Fourth Quarter Highlights
Full-Year Highlights
2025 Full-Year Guidance
CEO Commentary
"Our integrated model allows us to uniquely deliver a simpler, connected experience that saves time, saves money, and improves health. We have continued to see growth in key areas of our business, including the Pharmacy and Consumer Wellness segment, while we address the industry-wide challenges that have impacted our Health Care Benefits segment. Through the continued dedication of our colleagues, we will be positioned for strong performance in 2025 as we deliver simply better care for consumers while improving outcomes and reducing costs."
— David Joyner, CVS Health President and CEO
WOONSOCKET, R.I., Feb. 12, 2025 /PRNewswire/ -- CVS Health Corporation (NYSE: CVS) today announced operating results for the three months and year ended December 31, 2024.
| | Three Months Ended December 31, | ||||
| In millions, except per share amounts | 2024 | | 2023 | | Change |
| Total revenues | $ 97,710 | | $ 93,813 | | $ 3,897 |
| Operating income | 2,368 | | 3,373 | | (1,005) |
| Adjusted operating income (1) | 2,728 | | 4,227 | | (1,499) |
| Diluted earnings per share | $ 1.30 | | $ 1.58 | | $ (0.28) |
| Adjusted EPS (2) | $ 1.19 | | $ 2.12 | | $ (0.93) |
Fourth quarter GAAP diluted EPS of $1.30 decreased from $1.58 in the prior year and Adjusted EPS of $1.19 decreased from $2.12 in the prior year, primarily due to a decline in the Health Care Benefits segment's operating results, which reflect continued utilization pressure and the unfavorable impact of the Company's Medicare Advantage star ratings for the 2024 payment year.
The Company presents both GAAP and non-GAAP financial measures in this press release to assist in the comparison of the Company's past financial performance with its current financial performance. See "Non-GAAP Financial Information" beginning on page 11 and endnotes beginning on page 23 for explanations of non-GAAP financial measures presented in this press release. See pages 13 through 15 and page 22 for reconciliations of each non-GAAP financial measure used in this release to the most directly comparable GAAP financial measure.
Consolidated fourth quarter and full-year results
| | Three Months Ended | | Year Ended December 31, | ||||||||
| In millions, except per share amounts | 2024 | | 2023 | | Change | | 2024 | | 2023 | | Change |
| Total revenues | $ 97,710 | | $ 93,813 | | $ 3,897 | | $ 372,809 | | $ 357,776 | | $ 15,033 |
| Operating income | 2,368 | | 3,373 | | (1,005) | | 8,516 | | 13,743 | | (5,227) |
| Adjusted operating income (1) | 2,728 | | 4,227 | | (1,499) | | 11,976 | | 17,534 | | (5,558) |
| Net income | 1,623 | | 2,047 | | (424) | | 4,586 | | 8,368 | | (3,782) |
| Diluted earnings per share | $ 1.30 | | $ 1.58 | | $ (0.28) | | $ 3.66 | | $ 6.47 | | $ (2.81) |
| Adjusted EPS (2) | $ 1.19 | | $ 2.12 | | $ (0.93) | | $ 5.42 | | $ 8.74 | | $ (3.32) |
For the three months and year ended December 31, 2024 compared to the prior year:
Health Care Benefits segment
The Health Care Benefits segment offers a full range of insured and self-insured ("ASC") medical, pharmacy, dental and behavioral health products and services. The segment results for the three months and years ended December 31, 2024 and 2023 were as follows:
| | Three Months Ended December 31, | | Year Ended December 31, | ||||||||
| In millions, except percentages | 2024 | | 2023 | | Change | | 2024 | | 2023 | | Change |
| Total revenues | $ 32,958 | | $ 26,726 | | $ 6,232 | | $ 130,665 | | $ 105,646 | | $ 25,019 |
| Adjusted operating income (loss) (1) | (439) | | 676 | | (1,115) | | 307 | | 5,577 | | (5,270) |
| Medical benefit ratio ("MBR") (3) | 94.8 % | | 88.5 % | | 6.3 % | | 92.5 % | | 86.2 % | | 6.3 % |
| Medical membership (4) | | | | | | | 27.1 | | 25.7 | | 1.4 |
See the supplemental information on page 17 for additional information regarding the performance of the Health Care Benefits segment.
Health Services segment
The Health Services segment provides a full range of pharmacy benefit management solutions, delivers health care services in its medical clinics, virtually, and in the home, and offers provider enablement solutions. The segment results for the three months and years ended December 31, 2024 and 2023 were as follows:
| | Three Months Ended December 31, | | Year Ended December 31, | ||||||||
| In millions | 2024 | | 2023 | | Change | | 2024 | | 2023 | | Change |
| Total revenues | $ 47,020 | | $ 49,146 | | $ (2,126) | | $ 173,605 | | $ 186,843 | | $ (13,238) |
| Adjusted operating income (1) | 1,761 | | 1,860 | | (99) | | 7,243 | | 7,312 | | (69) |
| Pharmacy claims processed (5) (6) | 499.4 | | 600.8 | | (101.4) | | 1,917.6 | | 2,344.3 | | (426.7) |
See the supplemental information on page 18 for additional information regarding the performance of the Health Services segment.
Pharmacy & Consumer Wellness segment
The Pharmacy & Consumer Wellness segment dispenses prescriptions in its retail pharmacies and through its infusion operations, provides ancillary pharmacy services including pharmacy patient care programs, diagnostic testing and vaccination administration, and sells a wide assortment of health and wellness products and general merchandise. The segment also provides pharmacy services to long-term care facilities and pharmacy fulfillment services to support the Health Services segment's specialty and mail order pharmacy offerings. The segment results for the three months and years ended December 31, 2024 and 2023 were as follows:
| | Three Months Ended December 31, | | Year Ended December 31, | ||||||||
| In millions | 2024 | | 2023 | | Change | | 2024 | | 2023 | | Change |
| Total revenues | $ 33,514 | | $ 31,185 | | $ 2,329 | | $ 124,500 | | $ 116,763 | | $ 7,737 |
| Adjusted operating income (1) | 1,758 | | 2,027 | | (269) | | 5,774 | | 5,963 | | (189) |
| Prescriptions filled (5) (6) | 445.9 | | 431.5 | | 14.4 | | 1,715.5 | | 1,649.1 | | 66.4 |
See the supplemental information on page 19 for additional information regarding the performance of the Pharmacy & Consumer Wellness segment.
2025 Full-year guidance
The Company issued its full-year 2025 GAAP diluted EPS guidance range of $4.58 to $4.83 and its 2025 Adjusted EPS guidance range of $5.75 to $6.00. The Company also issued its full-year 2025 cash flow from operations guidance of approximately $6.5 billion.
The adjustments between full-year 2025 GAAP diluted EPS and Adjusted EPS include amortization of intangible assets, acquisition-related integration costs, office real estate optimization charges and the corresponding income tax benefit or expense related to the items excluded from adjusted income attributable to CVS Health.
Teleconference and webcast
The Company will be holding a conference call today for investors at 8:00 a.m. (Eastern Time) to discuss its fourth quarter and full-year results. An audio webcast of the call will be broadcast simultaneously for all interested parties through the Investor Relations section of the CVS Health website at http://investors.cvshealth.com. This webcast will be archived and available on the website for a one-year period following the conference call.
About CVS Health
CVS Health is a leading health solutions company building a world of health around every consumer, wherever they are. As of December 31, 2024, the Company had more than 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics, a leading pharmacy benefits manager with approximately 90 million plan members, and a dedicated senior pharmacy care business serving more than 800,000 patients per year. The Company also serves an estimated more than 36 million people through traditional, voluntary and consumer-directed health insurance products and related services, including highly rated Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan. The Company's integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs.
Cautionary statement concerning forward-looking statements
The Private Securities Litigation Reform Act of 1995 provides a safe harbor for forward-looking statements made by or on behalf of CVS Health Corporation. Statements in this press release that are forward-looking include, but are not limited to, the information under the headings "2025 Full-Year Guidance", "CEO Commentary" and "Financial Results Summary" and the information included in the reconciliations and endnotes. By their nature, all forward-looking statements are not guarantees of future performance or results and are subject to risks and uncertainties that are difficult to predict and/or quantify. Actual results may differ materially from those contemplated by the forward-looking statements due to the risks and uncertainties described in our Securities and Exchange Commission ("SEC") filings, including those set forth in the Risk Factors section and under the heading "Cautionary Statement Concerning Forward-Looking Statements" in our most recently filed Annual Report on Form 10-K, our Quarterly Reports on Form 10-Q for the quarterly periods ended March 31, 2024, June 30, 2024 and September 30, 2024 and our Current Reports on Form 8-K.
You are cautioned not to place undue reliance on CVS Health's forward-looking statements. CVS Health's forward-looking statements are and will be based upon management's then-current views and assumptions regarding future events and operating performance, and are applicable only as of the dates of such statements. CVS Health does not assume any duty to update or revise forward-looking statements, whether as a result of new information, future events, uncertainties or otherwise.
- Tables Follow -
| CVS HEALTH CORPORATION Condensed Consolidated Statements of Operations (Unaudited) | |||||||
| | |||||||
| | Three Months Ended December 31, | | Year Ended December 31, | ||||
| In millions, except per share amounts | 2024 | | 2023 | | 2024 | | 2023 |
| Revenues: | | | | | | | |
| Products | $ 61,911 | | $ 65,154 | | $ 231,521 | | $ 245,138 |
| Premiums | 30,913 | | 25,075 | | 122,896 | | 99,192 |
| Services | 4,131 | | 3,316 | | 16,239 | | 12,293 |
| Net investment income | 755 | | 268 | | 2,153 | | 1,153 |
| Total revenues | 97,710 | | 93,813 | | 372,809 | | 357,776 |
| Operating costs: | | | | | | | |
| Cost of products sold | 55,268 | | 57,419 | | 206,287 | | 217,098 |
| Health care costs | 29,543 | | 22,518 | | 115,121 | | 86,247 |
| Operating expenses | 10,521 | | 10,503 | | 41,606 | | 39,832 |
| Restructuring charges | 10 | | — | | 1,179 | | 507 |
| Opioid litigation charge | — | | — | | 100 | | — |
| Loss on assets held for sale | — | | — | | — | | 349 |
| Total operating costs | 95,342 | | 90,440 | | 364,293 | | 344,033 |
| Operating income | 2,368 | | 3,373 | | 8,516 | | 13,743 |
| Interest expense | 758 | | 690 | | 2,958 | | 2,658 |
| Gain on early extinguishment of debt | (491) | | — | | (491) | | — |
| Other income | (25) | | (22) | | (99) | | (88) |
| Income before income tax provision | 2,126 | | 2,705 | | 6,148 | | 11,173 |
| Income tax provision | 503 | | 658 | | 1,562 | | 2,805 |
| Net income | 1,623 | | 2,047 | | 4,586 | | 8,368 |
| Net (income) loss attributable to noncontrolling interests | 21 | | (1) | | 28 | | (24) |
| Net income attributable to CVS Health | $ 1,644 | | $ 2,046 | | $ 4,614 | | $ 8,344 |
| | | | | | | | |
| Net income per share attributable to CVS Health: | | | | | | | |
| Basic | $ 1.31 | | $ 1.59 | | $ 3.67 | | $ 6.49 |
| Diluted | $ 1.30 | | $ 1.58 | | $ 3.66 | | $ 6.47 |
| Weighted average shares outstanding: | | | | | | | |
| Basic | 1,259 | | 1,288 | | 1,259 | | 1,285 |
| Diluted | 1,261 | | 1,293 | | 1,262 | | 1,290 |
| CVS HEALTH CORPORATION Condensed Consolidated Balance Sheets (Unaudited) | |||
| | |||
| | At December 31, | ||
| In millions | 2024 | | 2023 |
| Assets: | | | |
| Cash and cash equivalents | $ 8,586 | | $ 8,196 |
| Investments | 2,407 | | 3,259 |
| Accounts receivable, net | 36,469 | | 35,227 |
| Inventories | 18,107 | | 18,025 |
| Other current assets | 3,076 | | 3,151 |
| Total current assets | 68,645 | | 67,858 |
| Long-term investments | 28,934 | | 23,019 |
| Property and equipment, net | 12,993 | | 13,183 |
| Operating lease right-of-use assets | 15,944 | | 17,252 |
| Goodwill | 91,272 | | 91,272 |
| Intangible assets, net | 27,323 | | 29,234 |
| Separate accounts assets | 3,311 | | 3,250 |
| Other assets | 4,793 | | 4,660 |
| Total assets | $ 253,215 | | $ 249,728 |
| | | | |
| Liabilities: | | | |
| Accounts payable | $ 15,892 | | $ 14,897 |
| Pharmacy claims and discounts payable | 24,166 | | 22,874 |
| Health care costs payable | 15,064 | | 12,049 |
| Accrued expenses and other current liabilities | 20,810 | | 23,515 |
| Other insurance liabilities | 1,183 | | 1,141 |
| Current portion of operating lease liabilities | 1,751 | | 1,741 |
| Short-term debt | 2,119 | | 200 |
| Current portion of long-term debt | 3,624 | | 2,772 |
| Total current liabilities | 84,609 | | 79,189 |
| Long-term operating lease liabilities | 14,899 | | 16,034 |
| Long-term debt | 60,527 | | 58,638 |
| Deferred income taxes | 3,806 | | 4,311 |
| Separate accounts liabilities | 3,311 | | 3,250 |
| Other long-term insurance liabilities | 4,902 | | 5,459 |
| Other long-term liabilities | 5,431 | | 6,211 |
| Total liabilities | 177,485 | | 173,092 |
| | | | |
| Shareholders' equity: | | | |
| Preferred stock | — | | — |
| Common stock and capital surplus | 49,661 | | 48,992 |
| Treasury stock | (36,818) | | (33,838) |
| Retained earnings | 62,837 | | 61,604 |
| Accumulated other comprehensive loss | (120) | | (297) |
| Total CVS Health shareholders' equity | 75,560 | | 76,461 |
| Noncontrolling interests | 170 | | 175 |
| Total shareholders' equity | 75,730 | | 76,636 |
| Total liabilities and shareholders' equity | $ 253,215 | | $ 249,728 |
| CVS HEALTH CORPORATION Condensed Consolidated Statements of Cash Flows (Unaudited) | |||
| | |||
| | Year Ended December 31, | ||
| In millions | 2024 | | 2023 |
| Cash flows from operating activities: | | | |
| Cash receipts from customers | $ 357,995 | | $ 345,464 |
| Cash paid for inventory, prescriptions dispensed and health services rendered | (197,726) | | (208,848) |
| Insurance benefits paid | (109,464) | | (84,097) |
| Cash paid to other suppliers and employees | (38,821) | | (34,735) |
| Interest and investment income received | 1,735 | | 1,584 |
| Interest paid | (2,909) | | (2,418) |
| Income taxes paid | (1,703) | | (3,524) |
| Net cash provided by operating activities | 9,107 | | 13,426 |
| | | | |
| Cash flows from investing activities: | | | |
| Proceeds from sales and maturities of investments | 10,353 | | 7,729 |
| Purchases of investments | (15,191) | | (9,043) |
| Purchases of property and equipment | (2,781) | | (3,031) |
| Acquisitions (net of cash and restricted cash acquired) | (95) | | (16,612) |
| Other | 101 | | 68 |
| Net cash used in investing activities | (7,613) | | (20,889) |
| | | | |
| Cash flows from financing activities: | | | |
| Commercial paper borrowings (repayments), net | 1,919 | | 200 |
| Proceeds from issuance of short-term loan | — | | 5,000 |
| Repayment of short-term loan | — | | (5,000) |
| Proceeds from issuance of long-term debt | 7,913 | | 10,898 |
| Repayments of long-term debt | (4,773) | | (3,166) |
| Repurchase of common stock | (3,023) | | (2,012) |
| Dividends paid | (3,373) | | (3,132) |
| Proceeds from exercise of stock options | 361 | | 277 |
| Payments for taxes related to net share settlement of equity awards | (185) | | (181) |
| Other | 26 | | (201) |
| Net cash provided by (used in) financing activities | (1,135) | | 2,683 |
| Net increase (decrease) in cash, cash equivalents and restricted cash | 359 | | (4,780) |
| Cash, cash equivalents and restricted cash at the beginning of the period | 8,525 | | 13,305 |
| Cash, cash equivalents and restricted cash at the end of the period | $ 8,884 | | $ 8,525 |
| CVS HEALTH CORPORATION Condensed Consolidated Statements of Cash Flows (Unaudited) | |||
| | |||
| | Year Ended December 31, | ||
| In millions | 2024 | | 2023 |
| Reconciliation of net income to net cash provided by operating activities: | | | |
| Net income | $ 4,586 | | $ 8,368 |
| Adjustments required to reconcile net income to net cash provided by operating | | | |
| Depreciation and amortization | 4,597 | | 4,366 |
| Loss on assets held for sale | — | | 349 |
| Stock-based compensation | 540 | | 588 |
| Gain on early extinguishment of debt | (491) | | — |
| Restructuring charges (impairment of long-lived assets) | 840 | | 152 |
| Deferred income taxes | (572) | | (676) |
| Other items | (502) | | 264 |
| Change in operating assets and liabilities, net of effects from acquisitions: | | | |
| Accounts receivable, net | (1,301) | | (6,260) |
| Inventories | (102) | | 1,233 |
| Other assets | (38) | | (510) |
| Accounts payable and pharmacy claims and discounts payable | 2,335 | | 3,618 |
| Health care costs payable and other insurance liabilities | 2,757 | | 394 |
| Other liabilities | (3,542) | | 1,540 |
| Net cash provided by operating activities | $ 9,107 | | $ 13,426 |
Non-GAAP Financial Information
The Company uses non-GAAP financial measures to analyze underlying business performance and trends. The Company believes that providing these non-GAAP financial measures enhances the Company's and investors' ability to compare the Company's past financial performance with its current and expected future performance. These non-GAAP financial measures, which are included in this press release and which may be referred to on the conference call discussing the Company's fourth quarter and full-year 2024 financial results, are provided as supplemental information to the financial measures presented in this press release and discussed on the conference call that are calculated and presented in accordance with GAAP. Non-GAAP financial measures should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP. The Company's definitions of its non-GAAP financial measures may not be comparable to similarly titled measures reported by other companies.
Non-GAAP financial measures such as consolidated adjusted operating income, adjusted earnings per share ("EPS") and adjusted income attributable to CVS Health exclude from the relevant GAAP metrics, as applicable: amortization of intangible assets, net realized capital gains or losses and other items, if any, that neither relate to the ordinary course of the Company's business nor reflect the Company's underlying business performance.
For the periods covered in this press release, the following items are excluded from the non-GAAP financial measures described above, as applicable, because the Company believes they neither relate to the ordinary course of the Company's business nor reflect the Company's underlying business performance:
See endnotes (1) and (2) on page 23 for definitions of non-GAAP financial measures. Reconciliations of each non-GAAP financial measure to the most directly comparable GAAP financial measure are presented on pages 13 through 15 and page 22.
| Reconciliations of Non-GAAP Financial Measures to the Most Directly Comparable GAAP Financial Measures Adjusted Operating Income (Unaudited) | |||||||||
| | |||||||||
| The following are reconciliations of consolidated operating income (GAAP measure) to consolidated adjusted operating income, as well as reconciliations of segment GAAP operating income (loss) to segment adjusted operating income (loss): | |||||||||
| | |||||||||
| | Three Months Ended December 31, 2024 | ||||||||
| In millions | Health Care Benefits | | Health Services | | Pharmacy & Consumer Wellness | | Corporate/ Other | | Consolidated Totals |
| Operating income (loss) (GAAP measure) | $ (757) | | $ 1,903 | | $ 1,694 | | $ (472) | | $ 2,368 |
| Amortization of intangible assets | 294 | | 147 | | 61 | | 1 | | 503 |
| Net realized capital (gains) losses | 15 | | (289) | | — | | 68 | | (206) |
| Acquisition-related integration costs | — | | — | | — | | 40 | | 40 |
| Restructuring charges | — | | — | | — | | 10 | | 10 |
| Office real estate optimization charges | 9 | | — | | 3 | | 1 | | 13 |
| Adjusted operating income (loss) (1) | $ (439) | | $ 1,761 | | $ 1,758 | | $ (352) | | $ 2,728 |
| | | ||||||||
| | Three Months Ended December 31, 2023 | ||||||||
| In millions | Health Care Benefits | | Health Services | | Pharmacy & Consumer Wellness | | Corporate/ Other | | Consolidated Totals |
| Operating income (loss) (GAAP measure) | $ 266 | | $ 1,710 | | $ 1,961 | | $ (564) | | $ 3,373 |
| Amortization of intangible assets | 294 | | 149 | | 65 | | 1 | | 509 |
| Net realized capital losses | 106 | | — | | 1 | | 45 | | 152 |
| Acquisition-related integration costs | — | | — | | — | | 193 | | 193 |
| Office real estate optimization charges | 10 | | 1 | | — | | (11) | | — |
| Adjusted operating income (loss) (1) | $ 676 | | $ 1,860 | | $ 2,027 | | $ (336) | | $ 4,227 |
| | | ||||||||
| | Year Ended December 31, 2024 | ||||||||
| In millions | Health Care Benefits | | Health Services | | Pharmacy & Consumer Wellness | | Corporate/ Other | | Consolidated Totals |
| Operating income (loss) (GAAP measure) | $ (984) | | $ 6,937 | | $ 4,770 | | $ (2,207) | | $ 8,516 |
| Amortization of intangible assets | 1,175 | | 595 | | 253 | | 2 | | 2,025 |
| Net realized capital (gains) losses | 97 | | (289) | | — | | 75 | | (117) |
| Acquisition-related integration costs | — | | — | | — | | 243 | | 243 |
| Restructuring charges | — | | — | | 747 | | 432 | | 1,179 |
| Office real estate optimization charges | 19 | | — | | 4 | | 7 | | 30 |
| Opioid litigation charge | — | | — | | — | | 100 | | 100 |
| Adjusted operating income (loss) (1) | $ 307 | | $ 7,243 | | $ 5,774 | | $ (1,348) | | $ 11,976 |
| | | ||||||||
| | Year Ended December 31, 2023 | ||||||||
| In millions | Health Care Benefits | | Health Services | | Pharmacy & Consumer Wellness | | Corporate/ Other | | Consolidated Totals |
| Operating income (loss) (GAAP measure) | $ 3,949 | | $ 6,842 | | $ 5,349 | | $ (2,397) | | $ 13,743 |
| Amortization of intangible assets | 1,177 | | 465 | | 260 | | 3 | | 1,905 |
| Net realized capital losses | 402 | | — | | 5 | | 90 | | 497 |
| Acquisition-related transaction and integration costs | — | | — | | — | | 487 | | 487 |
| Restructuring charges | — | | — | | — | | 507 | | 507 |
| Office real estate optimization charges | 49 | | 5 | | — | | (8) | | 46 |
| Loss on assets held for sale | — | | — | | 349 | | — | | 349 |
| Adjusted operating income (loss) (1) | $ 5,577 | | $ 7,312 | | $ 5,963 | | $ (1,318) | | $ 17,534 |
| Adjusted Earnings Per Share (Unaudited) | |||||||
| | |||||||
| The following are reconciliations of net income attributable to CVS Health to adjusted income attributable to CVS Health and calculations of GAAP diluted EPS and Adjusted EPS: | |||||||
| | |||||||
| | Three Months Ended December 31, 2024 | | Three Months Ended December 31, 2023 | ||||
| In millions, except per share amounts | Total | | Per | | Total | | Per |
| Net income attributable to CVS Health (GAAP measure) | $ 1,644 | | $ 1.30 | | $ 2,046 | | $ 1.58 |
| Amortization of intangible assets | 503 | | 0.40 | | 509 | | 0.39 |
| Net realized capital (gains) losses | (206) | | (0.16) | | 152 | | 0.12 |
| Acquisition-related integration costs | 40 | | 0.03 | | 193 | | 0.15 |
| Restructuring charges | 10 | | 0.01 | | — | | — |
| Office real estate optimization charges | 13 | | 0.01 | | — | | — |
| Gain on early extinguishment of debt | (491) | | (0.39) | | — | | — |
| Tax impact of non-GAAP adjustments | (7) | | (0.01) | | (162) | | (0.12) |
| Adjusted income attributable to CVS Health (2) | $ 1,506 | | $ 1.19 | | $ 2,738 | | $ 2.12 |
| | | | | | | | |
| Weighted average diluted shares outstanding | | | 1,261 | | | | 1,293 |
| | |||||||
| | Year Ended | | Year Ended | ||||
| In millions, except per share amounts | Total | | Per | | Total | | Per |
| Net income attributable to CVS Health (GAAP measure) | $ 4,614 | | $ 3.66 | | $ 8,344 | | $ 6.47 |
| Amortization of intangible assets | 2,025 | | 1.61 | | 1,905 | | 1.48 |
| Net realized capital (gains) losses | (117) | | (0.09) | | 497 | | 0.38 |
| Acquisition-related transaction and integration costs | 243 | | 0.19 | | 487 | | 0.38 |
| Restructuring charges | 1,179 | | 0.93 | | 507 | | 0.39 |
| Office real estate optimization charges | 30 | | 0.02 | | 46 | | 0.04 |
| Opioid litigation charge | 100 | | 0.08 | | — | | — |
| Gain on early extinguishment of debt | (491) | | (0.39) | | — | | — |
| Loss on assets held for sale | — | | — | | 349 | | 0.27 |
| Tax impact of non-GAAP adjustments | (745) | | (0.59) | | (863) | | (0.67) |
| Adjusted income attributable to CVS Health (2) | $ 6,838 | | $ 5.42 | | $ 11,272 | | $ 8.74 |
| | | | | | | | |
| Weighted average diluted shares outstanding | | | 1,262 | | | | 1,290 |
Supplemental Information
(Unaudited)
The Company's segments maintain separate financial information, and the Company's chief operating decision maker (the "CODM") evaluates the segments' operating results on a regular basis in deciding how to allocate resources among the segments and in assessing segment performance. The CODM evaluates the performance of the Company's segments based on adjusted operating income. Adjusted operating income is defined as operating income (GAAP measure) excluding the impact of amortization of intangible assets, net realized capital gains or losses and other items, if any, that neither relate to the ordinary course of the Company's business nor reflect the Company's underlying business performance as further described in endnote (1). The CODM uses adjusted operating income as its principal measure of segment performance as it enhances the CODM's ability to compare past financial performance with current performance and analyze underlying business performance and trends.
The following are reconciliations of financial measures of the Company's segments to the consolidated totals:
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