Analysis, playbooks, and research for government-sponsored health plans navigating a faster, more competitive market.
The most significant and surprising finding in Molina Healthcare’s Q1 2026 results is not the EPS beat—it is the explicit reversal of the 2025 acuity shift that destroyed earnings for the sector.
CVS Health delivered Q4 2025 adjusted EPS of $1.09, beating consensus of $1.00, on revenue of $105.7B (up 8.2% YoY). Full year 2025 adjusted EPS of $6.75 exceeded initial guidance on revenue of $402.1B (up 7.8%).
Molina Healthcare reported a Q4 2025 adjusted loss of $2.75 per share versus expectations of $0.34 EPS, a 909% miss that triggered a 30% premarket stock decline. The miss was driven by $2.00/share of unexpected California retroactive premium adjustments and persistent medical cost trend pressure across Medicare and Marketplace.
The most striking revelation from Centene’s Q4 2025 earnings call: management explicitly acknowledged that if they only deliver a stable 93.7% Medicaid HBR in 2025, CEO Sarah London will be “very disappointed”—signaling aggressive expectations for margin improvement beyond the conservative guidance baseline.
Elevance Health reported FY 2025 revenues of $197.6 billion, up 13% year-over-year, but faces continued margin pressure with operating margin declining 90 basis points to 3.6% and FY 2025 adjusted EPS is $30.29 while 2026 projected will be $25.50.
Alignment Healthcare delivered 46% revenue growth and transformed from breakeven ($1M adjusted EBITDA in 2024) to $110M adjusted EBITDA in 2025—a 270 basis point margin expansion—while navigating V28 phase-ins, Part D redesign, and industry-wide utilization pressure.
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