ELV · Health care(hospital & medical service plans) · 10 years of annual accounts filed with the SEC · latest fiscal year ended 2025-12-31
Elevance Health, Inc. reported revenue of $199.1 billion in fiscal 2025, after growing 9.9% a year over the previous 9 years. Its operating margin narrowed from 5.7% in 2016 to 3.6%, and it earned 8.0% on its invested capital in the latest year. Of the $63.0 billion its operations generated over 10 years, 32.5% went to buybacks and 26.0% to acquisitions; the share count fell 16.2%. On the accounting screens, it passes 6 of 9 Piotroski tests, its Altman Z'' of 3.13 is in the safe zone and its Beneish M-score is below the -1.78 line; 1 of the six cross-checks between its statements fires.
Revenue, fiscal 2025199.1B+9.9% a year over 9 years
Operating margin3.6%gross margin 89.4%
Return on invested capital8.0%9.4% on average over 5 years
Free cash flow after stock pay2.9B1.5% of revenue
Net debt ÷ EBITDA2.6×net debt 22.4B
Piotroski F-score6/9tests of improvement passed
Is it growing?
Revenue and the operating income it turns into. Growth that does not reach operating income is growth bought with margin.
RevenueOperating income
050.0B100.0B150.0B200.0B
2016Revenue 84.9BOperating income 4.8B
2017Revenue 90.0BOperating income 4.2B
2018Revenue 92.1BOperating income 5.4B
2019Revenue 104.2BOperating income 6.0B
2020Revenue 121.9BOperating income 6.4B
2021Revenue 138.6BOperating income 7.6B
2022Revenue 156.6BOperating income 8.3B
2023Revenue 171.3BOperating income 8.5B
2024Revenue 177.0BOperating income 7.9B
2025Revenue 199.1BOperating income 7.2B
2016201720182019202020212022202320242025
Compound growth a year
3 yrs
5 yrs
9 yrs
Revenue
+8.3%
+10.3%
+9.9%
Operating income
-4.6%
+2.5%
+4.6%
Net income
-1.3%
+4.4%
+9.7%
Earnings per share
+1.3%
+7.0%
+11.8%
Free cash flow per share
-22.1%
-18.0%
+3.9%
Dividend per share
+10.4%
+12.7%
+11.5%
Shares
-2.6%
-2.5%
-1.9%
Falling shares are buybacks: each remaining share owns more of the company.
Does it earn more than its capital costs?
Margins say how much of each sale is kept; return on invested capital says how much the business earns on the money it needs to operate. Growth only creates value when that return is above the cost of the capital.
Return on invested capitalCost of capital today · 7.7%
0.0%5.0%10.0%15.0%
2016Return on invested capital 6.4%
2017Return on invested capital 9.0%
2018Return on invested capital 8.6%
2019Return on invested capital 9.4%
2020Return on invested capital 8.8%
2021Return on invested capital 9.9%
2022Return on invested capital 10.7%
2023Return on invested capital 10.3%
2024Return on invested capital 8.2%
2025Return on invested capital 8.0%
2016201720182019202020212022202320242025
Economic profit
Economic profit
-1.0B01.0B2.0B
2016Economic profit -520.4M
2017Economic profit 554.6M
2018Economic profit 410.0M
2019Economic profit 864.9M
2020Economic profit 544.0M
2021Economic profit 1.3B
2022Economic profit 1.8B
2023Economic profit 1.6B
2024Economic profit 356.3M
2025Economic profit 212.4M
2016201720182019202020212022202320242025
(return on capital − cost of capital) × capital invested: the profit left after paying for the money used. Today's cost of capital is applied to every year, since a past one cannot be rebuilt honestly.
Return on equity
12.9%
Return on assets
4.7%
Asset turnover
1.64×
Overheads (SG&A)
10.5% of revenue
Is the profit cash, and where does the cash go?
Net income is an accounting opinion; free cash flow is what was left in the bank after investing. Stock-based pay does not leave the bank — shareholders pay it through dilution — so it is shown taken off as well.
Net incomeFree cash flowAfter stock-based pay
02.5B5.0B7.5B10.0B
2016Net income 2.5BFree cash flow 2.7BAfter stock-based pay 2.5B
2017Net income 3.8BFree cash flow 3.4BAfter stock-based pay 3.2B
2018Net income 3.8BFree cash flow 2.6BAfter stock-based pay 2.4B
2019Net income 4.8BFree cash flow 5.0BAfter stock-based pay 4.7B
2020Net income 4.6BFree cash flow 9.7BAfter stock-based pay 9.4B
2021Net income 6.2BFree cash flow 7.3BAfter stock-based pay 7.0B
2022Net income 5.9BFree cash flow 7.2BAfter stock-based pay 7.0B
2023Net income 6.0BFree cash flow 6.8BAfter stock-based pay 6.5B
2024Net income 6.0BFree cash flow 4.6BAfter stock-based pay 4.4B
2025Net income 5.7BFree cash flow 3.2BAfter stock-based pay 2.9B
2016201720182019202020212022202320242025
Where 10 years of operating cash went, 2016–2025
63.0B generated by the business. Each band is its share of that total.
Reinvested in the business 17%10.6B
Acquisitions 26%16.4B
Dividends 17%10.7B
Share buybacks 33%20.5B
Kept, or used to pay down debt 8%4.8B
Over the same years it paid 2.4B in stock. The share count fell 16.2%. 18.1B of the buybacks went beyond offsetting that dilution.
Per share
Earnings per shareFree cash flow per shareDividend per share
$0.00$10.00$20.00$30.00$40.00
2016Earnings per share $9.21Free cash flow per share $10.02Dividend per share $2.55
2017Earnings per share $14.35Free cash flow per share $12.67Dividend per share $2.63
2018Earnings per share $14.19Free cash flow per share $9.91Dividend per share $2.94
2019Earnings per share $18.47Free cash flow per share $19.15Dividend per share $3.14
2020Earnings per share $17.98Free cash flow per share $38.01Dividend per share $3.75
2021Earnings per share $24.95Free cash flow per share $29.49Dividend per share $4.47
2022Earnings per share $24.28Free cash flow per share $29.85Dividend per share $5.06
2023Earnings per share $25.22Free cash flow per share $28.50Dividend per share $5.88
2024Earnings per share $25.68Free cash flow per share $19.54Dividend per share $6.47
2025Earnings per share $25.21Free cash flow per share $14.13Dividend per share $6.81
2016201720182019202020212022202320242025
Shares outstanding
Diluted shares
220.0M240.0M260.0M280.0M
2016Diluted shares 268.1M
2017Diluted shares 267.8M
2018Diluted shares 264.2M
2019Diluted shares 260.3M
2020Diluted shares 254.3M
2021Diluted shares 246.8M
2022Diluted shares 242.8M
2023Diluted shares 237.4M
2024Diluted shares 232.9M
2025Diluted shares 224.6M
2016201720182019202020212022202320242025
How strong is the balance sheet?
Debt is not bad in itself; debt the business cannot service in a bad year is. Net debt is debt minus cash, and below zero the company holds more cash than it owes.
Net debt
010.0B20.0B30.0B
2016Net debt 11.2B
2017Net debt 15.0B
2018Net debt 14.1B
2019Net debt 14.4B
2020Net debt 14.3B
2021Net debt 17.9B
2022Net debt 16.5B
2023Net debt 18.4B
2024Net debt 22.6B
2025Net debt 22.4B
2016201720182019202020212022202320242025
Net debt ÷ EBITDA
2.6×
Interest coverage
5× operating income ÷ interest
Current ratio
1.54 current assets ÷ current liabilities
Cash conversion cycle
—
Three classic screens of the accounts
Each asks a different question of the same statements — is it improving, does it look like a company heading for distress, do the accounts resemble ones that were manipulated. None is a verdict; each shows what moves it.
Piotroski F-score
Is the business improving? Nine yes-or-no tests, this year against last.
6of 9 tests passed
✓ProfitableReturn on assets above zeropassed
✓Cash from operationsOperating cash flow above zeropassed
✕Profitability improvedReturn on assets higher than a year beforefailed
✕Profit backed by cashOperating cash flow above net income (low accruals)failed
✕Less long-term debtLong-term debt as a share of assets fellfailed
✓More liquidCurrent ratio higher than a year beforepassed
✓No new sharesShare count did not growpassed
✓Better gross marginGross margin higher than a year beforepassed
✓Sells more per assetAsset turnover higher than a year beforepassed
Where it misleads: it measures change, not level. An excellent business that stood still for a year scores low; a poor one recovering from a disaster scores high.
Altman Z''-score
Does the balance sheet look like those of companies that went bankrupt?
3.13safe zone
1.12.6
Working capital ÷ assets 0.18 × 6.56+1.19
Retained earnings ÷ assets 0.29 × 3.26+0.95
Operating income ÷ assets 0.06 × 6.72+0.40
Equity ÷ liabilities 0.57 × 1.05+0.59
Where it misleads: buybacks. A company that returns so much cash that its equity turns small or negative sinks the last two ratios without being anywhere near bankruptcy. Banks and insurers do not fit the model at all.
Beneish M-score
Do the accounts resemble those of companies that manipulated their earnings?
-2.32below the -1.78 line
-1.78
Receivables vs sales 1.00 (not reported, set to 1)+0.92
Gross margin slipping 0.99+0.52
Soft assets 0.97+0.39
Sales growth 1.12+1.00
Slower depreciation 0.93+0.11
Overheads vs sales 0.93-0.16
Profit not in cash 0.01+0.05
Leverage rising 0.99-0.32
Where it misleads: fast growth and acquisitions. Sales growth carries a heavy weight, so a company growing 50% a year scores like a suspect without having done anything. It is a screen from a 1999 study, not an accusation.
Where the statements disagree
Cross-checks between the income statement, the balance sheet and the cash flow for the latest year, each with the benign reading and the worrying one.
Reported profit comfortably exceeds the cash generated (5,662M against 4,290M).
Benign
Growth consuming working capital, or the seasonality of the year-end.
Worrying
Profit held up by accounting entries that do not turn into money.
What is it worth, under which assumptions?
A company is worth the cash it will generate, brought back to today. This model projects revenue with growth that fades over the years, applies a free cash flow margin, and discounts the result at the cost of capital. Every assumption says where it came from, and all of them can be changed.
Value per share, with these assumptions$739.28discounted at 7.7% a year · 63% of it from after year 10
Type a share price on the left to ask the reverse questions: what growth, what margin or what discount rate that price implies.
What the value implies, in the usual multiples
At this model's value
Price ÷ earnings
29.3×
Enterprise value ÷ EBITDA
21.5×
Enterprise value ÷ revenue
0.9×
Free cash flow yield
1.7%
From cash flows to a value per share
10 years of cash flow, today69.0B
Everything after, today119.4B
The whole business188.4B
Minus net debt-22.4B
What belongs to shareholders166.0B
Divided among 224.6M shares: <strong>$739.28</strong> each.
The projection next to its history
Reported free cash flow after stock pay, then the model's. A projection that looks nothing like the past needs a reason.
ReportedProjected
05.0B10.0B15.0B
2016Reported 2.5B
2017Reported 3.2B
2018Reported 2.4B
2019Reported 4.7B
2020Reported 9.4B
2021Reported 7.0B
2022Reported 7.0B
2023Reported 6.5B
2024Reported 4.4B
2025Reported 2.9B
2026Projected 7.6B
2027Projected 8.3B
2028Projected 9.0B
2029Projected 9.7B
2030Projected 10.4B
2031Projected 11.1B
2032Projected 11.6B
2033Projected 12.1B
2034Projected 12.5B
2035Projected 12.8B
2016201820202022202420262028203020322034
Year by year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
Revenue
220.0B
241.2B
262.2B
282.8B
302.4B
320.7B
337.3B
351.7B
363.6B
372.7B
Growth
10.5%
9.6%
8.7%
7.8%
6.9%
6.1%
5.2%
4.3%
3.4%
2.5%
Cash margin
3.4%
3.4%
3.4%
3.4%
3.4%
3.4%
3.4%
3.4%
3.4%
3.4%
Free cash flow
7.6B
8.3B
9.0B
9.7B
10.4B
11.1B
11.6B
12.1B
12.5B
12.8B
Worth today
7.0B
7.2B
7.2B
7.2B
7.2B
7.1B
6.9B
6.7B
6.4B
6.1B
If the least-known inputs move
Value per share as two inputs change at a time. Neighbouring cells that differ a lot are the conclusion: the value depends on numbers nobody knows to a point.
The discount rate and growth forever
discount ↓ · forever →
1.5%
2.0%
2.5%
3.0%
3.5%
6.7%
770
849
946
1,070
1,231
7.2%
691
755
832
928
1,049
7.7%
624
677
739
815
909
8.2%
568
612
664
726
800
8.7%
520
557
600
651
712
Year-one growth and the final margin
margin ↓ · growth →
6.5%
8.5%
10.5%
12.5%
14.5%
2.8%
494
545
600
660
724
3.1%
551
608
669
735
806
3.4%
610
672
739
812
889
3.8%
668
735
809
887
972
4.1%
727
800
879
965
1,057
All the inputs moving at once
5,000 valuations, each with growth, final margin, discount rate and growth forever drawn at random around the values on the left (spreads of 3.0%, 2.0%, 1.0% and 0.5%). Not a probability — the spreads are assumptions too — but an honest picture of how wide the answer is.
10th percentile$220.94
Median$737.83
90th percentile$1,443.49
$0.00$1,000.00$2,000.00
Half of the simulations land between <b>$452.00</b> and <b>$1,064.27</b>; one in ten below $220.94, one in ten above $1,443.49.
Does the long run make sense?
15.4×The terminal value prices the business in year 10 at 15.4 times that year's EBITDA.
Free growthIn year 10 free cash flow is at or above after-tax operating profit, yet the model grows 2.5% forever. Growth needs reinvestment; this assumes it comes for free, which flatters the terminal value.
63%of the value comes from after year 10. The more of it, the more the answer depends on the part nobody can see.
Accounts from the company's own SEC filings; lines some companies do not report are shown as a dash rather than estimated. The risk-free rate is the 10-year US Treasury yield. A DCF is a way of making assumptions explicit, not a forecast: it states what the company would be worth if the assumptions held. The scores are screens that point where to look, not verdicts. Nothing here is a recommendation to buy or sell.