Elevance Health

What Elevance Health does

Elevance Health is a publicly traded (NYSE: ELV) integrated health company headquartered in Indianapolis, Indiana, serving approximately 105 million consumers across medical, pharmacy, behavioral, clinical, and complex care solutions. Originally founded in 1944 as a Blue Cross plan and reorganized as Anthem Inc. in 2004 before rebranding to Elevance Health in 2022, the company operates through two primary segments: Health Benefits (commercial/employer, Medicare Advantage, Medicaid, and ACA individual plans) and Carelon (CarelonRx pharmacy benefit management and Carelon Health services including behavioral health and complex care). The Q1 2026 quarter generated $49.5 billion in operating revenue with $1.76 billion in net income, and the Carelon segment alone posted $18 billion in revenue with 8% year-over-year growth.

The company's underlying technology architecture centers on Health OS, a bi-directional clinical data interoperability platform integrated with Epic's Payer Platform that connects electronic health records, labs, and health information exchanges across 88,000+ care providers and 1,200+ provider organizations. The Sydney Health app delivers an AI-powered virtual assistant to members for benefits navigation, provider search, and cost estimation. The proprietary Whole Health Index uses 93 structured measures across physical, behavioral, and social domains to predict individual health trajectories. Supporting platforms include Concierge Care (digital chronic disease management), Community Connected Care (referrals to 300,000+ members for social services), the Crisis Safety Platform (988 Lifeline support across nine states), and the RISE substance use disorder program (8,000+ enrolled since 2019).

Elevance generates revenue primarily through health insurance premiums across Medicaid, Medicare Advantage, commercial/employer, and ACA lines, supplemented by pharmacy benefit management fees, care management fees, and value-based care arrangements that represented 63% of 2023 medical spending. Distribution combines enterprise field sales to large employers, broker/agent networks for mid-market and individual consumers, competitive bidding for state Medicaid and federal Medicare contracts, and direct digital self-service through Sydney Health. Recent M&A has prioritized vertical integration in specialty pharmacy (Paragon Healthcare, BioPlus, Kroger Specialty Pharmacy) and behavioral health (Beacon Health Options), with management restructuring in early 2026 to accelerate Carelon segment execution amid regulatory headwinds from CMS Medicare Advantage sanctions investigations.

Name

Elevance Health

Legal name

Elevance Health, Inc.

Website

https://elevancehealth.com

Company type

Public

Founded year

2004

Operating status

Operating

Headcount range

5,001–10,000 employees

Short description

Elevance Health is a publicly traded integrated health company (NYSE: ELV) serving approximately 105 million consumers across commercial, Medicare Advantage, Medicaid, and ACA plans, plus Carelon pharmacy, behavioral, and complex care services.

Ownership category

akta.pro rank

Product category

Managed Care Health Insurance

NAICS

Direct Life, Health, and Medical Insurance Carriers (52411), Insurance Carriers (5241)

SIC

Insurance Agents, Brokers & Service (6411), Services-Health Services (8000)

akta.pro primary industry

Employer Wellness & Population Health Programs (HLAEAAAH)

akta.pro secondary industry

ACA Marketplace (On-Exchange) Individual Plans (FSAIAEAA)

Keywords

• Health insurance plans
• Managed care services
• Pharmacy benefit management
• Behavioral health services
• Clinical data interoperability

Headquarters

HQ city

Indianapolis

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Operations, Personnel, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Health Benefits Premium Revenue: Revenue from health insurance premiums across Medicaid, Medicare Advantage, Commercial/Employer, and ACA Individual plans. Premium yield improvements and membership growth in government programs drive revenue. The company reported Q1 2026 operating revenue of $49.5 billion.
2. CarelonRx Pharmacy Services: Pharmacy benefit management and specialty pharmacy services including infusion services (Paragon Healthcare), Kroger Specialty Pharmacy acquisition, and BioPlus specialty pharmacy. Operates within CarelonRx segment with $18 billion in revenue.
3. Carelon Health Services: Risk-based care management solutions, behavioral health services through Carelon Behavioral Health, clinical solutions, and complex care services. Carelon segment posted 8% revenue growth to $18 billion in Q1 2026.
4. Fee-Based Services: Fee-based services including third-party administrator services, consulting, and technology solutions delivered through affiliated health plans and Carelon services division.

Pricing tiers

Go-to-market motion3 records

Distribution channels5 records

Marketing channels8 records

Core offering

Elevance Health is an integrated health benefits company that sells medical, pharmacy, behavioral, clinical, and complex care health insurance plans and services to employer groups, government programs (Medicaid and Medicare Advantage), and individual consumers. Its Carelon services portfolio provides pharmacy benefit management, behavioral health, and care coordination, supported by the proprietary Health OS platform and Sydney Health consumer app. The company serves over 105 million consumers across the United States through affiliated Blue Cross Blue Shield plans and specialized subsidiaries.

Product overview

Elevance Health is a health benefits company organized around an integrated whole-health approach, combining a core health insurance platform with a portfolio of clinical, pharmacy, behavioral, digital, and complex care services. The Health OS platform serves as the bi-directional clinical data interoperability layer, connecting electronic health records (EHRs), labs, and health information exchanges to streamline prior authorization and clinical review. The Sydney Health app provides the consumer-facing digital front door with AI-powered virtual assistant capabilities. CarelonRx operates pharmacy benefit management including specialty pharmacy (enhanced through acquisitions of Paragon Healthcare, Kroger Specialty Pharmacy, and BioPlus). Carelon Behavioral Health provides mental health and substance use disorder services through a network of 115,000+ providers. Supporting programs include Concierge Care (digital condition management), Proactive Member Engagement (AI-driven outreach), Whole Health Index (predictive health metric), Community Connected Care (social determinants), Get Connected for Health and CareBridge (digital access equity), Crisis Safety Platform (crisis call center technology), Total Movement Care (musculoskeletal), and the RISE Program (substance use disorder). Together these serve approximately 105 million consumers across medical, pharmacy, behavioral, and complex care solutions.

Differentiator

Problem solved

Functional benefit

Brands

• Sydney Health: AI-powered Virtual Assistant and member engagement app helping members navigate benefits, coverage, and care options
• Concierge Care
• Sydney Health App
• Community Connected Care
• Health OS
• Whole Health Index

Products and services

• Health OS
• Sydney Health App
• CarelonRx
• Carelon Behavioral Health
• Concierge Care
• Whole Health Index (WHI)
• Crisis Safety Platform
• RISE Program
• Community Connected Care
• Total Movement Care (TMC)
• Get Connected for Health
• CareBridge

Quantifiable outcome

• 61% reduction in prior authorization denials and nearly 60% fewer pending cases through Health OS platform
• +7 more outcomes

Named customers6 records

Segments5 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration3 records

AI capability9 records

Feature10 records

Partnerships

13 partnerships are on record, tiered core and minor.

• Plus Therapeutics / CNSide DiagnosticscoreTechnology or Integration · 25 June 2026National coverage agreement for CNSide CSF Tumor Cell Enumeration assay covering approximately 45.4 million people under Elevance Health plans, with demonstrated 92% sensitivity and 95% specificity across 11+ peer-reviewed publications and 11,000+ tests performed at over 120 U.S. cancer institutions.
• National Association of Community Health Centers (NACHC)coreStrategic or Co-development Partner · 18 August 2025Integration of Food as Medicine programming with primary care at Community Health Centers. Trains provider teams on FAM effectiveness and connects Medicaid members at risk for diet-related chronic conditions to personalized nutrition support as part of primary care.
• Verizon, Samsung, AT&T, T-MobilecoreStrategic or Co-development Partner · 10 January 2024Get Connected for Health program provides high-quality smartphones with unlimited data, talk, and texting at no cost to eligible Medicaid members. Devices preloaded with health apps and customized experience. Supported by FCC's Affordable Connectivity Program.
• EpiccoreTechnology or IntegrationHealth OS platform integrated with Epic's Payer Platform enabling bidirectional clinical data exchange for prior authorization, concurrent review, and care coordination. First insurer to use Epic's Payer Platform for inpatient concurrent care reviews.
• Impact Fitness FoundationcoreStrategic or Co-development PartnerFive-year partnership connecting Elevance Health Women's Fort Myers Tipoff collegiate basketball tournament with school fitness renovations. Over 40 Elevance Health volunteers have renovated fitness spaces for five consecutive years, supporting youth physical activity.
• EverfiminorGTM or Marketing PartnerOngoing collaboration supporting mental wellness and prevention education programs reaching nearly one million K-12 students during 2025-26 school year. Part of broader initiative with HCA Healthcare, NFL Foundation, Major League Baseball, and other organizations.
• 3Strands Global FoundationminorStrategic or Co-development PartnerSupport for ELEVATE program, a specialized education and training initiative for foster care landscape addressing trauma-informed practices and mental health needs. Program launching in Virginia before expanding nationally.
• Deloitte Consulting LLPcoreImplementation/ SI/ Consulting PartnerPartnership to deploy human-centered AI healthcare solutions streamlining provider operations such as claim research and correspondence management. Solution built on Google's Agent Development Kit, synthesizing unstructured provider data.
• Health Action AllianceminorStrategic or Co-development PartnerFounding member of Extreme Weather + Work initiative presented by Mercer, helping employers prepare workers for extreme weather-related disruptions. Initiative backed by polling showing 80% of U.S. workers experienced weather-related disruptions.
• CPESN USAcoreStrategic or Co-development PartnerCommunity Pharmacy Total Care program partners with over 500 independent community pharmacies across 10 states and Washington D.C. to deliver personalized medication management and care coordination for Medicaid members with complex conditions.
• Partners in Care FoundationcoreStrategic or Co-development PartnerCommunity-based organization partner in Community Connected Care program, helping address health-related social needs including language barriers through Spanish-speaking care providers and culturally aligned resources.
• Cost Plus DrugsminorChannel Partner/ Reseller/ DistributorPartnership expanding access to lower-cost generic medications through Mark Cuban's Cost Plus Drugs for employer benefits market, leveraging transparent pricing to manage pharmacy costs.
• AmwellcoreTechnology or IntegrationThree-year contract renewal for telehealth services providing virtual care access to Elevance Health members. Amwell's platform enables video visits and digital health services across the member base.

Scale indicators10 records

Recent moves9 records

Expansion highlights6 records

Broad incumbents

• Kaiser Permanente: Integrated nonprofit payer-provider system operating across multiple states. Comparable as a benchmark for fully integrated care delivery, though structurally different as a member-owned nonprofit.

Direct peers

• UnitedHealth Group: Largest U.S. health insurer and operator of Optum, a vertically integrated health services platform. Directly comparable to Elevance across commercial, Medicare Advantage, and Medicaid lines, and the lead competitive benchmark for Carelon-style services diversification.
• CVS Health (Aetna): Vertically integrated payer-provider-pharmacy operator combining Aetna insurance with CVS Caremark PBM, Oak Street Health, and Signify Health. Competes directly with Elevance in commercial, MA, and PBM, and is a key Carelon comparator.
• The Cigna Group: Major U.S. health insurer with a leading PBM (Express Scripts) and Evernorth health services platform. Competes directly with Elevance in commercial, ACA, and PBM, and pursues a comparable services-diversification strategy to Carelon.
• Humana: Largest pure-play Medicare Advantage insurer with growing CenterWell primary care and home health assets. Direct competitor in MA, especially given Elevance's MA exposure and CMS risk-adjustment challenges.
• Centene Corporation: Largest publicly traded Medicaid managed care insurer, also serving ACA marketplace and Medicare populations. Competes with Elevance in Medicaid and ACA and is the primary benchmark for government-program share.
• Molina Healthcare: Pure-play government-sponsored managed care company focused on Medicaid, Medicare, and dual-eligible markets. Closely comparable to Elevance's Medicaid segment, particularly around LTSS and duals strategy.

Regional players

• Health Care Service Corporation (HCSC): Mutual insurer and largest customer-owned Blue Cross Blue Shield plan, operating across TX, IL, MT, NM, and OK. Closest mutual/BCBS regional comparator to Elevance's Anthem-affiliated BCBS plans.
• GuideWell Mutual Holding Corporation (Florida Blue): Mutual holding company for Florida Blue and other health solutions subsidiaries. Comparable BCBS regional peer with growing services portfolio across Medicaid and Medicare.
• Blue Shield of California: California-focused nonprofit BCBS plan with growing integrated services and digital health initiatives. Comparable regional BCBS peer, particularly relevant to Elevance's California commercial exposure.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xx.com/elevancehealth
• LinkedInlinkedin.com/company/elevance-health

Revenue estimate

Valuation estimate

Number of profiles

Profiles29 records

Subsidiaries7 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A28 records

Investments16 records

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Elevance Health