Home > Comparison > Healthcare > ELV vs CI
The strategic rivalry between Elevance Health Inc. and Cigna Corporation defines the current trajectory of the healthcare plans industry. Elevance Health operates as a comprehensive health benefits provider with broad consumer reach, while Cigna focuses on integrated insurance and coordinated health services. This head-to-head contrasts scale and service integration in a sector driven by cost control and patient outcomes. This analysis will identify which model delivers superior risk-adjusted returns for a diversified portfolio.
Table of contents
Companies Overview
Elevance Health and Cigna Corporation are two heavyweight players shaping the US healthcare plans market.
Elevance Health Inc.: Comprehensive Health Benefits Leader
Elevance Health dominates as a health benefits company serving 118M people with medical, digital, pharmacy, behavioral, and clinical solutions. Its core revenue stems from integrated care services that connect consumers to comprehensive health resources. In 2026, the focus remains on expanding its portfolio to support whole-person health and improve patient outcomes.
Cigna Corporation: Coordinated Health Services Provider
Cigna is a leading provider of insurance and health services across multiple segments, including Evernorth’s pharmacy, benefits, and care management solutions. It generates revenue from diverse insurance products and coordinated health services for employers, government, and individuals. The company’s strategic focus targets enhancing integrated care delivery and expanding Medicare offerings.
Strategic Collision: Similarities & Divergences
Both firms emphasize integrated healthcare but differ in approach: Elevance pursues a holistic care ecosystem, while Cigna balances insurance breadth with point solutions. Their primary battleground is the delivery of coordinated care and chronic condition management. Investors face distinct profiles: Elevance leverages scale and service integration, whereas Cigna emphasizes diversified insurance products and care management innovation.
Income Statement Comparison
This comparison dissects the core profitability and scalability of both corporate engines to reveal who dominates the bottom line:
| Metric | Elevance Health Inc. (ELV) | Cigna Corporation (CI) |
|---|---|---|
| Revenue | 199.1B | 247.1B |
| Cost of Revenue | 148.2B | 221.2B |
| Operating Expenses | 42.8B | 16.5B |
| Gross Profit | 50.9B | 25.9B |
| EBITDA | 9.7B | 11.4B |
| EBIT | 8.1B | 9.7B |
| Interest Expense | 1.4B | 1.4B |
| Net Income | 5.7B | 3.4B |
| EPS | 25.18 | 12.25 |
| Fiscal Year | 2025 | 2024 |
Income Statement Analysis: The Bottom-Line Duel
This income statement comparison exposes each company’s operational efficiency and profit quality through recent revenue and net income trends.
Elevance Health Inc. Analysis
Elevance Health’s revenue rose steadily from 139B in 2021 to 199B in 2025, reflecting robust top-line growth. Gross margins improved to 25.6%, signaling strong cost control despite rising expenses. However, net income slightly declined to 5.66B in 2025, with net margin slipping to 2.8%, highlighting pressure on bottom-line efficiency amid rising operating costs.
Cigna Corporation Analysis
Cigna’s revenue jumped sharply from 160B in 2020 to 247B in 2024, showing aggressive expansion. Gross margins remained modest around 10.5%, constrained by higher cost of revenue. Although operating income grew, net income fell to 3.43B in 2024, dragging net margin down to 1.4%, indicating margin compression despite scale gains.
Margin Strength vs. Revenue Growth
Elevance delivers stronger gross margins and steadier net income, while Cigna leverages rapid revenue growth but struggles with profitability. Elevance’s higher margin profile offers better operational discipline. For investors prioritizing sustainable profitability, Elevance’s profile appears more attractive than Cigna’s high-growth but margin-challenged trajectory.
Financial Ratios Comparison
These vital ratios act as a diagnostic tool to expose the underlying fiscal health, valuation premiums, and capital efficiency of the companies compared:
| Ratios | Elevance Health Inc. (ELV) | Cigna Corporation (CI) |
|---|---|---|
| ROE | 12.9% | 8.4% |
| ROIC | 7.2% | 6.7% |
| P/E | 13.7 | 22.5 |
| P/B | 1.77 | 1.89 |
| Current Ratio | 1.54 | 0.84 |
| Quick Ratio | 1.54 | 0.73 |
| D/E | 0.73 | 0.78 |
| Debt-to-Assets | 26.4% | 20.5% |
| Interest Coverage | 5.0 | 6.6 |
| Asset Turnover | 1.64 | 1.59 |
| Fixed Asset Turnover | 42.5 | 298.5 |
| Payout Ratio | 27.0% | 45.6% |
| Dividend Yield | 1.97% | 2.02% |
| Fiscal Year | 2025 | 2024 |
Efficiency & Valuation Duel: The Vital Signs
Financial ratios act as the company’s DNA, exposing hidden risks and operational strengths that shape investor confidence and valuation accuracy.
Elevance Health Inc.
Elevance Health shows a solid 12.9% ROE and a 2.85% net margin, signaling moderate profitability. Its P/E of 13.7 suggests the stock trades at a reasonable valuation. With a 1.97% dividend yield and favorable liquidity ratios, Elevance balances shareholder returns with efficient capital allocation.
Cigna Corporation
Cigna presents a lower 8.4% ROE and a slim 1.39% net margin, indicating weaker profitability. The stock commands a higher P/E of 22.5, reflecting a stretched valuation. However, Cigna offers a slightly higher 2.02% dividend yield but struggles with liquidity, showing current and quick ratios below 1.
Valuation Discipline vs. Profitability Resilience
Elevance Health offers a better blend of valuation discipline and operational efficiency. Cigna’s higher valuation and weaker profitability increase risk exposure. Investors prioritizing stable returns and sound fundamentals may prefer Elevance’s profile, while those seeking yield under riskier conditions might lean toward Cigna.
Which one offers the Superior Shareholder Reward?
I compare Elevance Health Inc. (ELV) and Cigna Corporation (CI) on dividends, payout, and buybacks. ELV yields 1.97% with a 27% payout ratio, balancing dividends and buybacks sustainably. CI yields slightly higher at 2.02% but pays out 46% of earnings, risking cash flow strain. ELV’s free cash flow per share of $14.3 supports its 27% payout, indicating sustainable dividend coverage. CI’s aggressive 46% payout ratio pressures FCF, although it maintains strong buybacks. ELV’s lower payout and steady buybacks offer a more prudent long-term return. I conclude ELV delivers superior total shareholder reward in 2026 due to more balanced capital allocation and sustainable distributions.
Comparative Score Analysis: The Strategic Profile
The radar chart reveals the fundamental DNA and trade-offs of Elevance Health Inc. and Cigna Corporation, highlighting how each firm balances growth, profitability, leverage, and valuation:
Elevance Health shows a more balanced profile with solid ROE (4) and ROA (4) scores, paired with a very favorable DCF score (5). However, its debt-to-equity score is very unfavorable (1), signaling high leverage risk. Cigna matches Elevance’s DCF strength (5) but lags significantly on profitability metrics (ROE and ROA at 1) and suffers from poor valuation multiples, especially P/B (1). Cigna relies heavily on valuation and cash flow but struggles operationally. Elevance offers steadier fundamentals, while Cigna’s edge is limited to discounted cash flow appeal.
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Bankruptcy Risk: Solvency Showdown
The Altman Z-Scores place both firms in the grey zone, indicating moderate bankruptcy risk under current market conditions:
Elevance posts a Z-Score of 2.45, slightly below Cigna’s 2.69. Both scores suggest these companies face some financial stress but remain above distress levels, requiring careful monitoring of leverage and cash flow, especially given the sector’s cyclical pressures.
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Financial Health: Quality of Operations
Both Elevance and Cigna score an average Piotroski F-Score of 5, indicating moderate financial health with no clear red flags but room for improvement:
A score of 5 implies that neither company exhibits peak operational quality or robust internal financial strength. Investors should be cautious, as average scores in this domain often precede volatility in earnings and balance sheet metrics during economic downturns.
How are the two companies positioned?
This section dissects ELV and CI’s operational DNA by comparing revenue distribution and internal strengths and weaknesses. The goal is to confront their economic moats and identify which model sustains the strongest competitive advantage today.
Revenue Segmentation: The Strategic Mix
This comparison dissects how Elevance Health Inc. and Cigna Corporation diversify their income streams and where their primary sector bets lie:
Elevance Health anchors its 2025 revenue in Health Benefits ($167B) with a strong secondary Carelon Services segment ($71.7B), showing solid diversification. Cigna pivots mainly on Evernorth ($198B), which dwarfs its Cigna Healthcare segment ($47.5B), revealing a more concentrated mix. Elevance’s dual-segment approach reduces concentration risk, while Cigna’s reliance on Evernorth suggests ecosystem lock-in but higher segment dependency.
Strengths and Weaknesses Comparison
This table compares the Strengths and Weaknesses of Elevance Health Inc. and Cigna Corporation:
Elevance Health Inc. Strengths
- Diverse revenue streams with Carelon Services and Health Benefits segments
- Favorable asset turnover ratios indicate efficient use of assets
- Strong current and quick ratios show solid liquidity
- Favorable debt-to-assets ratio supports financial stability
Cigna Corporation Strengths
- Large revenue from Evernorth and Cigna Healthcare segments
- Favorable interest coverage ratio indicates strong ability to service debt
- Exceptional fixed asset turnover highlights operational efficiency
- Dividend yield slightly higher than Elevance
Elevance Health Inc. Weaknesses
- Low net margin signals weak profitability despite neutral ROE and ROIC
- Moderate debt-to-equity ratio requires monitoring
- Neutral price-to-book ratio limits valuation upside
Cigna Corporation Weaknesses
- Unfavorable net margin and ROE reflect profitability challenges
- Current and quick ratios below 1 indicate liquidity stress
- Higher debt-to-equity ratio than Elevance raises leverage concerns
Elevance Health shows a more balanced financial profile with better liquidity and efficiency metrics. Cigna relies heavily on large segments but faces liquidity and profitability pressures that could constrain strategic flexibility.
The Moat Duel: Analyzing Competitive Defensibility
A structural moat is the only reliable shield protecting long-term profits from relentless competitive pressures:
Elevance Health Inc. (ELV): Intangible Assets Powerhouse
I see Elevance’s moat mainly in its vast intangible assets and integrated care solutions. Its modest ROIC above WACC signals slight value creation, but declining profitability warns of emerging threats. In 2026, innovation in digital health could either deepen this moat or intensify competition.
Cigna Corporation (CI): Efficient Capital Allocation and Growth
Cigna’s moat rests on efficient capital use and expanding network effects through Evernorth services. Its ROIC sustainably outpaces WACC with strong growth trends, contrasting Elevance’s erosion. Cigna’s focus on coordinated care and international expansion offers promising moat reinforcement in 2026.
Intangible Assets vs. Capital Efficiency: Who Holds the Stronger Moat?
Cigna holds a deeper, growing moat, driven by superior capital efficiency and expanding service ecosystems. Elevance’s intangible asset moat faces erosion from declining ROIC. Cigna stands better poised to defend and grow market share in today’s evolving healthcare landscape.
Which stock offers better returns?
The past year shows significant price declines for both stocks, with recent modest recoveries suggesting shifting momentum and changing trading dynamics.
Trend Comparison
Elevance Health Inc. (ELV) faced a bearish trend over the past 12 months with a -33.93% price drop, showing accelerating decline and high volatility. Recent weeks reversed with a 5.36% gain.
Cigna Corporation (CI) also experienced a bearish trend with a -17.04% price fall, accelerating downward but with lower volatility than ELV. The recent 5.02% uptick indicates some recovery.
Comparing trends, both stocks fell sharply, but ELV’s losses were steeper. Recent gains are similar, though ELV’s higher volatility and deeper decline mark it as more volatile with weaker annual performance.
Target Prices
Analysts present a confident target price consensus for Elevance Health Inc. and Cigna Corporation, reflecting solid growth expectations.
| Company | Target Low | Target High | Consensus |
|---|---|---|---|
| Elevance Health Inc. | 332 | 425 | 387.14 |
| Cigna Corporation | 294 | 372 | 322.25 |
The consensus target for Elevance Health sits roughly 14% above its current 339 price, signaling upside potential. Cigna’s target consensus exceeds its 292 price by about 10%, indicating moderate bullish sentiment.
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How do institutions grade them?
The following tables summarize the most recent institutional grades for Elevance Health Inc. and Cigna Corporation:
Elevance Health Inc. Grades
The table below shows current grades from notable financial institutions for Elevance Health Inc.
| Grading Company | Action | New Grade | Date |
|---|---|---|---|
| JP Morgan | Maintain | Overweight | 2026-02-02 |
| Truist Securities | Maintain | Buy | 2026-02-02 |
| Barclays | Maintain | Overweight | 2026-01-30 |
| Wells Fargo | Maintain | Overweight | 2026-01-30 |
| Guggenheim | Maintain | Buy | 2026-01-29 |
| Guggenheim | Maintain | Buy | 2026-01-22 |
| Wolfe Research | Upgrade | Outperform | 2026-01-08 |
| Wells Fargo | Maintain | Overweight | 2026-01-07 |
| Barclays | Maintain | Overweight | 2026-01-05 |
| Deutsche Bank | Downgrade | Hold | 2025-12-19 |
Cigna Corporation Grades
Below is a summary of recent grades for Cigna Corporation by major grading companies.
| Grading Company | Action | New Grade | Date |
|---|---|---|---|
| RBC Capital | Maintain | Outperform | 2026-02-06 |
| Barclays | Maintain | Overweight | 2026-02-06 |
| Guggenheim | Maintain | Buy | 2026-02-06 |
| Guggenheim | Maintain | Buy | 2026-02-02 |
| Barclays | Maintain | Overweight | 2026-01-05 |
| Truist Securities | Maintain | Buy | 2026-01-05 |
| Bernstein | Maintain | Market Perform | 2025-11-12 |
| Wells Fargo | Maintain | Equal Weight | 2025-11-05 |
| Goldman Sachs | Maintain | Buy | 2025-11-04 |
| TD Cowen | Maintain | Buy | 2025-11-04 |
Which company has the best grades?
Both companies have strong institutional support with mostly positive grades. Elevance Health shows a slight downgrade from Deutsche Bank but many overweight and buy ratings. Cigna has consistent buy and outperform ratings without recent downgrades. Investors may view Cigna’s stable outlook as less volatile while Elevance Health’s ratings indicate confidence tempered by cautious voices.
Risks specific to each company
The following categories identify the critical pressure points and systemic threats facing both firms in the 2026 market environment:
1. Market & Competition
Elevance Health Inc. (ELV)
- Faces intense competition in healthcare plans but leverages scale with 118M people served.
Cigna Corporation (CI)
- Competes in diversified insurance and health services; smaller employee base may limit scale benefits.
2. Capital Structure & Debt
Elevance Health Inc. (ELV)
- Moderate leverage with debt/equity at 0.73; strong interest coverage (5.79x) supports stability.
Cigna Corporation (CI)
- Slightly higher leverage (D/E 0.78), but weaker liquidity ratios raise concern over short-term obligations.
3. Stock Volatility
Elevance Health Inc. (ELV)
- Beta of 0.503 indicates moderate volatility relative to market; steadier price movement.
Cigna Corporation (CI)
- Lower beta at 0.283 implies less sensitivity to market swings, appealing for risk-averse investors.
4. Regulatory & Legal
Elevance Health Inc. (ELV)
- Operates in a highly regulated US healthcare market; risks include policy shifts and compliance costs.
Cigna Corporation (CI)
- Similar regulatory exposure; complex international operations add legal risk layers.
5. Supply Chain & Operations
Elevance Health Inc. (ELV)
- Large-scale operations with a diverse service portfolio reduce supply chain disruption risks.
Cigna Corporation (CI)
- Reliance on third-party providers and multiple segments increases operational complexity and vulnerability.
6. ESG & Climate Transition
Elevance Health Inc. (ELV)
- Growing pressure to integrate ESG factors; proactive health-focused solutions may offer advantage.
Cigna Corporation (CI)
- ESG initiatives advancing but must balance traditional insurance lines with sustainability goals.
7. Geopolitical Exposure
Elevance Health Inc. (ELV)
- Primarily US-focused, limiting direct geopolitical risks but sensitive to domestic policy changes.
Cigna Corporation (CI)
- Broader international footprint increases exposure to geopolitical tensions and currency risks.
Which company shows a better risk-adjusted profile?
Elevance Health’s strongest risk is regulatory shifts impacting its vast US healthcare network. Cigna’s critical risk lies in weaker liquidity ratios amid complex global operations. I see Elevance Health as having a better risk-adjusted profile, supported by its favorable capital structure, stronger coverage ratios, and balanced market volatility. Recent data reveals Cigna’s current ratio below 1, signaling near-term liquidity strain, which elevates caution.
Final Verdict: Which stock to choose?
Elevance Health Inc. (ELV) stands out for its operational efficiency and solid asset turnover, delivering strong cash flow generation despite a recent margin contraction. Its key point of vigilance lies in declining profitability metrics, signaling the need for careful monitoring. ELV suits investors aiming for aggressive growth with a tolerance for volatility.
Cigna Corporation (CI) offers a durable strategic moat through its expanding return on invested capital and improving profitability trends. Its stronger safety profile and healthier free cash flow yield provide a steadier foundation than ELV. CI fits well in a GARP (Growth at a Reasonable Price) portfolio seeking stable growth with moderate risk.
If you prioritize operational efficiency and high growth potential, ELV is the compelling choice due to its robust cash conversion and asset utilization. However, if you seek better stability and a sustainable competitive advantage, CI offers superior value creation and a safer financial footing amid market challenges.
Disclaimer: Investment carries a risk of loss of initial capital. The past performance is not a reliable indicator of future results. Be sure to understand risks before making an investment decision.
Go Further
I encourage you to read the complete analyses of Elevance Health Inc. and Cigna Corporation to enhance your investment decisions:
