v3.25.4
Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Operating activities      
Net earnings $ 12,807 $ 15,242 $ 23,144
Noncash items:      
Depreciation and amortization 4,361 4,099 3,972
Deferred income taxes (1,752) (296) (245)
Share-based compensation 971 1,018 1,059
Loss on sale of subsidiary and subsidiaries held for sale 265 8,310 0
Net gains on dispositions and other strategic transactions (910) (3,333) (489)
Other, net 1,673 (28) (16)
Net change in other operating items, net of effects from acquisitions and dispositions:      
Accounts receivable (764) (1,437) (3,114)
Other assets (4,606) (4,140) (2,444)
Medical costs payable 5,824 2,503 3,482
Accounts payable and other liabilities 1,665 2,463 3,516
Unearned revenues 163 (197) 203
Cash flows from operating activities 19,697 24,204 29,068
Investing activities      
Purchases of investments (17,373) (27,308) (18,314)
Sales of investments 9,288 18,514 7,307
Maturities of investments 8,446 9,319 9,230
Cash paid for acquisitions and other transactions, net of cash assumed (4,509) (13,408) (10,136)
Purchases of property, equipment and capitalized software (3,622) (3,499) (3,386)
Loans to care providers - cyberattack 0 (9,033) 0
Repayments of care provider loans - cyberattack 1,680 4,514 0
Cash received from dispositions, net 561 2,041 685
Originations and purchases of loans (4,795) (2,477) (1,664)
Repayments and maturities of loans 1,980 908 613
Other, net (341) (98) 91
Cash flows used for investing activities (8,685) (20,527) (15,574)
Financing activities      
Common share repurchases (5,545) (9,000) (8,000)
Cash dividends paid (7,916) (7,533) (6,761)
Proceeds from common stock issuances 827 1,846 1,353
Repayments of long-term debt (3,050) (3,000) (2,125)
Proceeds from (repayments of) short-term borrowings, net 807 (151) 11
Proceeds from issuance of long-term debt 2,969 17,811 6,394
Customer funds administered 366 (1,560) (521)
Purchases of redeemable noncontrolling interests (165) (280) (730)
Other, net 63 (1,645) (1,150)
Cash flows used for financing activities (11,644) (3,512) (11,529)
Effect of exchange rate changes on cash and cash equivalents 40 (61) 97
(Decrease) increase in cash and cash equivalents, including cash within businesses held for sale (592) 104 2,062
Less: net increase in cash within businesses held for sale (355) (219) 0
Net (decrease) increase in cash and cash equivalents (947) (115) 2,062
Cash and cash equivalents, beginning of period 25,312 25,427 23,365
Cash and cash equivalents, end of period 24,365 25,312 25,427
Supplemental cash flow disclosures      
Cash paid for interest 4,030 3,594 3,035
Cash paid for income taxes $ 3,714 $ 4,620 $ 6,078