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Elevance Health Inc. (NYSE:ELV)

Cash Flow Statement
Quarterly Data

The cash flow statement provides information about a company cash receipts and cash payments during an accounting period, showing how these cash flows link the ending cash balance to the beginning balance shown on the company balance sheet.

The cash flow statement consists of three parts: cash flows provided by (used in) operating activities, cash flows provided by (used in) investing activities, and cash flows provided by (used in) financing activities.

Elevance Health Inc., consolidated cash flow statement (quarterly data)

US$ in millions

Microsoft Excel
3 months ended: Sep 30, 2026 Jun 30, 2026 Mar 31, 2026 Dec 31, 2025 Sep 30, 2025 Jun 30, 2025 Mar 31, 2025 Dec 31, 2024 Sep 30, 2024 Jun 30, 2024 Mar 31, 2024 Dec 31, 2023 Sep 30, 2023 Jun 30, 2023 Mar 31, 2023 Dec 31, 2022 Sep 30, 2022 Jun 30, 2022 Mar 31, 2022 Dec 31, 2021 Sep 30, 2021 Jun 30, 2021 Mar 31, 2021
Net income 1,343 1,454 1,760 546 1,187 1,744 2,184 413 1,008 2,301 2,249 831 1,300 1,856 2,004 961 1,613 1,650 1,795 1,125 1,502 1,801 1,667
Net (gains) losses on financial instruments 48 56 78 57 1 131 464 74 125 85 161 336 124 121 113 111 57 231 151 (211) 61 (172) 4
(Gain) loss on sale of business — — — — — — — — 39 (240) — — — — — — — — — — — — —
Equity in net (earnings) losses of other invested assets (541) (262) (305) (147) (113) (12) (126) (16) (11) (1) 27 (37) (3) 43 30 11 (46) (105) (153) (125) (128) (201) (108)
Depreciation and amortization 363 366 354 406 387 380 373 398 329 335 331 424 426 433 462 473 451 393 358 360 351 309 282
Deferred income taxes (143) 151 (274) (322) 269 (52) (174) (116) (224) (170) 136 (241) 32 (138) (255) 94 2 (80) (92) 212 122 (39) 31
Impairment of property and equipment 33 33 4 38 70 — — — 103 — — — 446 — — 7 — — — 73 — — —
Share-based compensation 80 75 55 30 84 81 81 (29) 66 92 62 72 78 78 61 73 69 72 50 59 63 69 64
Receivables, net (896) (657) (1,174) 756 815 (923) (3,174) (193) 851 (1,059) (282) (1,035) (428) (270) (29) (1,832) (16) 686 (1,348) (387) (119) (374) (1,258)
Other invested assets — — — 70 (35) (30) (5) (5) (26) (18) (29) (33) (4) (27) (15) (35) 14 25 7 (14) (12) (24) (20)
Other assets 179 111 (1,552) 460 201 43 (647) 1,758 (145) 315 (1,104) 261 (407) (181) (348) 594 (55) (66) (353) 507 (223) 41 (288)
Policy liabilities (858) (374) 1,590 1,101 (1,260) (213) 600 (28) (446) (1,397) 31 (186) (250) 277 306 717 23 439 1,075 269 416 457 1,455
Unearned income (3) (119) 266 (338) 270 (79) 132 (505) 312 8 72 (2,930) (126) 64 3,282 (2,590) 2,730 (239) 57 195 (128) (61) (119)
Accounts payable and other liabilities 1,240 1,238 2,886 (2,259) (151) 738 952 (1,200) 628 557 (257) (77) 1,557 142 18 226 (34) 204 428 (374) 533 202 358
Income taxes 427 (156) 644 (284) (616) 246 357 173 57 (407) 581 (360) (134) (448) 839 (297) 118 (727) 568 (28) 62 (332) 438
Other, net (5) (3) — (30) 26 — — (18) 11 46 — 4 2 — 1 (31) (2) (31) (2) 11 4 7 (1)
Changes in operating assets and liabilities 84 40 2,660 (524) (750) (218) (1,785) (18) 1,242 (1,955) (988) (4,356) 210 (443) 4,054 (3,248) 2,778 291 432 179 533 (84) 565
Adjustments to reconcile net income to net cash provided by operating activities (76) 459 2,572 (462) (52) 310 (1,167) 293 1,669 (1,854) (271) (3,802) 1,313 94 4,465 (2,479) 3,311 802 746 547 1,002 (118) 838
Net cash provided by operating activities 1,267 1,913 4,332 84 1,135 2,054 1,017 706 2,677 447 1,978 (2,971) 2,613 1,950 6,469 (1,518) 4,924 2,452 2,541 1,672 2,504 1,683 2,505
Purchases of investments (6,075) (3,132) (4,735) (2,761) (4,163) (4,138) (3,964) (3,280) (4,671) (3,932) (6,103) 8,101 (6,689) (10,205) (7,443) (5,334) (6,359) (8,203) (5,050) (3,539) (3,909) (4,243) (6,978)
Proceeds from sale of investments 4,196 2,976 3,094 2,666 2,975 3,533 4,150 4,936 4,027 2,686 4,898 2,766 2,491 2,850 2,489 2,586 2,262 4,093 3,047 1,930 1,994 1,695 4,650
Maturities, calls and redemptions from investments 389 432 552 576 447 324 424 544 445 501 535 (11,591) 3,875 7,123 3,533 3,014 3,259 3,138 1,209 956 1,142 1,248 998
Changes in securities lending collateral (231) 171 (313) 191 (110) (176) (290) 233 161 (109) (212) 23 (90) (59) 204 376 (57) (179) (441) 74 (388) 89 (731)
Purchases of subsidiaries, net of cash acquired (3) — 5 33 1 50 4 (3,685) — (4) (1,120) 18 81 (13) (1,638) (26) (14) (548) (61) (34) — (3,415) (27)
Proceeds from sale of subsidiaries, net of cash sold — — — — — — — (36) — 399 — — — — — — — — — — — — —
Purchases of property and equipment (267) (287) (235) (293) (360) (267) (196) (322) (332) (323) (279) (326) (319) (350) (301) (298) (305) (295) (254) (340) (258) (285) (204)
Other, net 4 (1) (10) 52 (14) (13) (25) (28) (31) (36) (29) (20) (36) (18) (28) (29) (33) (30) (28) (13) (21) (14) (15)
Net cash (used in) provided by investing activities (1,987) 159 (1,642) 464 (1,224) (687) 103 (1,638) (401) (818) (2,310) (1,029) (687) (672) (3,184) 289 (1,247) (2,024) (1,578) (966) (1,440) (4,925) (2,307)
Net proceeds from (repayments of) commercial paper borrowings — — — — — — — — — — — — (90) (235) 325 (675) 125 25 225 200 (450) 550 (250)
Proceeds from long-term borrowings — — — (3) 2,994 — — 5,130 — 1,230 1,350 — — — 2,574 1,785 (14) 1,300 — — — — 3,462
Repayments of long-term borrowings — — (750) 3 (900) — (1,250) (850) (800) — — (1) — — (1,908) (917) (39) (929) (14) (114) (2) (952) —
Proceeds from short-term borrowings — 101 724 515 990 — — 65 210 — — 225 — — — — 90 1,275 — 1,150 — 175 —
Repayments of short-term borrowings — (825) (150) (545) (1,170) 110 (115) (60) (75) — — — (175) (90) — — — (1,375) — (1,050) — — —
Changes in securities lending payable 231 (171) 313 (190) 110 176 290 (233) (162) 108 212 (23) 91 60 (205) (383) 65 179 441 (74) 388 (89) 731
Changes in bank overdrafts 1,281 (29) (1,152) 1,235 (554) 85 546 (466) 307 107 (586) 637 (23) (209) (291) 752 (636) 288 529 (692) (48) 364 —
Repurchase and retirement of common stock (330) (234) (1,124) (471) (876) (378) (880) (1,811) (60) (463) (566) (928) (480) (646) (622) (568) (579) (624) (545) (522) (451) (480) (447)
Cash dividends (373) (373) (376) (377) (381) (385) (386) (373) (378) (378) (379) (346) (348) (350) (351) (305) (306) (309) (309) (273) (276) (278) (277)
Proceeds from issuance of common stock under employee stock plans 25 26 37 58 — (2) 23 16 48 60 97 40 31 38 43 30 36 40 76 42 20 52 89
Taxes paid through withholding of common stock under employee stock plans (1) (1) (34) (1) 9 83 (123) (3) (6) — (100) — — (1) (98) (2) (3) (2) (86) (1) (8) (2) (91)
Other, net 5 12 (3) 12 21 3 (14) (7) 1 4 4 2 — 3 2 25 6 5 5 19 (3) (160) 171
Net cash provided by (used in) financing activities 838 (1,494) (2,515) 236 243 (308) (1,909) 1,408 (915) 668 32 (394) (994) (1,430) (531) (258) (1,255) (127) 322 (1,315) (830) (820) 3,388
Effect of foreign exchange rates on cash and cash equivalents (2) (3) (9) (6) (1) 1 1 (8) 7 (5) — 1 (4) 1 1 2 (6) (6) (4) (1) (2) (6) (1)
Change in cash and cash equivalents 116 575 166 778 153 1,060 (788) 468 1,368 292 (300) (4,393) 928 (151) 2,755 (1,485) 2,416 295 1,281 (610) 232 (4,068) 3,585

Based on: 10-Q (reporting date: 2026-09-30), 10-Q (reporting date: 2026-06-30), 10-Q (reporting date: 2026-03-31), 10-K (reporting date: 2025-12-31), 10-Q (reporting date: 2025-09-30), 10-Q (reporting date: 2025-06-30), 10-Q (reporting date: 2025-03-31), 10-K (reporting date: 2024-12-31), 10-Q (reporting date: 2024-09-30), 10-Q (reporting date: 2024-06-30), 10-Q (reporting date: 2024-03-31), 10-K (reporting date: 2023-12-31), 10-Q (reporting date: 2023-09-30), 10-Q (reporting date: 2023-06-30), 10-Q (reporting date: 2023-03-31), 10-K (reporting date: 2022-12-31), 10-Q (reporting date: 2022-09-30), 10-Q (reporting date: 2022-06-30), 10-Q (reporting date: 2022-03-31), 10-K (reporting date: 2021-12-31), 10-Q (reporting date: 2021-09-30), 10-Q (reporting date: 2021-06-30), 10-Q (reporting date: 2021-03-31).


Cash flow patterns demonstrate significant volatility, characterized by substantial swings in operating activities and a consistent commitment to shareholder returns and investment portfolio management. Operational cash generation is highly variable, often diverging from net income due to large adjustments in working capital and policy-related liabilities.

Operating Activities and Net Income
Net income exhibits a seasonal or periodic trend, typically peaking in the first quarter of each year, with notable highs in March 2023 ($2,004 million) and March 2024 ($2,249 million). However, net cash provided by operating activities shows much higher variance. Significant outflows were recorded in December 2022 (-$1,518 million) and December 2023 (-$2,971 million), while a peak occurred in March 2023 ($6,469 million). These fluctuations are primarily driven by changes in operating assets and liabilities, specifically policy liabilities and unearned income, which frequently create large non-cash adjustments to net income.
Investing Activities and Capital Allocation
Investing activities are dominated by the active management of an investment portfolio and strategic acquisitions. Purchases of investments consistently range between $2.7 billion and $10.2 billion per quarter, largely offset by proceeds from sales and maturities. Significant capital expenditures for subsidiaries are observed intermittently, with substantial outflows in June 2021 (-$3,415 million), March 2023 (-$1,638 million), and December 2024 (-$3,685 million), indicating a strategy of periodic inorganic growth. Capital expenditures for property and equipment remain relatively stable, generally fluctuating between $200 million and $360 million per quarter.
Financing Activities and Shareholder Returns
The financing strategy focuses on consistent shareholder distributions and flexible debt management. Cash dividends have grown steadily and predictably, increasing from approximately $270 million per quarter in 2021 to approximately $370 million to $380 million per quarter by 2025. Share repurchases are more volatile but aggressive, with a major spike in December 2024 (-$1,811 million). To fund these activities and investment outflows, the organization utilizes a mix of long-term borrowings and short-term financing, as evidenced by frequent fluctuations in commercial paper and bank overdrafts.
Liquidity and Cash Position
The net change in cash and cash equivalents reflects the combined impact of volatile operating inflows and heavy investing outflows. While there are quarters of significant cash accumulation, such as March 2021 ($3,585 million) and March 2023 ($2,755 million), these are often followed by periods of net cash reduction. This pattern suggests a cycle of accumulating operational liquidity to fund strategic acquisitions and shareholder returns.

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