CVS Health (CVS) earnings Q1 2026

CVS Health On Wednesday, it missed first-quarter earnings and revenue estimates and raised its 2026 guidance as its once-troubled insurance business improves.

CVS, which operates the nation’s largest pharmacy chain, projects full-year earnings of between $7.30 and $7.50 per share. This is higher than previous guidance of $7 to $7.20 per share.

The company also expects revenue of at least $405 billion in 2026, down from its previous outlook of at least $400 billion.

The majority of that $5 billion increase “reflects the headwinds we’re seeing” for insurer Aetna, CVS CFO Brian Newman said in an interview with CNBC.

All of the healthcare giant’s business segments, including insurance, retail pharmacy and its healthcare unit, beat Wall Street’s revenue expectations. But Aetna’s results are likely to stay top of mind for investors who have been watching how higher medical costs have affected major health insurers for the past two years.

The results showed continued progress on CVS’ broader turnaround plan, which includes cutting costs by $2 billion, closing underperforming stores, changing leadership and cutting costs.S. under privately operated Medicare Advantage plans.

“From an investor perspective, we said let’s set realistic, reasonable goals and then find ways to outperform. And we did that at the end of last year and quarter,” Newman said. “So to beat and elevate, which I think is probably the fourth or fifth in a row, it feels like we’re doing that.”

“We are very confident this year, but we still have a cautious and prudent perspective,” he said, noting that medical costs are still very high.

CVS shares rose more than 4% in premarket trading Wednesday.

Here’s what CVS reported in the first quarter compared to Wall Street’s expectations, based on a survey of analysts by LSEG:

• Earnings per share: $2.57 vs expected $2.20
• Revenues: 100.43 billion dollars, while the expectation was 95.09 billion dollars

The company reported first-quarter net income of $2.94 billion, or $2.30 per share. This compares with net income of $1.78 billion, or $1.41 per share, in the same period a year ago.

Excluding certain items such as restructuring expenses and capital losses, adjusted earnings for the quarter were $2.57 per share.

CVS posted sales of $100.43 billion in the first quarter, up 6.2% from the same period a year ago, as all three business segments showed growth.

CVS’s report also adds to an overall solid first quarter for the overall health insurance industry, but the second quarter will be even more important for these companies as they get a clearer read on medical costs.

The insurance business generated $35.97 billion in revenue in the quarter, up nearly 3% from the first quarter of 2025. That was above the $33.28 billion analysts expected, according to StreetAccount.

Newman attributed the quarter’s performance to Aetna’s core strength, noting organizational changes to processes or technology that enabled the company to “do things more efficiently.”

Aetna and other insurers have grappled with higher-than-expected medical costs last year as more Medicare Advantage patients returned to hospitals for procedures they had postponed during the pandemic. Medical costs remain high, but Aetna and other insurers appear to be becoming better equipped to manage this trend; as many are cutting membership and patient benefits and exiting unprofitable markets.

The insurance division’s medical aid rate (a measure of total medical expenses paid based on premiums collected) fell to 84.6% from 87.3% the previous year. A lower ratio generally indicates that a company collected more premiums than it paid out, leading to higher profitability.

Analysts were expecting a rate of 86.3%, according to StreetAccount.

Newman said medical costs haven’t improved, but CVS has internal programs that will “move costs away from the way we operate.” He noted that the company was able to better predict medical cost trends and was happy that “we didn’t run into too many surprises.”

But Newman said CVS should now focus on using the same tools to reduce medical costs.

CVS also said in a statement that the year-over-year improvement in the unit was due to the lack of a premium shortfall reserve recorded during the same period in 2025. This represents a liability that the insurer may have to cover if future premiums are not sufficient to cover expected damages and expenses.

CVS’ pharmacy and consumer health division reported sales of $31.99 billion in the first quarter, a relatively flat figure from the same period last year. Analysts were expecting sales of $31.70 billion, according to StreetAccount estimates.

The unit dispenses prescriptions and provides other services, such as vaccines and diagnostic tests, at CVS’s more than 9,000 retail pharmacies.

The company’s healthcare segment had revenue of $48.24 billion in the quarter, up 11% from the same period a year ago.

That unit includes pharmacy benefits manager Caremark, which negotiates drug discounts with manufacturers on behalf of insurance plans, creates lists or formularies of covered drugs, and reimburses pharmacies for prescriptions.