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Tuesday, April 22, 2025

Elevance Health execs seek to ease Wall Street's concerns about elevated MA costs

 Elevance Health executives sought to ease the minds of skittish investors on Wall Street Tuesday, saying that while medical costs in Medicare Advantage remain elevated—following with an ongoing trend in the industry—but in line with what they anticipated.

During the company's earnings call on Tuesday morning, Chief Financial Officer Mark Kaye said that while costs continue to be higher than in recent years, the elevated costs were "manageable" in the first quarter. He noted that in the early parts of Q1, Elevance saw a slight hike in utilization due to the flu and other respiratory illnesses, but that has evened out over the course of the quarter.

"Effectively, nothing has materially changed with respect to our prior commentary," Kaye said.

Kaye said that the company is looking to deploy disciplined cost management and "improved recognition of member acuity" as it adjusts to what seems to be a new normal in Medicare Advantage around utilization and medical cost. 

CEO Gail Boudreaux said the team built out a strategy around potential growth, geographic reach and the product portfolio that accounts for this environment.

Kaye added that the team is actively tracking and monitoring weekly claims data, prior authorization requests and provider-level interactions to identify potential utilization and cost spikes as they happen. 

"That's going to enable us to detect shifts and respond accordingly," he said. "But based on the most recent data review that we've conducted by our teams, we remain comfortable with the trend environment and the cost trajectory we've seen here to date."

Kaye said that the company's medical loss ratio in Medicare Part D was also in line with its expectations.

Elevance Health's earnings release follows shortly after industry behemoth UnitedHealth Group, which last week revealed a rough Q1 where it was battered by elevated medical costs, particularly in MA. UHG's earnings sent stocks tumbling across the insurance industry, as it generally serves as a bellwether for broader trends for payers.

Shares in Elevance were down pre-market on Tuesday but have climbed over the course of the day, and prices were up by about 2% at midday. 


Elevance Health brought in $2.2 billion in profit for the first quarter of 2025, a figure that surpassed Wall Street's expectations.

The company released preliminary results late last week after a rough Q1 for industry bellwether UnitedHealth Group sounded alarm bells for investors, reporting $11.97 in adjusted earnings per share. While its profit results did beat the Street, Elevance too noted ongoing elevated medical costs, posting an 86.4% medical loss ratio in the quarter.

By comparison, UnitedHealth reported an 84.8% MLR in its Q1 results last week.

Elevance said that its MLR was up 80 basis points compared to the prior-year quarter, and attributed that rise to cost trends in Medicaid, while it was Medicare Advantage that was the problem spot for UnitedHealth.

In the preliminary results released on Friday, Elevance Health did note that cost trends in MA remain elevated but that overall results for the quarter were in line with its expectations and pricing approach.

Profit was down slightly year over year, according to the full earnings report released Tuesday morning. For the first quarter of 2024, Elevance Health reported $2.25 billion in profit.

Revenues did increase compared to the prior-year quarter, however. For Q1 2025, Elevance Health brought in $48.9 billion in revenue, up from $42.6 billion in the first quarter of 2024. The company also surpassed investors' revenue forecasts, according to Zacks Investment Research

“At Elevance Health, our purpose—to improve the health of humanity—drives everything we do. In the first quarter, we made measurable progress reimagining the healthcare experience with personalized support, real-time digital solutions, and a whole-health model that improves outcomes and reduces cost," said CEO Gail Boudreaux in the press release. "Through Carelon and our broader enterprise, we’re delivering on our strategy to be a lifetime trusted health partner—and elevating health beyond healthcare.”

The insurer boasted 45.8 million members in Q1, growth of about 99,000 from the end of 2025. Elevance said that reflects growth in Medicare Advantage and its commercial risk-based clientele, though gains were partially offset by a "known customer transition" in the commercial fee-based segment.

Revenues at its health plan division were $41.4 billion in the first quarter, growing from $37.3 billion a year ago.

The company's Carelon unit also continues to grow, according to the earnings report. Revenues in Q1 were $16.7 billion, up from $12.1 billion in the prior-year quarter.

Elevance attributed the growth to recent acquisitions in the home health and pharmacy spaces, growth at the CarelonRx pharmacy benefit manager and the expansion of value-based care programs at Carelon Services.

Elevance Health expects between $34.15 and $34.85 in earnings per share for 2025, an estimate reaffirmed in its preliminary results filing on Friday.

https://www.fiercehealthcare.com/payers/elevance-health-beats-street-22b-q1-profit-elevated-cost-trends-pressure-industry

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