Share count
225Mpeak FY2016
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ELV, Elevance Health Inc.
Managed Care financial
Elevance Health sells health insurance. It collects premiums from employers, individuals, and government programs, then pays the medical, pharmacy, and behavioral-health bills of the people it covers and keeps the difference. It is among the largest Blue Cross Blue Shield licensees, operating Blue-branded plans across many states, and it also runs a health-services arm that manages pharmacy benefits and the delivery of care.
We are focused on enhancing well-being and advancing health outcomes by delivering integrated, whole health solutions across the care journey.
We support consumers throughout their full health journeys with medical, pharmacy, and behavioral health services designed to address their whole health needs.
The business
What it sells, where the money comes from, the kind of company it is.
Revenue · FY2025
$199.1B
+12.5% YoY · 10% 5-yr CAGR
Vital signs · TTM, with 5-yr average
Revenue $201.1B 5-yr avg $168.5B
Revenue $50.5B +1.4% vs yr-ago qtr
Operating margin 3.5% yr-ago 4.9%
Net income $1.5B yr-ago $1.7B
Net margin 2.9% yr-ago 3.5%
The business in brief
read the 10-K →What this business is and what moves its needle, from its own SEC filings.
- What moves the needle
- This is an underwriting business, and the test that governs it is whether the company can set premiums ahead of the cost of the care it must later pay for; get that wrong and a year's earnings can vanish, because the gap between premiums taken in and claims paid out is thin. Watch, too, for the cost position that scale and the Blue brand are meant to buy — whether size wins better terms from hospitals and drugmakers than a smaller rival can, and whether the pharmacy and services arm adds a spread of its own. Set against that, the company also sells into Medicaid and Medicare, where a government rather than a market sets the price, and the filing flags the antitrust litigation over the Blue Cross arrangement. The record below shows how wide the spread has been and how steady.
- Is it a good business?
- It pays out about 87% of premiums as medical care across the record (the medical loss ratio), keeping the rest to cover administration and profit against a regulated floor. That leaves a thin operating margin, a median of about 5.3%, the sign of a volume-and-cost-control business rather than a high-margin one, though turns that sliver over fast enough to earn roughly 14% on equity. Whether membership keeps growing and medical costs stay below premiums, especially as the Medicare Advantage and Medicaid mix shifts, is what the 10-K decides, not an earnings multiple.
Drafted from the company's filings and reviewed by hand; every number is shown in full in the sections below.
The record
Ten years of arithmetic, read across the cycle.
Revenue up 1.4% year over year; operating income down 27.3%
figures computed from the filing's XBRL
The record, 2016–2025
realized figures from each filing · older years to the left| 2016’16 | 2017’17 | 2018’18 | 2019’19 | 2020’20 | 2021’21 | 2022’22 | 2023’23 | 2024’24 | 2025’25 | TTMTTMJun 2026 | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Income statement | |||||||||||
| $84.9B | $90.0B | $92.1B | $104.2B | $121.9B | $138.6B | $156.6B | $171.3B | $177.0B | $199.1B | $201.1B | RevenueRevenue |
| $78.9B | $83.6B | $85.4B | $94.2B | $104.1B | $117.4B | $133.2B | $142.9B | $144.2B | $164.6B | $164.8B | Premiums earnedPremiums |
| 85% | 86% | 84% | 87% | 85% | 87% | 88% | 87% | 88% | 90% | 90% | Medical loss ratioMLR |
| 5.7% | 4.6% | 5.9% | 5.8% | 5.2% | 5.5% | 5.3% | 5.0% | 4.4% | 3.6% | 2.7% | Operating marginOp. mgn |
| $2.5B | $3.8B | $3.8B | $4.8B | $4.6B | $6.2B | $5.9B | $6.0B | $6.0B | $5.7B | $5.0B | Net incomeNet inc. |
| 46% | 3% | 26% | 20% | 27% | 23% | 23% | 22% | 24% | 16% | 16% | Effective tax rateTax rate |
| Cash flow & returns | |||||||||||
| 10% | 15% | 13% | 15% | 14% | 17% | 16% | 15% | 14% | 13% | 11% | Return on equityROE |
| 7% | 12% | 10% | 13% | 11% | 14% | 13% | 12% | 11% | 9% | 8% | Retained to equityRetained/eq |
| Balance sheet | |||||||||||
| $65.1B | $70.5B | $71.6B | $77.5B | $86.6B | $97.5B | $102.8B | $108.9B | $116.9B | $121.5B | $126.4B | Total assetsAssets |
| $25.1B | $26.5B | $28.5B | $31.7B | $33.2B | $36.1B | $36.2B | $39.3B | $41.3B | $43.9B | $44.9B | Shareholders’ equityEquity |
| Per share | |||||||||||
| 268M | 268M | 264M | 260M | 254M | 247M | 243M | 237M | 233M | 225M | 219M | Shares out (diluted)Shares |
| $316.53 | $336.22 | $348.62 | $400.36 | $479.23 | $561.75 | $644.95 | $721.74 | $760.03 | $886.58 | $917.91 | Revenue / shareRev/sh |
| $9.21 | $14.35 | $14.19 | $18.47 | $17.98 | $24.95 | $24.28 | $25.22 | $25.68 | $25.21 | $22.65 | EPS (diluted)EPS |
| $2.55 | $2.63 | $2.94 | $3.14 | $3.75 | $4.47 | $5.06 | $5.88 | $6.47 | $6.81 | $6.88 | Dividends / shareDiv/sh |
| $93.63 | $98.97 | $108.03 | $121.89 | $130.55 | $146.11 | $149.27 | $165.57 | $177.39 | $195.38 | $204.85 | Book value / shareBVPS |
Per-share growththe realized rate an owner's share compounded
| 9-yr | 5-yr | |
|---|---|---|
| Revenue / share | +12.1%/yr | +13.1%/yr |
| Owner earnings / share | +2.0%/yr | −18.0%/yr |
| EPS | +11.8%/yr | +7.0%/yr |
| Dividends / share | +11.5%/yr | +12.7%/yr |
| Capital spending / share | +9.6%/yr | +4.4%/yr |
| Book value / share | +8.5%/yr | +8.4%/yr |
The record, charted
FY2016–2025Each measure over its full record; the current point and the worst year marked.
Revenue
$199.1Blow FY2016
Quality & stewardship
Returns, the balance sheet, capital allocation, and pay.
Owner’s Scorecard
FY2025 10-K · source on SEC EDGAR →
Is it a good business?
- Medical loss ratio 90.0%Costs running highMedical costs $148.2B ÷ premiums earned $164.6BIndustry peers: median 85%
What this means
The number that runs a health plan: cents of every premium dollar paid back out as medical care. A regulated floor (about 80-85% under the ACA, or rebates are owed) means the plan keeps only a thin sliver, so the discipline is in pricing premiums ahead of medical cost trend. Read it across years, because a single bad cost trend, like the recent Medicare Advantage squeeze, shows up here first.
- Operating margin 3.6%Thin, as the model runsOperating income $7.2B ÷ revenue $199.1BIndustry peers: median 4%
What this means
Health plans earn a sliver on enormous revenue, so a few points of margin is the norm and the business is really a volume-and-cost-control game. Because the margin is so thin, a small miss on medical costs swings profit hard, which is why membership scale and cost management matter more than price.
- Return on equity 13%SolidNet income $5.7B ÷ equity $43.9BIndustry peers: median 13%
What this means
The thin margin turns over fast on a modest capital base, so a plan earning its keep still shows a good return on equity. Durably above the ~10% cost of equity is what compounds value; a year below it usually means medical costs outran premiums.
Does AI threaten the moat?
Low contestabilityThe moat is physical, regulated or balance-sheet-funded, the kind AI cuts costs within but does not contest.
In its own filing Raised, but not as a competitor
The filing raises AI among its risks, but in other terms (security, regulation, energy or the like), not as a competitor to its product.
AI is unlikely to contest a moat that is physical, regulated or balance-sheet-funded; here it reads more as a cost tool than a threat.
Read from the filing's own risk factors, paired with the industry's structure under its SIC code; the durability is read above, the price below.
All figures as filed; the source filing is linked above.
Current Position
as of the latest quarter, Jun 30, 2026Can the business pay what it owes this year, off the freshest balance sheet: the quality of the assets, the debt actually coming due, and what a low ratio means here.
Current assets$67.2B
- Cash & short-term investments$10.2B
- Other current assets$56.9B
Current liabilities$44.3B
- Debt due within a year$375M
- Accounts payable$6.6B
- Other current liabilities$37.2B
Current ratio1.52×all current assets ÷ what's due · Graham looked for 2×
Quick ratio1.52×stricter: inventory excluded
Cash ratio0.23×strictest: cash alone against what's due
Working capital$22.9Bthe cushion left after near-term bills
Debt due this year vs. cash$375M due · $10.2B cash
covered by cash on hand, no refinancing forced · both figures from the Jun 30, 2026 balance sheet
Revenue, latest quarter vs. a year ago+1.4%the freshest read on whether the business is still growing
Current ratio, recent quarters1.5× → 1.5×
Deeper floors
Tangible book value$5.6Bequity stripped of goodwill & intangibles
Net current asset value($14.2B)Graham's net-net: current assets less all liabilities
Debt incl. operating leases$31.7B$660M of it operating leases
From the company's latest filing.
Acquisitions & goodwill
from the balance sheet & the 10-year cash-flow recordGoodwill grows only when a company acquires and falls only when it concedes it overpaid. The size of that bet, the cash put into buying rather than building, and how much has already been written off.
Goodwill & intangibles$39.5B33% of all assets; the premium carried on the balance sheet for businesses acquired
Against book equity65%goodwill is this share of book equity; the rest is the company’s own retained and paid-in capital
Cash spent acquiring$16.4Bover 10 years buying other businesses, against $10.6B of capital spent building
None written down over the record; the goodwill is still carried at full cost. That is the deals holding their value on the books so far; whether they keep doing so is the test an owner watches, since the write-down, when it comes, is the admission the price was too high.
Goodwill, acquired intangibles and equity from the latest balance sheet; acquisition spend and write-downs summed across the 10-year record, from the company's own filings.
Management, ownership & pay
read the proxy →From the proxy: how much of the business the people running it own, and how they are paid, beside what the business earned for its owners in the same years.
| Fiscal year | Chief executive | Pay, as filed | “Actually paid” | Owner earnings |
|---|---|---|---|---|
| 2021 | Gail Boudreaux | $19.3M | $50.4M | $7.3B |
| 2022 | Gail Boudreaux | $20.9M | $35.3M | $7.2B |
| 2023 | Gail Boudreaux | $21.9M | $16.2M | $6.8B |
| 2024 | Gail Boudreaux | $20.5M | −$4.0M | $4.6B |
| 2025 | Gail Boudreaux | $22.6M | $18.8M | $3.2B |
Both pay figures are the company’s own, from the pay-versus-performance table its proxy statement files. “As filed” is the Summary Compensation Table total: salary, bonus, and equity awards at their value on the day of grant. “Actually paid” is the SEC’s prescribed recalculation, which re-marks those equity awards to what they became as they vested; it can swing far above or below the filed figure in either direction, and negative years occur. Owner earnings are the whole business's, from the record above, for the same fiscal years.
- Stock-based compensation$276M
The slice of the business handed to employees in shares this year, 0% of revenue, equal to 4% of operating profit. Buffett's oldest accounting fight: this is compensation, compensation is an expense, real whether or not the headline earnings admit it. One trap: the cash-flow statement adds SBC back, so the operating cash, and the owner earnings drawn from it, are flattered by exactly this amount; counted as the cost it is, what an owner keeps is lower.
What an owner would ask, FY2025
read the 10-K →- Which reported numbers are a judgment call?Management names Acquisitions, Insurance reserves as critical estimates
each rests partly on management's judgment; the filing's note sets out the assumptionsverify →
The questions the record and the charts do not answer on their own; each carries the figure and the place to look.
Peers, Managed Care
The same industry, side by side on the medical-loss-ratio lens. Each figure is a through-cycle median, so a peak or trough year can’t distort it; the group median at the foot is the line to read each against.
| Company | Revenue | Medical loss ratio | Op. margin | ROE |
|---|---|---|---|---|
| UNHUnitedhealth Group Incorporated | $447.6B | 84% | 8.1% | 22% |
| CIThe Cigna Group | $274.9B | 80% | 4.9% | 13% |
| ELVElevance Health Inc. | $199.1B | 87% | 5.3% | 14% |
| CNCCentene Corporation | $194.8B | — | 2.2% | 9% |
| HUMHumana Inc. | $129.7B | 89% | 3.9% | 17% |
| MOHMolina Healthcare | $45.4B | — | 3.9% | 26% |
| OSCROscar Health | $11.7B | 85% | -14.9% | -41% |
| ALHCAlignment Healthcare | $3.9B | — | -3.9% | -69% |
| Group median | — | 85% | 3.9% | 13% |
The price
What a price has to assume.
What the price implies
reverse-DCFType today's close and see the owner-earnings growth you'd have to believe to justify it, beside what Elevance Health Inc. has delivered.
$
Through the cycle, Elevance Health Inc. earns about $8.4B on its 4.2% median owner-earnings margin. This year’s 1.6% margin runs below that; the reported figure may understate a lean year. Normalize, below, values the price on that through-cycle figure rather than the latest year.
Base
—
The assumptions
9.0% = the 4.55% 10-year Treasury (Jul 15, 2026) + 4.45 points of equity premium. The rate you require is yours to set.
Enter a price above to run it.
A dated snapshot of the price you typed, the assumptions you set, and what the page showed for them. A snapshot is never edited after it is saved. Your notebook is yours alone — the commitment states what is stored and what we will never do.
Implied by the price—
Owner-earnings growth · ’21→’25−15%/yr
Owner-earnings growth · ’16→’25+3%/yr
Owner-earnings growth · ’16→’25+1%/yr
Owner-earnings yield—
What a growth belief costs, in multiples
The growth each return requires, at your price
P/E (3-yr earnings ’23–’25)—
P/B—
Graham’s price gate—
Graham capped the multiple at 15×; Buffett and Munger let that rule go: a wonderful business can deserve 50× if the thesis holds. The gate marks the bargain-hunter's floor.
Against a high-grade bond: Graham’s yardstick bond yield%
Prefilled with the 10-year Treasury (4.55%, as of Jul 15, 2026). Edit it for today’s exact figure, or a AAA corporate yield.
Graham measured a stock against the bond you could own instead, the heart of his margin of safety. Enter a price above to weigh the owner-earnings yield against this bond.
Owner-earnings yield—
High-grade bond yield—
Margin over the bond—
Owner earnings $6.3B on 217M shares outstanding, per the 10-Q cover, as of 2026-07-10; net debt $20.8B. The base is the latest year by default; Normalize values it on the through-cycle median owner-earnings margin (to avoid paying on a peak year). Net of stock comp treats option pay as the expense it is. The dials set the multiple a growth belief justifies; the price, and every dollar on this page, is yours.
Cite: Owner Scorecard, "Elevance Health Inc. (ELV), the owner's record," https://ownerscorecard.com/c/ELV, data as of 2026-07-09.
Manual order: ← ELS its page in the Manual EME →
Industry order: ← CNC the Managed Care chapter HUM →