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    CVS
    Earnings call· Dec 2025(Q4 FY25)

    CVS HEALTH Q4 FY25 earnings call CVS

    Feb 10, 2026 Source

    Executive summary

    CVS Health Q4 FY25 — Strong Financial Performance and Strategic Momentum Despite MA Rate Headwinds

    CVS Health reported strong Q4 FY25 results, exceeding full-year expectations for adjusted EPS and operating cash flow, driven by significant improvements in Aetna and a turnaround in the Pharmacy & Consumer Wellness segment. The company reaffirmed its FY26 adjusted EPS and revenue guidance, demonstrating confidence in its strategic initiatives and enterprise connectivity, even as it navigates elevated medical cost trends and advocates for more appropriate Medicare Advantage rates.

    Highlights

    5
    • Full year 2025 adjusted EPS of $6.75, exceeding initial expectations by approximately 15%.

    • Full year 2025 operating cash flow of $10.6 billion, meaningfully outperforming expectations.

    • Aetna business dramatically improved financial results, delivering over $2.6 billion year-over-year adjusted operating income improvement.

    • CVS Pharmacy exceeded expectations in 2025, establishing a new trajectory of at least flat earnings annually starting 2026.

    • Successfully completed the transition to cost-based reimbursement across all pharmacy lines of business.

    Concerns

    3
    • The proposed 2027 Medicare Advantage advanced rate notice does not match the level of medical cost trend in the industry.

    • Adjusted operating income in the Health Care Benefits segment declined due to changes in Medicare Part D program seasonality and deterioration of risk adjustment position in Individual Exchange.

    • Medical cost trends remained elevated across all products in Q4 FY25 and are not expected to change in 2026.

    Guidance & targets

    7
    CategoryTargetConfidence
    Full year 2026 adjusted EPS
    $7 to $7.20
    high materiality
    High
    Full year 2026 revenue
    at least $400 billion
    high materiality
    High
    Full year 2026 operating cash flow
    at least $9 billion
    medium materiality
    Medium
    Pharmacy & Consumer Wellness annual earnings outlook
    at least flat
    medium materiality
    High
    Medicare Advantage target margins
    unchanged commitment
    high materiality
    High
    Cumulative cash flow expectation
    increased by over $1.5 billion
    medium materiality
    High
    Medicare Benefit Ratio (MBR) increase
    approximately 850 basis points
    medium materiality
    High

    Segment performance

    3
    SegmentRevenueYoYQoQMargin
    Health Care Benefits
    Revenue increase primarily driven by Government business due to IRA impact on Medicare Part D. Year-over-year member decrease driven by declines in Individual Exchange and Government, partially offset by commercial fee-based growth. Operating loss driven by Medicare Part D seasonality, risk adjustment deterioration in Individual Exchange, and increased flu activity. MBR consistent with prior year, impacted by Medicaid pass-throughs, risk adjustment, and flu.
    Medical members: 26.6 millionMedical members YoY change: decrease of approximately 500,000Medical Benefit Ratio (Q4): 94.8%Medical Benefit Ratio (FY25): 91.2%Days claims payable: 38.9 days
    $36 billionover 10%adjusted operating loss of $676 million
    Health Services
    Revenue increase primarily driven by pharmacy drug mix and brand inflation, partially offset by pharmacy client price improvements. Operating income increase driven by improved purchasing economics, partially offset by client price improvements. Health Care Delivery growth driven by patient growth at Oak Street Health.
    Adjusted operating income YoY increase: over 9%Health Care Delivery total revenues growth (ex-CVS Accountable Care): approximately 21%
    over $51 billion9%adjusted operating income of approximately $1.9 billion
    Pharmacy & Consumer Wellness
    Revenue increase driven by pharmacy drug mix and increased prescription volume, including Rite Aid transaction. Partially offset by reimbursement pressure and generic drug introductions. Operating income increase driven by prescription volume and favorable drug mix, partially offset by reimbursement pressure and investments. Retail pharmacy script share growth supported by customer experiences and Rite Aid contribution.
    Adjusted operating income YoY increase: nearly 9%Full year adjusted operating income: over $6 billionFull year adjusted operating income YoY increase: over 4.5%Same-store total revenues increase: 16%Same-store pharmacy sales growth: over 19%Same-store prescription volumes increase: nearly 10%Same-store front store sales increase: 50 basis pointsRetail pharmacy script share: over 29%
    nearly $38 billionover 12%adjusted operating income of over $1.9 billion

    Operational metrics

    20
    Adjusted EPS
    $6.75exceeding initial expectations by approximately 15%
    FY25

    Full year adjusted earnings per share.

    Adjusted operating income
    $2.6 billionmodest declines from the prior year quarter
    Q4 FY25

    Consolidated adjusted operating income for the quarter.

    Adjusted EPS
    $1.09
    Q4 FY25

    Consolidated adjusted earnings per share for the quarter.

    Revenue
    over $105 billionincrease of over 8% over the prior year quarter
    Q4 FY25

    Consolidated revenue for the quarter.

    Total revenue
    over $400 billion
    FY25

    Full year consolidated revenue.

    Aetna adjusted operating income improvement
    over $2.6 billionyear-over-year
    FY25

    Improvement in Aetna's financial results.

    Branded drug price increases
    more than 750
    so far in 2026

    Number of branded drug price increases made by manufacturers.

    HUMIRA biosimilar adoption
    96%
    current

    Adoption rate of a low list price biosimilar.

    HUMIRA biosimilar members paying $0 out of pocket
    more than 80%
    current

    Percentage of members paying $0 out of pocket for the biosimilar.

    HUMIRA biosimilar savings
    more than $1.5 billion
    current

    Savings created for clients and members through the biosimilar strategy.

    Aetna network negotiations savings
    over $235 billion
    annual

    Annual savings generated for members and clients through Aetna's network negotiations.

    Caremark drug manufacturer negotiations savings
    $45 billionincremental
    annual

    Incremental annual savings delivered by Caremark's negotiations with drug manufacturers.

    Total annual savings generated for clients and members
    over $280 billion
    annual

    Combined annual savings from Aetna and Caremark.

    Prior authorization approval within 24 hours
    95%
    current

    Percentage of eligible prior authorizations approved within 24 hours by Aetna.

    Cash at parent and unrestricted subsidiaries
    approximately $2.8 billion
    end of Q4 FY25

    Cash balance at year-end.

    Dividends distributed
    over $3 billion
    FY25

    Total dividends paid to shareholders in 2025.

    New patients from Rite Aid acquisition
    9 million
    current

    Number of new patients welcomed into stores due to Rite Aid asset acquisition.

    New colleagues from Rite Aid acquisition
    over 3,500
    current

    Number of new colleagues welcomed from Rite Aid into CVS Health.

    Consumers engaged across CVS Health
    over 185 million
    annually

    Total number of consumers engaging with CVS Health annually.

    Community pharmacy destinations
    9,000
    current

    Number of community pharmacy destinations in local footprint.

    Industry KPIs

    9
    MetricValueDetails
    Utilization trendselevated
    Stars rate environmentleading Stars position
    Medical loss care ratio94.8%%
    Pharmacy scripts specialtynearly 10%%
    Membership covered lives by line26.6 millionmembers
    Prior year reserve development pdrutilization of premium deficiency reserves
    Adjusted EPS EBITDA leverage guidanceapproximately 4x
    Prior authorization operational metrics95%%
    Medical cost trend vs pricing assumptionelevated

    Deals & partnerships

    1
    Rite Aidacquisition

    CVS Health successfully acquired Rite Aid assets, welcoming 9 million new patients into stores and over 3,500 new colleagues.

    Risks & headwinds

    5
    Proposed 2027 Medicare Advantage advanced rate notice2027

    Rates do not match the level of medical cost trend in the industry.

    Mitigation: Actively advocating for more appropriate funding; commitment to MA margin recovery is unchanged; focus on improving margins while ensuring a sustainable and compelling product offering.

    Elevated medical cost trendsQ4 FY25 and 2026

    Medical cost trends remained elevated across all products in Q4 FY25 and are not expected to change in 2026.

    Mitigation: Disciplined pricing approach; strong rate advocacy; clinical and operational excellence; value-based care models.

    Deterioration of risk adjustment position in Individual Exchange businessQ4 FY25

    Contributed to an adjusted operating loss in the Health Care Benefits segment.

    Mitigation: Not explicitly stated, but overall focus on strengthening the business with a better geographic and product mix.

    Changes in seasonality of the Medicare Part D program due to Inflation Reduction ActQ4 FY25

    Primary driver for the expected decline in adjusted operating income in the Health Care Benefits segment.

    Mitigation: Company is adapting to regulatory changes and has time for implementation.

    Pharmacy reimbursement pressure and impact of recent generic drug introductionsQ4 FY25

    Partially offset revenue growth in the Pharmacy & Consumer Wellness segment.

    Mitigation: Increased prescription volume; favorable drug mix; successful transition to cost-based reimbursement models.

    Q&A highlights

    7

    How do the preliminary 2027 MA rates affect the company's goal of returning to target margins by 2028 and the mid-teens earnings growth target?

    Management reaffirms commitment to MA margin recovery and long-term enterprise earnings guide, stating the preliminary 2027 MA rates are disappointing but do not impact their long-term targets. They are advocating for more appropriate funding, noting current rates don't match medical cost trends. Aetna's strong foundation, successful AEP, and leading Stars position are highlighted as drivers for continued progress.

    I think the most important question that you asked is how -- while its disappointment in terms of the -- what we've seen is the preliminary rate for '27, we're committed to the Aetna margins, and that commitment remains unchanged. And we do not see this impacting our long-term enterprise guide that we provided in December during the Investor Day.

    asked by Justin Lake · answered by J. Joyner

    2 min read6 chapters

    Detailed Narrative

    01

    Medicare Advantage Outlook and Advocacy

    CVS Health expressed disappointment with the proposed 2027 Medicare Advantage advanced rate notice, stating it does not adequately reflect current medical cost trends. The company is actively advocating for more appropriate funding to ensure the program's stability and access for seniors. Despite this, management reaffirmed its commitment to Aetna's target margins and the long-term enterprise earnings guide, highlighting Signify's critical role in providing in-home health evaluations and value-based care, which aligns with CMS's focus on diagnosis to encounters with medical professionals.

    02

    PBM Strategy and Regulatory Environment

    Caremark continues to position itself as a crucial check on rising branded drug prices, which have outpaced inflation by 4% annually since 2012. The company supports legislation promoting competition and transparency, particularly those enabling savings at the pharmacy counter. Management noted that recent regulatory changes impacting the commercial market are manageable and align with their TrueCost model, which was introduced in December 2023, anticipating these shifts and aiming to accelerate its adoption for greater transparency and affordability.

    03

    Retail Pharmacy Turnaround and Strategy

    The Pharmacy & Consumer Wellness segment delivered strong results in 2025, establishing a new trajectory of at least flat annual earnings starting in 2026. This performance was driven by investments in colleagues, technology, and consumer experience, including the successful integration of Rite Aid assets, which brought 9 million new patients. The company has also completed its transition to cost-based reimbursement models, which are performing in line with expectations, reinforcing its position as a leading national pharmacy focused on local community care.

    04

    Aetna's Performance and Strategic Initiatives

    Aetna achieved significant financial improvement in 2025, with over $2.6 billion in year-over-year adjusted operating income growth and a leading Stars position. The business is focused on enhancing member experience and reducing administrative burdens, notably having the fewest medical services subject to prior authorization among competitors. 95% of eligible prior authorizations are approved within 24 hours, with condition-specific bundled authorizations expediting care for musculoskeletal, oncology, and IVF patients.

    05

    Enterprise Connectivity and Savings Generation

    CVS Health leverages its combined enterprise capabilities to deliver better outcomes and lower costs. Examples include the HUMIRA biosimilar strategy, which achieved 96% adoption of a low list price biosimilar, resulting in over $1.5 billion in savings for clients and members. Overall, Aetna's network negotiations and Caremark's drug manufacturer negotiations collectively generated over $280 billion in annual savings for clients and members, counterbalancing inflationary pressures from hospitals and branded pharmaceutical manufacturers.

    06

    Technology and AI Investments

    The company is making strategic investments in technology and AI to reimagine the healthcare experience, placing the consumer at the center. These investments are driving efficiencies and enabling product innovation, such as the open engagement platform, which aims to leverage CVS Health's extensive consumer base (over 185 million annually) and local pharmacy footprint (9,000 locations) to improve healthcare engagement, quality, and lower overall costs. New product launches and partnerships are anticipated in coming quarters.

    AI-generated summary of the company’s earnings call. Not investment advice.