Elevance Health Inc. (NYSE:ELV)

EBITDA for the period demonstrates a generally positive trajectory from 2021 to 2023, followed by a decline in the subsequent two years. While net income exhibits a consistent, albeit modest, downward trend throughout the entire period, the progression of EBITDA reveals a more nuanced picture of operational performance.

Overall EBITDA Trend

EBITDA increased from US$10,025 million in 2021 to US$10,490 million in 2023, representing a cumulative growth of approximately 4.6%. However, this was followed by a decrease to US$10,482 million in 2024 and a more substantial decline to US$9,658 million in 2025. The 2025 value represents a decrease of approximately 8.1% from the 2023 peak.

EBITDA vs. EBIT

The difference between EBITDA and EBIT remained relatively stable between 2021 and 2023, fluctuating around US$1,300 million. In 2024, this difference widened to approximately US$1,400 million, before decreasing to US$1,500 million in 2025. This suggests that depreciation and amortization expenses remained consistent as a proportion of EBIT for the majority of the period, with a slight increase in 2024 and 2025.

EBITDA vs. EBT

The gap between EBITDA and Earnings Before Tax (EBT) also remained relatively consistent between 2021 and 2023, averaging around US$2,300 million. A narrowing of this gap occurred in 2024, followed by a more pronounced narrowing in 2025, reaching approximately US$2,900 million. This indicates a potential shift in the proportion of income allocated to interest expense or a change in the effective tax rate.

EBITDA vs. Net Income

EBITDA consistently exceeded Shareholders’ Net Income throughout the observed period, as expected. The difference between the two metrics widened slightly from 2021 to 2023, then remained relatively stable through 2024, before increasing in 2025. This suggests that factors beyond operational profitability, such as interest, taxes, and potentially non-operating items, are increasingly impacting net income.

The observed decline in EBITDA from 2023 to 2025 warrants further investigation. While operational performance initially improved, the subsequent decrease suggests potential challenges related to cost management, revenue generation, or increased competitive pressures. The concurrent decline in net income reinforces the need to understand the underlying drivers of these trends.

The Enterprise Value to EBITDA ratio demonstrates a declining trend over the five-year period. Initially, the ratio exhibited relative stability before a noticeable decrease in later years.

Enterprise Value to EBITDA – Overall Trend

The EV/EBITDA ratio began at 10.05 in 2021 and increased slightly to 10.26 in 2022. It remained relatively consistent at 10.24 in 2023. A significant decrease is then observed, falling to 8.15 in 2024 and further to 7.34 in 2025. This indicates a decreasing multiple of enterprise value relative to earnings before interest, tax, depreciation, and amortization.

Enterprise Value remained relatively stable between 2021 and 2023, fluctuating between US$100,728 million and US$107,367 million. However, a substantial decline is apparent in 2024 and 2025, reaching US$85,443 million and US$70,889 million respectively.

EBITDA Trend

EBITDA showed modest growth from US$10,025 million in 2021 to US$10,490 million in 2023. In 2024, EBITDA remained nearly unchanged at US$10,482 million, before decreasing to US$9,658 million in 2025. The relatively stable EBITDA, coupled with the declining Enterprise Value, is a primary driver of the observed decrease in the EV/EBITDA ratio.

The combined effect of decreasing Enterprise Value and a slight decrease in EBITDA contributes to the overall downward trend in the EV/EBITDA ratio. The most significant change occurs between 2023 and 2025, with the ratio decreasing by approximately 28.8%.