CVS Health shares fell 12.53% to $79.96 on Wednesday 4 November, the biggest move of the US healthcare earnings week, after it announced a split into two companies on the morning it beat forecasts, according to its releases and StockAnalysis closing data. CVS earned $2.09 a share in adjusted terms against the $1.62 Zacks consensus, on revenue of $108.4 billion against $105.04 billion expected.
Financial analyst Ruslan Averin notes that all six companies that reported between Wednesday 4 and Friday 6 November beat the Zacks earnings consensus, and five of them raised guidance. The stocks split on something else: CVS on the breakup, Cencora on a fiscal 2027 outlook below the Street, and Humana on a better-than-feared quarter.
The scorecard: actual against the Zacks consensus
| Company | Reported | Adjusted EPS vs Zacks | Revenue vs Zacks | Guidance | Close on reaction day |
|---|---|---|---|---|---|
| CVS Health | Wed 4 Nov, before open | $2.09 vs $1.62 | $108.40 billion vs $105.04 billion | 2026 at least $8.20 (was $7.90–8.10); 2027 at least $8.65 | $79.96, −12.53% (4 Nov) |
| Cencora | Wed 4 Nov, before open | $4.66 vs $4.56 | $88.35 billion vs $88.16 billion | FY2027 $19.40–19.75 (Zacks $19.78) | $354.00, +3.96% (4 Nov) |
| McKesson | Wed 4 Nov, after close | $11.68 vs $10.69 | $110.96 billion vs $110.11 billion | FY2027 $45.60–46.40 (was $44.20–45.00) | $1,072.00, +0.24% (5 Nov) |
| Cardinal Health | Thu 5 Nov, before open | $3.26 vs $2.92 | $67.51 billion vs $66.96 billion | FY2027 $12.80–13.00 (was $12.40–12.60) | $267.82, +2.25% (5 Nov) |
| Cigna | Thu 5 Nov, before open | $7.98 vs $7.46 | $73.79 billion vs $73.53 billion | 2026 at least $30.60 (+$0.15) | $301.48, −1.29% (5 Nov) |
| Humana | Fri 6 Nov, before open | −$0.70 vs −$1.03 | $40.83 billion vs $40.46 billion | 2026 at least $9.50 (was at least $9.00) | $433.74, +5.33% (6 Nov) |
Sources: company releases filed with the SEC; Zacks consensus and Zacks-basis revenue from Zacks earnings tables; closes from StockAnalysis.
CVS: a clean beat, then a breakup
The quarter matched the constructive case in my CVS preview. Aetna's medical benefit ratio (MBR) was 91.3%, against 92.4% in the Zacks consensus and 92.8% a year earlier. Health Care Benefits adjusted operating income rose to $912 million from $314 million; the guidance had implied a second-half loss.
Reserve help was small. Prior-year claims developed favourably by $1.3 billion in nine months against $1.2 billion in the first half, so about $0.1 billion came in the third quarter, by my calculation from the rounded figures. Days claims payable rose 0.2 days to 41.9.
CVS raised 2026 adjusted EPS guidance to at least $8.20 from $7.90–8.10. On the call chief financial officer Brian Newman set 2027 adjusted EPS at least $8.65, above the earlier $8.44 floor and the $8.51 Zacks consensus cited in the preview. Caremark is weaker: Health Services should earn at least $7 billion in 2027. "We are confident 2027 will reflect trough earnings for this segment," Newman said.
The same morning CVS said it will separate into two listed companies by the first half of 2028, in a deal intended to be tax-free. CVS Health would keep Aetna, Caremark, CVS Specialty, Oak Street Health and Signify Health under chief executive David Joyner. CVS Pharmacy would take about 9,000 stores, mail pharmacy, MinuteClinic and Health100 under Prem Shah. CNBC reported that the shares fell about 12% on the announcement.
The stock recovered 1.71% on Thursday and 3.10% on Friday 6 November to close at $83.85, still 8.3% below the $91.41 close of Tuesday 3 November. In my view the market is pricing separation costs and a Caremark trough; the quarter itself was not the problem.
Humana and Cigna: insurers rewarded for cost control
Humana reported on Friday 6 November, not Thursday as our preview had it. Its adjusted loss of $0.70 a share compared with a Zacks consensus loss of $1.03 and the company's own guide of about $1.00. The Insurance segment benefit ratio was 93.7%, better than management's "slightly above 94%". Full-year guidance rose to at least $9.50 from at least $9.00.
Chief financial officer Celeste Mellet said on the call that Humana expects Part D cost trend of 14–15% in 2027, against 11–12% this year, and core medical trend of 8–9% against 7–8%. The stock rose 5.33% to $433.74.
Cigna reported on Thursday 5 November: adjusted EPS of $7.98 against $7.46 expected by Zacks. Its Cigna Healthcare medical care ratio rose to 85.0% from 84.8%, and Pharmacy Benefit Services pre-tax adjusted income fell 22% to $765 million on large client renewals. The stock fell 1.29% that day and 2.62% on Friday to $293.59. The payer backdrop from October is in our UnitedHealth Q3 review.
McKesson: the raise the market wanted
McKesson reported after the close on Wednesday 4 November. Adjusted EPS of $11.68 rose 18% and beat the $10.69 Zacks consensus; revenue rose 8% to $111.0 billion. Guidance moved to $45.60–46.40 from $44.20–45.00, above the $45.00 my distributor preview set as the bar.
GLP-1 distribution revenue was $16 billion, up 26% and 8% from the June quarter, chief financial officer Kenny Cheung said on the call, faster than the 24% of the previous quarter. Oncology & Multispecialty revenue rose 24% to $15.0 billion, but its adjusted operating profit only 8%, after 41% in the June quarter.
The stock had already risen 6.98% to $1,069.44 during Wednesday's session, a record for 2026. It added 0.24% on Thursday and lost 1.04% on Friday to $1,060.84.
Cencora: a beat, and a fiscal 2027 guide below the Street
Cencora earned $4.66 a share in its fiscal fourth quarter against $4.56 expected by Zacks, and $17.97 for the year. The fiscal 2027 guide of $19.40–19.75 has a midpoint of $19.575, below the $19.78 Zacks figure in our preview. Revenue growth is guided at 3–5%, against 5.0% in fiscal 2026.
The mix explains it. Specialty Pharmaceutical and Provider Services is guided to grow operating income 18–21%, but Pharmaceutical Distribution and Services only 2–4%. GLP-1 sales added $2.8 billion of revenue in the quarter, and manufacturer price cuts took away the same $2.8 billion, the company said on its call.
The stock rose 3.96% to $354.00 on Wednesday, then fell 4.05% and 1.80% to $333.56 on Friday, 2.0% below its pre-report close. For the earlier steps see Cencora's June guidance raise.
Cardinal Health: the cleanest raise
Cardinal Health reported on Thursday 5 November: adjusted EPS of $3.26, up 28%, against a Zacks consensus of $2.92, on revenue of $67.5 billion, up 5%. It raised fiscal 2027 guidance to $12.80–13.00 from the $12.40–12.60 set in August (our August article). Pharmaceutical and Specialty Solutions profit rose 17% to $783 million, and specialty revenue grew 18%. GLP-1 drugs added about 500 basis points of revenue growth, while price cuts under the Inflation Reduction Act took away about 400. The stock closed at $267.82, up 2.25%.
What came true from our previews
- CVS: all three conditions of the constructive case were met: MBR below 92%, guidance above $8.10 and a 2027 bar above $8.44. The stock still fell: the breakup was not in the preview.
- Cencora: the midpoint came in below $19.78, as the negative case described. The stock still rose on the day before giving it back.
- McKesson: the raise above $45.00 arrived, and GLP-1 growth beat 24%.
- The read-across I flagged, a weak Cencora dragging McKesson, did not happen: McKesson rose 6.98% the same day.
What to watch next
- Friday 13 November: record date for Cencora's dividend, raised 10% to $0.66 and payable on Monday 30 November.
- Monday 7 December: Medicare open enrollment ends, setting 2027 membership at Aetna and Humana.
- Monday 11 – Thursday 14 January 2027: J.P. Morgan Healthcare Conference.
- First half of 2028: target date for the CVS separation, subject to a Form 10 filing and board approval.
Related: CVS Q3 2026 preview, McKesson and Cencora preview and the US midterms and markets.