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CVS Health Corp.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 10 February 2026: press release. Guidance figures: 1 lowered, 2 kept. The quarter’s numbers.

Key takeaways

  • Fourth-quarter revenue rose 8.2%: Revenue was $105.7 billion, against $97.7 billion a year earlier. GAAP diluted EPS was $2.30 versus $1.30, and Adjusted EPS was $1.09 versus $1.19. Source
  • Adjusted EPS fell on Health Care Benefits: Management attributed the fourth-quarter Adjusted EPS decline to lower adjusted operating income in the Health Care Benefits segment. Source
  • Full-year medical benefit ratio improved: The MBR was 91.2% for the year against 92.5%, and full-year adjusted operating income was $2.9 billion against $0.3 billion. Favorable prior-year development of $2.0 billion contributed. Source
  • Goodwill impairment of $5.7 billion: Full-year operating income absorbed a $5.7 billion goodwill impairment on the Health Care Delivery unit within the Health Services segment. It is excluded from adjusted figures. Source
  • Operating cash flow reached $10.6 billion: Full-year cash flow from operations was $10.6 billion against $9.1 billion in 2024. Source
  • GAAP EPS range confirmed for 2026: Management confirmed GAAP diluted EPS of $5.94 to $6.14 for 2026, equal to net income attributable to CVS Health of $7,638 million to $7,892 million. Source
  • Operating cash flow guidance lowered to $9.0 billion: Cash flow from operations guidance for 2026 moved to at least $9.0 billion from at least $10.0 billion. Source

“Our fourth quarter and full-year results demonstrate the progress we are making in transforming the health care experience with our unique collection of businesses.”

David Joyner, CVS Health President and CEO

Guidance

AreaPeriodFigureAgainst last quarter
GAAP diluted EPS Sourcefull year 2026$5.94 to $6.14Kept
Adjusted EPS Sourcefull year 2026$7.00 to $7.20Kept
Cash flow from operations Sourcefull year 2026at least $9.0 billionLowered from at least $10.0 billion
Amortization of intangible assets (excluded from Adjusted EPS) Sourcefull year 2026$1,730 million

What changed from last quarter

  • New guidance: Full-year 2026 guidance was given; the fourth-quarter release provides 2026 ranges for GAAP and Adjusted EPS. Source
  • Guidance lowered: Cash flow from operations guidance was reduced to at least $9.0 billion from at least $10.0 billion. Source
  • Guidance kept: The GAAP and Adjusted EPS guidance ranges were confirmed. Source
  • New: CVS Pharmacy completed its transition to cost-based reimbursement across four business lines. Source

Quarter and full-year results

  • Fourth-quarter revenue rose 8.2%: Revenue was $105.7 billion, against $97.7 billion a year earlier. GAAP diluted EPS was $2.30 versus $1.30, and Adjusted EPS was $1.09 versus $1.19. Source
  • Adjusted EPS fell on Health Care Benefits: Management attributed the fourth-quarter Adjusted EPS decline to lower adjusted operating income in the Health Care Benefits segment. Source
  • Full-year revenue reached a record: Full-year revenue was $402.1 billion, up 7.8%. Full-year GAAP diluted EPS was $1.39 versus $3.66, and Adjusted EPS was $6.75 versus $5.42. Source
  • Adjusted operating income up 20.6%: Adjusted operating income fell 4.8% in the fourth quarter and rose 20.6% for the year. Reported operating income fell 45.3% for the year, after a goodwill impairment and legacy litigation charges. Source

Health Care Benefits segment

  • Government business lifted revenue: Segment revenue rose 10.1% in the quarter to $36.3 billion and 9.7% for the year to $143.4 billion, with Government growth linked to the IRA's effect on Medicare Part D. Source
  • Quarterly adjusted loss widened $237 million: Adjusted operating loss was $676 million against $439 million. Management cited Part D seasonality under the IRA and premium deficiency reserves, partly offset by Government performance. Source
  • Full-year medical benefit ratio improved: The MBR was 91.2% for the year against 92.5%, and full-year adjusted operating income was $2.9 billion against $0.3 billion. Favorable prior-year development of $2.0 billion contributed. Source
  • Medical membership fell 504,000: Medical membership was 26.6 million at year-end, down 504,000 from December 2024, mainly in individual exchange and Government, partly offset by Commercial ASC. Days claims payable were 38.9 days. Source

“we are well positioned to achieve our ambition to be the most trusted health care company in America.”

David Joyner, CVS Health President and CEO

Health Services segment

  • Health Services revenue up 9.7%: Fourth-quarter revenue rose 9.0% to $51.2 billion and full-year revenue rose 9.7% to $190.4 billion, on drug mix and brand inflation, net of client price improvements. Source
  • Quarter adjusted operating income up 9.2%: Adjusted operating income reached $1.9 billion in the quarter, helped by improved purchasing economics. Source
  • Full-year adjusted income slipped 1.3%: Full-year adjusted operating income was $7.2 billion, down 1.3%. Management cited client price improvements and a higher medical benefit ratio in the health care delivery business. Source
  • Pharmacy claims processed fell: Claims processed fell 1.5% in the quarter and 0.9% for the year, on a 30-day equivalent basis. Source

Pharmacy & Consumer Wellness segment

  • Prescription volume drove revenue growth: Segment revenue rose 12.4% in the quarter to $37.7 billion and 11.9% for the year to $139.4 billion, on drug mix and prescription volume, including Rite Aid files. Source
  • Same store prescription volume up 9.7%: Same store prescription volume rose 9.7% in the quarter and 8.0% for the year on a 30-day equivalent basis. Prescriptions filled rose 6.3% in the quarter. Source
  • Adjusted operating income up 4.6% for year: Quarter adjusted operating income rose 8.7% to $1.9 billion; the year rose 4.6% to $6.0 billion. Reimbursement pressure and colleague investments partly offset the gains. Source

Costs, charges and tax

  • Goodwill impairment of $5.7 billion: Full-year operating income absorbed a $5.7 billion goodwill impairment on the Health Care Delivery unit within the Health Services segment. It is excluded from adjusted figures. Source
  • Legacy litigation charges about $1.2 billion: Charges of $387 million (Omnicare False Claims Act, first quarter), $542 million in penalties (second quarter) and $291 million in PBM reporting litigation (second quarter) were recorded in 2025. Source
  • Prior-year restructuring charges absent: Operating income benefited from the absence of about $1.2 billion of restructuring charges booked in the prior year. Source
  • Fourth-quarter tax benefit from worthless stock: Fourth-quarter income tax was a benefit at a (115.9)% effective rate, due to a worthless stock deduction tied to a subsidiary that filed for bankruptcy. Source

Cash flow and capital

  • Operating cash flow reached $10.6 billion: Full-year cash flow from operations was $10.6 billion against $9.1 billion in 2024. Source
  • Investment purchases and capex: Purchases of property and equipment were $2,832 million against $2,781 million in 2024. Purchases of investments were $15,012 million. Source
  • No share repurchases in 2025: No common stock was repurchased in 2025, against $3.0 billion in 2024. Dividends paid were $3.4 billion in each year. Source
  • Interest expense rose on new debt: Full-year interest expense was $3.1 billion, up $161 million or 5.4%, from long-term debt issued in December 2024 and August 2025. Source

2026 guidance

  • GAAP EPS range confirmed for 2026: Management confirmed GAAP diluted EPS of $5.94 to $6.14 for 2026, equal to net income attributable to CVS Health of $7,638 million to $7,892 million. Source
  • Adjusted EPS range confirmed for 2026: Adjusted EPS guidance of $7.00 to $7.20 was confirmed, against adjusted income of $8,998 million to $9,252 million. Source
  • Operating cash flow guidance lowered to $9.0 billion: Cash flow from operations guidance for 2026 moved to at least $9.0 billion from at least $10.0 billion. Source

Operations, customers and clinics

  • Aetna prior authorizations approved quickly: Aetna approved more than 95% of eligible prior authorizations within 24 hours, with many completed instantly, as it works to improve the provider experience. Source
  • Caremark wins and retention into 2026: Caremark closed 2025 with significant customer wins and retention, which management said gives momentum into 2026. Source
  • Cost-based reimbursement transition completed: CVS Pharmacy completed its move to cost-based reimbursement across Commercial, Third-Party Discount, Medicare and Medicaid. Source

Coming up, as management said on 10 February 2026

  • Oak Street clinic closures in 2026: Planned closure of certain existing Oak Street Health clinics in 2026, with associated severance expected; the related charge writes down long-lived assets. Source

Figures management reported

FigureReported
Same store sales, total, Q4 2025 Source16.0%
Same store sales, pharmacy, Q4 2025 Source19.3%
Same store sales, Front Store, Q4 2025 Source0.5%
Same store prescription volume, Q4 2025 Source9.7%
Inventories, December 31, 2025 Source$19,246 million
Gross margin, Pharmacy & Consumer Wellness, Q4 2025 Source18.8%
Gross margin, Health Services, Q4 2025 Source5.2%
Retail pharmacy locations, December 31, 2025 Sourceapproximately 9,000

Risks management discussed

  • Regulatory: Medicare Part D seasonality changed under the IRA, shifting Health Care Benefits results between periods. Source
  • Operational: Premium deficiency reserves created a year-over-year headwind to Health Care Benefits adjusted results. Source
  • Demand: Individual exchange membership declines reduced medical membership, partly offset by Commercial ASC growth. Source
  • External: Continued pharmacy client price improvements reduced Health Services revenue growth and adjusted operating income. Source

Earlier plans management reported on

  • Met: Management reports the cost-based reimbursement transition is complete across Commercial, Third-Party Discount, Medicare and Medicaid. Source
  • Not stated: Management confirmed the 2026 GAAP diluted EPS range, which it had already given. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.