this us morning. everyone David, thanks start you, for I'll Thank with company highlights to few total and on joining a performance.
increase year operating the approximately were health our X% approximately primarily $X.XX. an over quarter adjusted wellness benefits and care growth EPS segments. and prior billion, approximately pharmacy Third income of in consumer quarter, and We reflecting of adjusted revenues billion, of delivered $XX.X $X.X
from operations billion, year, last a result timing period higher earnings. flow impact same cash and to were Year-to-date $X.X HCV the the lower of CMS as receipts approximately primarily to compared on the utilization due of
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primarily million. reserves $XXX individual recorded During includes This adjusted deficiency our the Medicare of businesses. segment of loss approximately the result of an impact billion premium the in and $X.X exchange quarter, generated operating
variable PDRs acquisition comprised reminder, deferred of product the costs. expenses, approximately of do contemplate unamortized measure related write-off and losses a million costs. the million expenses. and fixed $XXX in to The of specifically of a of PDRs generally operating As health $XXX aggregate not was care
with the cadence earnings policy, all the the shifting were between the fourth and of charges Substantially, third associated XXXX quarters.
elevated the utilization, of XX.X% primarily benefit medical accrual. including higher a impact XXX ratio our the premium our Medicaid, XXXX Medicare ratings Stars costs point update remain and payment levels our from Our prior adjustment lower PDRs. acuity the risk guidance. year what an quarter exchange driven points in impact from of in previous at contemplated Medical XXXX XXX increased higher basis book by above was increase for in This basis and to was individual year
same largely we and outpatient, last categories attributable inpatient, pharmacy. the Pressure quarter, supplemental is discussed to including benefits
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for During our the third exchange quarter, business. adjustment we individual risk also received data updated
in year the we approximately quarter. increased by adjustment result, As accrual risk a our for XXXX plan million $XXX the
the into to continue later business, Medicaid pressure additional our our continue others the and we redeterminations. stabilized of XXXX. on revenue as evaluate end updated third potential level of We will the experience higher data accruals risk for consistent receive acuity We impact quarter. between our in we towards scores early believe this rates the acuity the year industry, with to related dislocation In to of and
work We align acuity. with to state our to continue closely in changes partners with the rates
pressures XXXX, second with partners some constructive, half our engagement the levels seen been across of Benefits to in this cover commercial in the our In pressures Care seen current updates have segment we largely of in Although group acuity. continue the have watch we remain manageable. state XXXX, light they to elevated the been utilization business we closely rate To has business. Health have inadequate of date,
earnings grow We ability XXXX, will commercial have emerging lower in to hindering our cost result business. membership in to medical rate in cover risk This proactively trends. pushed this
XX.X Medicare of quarter, the by at from primarily days, the increased our prior driven and the claims remain up the growth was X.X of X.X the premium the the adequacy in Days [indiscernible] end We in down reserves. primarily business impact reserves. impact trends. quarter pharmacy by sequentially, payable driven of of confident deficiency year our was days days
strong delivered generated loss $XX.X large of driven a improvements. Health announced client segment Services by quarter. primarily pharmacy billion during Our year-over-year, X% the We quarter, of revenue another of decrease and continued client approximately a price previously the
assets our care health from These offset billion $X.X and of of were partially by income the $XX contributions approximately economics, and purchasing from was large in client improved partially improvements specialty client. quarter, million. increased approximately pharmacy quarter processed decreases year total previously Services of reflecting announced in in prior drug mix, pharmacy. offset membership the growth Adjusted delivery continued XX% increased were the operating of end the pharmacy Total $XXX claims as price approximately quarter the loss million by Pharmacy pharmacy a
to continue our We be assets. health encouraged the of growth care by delivery
XX% strong approximately Oak points year CVS to revenue of David Health. As the ability strong approximately same increased over prior mentioned, approximately Signify use by quarter. quarter, its risk in driven membership our growth the generating year. supported quarter, across revenue members the Street by quarter last growth. significantly increased growing XX%, in compared by the At continued performance to XX% touch
We by are challenging encouraged Street's this in performance environment. Oak
Consumer During and prior Wellness Pharmacy Adjusted XX% year approximately $XX.X increased segment prior income an increased driven a of over from and the front billion, reimbursement our and offset approximately XX% of pharmacy lower partially basis. generated quarter, revenue continued prescription on including volume, by the of nearly XX% purchasing increase operating increased same-store vaccines billion versus the and over drug by volumes. pressure store $X.X year, contributions versus improved
by increased by Same-store prescription prior in approximately volumes X%. year versus XX% the increased and pharmacy sales same-store nearly the quarter
a the discontinuation This the impairment reflects expect of costs several related workforce including of XXXX, close charge and I the share stores to we we continue down noncore would retail item As restructuring of nearly Same-store, businesses a highlight investors One is that approximately pharmacy took optimization. front X% year. to associated components, XXX approximately for we to script for sales position, like last with in quarter billion to David mentioned, charges our approximately amount grow share same $X.X versus achieving were store XX.X%. other costs quarter. in
balance and cash the flow now Shifting sheet. to
year-to-date For of flow third quarter, operations our approximately we $X.X billion. generated from cash
through approximately cash quarter, billion the the with million at of $XXX to we dividend, During the we $X.X unrestricted quarterly and returned ended our subsidiaries. shareholders quarter and parent
ratio at long-term our the remain our Aetna levels margin our in target. of execute leverage maintaining the return business. recovery above current X.Xx, was to Our as is on investment-grade and approximately We end to committed to the normalized we which quarter more expect leverage ratings
are outlook stage. As David formal mentioned, at providing this a not for we XXXX
our to moving with However, provide like better and understand would see consumer help segments. the pharmacy we directional wellness we to Starting services commentary you parts. and some how health
continue previously season in deliver the to results. to the strong off while have shared into highlighted, businesses start In we give previous outlook confidence quarter, us those stronger we shifting to third we PCW, a growth demand As the investors. continues strong script immunization got with expected, than
In the XXXX Health steadily Services over the and progression segment, but slow, Caremark's second started in third quarters. earnings momentum built
maintain remain While we on additional our we call. health the outlook cautious to in care the quarter we for Health Services segment shared confident our trend-related delivery a with second business Medicare our as on risks, outlook investors earnings deliver on ability potential evaluate we
continue quarter environmental third benefits, elevated. grapple you health Similar results. company-specific with we utilization our care have seen continues within both be Within to as and to Medicare the industry, challenges with to others Advantage
higher benefit dislocation benefit to with We rates between and have Medicaid continues some well very pockets of also as the resulted has utilization. in rapidly grown a offering, induced membership which by seeing as pressured be acuity very utilization. rich
and some has in exchange in our higher-than-expected We individual to risk-adjusted on seen states, revenue led growth business, utilization. rapid disappointing several have which updates also
To combination visibility our outlook. these XXXX and of the has factors our date, challenged
develop our have are as compared and we If increase unfavorably quarter in you could levels quarter one walk the significant the today, fourth we MBR XXXX. me XXX months, providing points reported to through fourth by potential over basis that scenario. recent formal persist trends experienced of While let not guidance
taken Additionally, a XXXX, business we us results. Advantage position would pressure beyond. in likely our of XXXX XXXX that in related challenges need this further for to PDR take deliberate Despite dates actions which to we in and would scenario, growth in Medicare group have service, XXXX
to cost not framework. we with give XXXX our on of the earnings PCW next we and our will expect an decline we update visibility While when segment, year headwinds. XXXX with some changing to provide until medical membership, headwinds our baseline long-term guidance on our formal key better I In tailwinds. and line want guidance in first Starting have the
of X. mentioned, are CVS David of As we on to adoption the cost January scripts this commercial by and encouraged vintage model shift the
We a outperformance be for that target year future long-term expect transition XXXX us of in to growth positions years. our
store quarters, remain cautious also recent been sales, broader have We in pressured macroeconomic front with for backdrop. our outlook consistent in the which
expect return certain corporate As variable we of the discussed, previously we expenses.
count. as XXXX the May and modest higher annualize we net expense share a income expect also the from from financing, dilution our We decline interest in increase in our investment
Shifting now to the tailwinds.
XX% We focused deliberate to expect Benefits our contributions to approach with first Care expect significant back which our X% step our to of to when bids improved Medicare disenrollment X% XXXX in on margin improvement our our combined We X%. our of target from to footprint, result membership and Star a Advantage is result in changes Health margins segment. This in we to recovery. will our ratings, journey believe
to expect and view to resolved between in over temporary pricing be rates this and dislocation continue subsequent cycles. the as We Medicaid Acuity
dislocation end However, before we not expect resolved of XXXX. fully be the the do to
exchange as pricing project and in in business actions deliberate will in our We block expect of this individual business decrease we a of result repositioning, our XXXX. improvement membership which product
We to sustainability. product long-term offerings will for refine continue our
continue We health value drive businesses. underlying in incremental our pharmacy in our we also and our as care growth in growth to expect clients business, services Services including for Health improvement delivery
our segment but year. long-term initial outlook of for expect opportunities will framework, provide growth prudently will for over upside below the the this be course We our
year our business. Benefits multiyear variable has we We Medicare Taking expense cost million XXXX. mid-single-digit losses a year, step over will helping to generate experience segment. $XXX initiative next our in percentage expect the of Health disappointing offset executed XXXX Care back, step our Finally, in savings first we have the could of been a that performance for return in
double could in the digits. business negative approach foray that margins result into Our exchange individual
We projecting our Medicaid business. margins negative modest are also in
we benefits XXXX in over adjusted that our of that health could operating of well means generating show It this billion levels. possible benefits, losses for we took Advantage and over XXXX is prices. if and care has embedded to exchange both $X action Open products Conversely, are after meaningful $X.X Aetna could EPS XXXX. curtailing business in and adjusting where there Medicare operating in adjusted that appropriate, profitability enrollment individual return demonstrated income raising
are While on first outlook We the taken business have will we steps confident on time. next forward in initial XXXX recovery look we more road Benefits year. take the our to right actions, we those the details have moving to providing Care clarity our journey more our on and Health parts
your that, will to open questions. call With now Operator? we the
