV) Q4 2024 Earnings Call Transcript

Company Participants