What were the key expense drivers for Elevance Health in 2023?

Elevance Health's key expense drivers in 2023 were primarily related to its operating expenses, which included: 1. **Benefit Expense**: The benefit expense ratio decreased to 86.4% in Q2 2023, a decrease of 70 basis points year-over-year, primarily driven by premium rate adjustments to more accurately reflect the cost of care. This adjustment was a key factor in managing the benefit expense and maintaining profitability. 2. **Medical Enrollment**: While medical enrollment increased in some periods, such as the addition of 938 thousand members year-over-year to 48.0 million members during Q2 2023, the attrition in Medicaid membership due to the resumption of eligibility redeterminations and the entry of new competitors into state Medicaid programs contributed to the decrease in membership in certain periods. 3. **Membership Growth**: The expectation of only ~1% membership growth for 2023, coupled with the projection of a lower-than-expected earnings outlook, indicated that the growth in membership was not a significant driver of expenses but rather a factor in maintaining the existing membership base. 4. **Pharmacy Benefits Manager**: The contribution from its pharmacy benefit manager, CarelonRx, which brought in $7.5 billion in revenue with ~11% year-over-year growth, was a positive factor, indicating that the integration of this business unit was beneficial in managing overall expenses. In summary, Elevance Health's key expense drivers in 2023 were primarily related to managing benefit expenses through premium rate adjustments, managing medical enrollment, and leveraging the contributions from its pharmacy benefit manager, CarelonRx.