Operating margins have compressed to 5.3% in 2026Q1, reflecting an inability to scale administrative overhead against rising medical costs.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 | Dec'06 | Dec'05 | Dec'04 | Dec'03 | Dec'02 | Dec'01 |
|---|
| Revenue | 200.41B | 199.13B | 176.81B | 171.34B | 156.59B | 138.64B | 121.87B | 104.21B | 92.11B | 90.04B | 84.98B | 79.24B | 73.92B | 71.12B | 61.53B | 60.8B | 58.84B | 61.64B | 62.46B | 61.39B | 57.01B | 45.15B | 20.82B | 16.75B | 13.26B | 10.44B |
| Revenue Growth % | 9.44% | 12.62% | 3.19% | 9.42% | 12.95% | 13.76% | 16.94% | 13.15% | 2.29% | 5.96% | 7.24% | 7.19% | 3.94% | 15.58% | 1.2% | 3.34% | -4.55% | -1.3% | 1.73% | 7.69% | 26.26% | 116.91% | 24.26% | 26.38% | 26.91% | - |
| Medical Costs & Claims | 153.99B | 148.22B | 127.57B | 124.33B | 116.64B | 102.64B | 88.05B | 81.79B | 71.89B | 72.24B | 66.83B | 61.12B | 56.85B | 56.24B | 48.21B | 47.65B | 44.93B | 46.99B | 48.21B | 46.44B | 42.52B | 0 | 0 | 0 | 0 | 0 |
| Medical Cost Ratio % | 76.84% | 74.44% | 72.15% | 72.56% | 74.49% | 74.04% | 72.25% | 78.48% | 78.06% | 80.23% | 78.65% | 77.13% | 76.91% | 79.07% | 78.35% | 78.36% | 76.35% | 76.23% | 77.19% | 75.64% | 74.58% | 0% | 0% | 0% | 0% | 0% |
| Gross Profit | 46.43B | 50.9B | 49.24B | 47.01B | 39.95B | 35.99B | 33.82B | 22.43B | 20.21B | 17.8B | 18.14B | 18.12B | 17.07B | 14.89B | 13.32B | 13.16B | 13.91B | 14.65B | 14.25B | 14.96B | 14.49B | 0 | 0 | 16.75B | 13.26B | 10.44B |
| Gross Margin % | 23.16% | 25.56% | 27.85% | 27.44% | 25.51% | 25.96% | 27.75% | 21.52% | 21.94% | 19.77% | 21.35% | 22.87% | 23.09% | 20.93% | 21.65% | 21.64% | 23.65% | 23.77% | 22.81% | 24.36% | 25.42% | 0% | 0% | 100% | 100% | 100% |
| Gross Profit Growth % | - | 3.37% | 4.75% | 17.66% | 11% | 6.42% | 50.81% | 10.97% | 13.52% | -1.88% | 0.12% | 6.18% | 14.66% | 11.74% | 1.25% | -5.45% | -5.05% | 2.85% | -4.74% | 3.23% | - | - | -100% | 26.38% | 26.91% | - |
| Operating Expenses | 38.79B | 42.79B | 40.35B | 38.27B | 31.5B | 27.05B | 26.11B | 15.69B | 14.37B | 12.82B | 12.72B | 12.76B | 11.97B | 10.2B | 8.91B | 8.68B | 9.08B | 9.71B | 9.29B | 9B | 9.13B | 0 | 3.54B | 15.55B | 12.44B | 9.92B |
| OpEx / Revenue % | 19.36% | 21.49% | 22.82% | 22.33% | 20.12% | 19.51% | 21.43% | 15.06% | 15.61% | 14.24% | 14.97% | 16.11% | 16.19% | 14.34% | 14.49% | 14.27% | 15.43% | 15.75% | 14.87% | 14.66% | 16.01% | 0% | 17% | 92.84% | 93.89% | 94.98% |
| Depreciation & Amortization | 1.28B | 1.55B | 1.39B | 1.75B | 1.68B | 1.3B | 1.15B | 1.13B | 1.13B | 891M | 912M | 907.9M | 851M | 908.8M | 740.7M | 637.2M | 600.8M | 553.5M | 571.7M | 120.2M | 133M | 633.8M | 279.1M | 245M | 157M | 31.5M |
| Combined Ratio % | 96.19% | 95.93% | 94.97% | 94.9% | 94.6% | 93.55% | 93.67% | 93.54% | 93.66% | 94.46% | 93.62% | 93.24% | 93.1% | 93.41% | 92.84% | 92.63% | 91.79% | 91.98% | 92.06% | 90.3% | 90.59% | 0% | 17% | 92.84% | 93.89% | 94.98% |
| Operating Income | 7.63B | 8.11B | 8.89B | 8.74B | 8.45B | 8.95B | 7.71B | 6.73B | 5.84B | 4.99B | 5.42B | 5.36B | 5.1B | 4.69B | 4.41B | 4.48B | 4.83B | 4.94B | 4.96B | 5.95B | 5.36B | 4.13B | 1.79B | 1.2B | 810.5M | 524.6M |
| Operating Margin % | 3.81% | 4.07% | 5.03% | 5.1% | 5.4% | 6.45% | 6.33% | 6.46% | 6.34% | 5.54% | 6.38% | 6.76% | 6.9% | 6.59% | 7.16% | 7.37% | 8.21% | 8.02% | 7.94% | 9.7% | 9.41% | 9.15% | 8.62% | 7.16% | 6.11% | 5.02% |
| Operating Income Growth % | - | -8.73% | 1.64% | 3.48% | -5.53% | 16.02% | 14.53% | 15.35% | 17.09% | -8.01% | 1.14% | 5.08% | 8.79% | 6.33% | -1.64% | -7.28% | -2.21% | -0.36% | -16.69% | 11.03% | 29.8% | 130.31% | 49.62% | 47.93% | 54.5% | - |
| EBITDA | 8.92B | 9.66B | 10.28B | 10.49B | 10.13B | 10.25B | 8.87B | 7.87B | 6.97B | 5.88B | 6.33B | 6.27B | 5.95B | 5.6B | 5.15B | 5.12B | 5.43B | 5.5B | 5.53B | 6.07B | 5.5B | 4.77B | 2.07B | 1.44B | 967.5M | 556.1M |
| EBITDA Margin % | 4.45% | 4.85% | 5.81% | 6.12% | 6.47% | 7.39% | 7.27% | 7.55% | 7.57% | 6.53% | 7.45% | 7.91% | 8.05% | 7.87% | 8.37% | 8.42% | 9.24% | 8.92% | 8.86% | 9.89% | 9.64% | 10.55% | 9.96% | 8.62% | 7.3% | 5.32% |
| Interest Expense | 1.42B | 1.4B | 1.19B | 1.03B | 851M | 798M | 784M | 746M | 753M | 739M | 723M | 653M | 600.7M | 602.7M | 511.8M | 430.3M | 418.9M | 447.4M | 469.8M | 447.9M | 403.5M | 226.2M | 142.3M | 131.2M | 98.5M | 60.2M |
| Non-Operating Income | 0 | 0 | -201M | 0 | 0 | 223M | 689M | 2M | 16M | 282.4M | 140.7M | 74.1M | 130.1M | 244.2M | 37.8M | 93.3M | 60.5M | -2.91B | 1.35B | 259.7M | 56.2M | 14.8M | 208.4M | -151.3M | 712M | -60.2M |
| Pretax Income | 6.22B | 6.71B | 7.9B | 7.71B | 7.6B | 7.92B | 6.24B | 5.99B | 5.07B | 3.96B | 4.56B | 4.63B | 4.37B | 3.84B | 3.86B | 3.96B | 4.35B | 7.4B | 3.12B | 5.26B | 4.91B | 3.89B | 1.44B | 1.22B | 0 | 524.6M |
| Pretax Margin % | 3.1% | 3.37% | 4.47% | 4.5% | 4.85% | 5.72% | 5.12% | 5.74% | 5.5% | 4.4% | 5.36% | 5.84% | 5.91% | 5.4% | 6.27% | 6.51% | 7.4% | 12.01% | 5% | 8.56% | 8.62% | 8.62% | 6.93% | 7.28% | 0% | 5.02% |
| Income Tax | 980M | 1.05B | 1.93B | 1.72B | 1.71B | 1.83B | 1.67B | 1.18B | 1.32B | 121M | 2.09B | 2.07B | 1.81B | 1.21B | 1.21B | 1.31B | 1.47B | 2.66B | 631.7M | 1.91B | 1.82B | 1.43B | 483.2M | 440.1M | 255.2M | 183.4M |
| Effective Tax Rate % | 15.76% | 15.63% | 24.46% | 22.35% | 22.53% | 23.09% | 26.71% | 19.68% | 26.01% | 3.05% | 45.78% | 44.72% | 41.39% | 31.4% | 31.29% | 33.13% | 33.69% | 35.89% | 20.23% | 36.37% | 37.02% | 36.67% | 33.48% | 36.1% | - | 34.96% |
| Net Income | 5.24B | 5.66B | 5.98B | 5.99B | 5.89B | 6.1B | 4.57B | 4.81B | 3.75B | 3.84B | 2.47B | 2.56B | 2.57B | 2.65B | 2.66B | 2.65B | 2.89B | 4.75B | 2.49B | 3.35B | 3.09B | 2.46B | 960.1M | 774.3M | 549.1M | 342.2M |
| Net Margin % | 2.62% | 2.84% | 3.38% | 3.49% | 3.76% | 4.4% | 3.75% | 4.61% | 4.07% | 4.27% | 2.91% | 3.23% | 3.48% | 3.73% | 4.32% | 4.35% | 4.91% | 7.7% | 3.99% | 5.45% | 5.43% | 5.46% | 4.61% | 4.62% | 4.14% | 3.28% |
| Net Income Growth % | -11.39% | -5.32% | -0.12% | 1.58% | -3.44% | 33.51% | -4.89% | 28.19% | -2.41% | 55.59% | -3.52% | -0.38% | -3.18% | -0.05% | 0.33% | -8.33% | -39.17% | 90.54% | -25.55% | 8.09% | 25.61% | 156.62% | 24% | 41.01% | 60.46% | - |
| EPS (Diluted) | 23.79 | 25.12 | 25.68 | 25.22 | 24.28 | 24.73 | 17.98 | 18.47 | 14.19 | 14.35 | 9.21 | 9.38 | 8.95 | 8.74 | 8.18 | 7.25 | 6.94 | 9.88 | 4.76 | 5.56 | 4.82 | 3.94 | 3.05 | 2.73 | 2.26 | 1.65 |
| EPS Growth % | -8.27% | -2.18% | 1.82% | 3.87% | -1.82% | 37.54% | -2.65% | 30.16% | -1.11% | 55.81% | -1.81% | 4.8% | 2.4% | 6.85% | 12.83% | 4.47% | -29.76% | 107.56% | -14.39% | 15.35% | 22.34% | 29.18% | 11.72% | 20.8% | 36.97% | - |
| EPS (Basic) | - | 25.18 | 25.81 | 25.38 | 24.56 | 25.25 | 18.23 | 18.81 | 14.53 | 14.70 | 9.39 | 9.73 | 9.31 | 8.89 | 8.26 | 7.80 | 7.64 | 9.96 | 4.79 | 5.64 | 4.93 | 4.03 | 3.15 | 2.80 | 2.31 | 1.66 |
| Diluted Shares Outstanding | 220.4M | 221.8M | 232.9M | 237.4M | 242.8M | 246.8M | 254.3M | 260.3M | 254.3M | 267.8M | 268.1M | 272.9M | 285.9M | 303.8M | 324.8M | 365.1M | 415.8M | 483.2M | 524.3M | 602M | 642.1M | 625.33M | 285.67M | 283.63M | 242.96M | 207.39M |
Medical loss ratio volatility
According to the latest quarterly filings, Elevance Health's revenue growth has decelerated to 2.6% in 2026Q1, a significant cooling from the double-digit expansion observed throughout 2025, suggesting that the company is struggling to maintain its previous momentum amidst a challenging regulatory and competitive landscape.
The sharp decline in year-over-year revenue growth indicates that the tailwinds from post-pandemic enrollment may be fully exhausted. Investors should monitor whether this deceleration reflects a permanent shift in market share or merely a temporary pause as the company navigates the ongoing Medicaid redetermination process.
As reported in recent financial statements, ELV's gross margin contracted to 18.1% in 2026Q1, down from the 27.8% peak seen in early 2025, which highlights the company's vulnerability to rising medical utilization and the inherent difficulty in adjusting premium pricing to match rapid cost inflation.
The compression in gross margins suggests that the company's ability to pass through medical cost increases is currently constrained by competitive pricing and regulatory caps. This trend warrants further investigation into whether the Carelon services arm can eventually provide the necessary margin buffer to offset these core insurance losses.
Based on the provided income statement data, ELV's operating margin has compressed to 5.3% in 2026Q1, reflecting a failure to scale operating income in proportion to revenue, which suggests that administrative overhead is becoming increasingly difficult to manage in the current high-utilization environment.
The inability to maintain operating leverage implies that the company's cost structure is becoming less efficient as it attempts to integrate new services. Investors should be cautious, as the lack of consistent operating margin expansion may indicate that the company is spending more to retain members than it is gaining in incremental value.
Data from the last ten quarters reveals significant EPS volatility, with a 16.8% decline in 2026Q1 following a 36.5% surge in 2025Q4, suggesting that the company's bottom-line performance is highly sensitive to non-operating items and reserve adjustments rather than purely sustainable operational growth.
Short-sellers may focus on this earnings instability as evidence that the company's core profitability is less predictable than management's rebranding strategy implies. The wide swings in quarterly net income appear to undermine the narrative of a stable, diversified health services provider, suggesting that the insurance risk remains the dominant, and volatile, driver of value.
Quick answers to the most common questions about buying ELV stock.
For fiscal year 2025, Elevance Health Inc. (ELV) reported total revenue of $199.13B. This represents a 1806.5% increase compared to $10.44B in 2001.
Elevance Health Inc. (ELV) is profitable, generating $5.66B in net income for the fiscal year ending 2025 with a net profit margin of 2.8%.
Elevance Health Inc. (ELV) reported an operating income of $8.11B, resulting in an operating profit margin of 4.1%. This margin reflects the operational efficiency of the business before interest and taxes.
Elevance Health Inc. (ELV) generated $50.90B in gross profit for the year, representing a gross profit margin of 25.6%. This demonstrates the company's core pricing power and production efficiency.