Operator: Hello and welcome to CVS Health's third quarter 26 earnings call. We ask that you please hold all questions until the end of the prepared remarks at which time you will be given instructions for the question-and-answer session. As a reminder, this conference is being recorded today. If you have any objections, please disconnect at this time. I would now like to pass the call to Larry McGrath. Larry, please proceed.
Larry McGrath: Good morning, and welcome to the CVS Health Third Quarter 26 Earnings and Business Update Call and Webcast. I am Larry McGrath, executive vice president of capital markets at CVS Health. I am joined this morning by David Joyner, Chairman and Chief Executive Officer and Brian O. Newman, Chief Financial Officer. Following our prepared remarks, we will host a question-and-answer session that will include additional members of the leadership team. Our press releases and slide presentations have been posted to our Web site. Along with our Form 10 Q filed this morning with the SEC. Today's call is also being broadcast on our website. During this call, we will make certain forward-looking statements. Our forward-looking statements are subject to significant risks and uncertainties that could cause actual results to differ materially from currently projected results. We strongly encourage you to review the reports we file with the SEC regarding these risks and uncertainties. In particular those that are described in the cautionary statement concerning forward-looking statements and risk factors in our most recent annual report on Form 10 ks our quarterly report on Form 10 Q filed this morning, and our recent filings on Form 8 ks including this morning's earnings press release. During this call, we will use certain non GAAP measures when talking about the company's financial performance and financial condition and you can find a reconciliation of these non GAAP measures in this morning's press release and in the reconciliation document posted to the Investor Relations portion of our website. With that, I would like to turn the call over to David. David?
J. David Joyner CEBS: Thank you, Larry, and good morning, everyone. Our organization has a long and distinguished history And in my 40 years at this company, there has been 1 constant. We act, we evolve, we proactively shape the future of healthcare. Today, announced our intention to separate into 2 independent publicly traded companies. This decision marks the next important chapter in the evolution of CVS Health. We are creating 2 distinct leaders in health care, The first will be a healthcare solutions company that brings together medical, pharmacy, specialty, and care delivery capabilities integrated where it matters. In the interim period, we are referring to this business as CVS Health. The second company will be a leading national retail pharmacy and community health care company. This business will be named CVS Pharmacy. Both companies will be led by experienced leadership teams, have a clear right to win in their respective markets, and we expect will be supported by solid investment grade balance sheets enabling each company to pursue disciplined and tailored capital allocation. We take this action from a position of strength. Which you can see in the consistent progress we have made since 2024. As well as in the third quarter results the updated guidance we announced this morning. This quarter, we generated adjusted operating income of $4.2 billion and adjusted earnings per share of $2.09 Building on our continued strong performance so far this year, we are raising our full-year 2026 adjusted earnings per share guidance to at least $8.20, an increase from our prior range of $7.90 to $8.10. We are also updating our full year expectation for cash flow from operations to at least $15.5 billion With this latest update, our 2026 adjusted EPS guidance is now more than $1 above our initial expectations for 2026. And our cash flow from operations outlook has increased by more than $5.5 billion for the year. This progress clearly reflects our growing momentum. I will now ask Brian to provide more details on the results this quarter. Our updated full year 2026 guidance, and perspective on the factors shaping our 2027 expectations. I will then come back to provide more details on our announcement. Brian?
Brian O. Newman: Thank you, David and good morning. I will cover 4 key topics in my remarks this morning. First, an update on our third quarter results. Second, I will discuss cash flow. The balance sheet and capital deployment. After that, I will provide an updated financial outlook for 2026 And finally, I will share some headwinds and tailwinds as we look ahead to 2027. Our third quarter results demonstrate the discipline with which we continue to manage the enterprise. We once again delivered on our commitments and raised our full-year outlook for revenue, adjusted EPS and cash flow from operations. Our execution has significantly strengthened our balance sheet allowing us to achieve target leverage ahead of schedule and will enable us to resume our share repurchase program in the fourth quarter. Let me start by highlighting some of our enterprise results in the quarter. We generated over $108 billion of revenue and delivered nearly $4.2 billion of adjusted operating income. Once again reflecting earnings growth across all of our operating segments. We delivered adjusted EPS of $2.09, an increase of over 30% from the prior year quarter. And finally, in the quarter, we generated cash flow from operations of approximately $4.7 billion bringing our year to date cash flow from operations to $15.3 billion Turning now to each of our segments. In Healthcare Benefits, we continue to make strong progress in our return to target margins. In the quarter, we delivered adjusted operating income of $900 million an increase of nearly $600 million from the prior year quarter. Our medical benefit ratio was 91.3%. An improvement of approximately 150-basis-points from the prior year. These results were primarily driven by improved underlying performance in our Medicare business. Across our businesses, we continue to successfully navigate elevated trends that remain above historical levels throughout the industry. But were broadly in line with our expectations. Performance in our Medicare book modestly exceeded our expectations driven by pockets of favorability as a result of strong medical cost management and disciplined pricing. We remain confident in the adequacy of our reserves. In our Health Services segment, we continue to execute against our objectives. During the quarter, we delivered adjusted operating income of $2.1 billion an increase of nearly 3% from the prior year quarter. Primarily driven by improved purchasing economics and pharmacy drug mix partially offset by continued pharmacy client price improvements. Results in our pharmacy services business were in line with our expectations during the quarter. Including performance in both our 340B business and rebate guarantees. Healthcare delivery also performed as expected. As we continue to drive improvement in the business. Our Pharmacy and Consumer Wellness segment delivered another strong quarter. We generated adjusted operating income of over $1.6 billion an increase of over 10% from the prior year. Primarily driven by core pharmacy strength including a nearly 4% increase in same store prescription volumes partially offset by continued business investments and the impact of consumer dynamics. Turning now to cash flow and the balance sheet. Year to date, we have generated cash flow from operations of $15.3 billion reflecting strong earnings as well as the impact of improvements in working capital. So far in 2026, we have returned $2.6 billion to our shareholders through our shareholder dividend. We ended the quarter with $6 billion of cash at the parent and unrestricted subsidiaries. As I mentioned earlier, we have made significant progress strengthening our balance sheet and have achieved our leverage goal ahead of schedule. This improved position combined with our strong cash flow, will enable us to resume our share repurchase program in the fourth quarter. Shifting now to our guidance for 2026. We are increasing our full year 2026 guidance for adjusted EPS to at least $8.20, an increase of $0.20 from the midpoint of our previous outlook. We now also expect our full year total revenues to be at least $420 billion In our health care benefits segment, we now expect full year adjusted operating income to be at least $5.4 billion an increase of $200 million. Relative to the midpoint of our prior outlook. We now expect our full year MBR to be in the lower half of our previously discussed range of 89.75% plus or minus 25-basis-points. This outlook continues to maintain a respectful and prudent view of medical cost trends. In our pharmacy and consumer wellness segment, we now expect full year adjusted operating income of $6.5 billion an increase of $100 million from our prior guidance and nearly 8% growth from the prior year. This reflects our strong performance in the quarter and our updated expectations for the remainder of the year. We are also reiterating our full year adjusted operating income outlook for our Health Services segment. In aggregate, we now expect full year enterprise adjusted operating income to be at least $17.05 billion We are also increasing our outlook for full year cash flow from operations to at least $15.5 billion reflecting our updated earnings outlook as well as the impact of working capital improvements and the timing of certain payments. Cash generation has long been a strength of this enterprise. And we continue to build on that strength as we deliver on our embedded earnings and unlock further working capital efficiencies. You can find additional details on the components of our updated 2026 guidance on our Investor Relations website. Turning now to 2027. Consistent with past practice, we expect to provide formal 2027 guidance on our fourth quarter earnings call early next year. Today, I will share an update on some of the key headwinds and tailwinds we are considering for 2027. Starting first with our health care benefits business. We expect another year of meaningful margin improvement. As Aetna makes strong progress on its path back to target margins. Once again, this improvement will be largely driven by the deliberate actions we took in our Medicare Advantage business along with continued disciplined underwriting and pricing across our businesses. In response to the elevated trend environment we expect will persist in 2027. In our Health Services segment, we expect to generate adjusted operating income of at least $7 billion This includes our previously discussed expectations for a year-over-year decline in our 340B business as well as headwinds from the impact of a less robust selling season and health plan client membership attrition. We also expect tailwinds from continued strength in specialty, and another year of improvement in our healthcare delivery business. We continue to expect our 340B business to largely stabilize by the end of next year. And we have confidence as we enter the 2028 PBM selling season. We are confident 2027 will reflect trough earnings for this segment, and we expect to return to growth from there. In our Pharmacy and Consumer Wellness business, we expect adjusted operating income to grow low single digits off our current 2026 guidance of $6.5 billion driven by continued pharmacy strength. This marks the third consecutive year of growth in earnings for this segment. Our updated outlook reflects the progress we have made differentiating our business and solidifying our position as the best run national pharmacy while maintaining a prudent view of consumer dynamics. Pulling it all together, and reflecting the strong performance we saw in the third quarter we now expect to deliver at least $8.65 in adjusted EPS in 2027, reflecting approximately 13% growth off an adjusted 2026 baseline. Our strong results demonstrate the progress we are making across the enterprise. We have strengthened our financial position created greater capacity for capital deployment, and built increased confidence in the long term expectations we outlined at Investor Day. We now believe we will be in the high end of our mid-teens adjusted EPS CAGR through 2028 Importantly, these expectations remain grounded in the same guidance philosophy of establishing credible targets, delivering with disciplined execution, and highlighting for outperformance. We will continue delivering on our say-do ratio and that discipline will remain as we progress towards separation. With that, I will now turn the call back over to David. David?
J. David Joyner CEBS: Thank you, Brian. As Brian highlighted, we are executing against our strategy and our businesses continue to deliver durable results. Today, we announced that we are building on that momentum. CVS Health is taking an important step in its evolution to create 2 independent publicly traded companies. Each of the 2 companies will remain a leader in their respective markets powered by the right assets, the right focus, and the ability to adapt and move faster. We can take this strategic action today because of our tremendous progress since 2024. We rebuilt our leadership team and instilled a clear culture of accountability, excellence, and execution across the organization. We significantly improved our financial performance, strengthened our balance sheet, and reached our target leverage ratio ahead of schedule creating capacity for disciplined capital deployment. We expanded our technology capabilities across our enterprise. Thoughtfully embedding AI throughout our businesses and creating a differentiated foundation to simplify and improve the health care experience. As we have consistently demonstrated, we are making great strides delivering against our goals while remaining focused on improving the health and care of the 185 million people we serve. As we have advanced our strategy, the environment around us is constantly changing. We will be better positioned to address this changing environment as 2 strong independent health care leaders. Following a thoughtful and deliberate strategic review by the board and senior management, we have a structure and plan that are built to win, and represent the best path to create value over the long term. As we announced CVS Health will retain Aetna, Caremark and Pharmacy Services, Specialty Pharmacy, Oak Street and Signify Health. Enables us to maintain and expand integration where it matters. Combining the tools necessary to improve affordability within medical and pharmacy benefits, and deliver care to high acuity populations including in Medicare and specialty pharmacy. CVS Pharmacy will be the leading national retail pharmacy and community healthcare company. It will include our retail pharmacy stores, mail order, MinuteClinic and Health 100, our AI native integrated healthcare engagement platform for consumers. The rationale for the separation is simple. With 4 clear benefits. First, focus. Each company will have an experienced dedicated leadership team that can concentrate on the areas where it has the greatest opportunity to create value. The same mission sharper focus. Second, capital allocation. Each company is expected to have a solid investment grade capital structure strong free cash flow This will enable tailored capital allocation more closely aligned with each company's strategy and growth opportunities. What will not change is the discipline that each company demonstrates and the deployment of capital. Third is agility. Each company will have greater flexibility to adopt the technologies that best fit its needs, improve efficiency, and more effectively adapt to the regulatory and other external dynamics. As independent companies, we will innovate and move faster as we work to improve how healthcare is experienced today. Finally, and importantly, simplicity. Greater independence, will make it easier to serve consumers, members, patients and communities and will create opportunities for each company to pursue a broader range of partnerships. By taking this deliberate action, we are creating simpler, stronger, and more focused companies. CVS Health will be a scaled health solutions company with attractive growth and strong cash flow generation. This business will preserve a well diversified mix of assets and capabilities to address a $2+ trillion growing market across Medicare, commercial and Medicaid. We will stay relentlessly focused on affordability, access and health outcomes I will serve as Chairman and CEO alongside the best in class leadership team in place today. CVS Pharmacy will be the national leader in pharmacy and community health care. Our investments in technology and our colleagues continue to set us apart in this greater than a $500 billion market. This is an economically resilient sector where prescription growth will continue to be driven by medical innovation and demographics. CVS Pharmacy will build on its position as the most trusted most frequent consumer touch point in healthcare. Prem S. Shah, currently the group president of CVS Health, will become CEO of CVS Pharmacy upon separation. He will be supported by the experienced leaders and colleagues who reset the trajectory and reinvigorated our retail pharmacy business. With attractive growth, enviable cash flow and a strong balance sheet, CVS Pharmacy will be a unique asset across healthcare and retail. Both companies remain committed to unlocking the tremendous potential of Health 100. Our AI native consumer engagement platform. The mission of Health 100 remains unchanged to be the front door of health and care. By focusing on consumers, Health 100 will truly change the way health care is experienced in this country. Will drive greater interoperability to remove friction from the system, and engage with consumers in a way that no 1 else has ever done before. Believe this separation will accelerate the adoption and development of Health 100 and allow us to drive innovation improve connectivity and unlock greater value across both companies. We expect the separation transaction to be tax free for U. S. Federal income tax purposes. And to be completed in the first half of 28. Subject to customary conditions including final board approval Form 10 effectiveness and receipt of customary tax confirmation. Following separation, CVS Health shareholders will own shares in both companies. We will be transparent about our progress and we will provide additional details along the way. I want to emphasize that we will not lose sight of the need to execute with excellence every single day and consistently deliver on our commitments to all of our stakeholders. Our purpose is clear, to simplify healthcare 1 person 1 family and 1 community at a time. I am confident this decision will allow both companies to better deliver on that promise and create lasting value for all stakeholders. With that, we will now open the call for your questions. Operator?
Operator: Thank you. At this time, if you would like to ask a question, please click on the raise hand button, which can be found on the black bar at the bottom of your screen. When it is your turn, you will receive a message on your screen, and then you will hear your name called. Please accept, unmute your audio, and ask your question. If you are calling in today, star 9 will activate the raised hand feature and star 6 can be used to unmute and mute your line. We ask that you please limit yourself to 1 question this morning. We will wait 1 moment to allow the queue to form. Our first question will come from the line of Lisa Gill with JPMorgan. Please unmute your line and ask your question.
Lisa Gill: Good morning, and thanks for taking the question. I cannot help but to think that November 1, 20 years ago, CVS and Caremark came together. I know you were head of sales at Caremark at the time, so I am sure that this is a very important date for you. But can we first start with just the timing of this and the rationale You walked through, you know, a number of the components, but if we could just maybe better understand especially the timing aspect.
J. David Joyner CEBS: Sure. So. And, Lisa, good to hear from you. And, yes, I do remember 20 years ago, in, 2006 talking about what we were trying to build as a very different, you know, pharmacy services company. And incredibly proud of the work that we have done over the last 20 years. And as I reflect back on, on that, I cannot help but think how much has changed since 2006. To 2026. So 20 years have changed. And even, quite frankly, the change that we have seen from the timing of the acquisition of Aetna. So the market continues to evolve and change. And as a company, we need to continue to evolve with it. So in the 2 years of being in this position, I have been afforded the unique opportunity of actually thinking about this from a position of strength. it is 8 quarters of both a beat and raise and a financial or balance sheet that is on. Is ahead of schedule in terms of its leverage. So we are. We just. We are afforded different decisions based off of the strength of the business, And I think there is 2 important things that I would point to. 1 is most of the energy over the last 2 years has been focusing on the Medicare recovery, and we are now entering our 3rd year of that important transition. And I think you will hear a lot of that today. But I think that actually sets the stage for the fact that we actually have what we think is a repeatable process to be able to compete effectively in that market. 1 thing we have not talked a lot about is the progress that we have made at retail. And with prem leading the recovery effort, from a business that was guiding to -5% 2 years ago to now where we are guiding our 3rd year of growth in that business. It just creates an opportunity to say, what is the future of this business? How should we be organized to be able to compete effectively? And I think what we look for is the integration that matters, and what we have done the last 2 years is to integrate quite a bit inside of CVS Health with both Caremark and Aetna. And some of the health care delivery assets that is helping us lean into value based care. But retail, has, for the most part, for the last 2 decades, operated behind a firewall. So we have always had to negotiate at arm's length. it is run independent of the business. And I think that the timing of this decision is saying, you know, now is the time because we are not doing anything out of a distressed decision. We actually are doing it because we actually have healthy balance sheets with appropriate capital allocation opportunities and momentum in each 1 of the businesses that we are operating. So again, I feel really good about the timing. I feel really good about the decision, and I feel equally as important about the team that is gonna allow us to execute against this plan.
Lisa Gill: I David, if I can sneak 1 more in. Just on the quarter and on Brian's comments on 2027, and 340B. I understand it is incorporated in the way you are thinking about 2027, but really just want to understand 2 things. 1, is this a change in the way that you are contracting? And 2, Brian made the comment that you have line of sight that it ends in 2027. It does not spill into to 2028. Can you maybe just help me to understand that when I think about what is happening here and why you have line of sight that it is only going to have an impact here in 2026 and 2027.
J. David Joyner CEBS: Yeah. it is a great question, Lisa. And I know there is been a lot of topics since our last earnings call on 340B, which is why we tried to size it as we head into 2027. So maybe I will have Brian speak a little bit about how we are thinking about HSS and then specifically 340B. And then I wanna have Prem speak a little bit to how we have our arms around and how we are thinking about, you know, specifically the 340B business. Brian?
Brian O. Newman: Sure. Thanks, David. And Lisa, thanks for the question. And as I think about the quarter itself, and then I will progress on to 27, performance in HSS, Lisa, was in line with our expectations. And you asked specifically about PS. And 340B Both 340B and rebate carry performance, we saw no surprises from our expectations. So we also continued to see strong performance in specialty, in the quarter. We maintained our guide for the full year, so not expecting any surprises balance of the year. I will comment since it is in the segment. HCD as well was consistent with our expectations, and we continue to see Oak Street perform, quite well. As we thought about next year, Lisa, and looking ahead to 2027, I thought it was important to establish a floor for the HS segment. And that is respectively what we have done today. We are we are we are confident that we would deliver at least 7 billion in HSS, AOI next year That includes the discussions around a year-over-year decline in 340B next year. And the impact of lower Caremark membership, those 2 elements. And so it also includes tailwinds from continued strength in specialty, as well as the second year of improvement in HCD, as we make progress towards our path to profitability at Oak Street, etcetera. So confident in our ability to manage the near term dynamics, Lisa, and 2027, as I mentioned previously, to reflect trough earnings for the segment as we return to growth in 2027 as we look downward. So, Prem, do you wanna color that up?
Prem S. Shah: Yeah. Thanks, Brian. And David, and, first off, thank you for the opportunity to lead. CVS Pharmacy upon separation. it is incredible opportunity, and wanna thank David and the board for that. When you when you think about the HSS segment, you know, as Brian said, pharmacy services was. In the quarter was in line with our expectations. We continue to feel good about our outlook for the remainder of the year. As you look into 2027, we are also confident in our position and our ability to manage through the transitory dynamics that we discussed prior. And, you know, coming out of the last call, I think there is 2 areas 340B was 1 and the selling season. Was the second that I wanna take a few minutes to really spend a little bit more time on. So with respect to 340B, we do not expect this to be a topic we need to discuss going forward. The level of contribution that we have our 2027 plan is an even smaller portion of the HSS segment earnings than it has been historically. And I would also reiterate that the. it is an important program relied on by safety net hospitals and covered entities across the country. And we do not expect the program to go away fully in the future. Secondly, when you look at the 2028 selling season, headed into the season with confidence. If you look at the value proposition for Caremark has and has always been, It really starts with our industry leading cost of goods. Our customer focus, our sophisticated capabilities and our price model flexibility that we offer to our customers, that it really address their top concerns and priorities, which is affordability, transparency, and experience. Recall that 2026 for Caremark was an incredibly strong selling season. We achieved approximately $6 billion of gross new wins. And as Brian said, a portion of the membership declines we expect in 2027 reflect strategic business decisions for our health plan clients including what you saw in Aetna's PDP book, which are not a reflection of Caremark's offerings that we have in the marketplace. And we expect the 2028 sales season and the new business pipeline to be robust and we remain confident in our position and the value proposition that we are providing into the marketplace. And finally, we have an incredibly strong and robust CVS specialty pharmacy business that is focused on the patients that we serve, but more importantly, the payers that we serve. Specialty continues to be a main driver of cost trend for us for our customers. We continue very diligent in driving competition and creating value. for our payer partners, and it is an area that we have invested a lot in technology and AI. Continue to make the consumer experiences seamless. We continue to really drive an integrated and a very strong offering there for the patients that we serve. So, overall, I would just summarize this with we expect 2027 to represent trough earnings of at least $7 billion. And for our health services segment, and we are going to return to growth thereafter.
Operator: Your next question will come from the line of Justin Lake with Wolfe Research. Please unmute your line and ask your question.
Justin Lake: Thanks. Good morning. I wanted to understand the impact of the breakup on the balance sheet and capital deployment opportunities? Specifically, I assume the rating agencies are now gonna look at CVS Health as a managed care organization, meaning debt to cap versus debt to EBITDA. Wanted to hear how this might impact your leverage versus today. And then we have all been expecting significant share repo into 2027 and beyond. Is there any impact on the company's ability to deploy capital versus that $35 billion of deployable capital opportunity you discussed at the Investor Day kind of post the breakup Thanks.
J. David Joyner CEBS: Yeah. So thanks, Justin. I will, I am gonna let Brian speak to this, but I do wanna just remind everybody that as we split CVS Pharmacy, the expectation is that we will have solid investment grade positions on both of these companies. And I. It speaks to the strength of each 1 of the businesses that, that remain in our confidence in the balance sheet and the ability to have the appropriate cap. Capital allocation flexibility. So, Brian, do you want to-- yeah.
Brian O. Newman: Thanks, David. And, Justin, it is it is a good question, and, obviously, I have spent a lot of time on the leverage. Both together and some of the parts as we think about the business. And I can say with a high degree of confidence that both companies will be solid investment grade with strong free cash flow generation. As you mentioned, we will target leverage or debt to cap, metrics that are appropriate for that rating level. We will we will we will bring you along on the process, Justin, as we move throughout the next 15, 18 months. You asked about share repo as well. I can tell you we basically have a history of generating cash You saw that in the guide? We raised our cash by $4 billion. And my expectation to get back into the market here in the fourth quarter. With the share repo program. So, as we think about restoring that leverage ratio, and targets, ahead of schedule. As I look out to the future and the transaction, I would not see anything getting in the way of our ability to deploy capital going forward.
Operator: Next question will come from the line of Michael Cherny with Leerink Partners. Please unmute and ask your question.
Michael Cherny: Good morning, and thank you for taking the question. Maybe to dive a little bit on Futureco. As you think about the business, clearly been numerous instances where CVS Pharmacy and Caremark made each other better. I am thinking of the expansion and creation of made. Of maintenance choice among other different areas. How do you think about the potential I do not wanna call them dyssynergies specifically, but the strategic rationale for the overlap going forward between the 2 entities and how that the competitive differentiation that both entities have been able to generate by being together, by being aligned between the store and the PBM that they do not lose that capability going forward.
J. David Joyner CEBS: Yeah. it is a great question, Michael. Something we have given quite a bit of thought to because we do think that there is something unique between CVS and Caremark, even the role that Aetna plays in terms of engaging the pharmacist, in, in the delivery of care. But the unique products that we built over the last you know, 20 years, are things that we are going to be preserved and commercial agreements between the 2 organizations. So we do not need the integration of. In an operating structure, We need to make sure that we are aligned around where we believe that there can be value creation and ensure that there is an appropriate commercial agreement in place to support that. So that is in large part what will be working on over the course of the next 15 to 18 months, is why the mail service is actually inside of CVS Pharmacy because we have reinvented how pharmacy is delivered. So it is not the traditional mail order and retail. It is basically a 90 day supply focused and organized around how the consumer wants to get their medication. So we can choose to deliver it to the home. We can. They can pick it up in the store. They can come through something maybe as convenient as a drive through. But the idea is that we are organizing pharmacy around the consumer and that Caremark gets the benefit of partnering with a company like CVS Pharmacy that continues to push the envelope on ways in which to better engage the consumer. The thing that we spent more time on as opposed to the products that we built in the past is where we are going in the future. And that is the emphasis around the technology platform of Health 100, It will be the connective tissue between the 2 organizations because CVS Pharmacy becomes the engagement engine, it is the most heavily transacted health care service And as a result, more frequent transactions and a higher engagement rate with the consumer And what Aetna and Caremark bring to the table is all the financial information to help make more informed and better decisions around their health care. So you connect those 2, which both organizations are committed to, we think we will build a world class consumer engagement platform to be able to help take advantage of where we believe. See technology going and also being able to democratize the data that, we know is an important part of, of where health care is headed. So I think the most important takeaway is that we have given a of thought about what is unique, that can. That needs to be organized a certain way, which is why mail services at CVS retail. And it is why we need to focus on the commercial agreements so we have the sustainability and the durability of being able to continue to organize and service the, you know, the consumer.
Operator: Next question. Will come from the line of Elizabeth Anderson with Evercore ISI. Please unmute and ask your question.
Elizabeth Anderson: Hi, guys. Good morning, and thanks so much for the question. Maybe 1 for you, Prem. I appreciate that comment you gave about sort of the ability for the new. 2 organizations to continue to work together going forward Prem, where do you see sort of additional opportunities or additional sort of areas you could focus on for the stores going forward as an independent, entity that we are not you know, available to you sort of in the current form? And then 2, maybe David could you just comment on, where you sort of trend overall? You talked about obviously pockets of strength in MA, but any more details you could provide on that to just continue to understand the improving strength there. Thank you very much.
J. David Joyner CEBS: Yeah. Perfect. Thanks, Elizabeth. And let me. But I am I am gonna have Prem speak to where the future opportunities, but I think it is worth noting what we have done over the last 2 plus years to get ourselves in a position to go build new products and services and create new opportunities. So, Prem, if you could just take a second talking about your priority and why we are in a growth mode at retail and what gives you confidence we are gonna expand into new areas.
Prem S. Shah: Yeah. Thanks, David. And Liz thank you for the question. This is an incredibly exciting time. And if you look at our retail business, if you look back, and I go back 3 or 4 years when we started to talk about the changes, the intentional changes that we are making here, Historically, that was focused on really 3 things. First and foremost, we invested in the technology platform to create better experiences And if you think about just some clear examples, AI now supports our pharmacy workflow for 85% of our prescriptions. Second, we invest in our colleagues. We know that our 30 thousand pharmacists, we know that our 200 thousand store colleagues essential components to deliver health care locally, and we know that health care is done by humans. In our local communities. And we have a tremendous focus on ensuring that our colleagues are enabled and successful in everything that they do. And lastly, I think some of the things that we focused on around customer NPS. So the customers that walk in our stores, how do we really improve that experience for them? How do we make that omnichannel? How do we make it consistent across the board? These are 3 areas we really spent a lot of time focusing on, and you can see that flow through in our results in this quarter. Right? As you saw in the quarter, our comp scripts, grew 3.9%. But, also, we were also able to take advantage of new opportunities I think GLP ones is another great example Our scripts in GLP ones this quarter grew 23%. And it is because we took action, we made access more affordable, we made it easier for patients to show up, I mean, we really drove down the. We really drove focus on what is most important for the people walking into our stores. And then lastly, I think it is really important to talk about our evolution of the reimbursement model. We focused on that over time with CVS CostVantage. And, you know, let me just be really clear. CVS and Caremark relationships have operated behind a firewall for more than you know, 2 decades. So this is something that we continually do but we continue to be focused on the value proposition that we create to payers And as I look forward, I think the excitement I have in our CVS Pharmacy asset is we have a well run strong service offering for the customers you serve. We are in a position now to offer incremental health care services leverage our 9 thousand stores, leverage our footprint in very different ways Because, you know, the key thing for most. For almost all payers, I do not care who you are in this country, is we have a challenge with affordability. And CVS Pharmacy affords us the privilege to serve in every community standardize health care services, and transform the industry in terms of what we can do. And this will afford us the right to really drive this forward into the marketplace.
J. David Joyner CEBS: that is perfect. So Prem is effectively running America's pharmacy. And we say this all the time. We think this country needs CVS Pharmacy and the community based services that we are providing because we are investing in the communities. And we are gonna continue to extend that reach as we, as we go forward. And now if I could just speak to the remaining CVS Health Organization and to Prem's point about this focus on affordability. We think the focus will now be purely on what we believe are the drivers of health care in this country. And if you look at the drivers of the spend coming from both the health systems and the drug manufacturers, with increases that, in most cases, are high single or low double digits, There is a significant opportunity for this organization to tackle that challenge on behalf of the customers in which we serve. So we are declaring that the company that will remain will be focused on supporting the payers and bringing affordability improving access. So, Steven, you wanna just give a little bit of color on the trend environment and how we are looking, maybe just on Medicare as an example?
Steven Hale Nelson: Sure. So thanks, David. Good morning. Elizabeth. So Aetna has had a strong quarter as we talked about. Really nice progress across all the businesses. At Aetna as we return the business to target margins. But I will just specifically comment on Medicare. You know, we have seen some pockets of favorability continues to be a high trend environment generally, but as we have laid down the foundation for this business over the last couple of years, we have seen tremendous improvement. And we are gonna build on that. We took the same discipline into our 2027 price pricing assumed trends remained elevated, and the priorities were unchanged. We were going after, 1 more year of margin improvement, and we pulled several levers to achieve that. We obviously as you could see, we did mix adjustments to benefits. But beyond that, we made adjustments to our geography, our product mix, We brought leading star scores in the 2027 payment year. We made adjustments to our network, so we had the highest performing providers in the markets where we wanted to perform and we. And we have built robust capabilities around medical cost management. So all those levers, were able to put into place as we think about 2027. And just a little insight here early into AEP, but so far, it is playing out exactly as we expected. We will be able to get more color to that as we complete AAP But this business is performing really well. And we expect another year of margin improvement. With some modest growth, actually. The benefit stability we are able to put into the marketplace is, I think, going to be important as we think about high retention of our current members. That helps engage the members creates actually better healthcare costs, and a higher satisfaction. So really like the position of the business. We have more work to do. Still a high trend environment. But we are lining up a lot of capabilities at Aetna with our investment in technology. And the tools we are putting into place. it is. We really think we have an opportunity to impact the affordability and access issue that is so much needed in our health care system.
J. David Joyner CEBS: Thanks. Steven? Next question, operator.
Operator: Next question will come from Erin Wilson Wright with Morgan Stanley. Your line is now open. Please unmute and ask your question.
Erin Wilson Wright: Hi. Good morning. So can you speak to the rationale retaining specialty at CVS Health and how you see the long term drivers and synergies playing out as also alongside kind of the PBM becomes more stable, more of a fee for service business over time. I guess, do you see opportunities to further lean into specialty as that becomes a larger component of RemainCo or CVS Health?
J. David Joyner CEBS: Yeah. that is a great question, Erin. And I think you are hearing 2 things from the remaining CVS Health Organization, and that is the focus on affordability and access, and it also is the role that we play in trying to tackle those challenges for, for our customers. And Steve just talked a lot about Medicare. It is a growing part of the business as we have an aging population, and we believe that there is an important step from moving from a fee for service operating environment to, to value based care. So that piece is a heavy investment for the business, and we need to make sure we have the appropriate assets that create the synergistic and the value prop for how we are gonna tackle, you know, that. Those unique high acuity populations. The same thing holds true on specialty. And we have talked for a long time. You know, I started in 1.99 thousand with Caremark was leading the part of how specialty integrates into the PBM. And if I fast forward, you know, 30 plus years later, you know, there is 2% of this population that is driving more than 50% of the spend of pharmacy, and it is growing at a rate that is not affordable and it is not sustainable. And so it is why you need all of the levers of classic PBM in order to continue to attack the rising drug cost and the way in which, you know, we create competition. And so we think the synergistic opportunity with the PBM in specialty remains intact. Because that is, again, 1 of the most important priorities for the customers that we are serving. And so that is part of the logic of keeping it together. And then as I look specifically at the integration that matters, which I mentioned on the front end of the call, This has been a really interesting 8 years in terms of bringing the businesses together. And what Aetna has been able to gain through the, you know, through the combination of the asset is a world class PBM. So Aetna is far more sophisticated and far more effective in managing their pharmacy benefit in addition to the total cost of care because of the assets that Caremark and our specialty business brings to the table. And on the flip side of this, Caremark is been far more effective in terms of thinking about the role of pharma and how it impacts the total cost of care. Because it is outside of just the pharmacy benefit, and it. And it is the role that actually medications play in managing, you know, the total cost of care of which Aetna is managing total risk. So there has been a really interesting and, I think, evolving, integration opportunities between the businesses, and I expect that will continue. As we find new markets and new opportunities. And this is in large part, delivered to both our Medicare population and equally as important to the commercial platforms and franchises that we have across both Aetna and Caremark. And lastly, Medicaid becomes very complementary to the business because these are high risk populations. And actually in markets that complement the roles that we are playing with Medicare. And even the providers that we are working with across commercial.
Operator: Next question will come from the line. Question Steven Baxter with Wells Fargo. Please unmute your line and ask your question.
Stephen Baxter: Yeah. Hi. Thanks. You have touched on the, I guess, the capital and strategic parts of this. But if we think purely a bit about the operating cost structure, we can look back to the original Caremark and CVS transactions or the more recent CVS Aetna transactions and to see that, you know, operating cost synergies were a big part of the financial rationale of those deals. I know it is early, but I guess how are you thinking about what the potential financial dissynergies could be? And any color on whether you think they will sit entirely in the newly created CVS Pharmacy business or, I guess, shared or allocated across the 2 businesses? Thank you.
J. David Joyner CEBS: Yes. So let me start, and I will let Brian finish. So we obviously are contemplating some onetime cost in so that has been contemplated in our guidance and how we are thinking about the future, but we feel like these are all manageable as we look at the opportunities that we have been describing on today's call, we think this will more than offset some of those expenses. So, Brian, I do not know if you have anything else to add.
Brian O. Newman: Yeah. Thanks, David. I just. Steven, I just offer that know, when we looked at the deal, the strategic value created by taking this action is gonna far outweigh any dis synergies. As I look at the run rate AOI impact of any stranded or public company cost, as well as any onetime cost they are they are they are certainly manageable, and in line with other transactions of this type. So we are gonna look to offset any run rate costs over time. Including, you know, pursuing opportunities created by a simpler independent structure that David referenced earlier. it is. As you said, it is early in the process, so expect us to come back with more details we progress through the separation. But I am I am confident that we certainly can manage the. Any dyssynergies there.
Operator: Next question will come from Andrew Mok with Barclays. Please unmute and ask your question.
Andrew Mok: Hi. Good morning. Just wanted to make sure I your 2027 EPS outlook of $8.65 in the context of all of today's results and announcements. So given the $0.20 raise to this year's EPS guidance, it does not look like you are assuming much EPS contribution from the resumption of share repurchase in 2027. Can you help us understand that dynamic and whether there are any other offsets embedded in the outlook, including no breakup costs you might incur next year? Thanks.
Operator: Go ahead, Brian.
Brian O. Newman: Yeah. So you are reading it right, which is we took the guide this year up $0.20, and effectively flowed that through. We had talked about an $8.45 floor next year, so now it is $8.65. Rounded up a penny. So we are at $8.65 next year. That only assumes the offset of dilution in share repo. So as you can imagine, as cash is back, leverage is where we want it to be. We have got some dry powder to leverage. So net, what is implied in the guide next year where we set a floor is just the offset of dilution. Hopefully, that answers your question.
Operator: Next up will be Ann Hynes with Mizuho. Your line is now open. Please unmute and ask your question.
Ann Hynes: Great. Thank you. I know that you said 2028 should be on higher end of your range you provided at Investor Day. Are you ready to give any kind of growth algorithms whether on a operating income or EPS for the 2 new companies on a stand alone basis? Thanks.
J. David Joyner CEBS: Yeah. Go ahead, Brian. We were not really guiding beyond 2028 at this point. And, Brian, you.
Brian O. Newman: Yeah. I would just I was thinking back to investor day, and we set out a road map, which was in the mid teens. Which gets us to the 2028 horizon. We are tracking well against that. We always talked about multiple paths to get there. I think the businesses are performing very well. We just took 2026 up again. that is $1 over where we started. We just put a floor in for 2027. And I. By signaling that we are gonna be at the upper end in the upper end of mid teens by 2028. I just wanted to give the street confidence that we are on track to meet or exceed our expectations. Well, we will come back to you, on the February call, and, we will talk more about the details around the 2027 guide, and that will give you a firmer base.
J. David Joyner CEBS: Yeah. So, I mean, this is all a timing issue. You know? We gave headwinds and tailwinds early you know, last quarter than we normally do, and so we will be back in February with more clarity. And maybe just a reminder in case people are questioning this, this we are doing this from a position of strength. We do not have to make the decisions And so as we are looking at the business and how it is performing, we have confidence and we are actually doing this because we believe this is the right thing to do for the long term growth of the business, not because there is any issue that may be, on the horizon in 28.
Operator: Next question will come from Scott Fidel with Goldman Sachs. Please unmute and ask your question.
Scott Fidel: Hi. Thanks. Good morning. Wanted to just go back to the margin improvement and expansion. that is been, been, sustaining over at Aetna. And where you are specifically in that journey. Clearly, Medicare Advantage being the particular driver of that. It seems like at this point, based on your updated guidance, you probably breached into getting towards I would think, sort of a very low level of profitability back in the Medicare Advantage business. For 2026 inside of the guidance. Just wanted to confirm that. And then, I know, Steven, you mentioned how, I think he sent, you know, another 1 more year of, you know, sort of, you know, focused sort of margin improvement targeted for 2027. Should I read into that anything in terms of where you expect to take the margins for 2027 back toward target, or is this still a multiyear journey in terms of getting back to that 3% to 4% target margin for Medicare Advantage? Thanks.
Analyst: Okay, Steve.
Steven Hale Nelson: Sure. Thanks. Yeah. I can confirm the business is on. Still on its multiyear journey. But it is ahead of expectations. We are moving into the profitable territory in 2026, so I can confirm that. And then as we look to 2027, we are gonna expand on that for the reasons I indicated earlier. Just maybe a couple more thoughts as we think about the business and why we are so confident in the margin expansion 2027. Beyond the levers that I talked about, and the repositioning of sort of the holistic Medicare. So as we think about our Part D stand-alone was performing well, we did a reset there. that is gonna contribute our group Medicare Advantage business. We talked about that as we got through 2027, we would be we would have about 75% of the book repriced. that is very much on track. And so holistically, as you think about it. And then and then as I said, we were able to add stability, so we will be able to see some modest growth in the areas that we want. To see that growth. And so all this kind of comes together just as we hoped, it is. And we planned for and strong execution by the team, and so really proud of where we are. it is positioned nicely to go into 2027 with another year of nice margin expansion.
J. David Joyner CEBS: Great. Thanks, Steven. Alright. Operator, I think we have time for 1 more question.
Operator: Okay. Your last question will come from George Hill with DB. Please unmute and ask your question.
George Hill: Yeah. Thanks, guys. And I appreciate you taking the question. I guess, David, to just kind of round this out, I would ask as we think about the future split up kind of what changed I guess could you talk a little bit more about like what changed in the outlook in healthcare from a year ago versus where you are now? And could you talk about, like, how you saw each business kinda like, what was competitively disadvantaged, and what becomes competitively advantaged? Through the split up. I will end it there. Thanks.
J. David Joyner CEBS: Yeah. George, thanks for the question. Maybe I will I will end the way I started. Know, 2 years ago, when I took this job, we did not have the ability to make decisions like this because we were struggling on our Medicare business. PCW, was guiding down 5%, and we were focused purely on running and operating this business against what we knew we were we were capable of doing. And so I look 2 years later, and the say do ratio that Brian has been so consistent on in terms of making sure that we that we that we underpromise and overdeliver. And we have been 8 quarters of delivering on that. And so what is changed in 2 years is the fact that we now can look at this business and the assets that are assembled and really determine without any distress or without anything that we have to do on what is the right strategic decision to make. And so as we said, CVS Pharmacy has been operating behind a firewall for the last 2 decades. it is always been an arm's length negotiation and structure, which again, just reinforces the fact that there are integration opportunities, but nothing that we cannot solve for with a commercial agreement. But what is powerful is where we see health care going is in the area of technology. And so how do we make sure we capitalize on this next wave of change that we know is going to be very prevalent inside the health care space, and make sure we leverage everything that we actually have in this current enterprise and preserve it for the future. that is why we are spending as much time on connecting and integrating where we believe it matters And so we are preserving the CVS and Aetna integration. We are preserving the Oak Street and, and Aetna. And Signify, and we are also now focusing on areas that we know we can capitalize on the future around technology. So I would just say you know, I could not be happier and more proud of the team's performance that led us to a place where we could make the decisions out of, you know, out of strength And, also, the fact that, you know, that we, that we believe this is the right thing for all stakeholders involved. We believe we are going to gonna serve our consumers more effectively. We are gonna serve our customers more effectively. And, hopefully, that will actually be viewed favorably from the shareholders that are investing in this company. So And just in closing, I just wanna thank everyone for joining this morning. Incredibly excited about this next step in our evolution. Want to specifically thank our colleagues across the country and across this company and the work the work that they do every day to serve our customers. Their dedication and relentless commitment to those we serve has built the foundation for everything we have discussed today. We have taken this deliberate action to create long term value and do even more to deliver on our purpose, to simplify health care 1 person, 1 family, and 1 community at a time, and I look forward to keeping you updated on our progress.
Operator: Thank you for joining CVS Health's third quarter 26 earnings call. This concludes today's conference call. You may now disconnect.
