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CVS HEALTH REPORTS STRONG FOURTH QUARTER AND FULL-YEAR 2022 RESULTS WOONSOCKET

Key Takeaway: CVS Health Corporation reported strong financial results for the fourth quarter and full year ending December 31, 2022, with a revenue increase of 9.5% and 10.4% respectively. The company generated $16.2 billion in cash flow from operations and raised its quarterly dividend by 10%. However, operating income for the year decreased by 41.3% due to opioid litigation charges and a significant loss from its Omnicare business. CVS also finalized its acquisition of Signify Health, expanding its capabilities in home health care.

Market Sentiment Analysis

POSITIVE FACTORS

  • Total revenues increased by 9.5% in the fourth quarter and 10.4% for the full year.
  • CVS announced a 10% increase in quarterly shareholder dividends.
  • Generated significant cash flow from operations amounting to $16.2 billion.
  • Acquisition of Signify Health could enhance home care capabilities.

CONCERNS & RISKS

  • Operating income for the year decreased by 41.3% primarily due to opioid litigation charges.
  • Recorded a $2.5 billion loss on assets related to the Omnicare long-term care business.
  • Effective income tax rate increased to 26%, indicating a reduction in net earnings.

Full Press Release Details

CVS HEALTH REPORTS STRONG FOURTH QUARTER AND FULL-YEAR 2022 RESULTS
WOONSOCKET, RHODE ISLAND, February 8, 2023 - CVS Health Corporation (NYSE CVS) today announced operating results for the three months and year ended December 31, 2022.
Total revenues increased to $83.8 billion, up 9.5% compared to prior year
GAAP diluted EPS of $1.75 and Adjusted EPS of $1.99
Total revenues increased to $322.5 billion, up 10.4% compared to prior year
GAAP diluted EPS of $3.14 and Adjusted EPS of $8.69
Generated cash flow from operations of $16.2 billion
Repaid $4.1 billion of long-term debt
Three Months Ended December 31,
In millions, except per share amounts 2022 2021 Change
Total revenues $ 83,846 $ 76,604 $ 7,242
Operating income 3,618 2,229 1,389
Adjusted operating income (1) 4,006 4,147 (141)
Diluted earnings per share $ 1.75 $ 0.98 $ 0.77
Adjusted EPS (2) $ 1.99 $ 1.98 $ 0.01
2023 FULL-YEAR GUIDANCE
GAAP diluted EPS guidance range of $7.73 to $7.93 Adjusted EPS guidance range of $8.70 to $8.90 Cash flow from operations guidance range of $12.5 billion to $13.5 billion
Entered into a definitive agreement to acquire Signify Health, a leader in home Health Risk Assessments, value-based care and provider enablement with a network of more than 10,000 clinicians across all 50 states.
Announced a 10% increase to the quarterly shareholder dividend, which became effective with the February 1, 2023 dividend distribution. Returned $2.9 billion to shareholders through dividends, while repurchasing 34.1 million shares of common stock and authorizing a new $10.0 billion share repurchase program.
Increased unique digital customers by seven million to over 47 million, reached eight million active users on CVS Health's individualized Health Dashboard and interacted with nearly five million customers daily across our community footprint.
Deepened our executive bench with several key appointments, including Dr. Amar Desai as President, Health Care Delivery and Tilak Mandadi as Executive Vice President and Chief Data, Digital and Technology Officer.
Investor Contact Larry McGrath Senior Vice President Business Development and Investor Relations (800) 201-0938
Media Contact T.J. Crawford Vice President External Affairs (212) 457-0583
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 12 and endnotes beginning on page 24 for explanations of non-GAAP financial measures presented in this press release. See pages 14 through 16 and page 23 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 December 31, Year Ended December 31,
In millions, except per share amounts 2022 2021 Change 2022 2021 Change
Total revenues $ 83,846 $ 76,604 $ 7,242 $ 322,467 $ 292,111 $ 30,356
Operating income 3,618 2,229 1,389 7,746 13,193 (5,447)
Adjusted operating income (1) 4,006 4,147 (141) 17,532 17,312 220
Net income 2,300 1,296 1,004 4,165 7,898 (3,733)
Diluted earnings per share $ 1.75 $ 0.98 $ 0.77 $ 3.14 $ 5.95 $ (2.81)
Adjusted EPS (2) $ 1.99 $ 1.98 $ 0.01 $ 8.69 $ 8.40 $ 0.29
For the three months and year ended December 31, 2022 compared to the prior year
Total revenues increased 9.5% and 10.4%, respectively, driven by growth across all segments.
Operating income increased 62.3% in the three months ended December 31, 2022 compared to the prior year primarily due to the absence of a store impairment charge of approximately $1.4 billion recorded in the prior year, as well as a pre-tax gain of $250 million on the sale of the Company's wholly-owned subsidiary bswift LLC ("bswift") recorded in the three months ended December 31, 2022. These increases were partially offset by the decreases in adjusted operating income described below.
Operating income decreased 41.3% for the year ended December 31, 2022 compared to the prior year primarily due to $5.8 billion of opioid litigation charges and a $2.5 billion loss on assets held for sale related to the write-down of the Company's Omnicare long-term care business ("LTC business"), both of which were recorded during 2022. These decreases were partially offset by the absence of the store impairment charge of approximately $1.4 billion and a $431 million goodwill impairment charge on the remaining goodwill of the LTC reporting unit, both of which were recorded in the prior year, a decrease in amortization of intangible assets compared to the prior year, as well as pre-tax gains of $250 million on the sale of bswift and $225 million on the sale of PayFlex Holdings, Inc. ("PayFlex") recorded in 2022.
Adjusted operating income decreased $141 million in the three months ended December 31, 2022 compared to the prior year primarily driven by declines in the Retail LTC and Corporate Other segments, largely offset by increases in the Health Care Benefits and Pharmacy Services segments. Adjusted operating income increased $220 million in the year ended December 31, 2022 compared to the prior year primarily driven by increases in the Health Care Benefits and Pharmacy Services segments, partially offset by declines in the Retail LTC and Corporate Other segments. See pages 3 through 5 and page 22 for additional discussion of adjusted operating income performance of the Company's segments.
Interest expense decreased $56 million, or 9.2%, and $216 million, or 8.6%, respectively, due to lower debt in the three months and year ended December 31, 2022.
The effective income tax rate in the fourth quarter increased to 26.0% compared to 17.5% in the prior year primarily due to the absence of the favorable impact of a prior year refund claim. The effective income tax rate for the full year increased to 26.0% compared to 24.2% in the prior year primarily due to certain nondeductible legal charges and basis differences on the sale of certain subsidiaries in the year ended December 31, 2022. These increases were partially offset by the impact of certain discrete tax items concluded in the first quarter of 2022.
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, 2022 and 2021 were as follows
Three Months Ended December 31, Year Ended December 31,
In millions, except percentages 2022 2021 Change 2022 2021 Change
Total revenues $ 23,033 $ 20,699 $ 2,334 $ 91,409 $ 82,186 $ 9,223
Adjusted operating income (1) 858 510 348 5,984 5,012 972
Medical benefit ratio ("MBR") (3) 86.0 % 87.0 % (1.0) % 84.0 % 85.0 % (1.0) %
Medical membership (4) 24.4 23.8 0.6
Total revenues increased 11.3% and 11.2% for the three months and year ended December 31, 2022, respectively, compared to the prior year driven by growth across all product lines.
Adjusted operating income increased 68.2% for the three months ended December 31, 2022 compared to the prior year primarily driven by the net favorable impact of COVID-19 compared to the prior year and strong underlying performance, partially offset by the unfavorable impact of the flu compared to the prior year.
Adjusted operating income increased 19.4% for the year ended December 31, 2022 compared to the prior year primarily driven by the net favorable impact of COVID-19 compared to the prior year, strong underlying performance and membership growth. These increases were partially offset by incremental investments to support growth in the business, the unfavorable impact of the flu compared to the prior year and net realized capital losses.
The MBR decreased from 87.0% to 86.0% in the three months ended December 31, 2022 compared to the prior year and decreased from 85.0% to 84.0% in the year ended December 31, 2022 compared to the prior year. The decrease in both periods was primarily driven by the net favorable impact of COVID-19 compared to the prior year, partially offset by the unfavorable impact of the flu compared to the prior year.
Medical membership as of December 31, 2022 of 24.4 million increased 109,000 members compared with September 30, 2022, reflecting increases across all product lines.
Medical membership as of December 31, 2022 of 24.4 million increased 548,000 members compared with December 31, 2021, reflecting increases in Medicare and Commercial membership, as underlying Commercial growth more than offset the impact of international divestitures. These increases were partially offset by a decline in Medicaid membership reflecting the previously disclosed loss of a large customer in the third quarter of 2022.
The segment experienced favorable development of prior-periods' health care cost estimates in its Government Services and Commercial businesses during the three months ended December 31, 2022, primarily attributable to third quarter 2022 performance.
Prior years' health care costs payable estimates developed favorably by $654 million during the year ended December 31, 2022. This development is reported on a basis consistent with the prior years' development reported in the health care costs payable table in the Company's annual audited financial statements and does not directly correspond to an increase in 2022 operating results.
See the supplemental information on page 18 for additional information regarding the performance of the Health Care Benefits segment.
Pharmacy Services Segment
The Pharmacy Services segment provides a full range of pharmacy benefit management solutions to employers, health plans, government employee groups and government sponsored programs. The segment results for the three months and years ended December 31, 2022 and 2021 were as follows
Three Months Ended December 31, Year Ended December 31,
In millions 2022 2021 Change 2022 2021 Change
Total revenues $ 43,747 $ 39,341 $ 4,406 $ 169,236 $ 153,022 $ 16,214
Adjusted operating income (1) 1,988 1,824 164 7,356 6,859 497
Total pharmacy claims processed (5) (6) 600.4 582.2 18.2 2,336.6 2,244.7 91.9
Pharmacy network (7) 517.9 498.2 19.7 2,003.6 1,914.0 89.6
Mail choice (8) 82.5 84.0 (1.5) 333.0 330.7 2.3
Total revenues increased 11.2% and 10.6% for the three months and year ended December 31, 2022, respectively, compared to the prior year primarily driven by increased pharmacy claims volume, growth in specialty pharmacy and brand inflation, partially offset by continued client price improvements.
Adjusted operating income increased 9.0% and 7.2% for the three months and year ended December 31, 2022, respectively, compared to the prior year primarily driven by improved purchasing economics, including increased contributions from the products and services of the Company's group purchasing organization, partially offset by continued client price improvements.
Total pharmacy claims processed increased 3.1% and 4.1% on a 30-day equivalent basis for the three months and year ended December 31, 2022, respectively, compared to the prior year primarily driven by net new business, increased utilization and the impact of an elevated cough, cold and flu season compared to the prior year. These increases were partially offset by a decrease in COVID-19 vaccinations. Excluding the impact of COVID-19 vaccinations, total pharmacy claims processed increased 4.6% and 5.1% on a 30-day equivalent basis for the three months and year ended December 31, 2022, respectively, compared to the prior year.
See the supplemental information on page 20 for additional information regarding the performance of the Pharmacy Services segment.
The Retail LTC segment fulfills prescriptions for medications, provides patient care programs, sells a wide assortment of health and wellness products and general merchandise, provides health care services through walk-in medical clinics, provides medical diagnostic testing, administers vaccinations and provides pharmacy services to long-term care facilities. The segment results for the three months and years ended December 31, 2022 and 2021 were as follows
Three Months Ended December 31, Year Ended December 31,
In millions 2022 2021 Change 2022 2021 Change
Total revenues $ 28,184 $ 27,111 $ 1,073 $ 106,594 $ 100,105 $ 6,489
Adjusted operating income (1) 1,840 2,457 (617) 6,705 7,623 (918)
Prescriptions filled (5) (6) 423.1 419.8 3.3 1,623.8 1,587.6 36.2
Total revenues increased 4.0% and 6.5% for the three months and year ended December 31, 2022, respectively, compared to the prior year primarily driven by increased prescription and front store volume, including the impact of an elevated cough, cold and flu season compared to the prior year, pharmacy drug mix and brand inflation. These increases were partially offset by decreased COVID-19 vaccinations and diagnostic testing, the impact of recent generic introductions and continued pharmacy reimbursement pressure.
Adjusted operating income decreased 25.1% and 12.0% for the three months and year ended December 31, 2022, respectively, compared to the prior year primarily driven by decreased COVID-19 vaccinations and diagnostic testing, continued pharmacy reimbursement pressure, increased investments in the segment's operations and capabilities and decreased gains from legal settlements compared to the prior year. These decreases were partially offset by the increased prescription volume described above, improved generic drug purchasing and the favorable impact of business initiatives in the three months and year ended December 31, 2022. The decrease in adjusted operating income for the year ended December 31, 2022 was also partially offset by increased front store volume.
Prescriptions filled increased 0.8% and 2.3% on a 30-day equivalent basis for the three months and year ended December 31, 2022, respectively, compared to the prior year primarily driven by increased utilization and the impact of an elevated cough, cold and flu season compared to the prior year, partially offset by a decrease in COVID-19 vaccinations. Excluding the impact of COVID-19 vaccinations, prescriptions filled increased 4.0% and 4.4% on a 30-day equivalent basis for the three months and year ended December 31, 2022, respectively, compared to the prior year.
See the supplemental information on page 21 for additional information regarding the performance of the Retail LTC segment.
2023 Full-Year Guidance
The Company issued its full-year 2023 GAAP diluted EPS guidance range of $7.73 to $7.93 and reaffirmed its full-year 2023 Adjusted EPS guidance range of $8.70 to $8.90. The Company also issued its full-year 2023 cash flow from operations guidance range of $12.5 billion to $13.5 billion.
The adjustments between full-year 2023 GAAP diluted EPS and Adjusted EPS include amortization of intangible assets, 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.
The Company's full-year 2023 guidance does not include any impact, including acquisition-related transaction and integration costs, related to the pending acquisition of Signify Health, Inc. ("Signify 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.
CVS Health is the leading health solutions company, delivering care like no one else can. We reach more people and improve the health of communities across America through our local presence, digital channels and over 300,000 dedicated colleagues - including more than 40,000 physicians, pharmacists, nurses, and nurse practitioners. Wherever and whenever people need us, we help them with their health - whether that's managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system - and their personal health care - by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day. Follow CVSHealth on social media.
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, Ms. Lynch's quotation, the information under the headings "2023 Full-Year Guidance" and "2022 In The Spotlight" 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 related to CVS Health's proposed acquisition of Oak Street Health, Inc. and pending acquisition of Signify Health, Inc., and the COVID-19 pandemic, including the potential emergence of additional variants, vaccine and testing protocols, government testing initiatives, the geographies impacted by and the severity and duration of the pandemic, the pandemic's impact on the U.S. and global economies and consumer behavior and health care utilization patterns, and the timing, scope and impact of stimulus legislation and other federal, state and local governmental responses to the pandemic.
Certain additional risks and uncertainties are 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 and our other filings with the SEC.
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.
CVS HEALTH CORPORATION
Condensed Consolidated Statements of Operations
Three Months Ended December 31, Year Ended December 31,
In millions, except per share amounts 2022 2021 2022 2021
Revenues
Products $ 59,657 $ 53,973 $ 226,616 $ 203,738
Premiums 21,436 19,205 85,330 76,132
Services 2,430 3,059 9,683 11,042
Net investment income 323 367 838 1,199
Total revenues 83,846 76,604 322,467 292,111
Operating costs
Cost of products sold 51,728 46,378 196,892 175,803
Benefit costs 18,305 16,574 71,281 64,260
Opioid litigation charges 99 - 5,803 -
Loss on assets held for sale 12 - 2,533 -
Store impairments - 1,358 - 1,358
Goodwill impairment - - - 431
Operating expenses 10,084 10,065 38,212 37,066
Total operating costs 80,228 74,375 314,721 278,918
Operating income 3,618 2,229 7,746 13,193
Interest expense 552 608 2,287 2,503
Loss on early extinguishment of debt - 89 - 452
Other income (43) (38) (169) (182)
Income before income tax provision 3,109 1,570 5,628 10,420
Income tax provision 809 274 1,463 2,522
Net income 2,300 1,296 4,165 7,898
Net (income) loss attributable to noncontrolling interests 2 10 (16) 12
Net income attributable to CVS Health $ 2,302 $ 1,306 $ 4,149 $ 7,910
Net income per share attributable to CVS Health
Basic $ 1.76 $ 0.99 $ 3.16 $ 6.00
Diluted $ 1.75 $ 0.98 $ 3.14 $ 5.95
Weighted average shares outstanding
Basic 1,310 1,322 1,312 1,319
Diluted 1,319 1,336 1,323 1,329
Dividends declared per share $ 0.55 $ 0.50 $ 2.20 $ 2.00
CVS HEALTH CORPORATION
Condensed Consolidated Balance Sheets
At December 31,
In millions 2022 2021
Assets
Cash and cash equivalents $ 12,945 $ 9,408
Investments 2,778 3,117
Accounts receivable, net 27,276 24,431
Inventories 19,090 17,760
Assets held for sale 908 -
Other current assets 2,685 5,292
Total current assets 65,682 60,008
Long-term investments 21,096 23,025
Property and equipment, net 12,873 12,896
Operating lease right-of-use assets 17,872 19,122
Goodwill 78,150 79,121
Intangible assets, net 24,754 29,026
Separate accounts assets 3,228 5,087
Other assets 4,620 4,714
Total assets $ 228,275 $ 232,999
Liabilities
Accounts payable $ 14,838 $ 12,544
Pharmacy claims and discounts payable 19,423 17,330
Health care costs payable 10,406 8,808
Policyholders' funds 1,500 4,301
Accrued expenses 18,745 17,670
Other insurance liabilities 1,140 1,303
Current portion of operating lease liabilities 1,678 1,646
Current portion of long-term debt 1,778 4,205
Liabilities held for sale 228 -
Total current liabilities 69,736 67,807
Long-term operating lease liabilities 16,800 18,177
Long-term debt 50,476 51,971
Deferred income taxes 3,880 6,270
Separate accounts liabilities 3,228 5,087
Other long-term insurance liabilities 6,108 6,402
Other long-term liabilities 6,732 1,904
Total liabilities 156,960 157,618
Shareholders' equity
Preferred stock - -
Common stock and capital surplus 48,193 47,377
Treasury stock (31,858) (28,173)
Retained earnings 56,145 54,906
Accumulated other comprehensive income (loss) (1,465) 965
Total CVS Health shareholders' equity 71,015 75,075
Noncontrolling interests 300 306
Total shareholders' equity 71,315 75,381
Total liabilities and shareholders' equity $ 228,275 $ 232,999
CVS HEALTH CORPORATION
Condensed Consolidated Statements of Cash Flows
Year Ended December 31,
In millions 2022 2021
Cash flows from operating activities
Cash receipts from customers $ 313,662 $ 284,219
Cash paid for inventory and prescriptions dispensed by retail network pharmacies (189,766) (165,783)
Insurance benefits paid (69,728) (63,598)
Cash paid to other suppliers and employees (32,662) (31,652)
Interest and investment income received 1,026 743
Interest paid (2,239) (2,469)
Income taxes paid (4,116) (3,195)
Net cash provided by operating activities 16,177 18,265
Cash flows from investing activities
Proceeds from sales and maturities of investments 6,729 7,246
Purchases of investments (7,746) (9,963)
Purchases of property and equipment (2,727) (2,520)
Acquisitions (net of cash acquired) (139) (146)
Proceeds from sale of subsidiaries (net of cash and restricted cash sold of $2,854 and $0) (1,249) -
Other 85 122
Net cash used in investing activities (5,047) (5,261)
Cash flows from financing activities
Proceeds from issuance of long-term debt - 987
Repayments of long-term debt (4,211) (10,254)
Repurchase of common stock (3,500) -
Dividends paid (2,907) (2,625)
Proceeds from exercise of stock options 551 549
Payments for taxes related to net share settlement of equity awards (370) (168)
Other (79) 155
Net cash used in financing activities (10,516) (11,356)
Net increase in cash, cash equivalents and restricted cash 614 1,648
Cash, cash equivalents and restricted cash at the beginning of the period 12,691 11,043
Cash, cash equivalents and restricted cash at the end of the period $ 13,305 $ 12,691
CVS HEALTH CORPORATION
Condensed Consolidated Statements of Cash Flows
Year Ended December 31,
In millions 2022 2021
Reconciliation of net income to net cash provided by operating activities
Net income $ 4,165 $ 7,898
Adjustments required to reconcile net income to net cash provided by operating activities
Depreciation and amortization 4,247 4,512
Loss on assets held for sale 2,533 -
Store impairments - 1,358
Goodwill impairment - 431
Stock-based compensation 447 484
Gain on sale of subsidiaries (475) -
Loss on early extinguishment of debt - 452
Deferred income taxes (2,075) (428)
Other noncash items 332 (390)
Change in operating assets and liabilities, net of effects from acquisitions
Accounts receivable, net (2,971) (2,703)
Inventories (1,435) 735
Other assets (566) (3)
Accounts payable and pharmacy claims and discounts payable 4,260 2,898
Health care costs payable and other insurance liabilities 1,247 169
Other liabilities 6,468 2,852
Net cash provided by operating activities $ 16,177 $ 18,265
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 performance. These non-GAAP financial measures are provided as supplemental information to the financial measures presented in this press release 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 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
The Company's acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in the condensed consolidated statements of operations in operating expenses within each segment. Although intangible assets contribute to the Company's revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company's insurance products, the services performed for the Company's customers or the sale of the Company's products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company's acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company's and investors' ability to compare the Company's past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company's GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.
During the three months and year ended December 31, 2022, the office real estate optimization charges primarily relate to the abandonment of leased real estate and the related right-of-use assets and property and equipment in connection with the planned reduction of corporate office real estate space in response to the Company's new flexible work arrangement. The Company anticipates additional office real estate optimization charges will be recorded in 2023. The office real estate optimization charges are reflected in the Company's condensed consolidated statements of operations in operating expenses within the Health Care Benefits, Corporate Other and Pharmacy Services segments.
During the three months and year ended December 31, 2022, the gain on divestiture of subsidiary represents the pre-tax gain on the sale of bswift, which the Company sold in November 2022. During the year ended December 31, 2022, the gain on divestiture of subsidiaries also includes the pre-tax gain on the sale of PayFlex, which the Company sold in June 2022. The gains on divestitures are reflected as a reduction of operating expenses in the Company's condensed consolidated statements of operations within the Health Care Benefits segment.
During the three months and year ended December 31, 2022, the opioid litigation charges relate to agreements to resolve substantially all opioid claims against the Company by certain states and governmental entities. The opioid litigation charges are reflected within the Corporate Other segment.
During the three months and year ended December 31, 2022, the loss on assets held for sale relates to the LTC reporting unit within the Retail LTC segment. The Company continually evaluates its portfolio for non-strategic assets. The Company determined that its LTC business was no longer a strategic asset and during the third quarter of 2022 committed to a plan to sell the LTC business. As of September 30, 2022, the LTC business met the criteria for held-for-sale accounting and its net assets were accounted for as assets held for sale. The carrying value of the LTC business was determined to be greater than its estimated fair value less costs to sell and a loss on assets held for sale was recorded during the third quarter of 2022. As of December 31, 2022, the net assets of the LTC business continued to meet the criteria for held-for-sale accounting and during the fourth quarter of 2022, an incremental loss on assets held for sale was recorded to write down the carrying value of the LTC business to its estimated fair value less costs to sell. During the year ended December 31, 2022, the loss on assets held for sale also relates to the Commercial Business reporting unit within the Health Care Benefits segment. In March 2022, the Company reached an agreement to sell its international health care business domiciled in Thailand ("Thailand business"), which was included in the Commercial Business reporting unit. At that time, a portion of the Commercial Business goodwill was specifically allocated to the Thailand business. The net assets of the Thailand business were accounted for as assets held for sale at March 31, 2022. The carrying value of the Thailand business was determined to be greater than its estimated fair value less costs to sell and a loss on assets held for sale was recorded during the first quarter of 2022. The sale of the Thailand business closed in the second quarter of 2022, and the ultimate loss on the sale was not material.
During the three months and year ended December 31, 2021, acquisition-related integration costs relate to the acquisition of Aetna Inc. The acquisition-related integration costs are reflected in the Company's condensed consolidated statements of operations in operating expenses within the Corporate Other segment.
During the three months and year ended December 31, 2021, the store impairment charge relates to the write-down of operating lease right-of-use assets and property and equipment in connection with the planned closure of approximately 900 retail stores between 2022 and 2024. The store impairment charge is reflected within the Retail LTC segment.
During the year ended December 31, 2021, the goodwill impairment charge relates to an impairment of the remaining goodwill of the LTC reporting unit within the Retail LTC segment.
During the three months and year ended December 31, 2021, the loss on early extinguishment of debt relates to the Company's repayment of approximately $2.3 billion of its outstanding senior notes in December 2021 pursuant to its early redemption make-whole provision for such senior notes. During the year ended December 31, 2021, the loss on early extinguishment of debt also relates to the Company's repayment of approximately $2.0 billion of its outstanding senior notes in August 2021 pursuant to its tender offer for such senior notes.
During the year ended December 31, 2021, the Company received $61 million related to a purchase price working capital adjustment for an acquisition completed during the first quarter of 2020. The resolution of this matter occurred subsequent to the acquisition accounting measurement period and is reflected in the Company's condensed consolidated statement of operations as a reduction of operating expenses within the Health Care Benefits segment.
The corresponding tax benefit or expense related to the items excluded from adjusted income attributable to CVS Health and Adjusted EPS above. The nature of each non-GAAP adjustment is evaluated to determine whether a discrete adjustment should be made to the adjusted income tax provision. During the year ended December 31, 2022, the Company's adjusted income tax provision also excludes the impact of certain discrete tax items concluded in the first quarter of 2022. During the three months and year ended December 31, 2021, the Company's adjusted income tax provision also excludes certain tax benefits primarily related to a prior year refund claim.
See endnotes (1) and (2) on page 24 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 14 through 16 and page 23.
Reconciliations of Non-GAAP Financial Measures to the Most Directly Comparable GAAP Financial Measures
Adjusted Operating Income
The following are reconciliations of consolidated operating income (GAAP measure) to consolidated adjusted operating income, as well as reconciliations of segment GAAP operating income to segment adjusted operating income
Three Months Ended December 31, 2022
In millions Health Care Benefits Pharmacy Services Retail LTC Corporate Other Intersegment Eliminations Consolidated Totals
Operating income (loss) (GAAP measure) $ 711 $ 1,945 $ 1,760 $ (626) $ (172) $ 3,618
Amortization of intangible assets 300 41 68 1 - 410
Office real estate optimization charges 97 2 - 18 - 117
Gain on divestiture of subsidiary (250) - - - - (250)
Opioid litigation charges - - - 99 - 99
Loss on assets held for sale - - 12 - - 12
Adjusted operating income (loss) (1) $ 858 $ 1,988 $ 1,840 $ (508) $ (172) $ 4,006
Three Months Ended December 31, 2021
In millions Health Care Benefits Pharmacy Services Retail LTC Corporate Other Intersegment Eliminations Consolidated Totals
Operating income (loss) (GAAP measure) $ 152 $ 1,780 $ 973 $ (488) $ (188) $ 2,229
Amortization of intangible assets 358 44 126 1 - 529
Acquisition-related integration costs - - - 31 - 31
Store impairments - - 1,358 - - 1,358
Adjusted operating income (loss) (1) $ 510 $ 1,824 $ 2,457 $ (456) $ (188) $ 4,147
Year Ended December 31, 2022
In millions Health Care Benefits Pharmacy Services Retail LTC Corporate Other Intersegment Eliminations Consolidated Totals
Operating income (loss) (GAAP measure) $ 5,118 $ 7,187 $ 3,778 $ (7,609) $ (728) $ 7,746
Amortization of intangible assets 1,203 167 435 3 - 1,808
Office real estate optimization charges 97 2 - 18 - 117
Gain on divestiture of subsidiaries (475) - - - - (475)
Opioid litigation charges - - - 5,803 - 5,803
Loss on assets held for sale 41 - 2,492 - - 2,533
Adjusted operating income (loss) (1) $ 5,984 $ 7,356 $ 6,705 $ (1,785) $ (728) $ 17,532
Year Ended December 31, 2021
In millions Health Care Benefits Pharmacy Services Retail LTC Corporate Other Intersegment Eliminations Consolidated Totals
Operating income (loss) (GAAP measure) $ 3,521 $ 6,667 $ 5,322 $ (1,606) $ (711) $ 13,193
Amortization of intangible assets 1,552 192 512 3 - 2,259
Acquisition-related integration costs - - - 132 - 132
Store impairments - - 1,358 - - 1,358
Goodwill impairment - - 431 - - 431
Acquisition purchase price adjustment outside of measurement period (61) - - - - (61)
Adjusted operating income (loss) (1) $ 5,012 $ 6,859 $ 7,623 $ (1,471) $ (711) $ 17,312
Adjusted Earnings Per Share
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, 2022 Three Months Ended December 31, 2021
In millions, except per share amounts Total Company Per Common Share Total Company Per Common Share
Net income attributable to CVS Health (GAAP measure) $ 2,302 $ 1.75 $ 1,306 $ 0.98
Amortization of intangible assets 410 0.31 529 0.40
Office real estate optimization charges 117 0.09 - -
Gain on divestiture of subsidiary (250) (0.19) - -
Opioid litigation charges 99 0.08 - -
Loss on assets held for sale 12 0.01 - -
Acquisition-related integration costs - - 31 0.02
Store impairments - - 1,358 1.02
Loss on early extinguishment of debt - - 89 0.07
Tax impact of non-GAAP adjustments (71) (0.06) (674) (0.51)
Adjusted income attributable to CVS Health (2) $ 2,619 $ 1.99 $ 2,639 $ 1.98
Weighted average diluted shares outstanding 1,319 1,336
Year Ended December 31, 2022 Year Ended December 31, 2021
In millions, except per share amounts Total Company Per Common Share Total Company Per Common Share
Net income attributable to CVS Health (GAAP measure) $ 4,149 $ 3.14 $ 7,910 $ 5.95
Amortization of intangible assets 1,808 1.37 2,259 1.70
Office real estate optimization charges 117 0.09 - -
Gain on divestiture of subsidiaries (475) (0.36) - -
Opioid litigation charges 5,803 4.39 - -
Loss on assets held for sale 2,533 1.91 - -
Acquisition-related integration costs - - 132 0.10
Store impairments - - 1,358 1.02
Goodwill impairment - - 431 0.33
Acquisition purchase price adjustment outside of measurement period - - (61) (0.05)
Loss on early extinguishment of debt - - 452 0.34
Tax impact of non-GAAP adjustments (2,436) (1.85) (1,316) (0.99)
Adjusted income attributable to CVS Health (2) $ 11,499 $ 8.69 $ 11,165 $ 8.40
Weighted average diluted shares outstanding 1,323 1,329

Frequently Asked Questions

What were CVS Health's total revenues for Q4 2022?

CVS Health reported total revenues of $83.8 billion for Q4 2022.

How much did CVS Health's full-year revenues increase?

Full-year revenues increased to $322.5 billion, up 10.4% from the prior year.

What was CVS Health's GAAP diluted EPS for Q4 2022?

The GAAP diluted EPS for Q4 2022 was $1.75.

What was the cash flow from operations in 2022?

CVS Health generated cash flow from operations of $16.2 billion in 2022.

How many unique digital customers did CVS gain in 2022?

CVS Health added seven million unique digital customers, totaling over 47 million.

Last updated: Feb 8, 2023