Please welcome to the stage Vice President, Investor Relations, Stephen Tanal.
Good morning to everyone here with us in person or on the webcast online. Thank you for joining us today and for your interest in Elevance Health. Today, you will hear from our leadership team about how we will continue to deliver best-in-class business results through the focused execution of our strategy to become a lifetime trusted health partner for the consumers that we are privileged to serve. You'll hear today about how we are optimizing our mature businesses for sustainable growth and margins, about the investments we are making in high-growth opportunities, and how we will continue to accelerate the growth of our organization through our enterprise strategy. The strategy you're gonna hear about today really builds on the foundation of the one that we introduced at this event four years ago.
It's what's enabled us to grow medical membership by 7.6 million net new members over that time to create Carelon, which is now a $41 billion services business from essentially nothing, and to exceed the high end of our long-term compound annual growth rate target for adjusted earnings per share of 12%-15%. Today is gonna be about how we will extend our success into the future, looking out over the next five years through 2027. We believe that we have the right strategy, the right team, and the powerful foundation of businesses to build upon to do that. Perhaps most importantly, we have the focus and the discipline to do it.
I hope that you'll find today's content as compelling as I do, and I look forward to interacting with you in the future in my role as Vice President of Investor Relations. Before I turn the floor over to Gail, I must remind everyone that during our presentations today, we will make forward-looking statements. Listeners are cautioned that these statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond the control of Elevance Health. These risks and uncertainties can cause actual results to differ materially from our current expectations. We advise listeners to carefully review the risk factors discussed in our SEC filings. We will also reference certain non-GAAP measures. Reconciliations of these non-GAAP measures to the most directly comparable GAAP measures are available on our website, elevancehealth.com. It's my pleasure to introduce Elevance Health's President and CEO, Gail Boudreaux.
Well, good morning, and welcome to Elevance Health 2023 Investor Conference. Thank you for joining us today. We very much appreciate your interest. As you saw in the opening video, Elevance Health is evolving from a traditional health insurer to a lifetime trusted health partner by addressing the physical, social, and behavioral health needs of consumers. Today, we'll illustrate how we're working across our organization to deliver whole health, which remains key to our strategy and will enable continued growth for years to come. Our strategy of being a lifetime trusted health partner is built on our strong foundation, a balanced and resilient health benefits business positioned to serve consumers regardless of their unique needs and at every stage of life.
We will leverage our substantial scale in our commercial and Medicaid health plans to optimize these businesses from a position of strength, while we continue to invest in Medicare Advantage where there is significant room to grow over the long term. In our services business, Carelon, we are uniquely well-positioned to accelerate our growth given the nearly $21 million risk-based consumers and roughly $27 million fee-based members that we serve through our own health plans, in addition to opportunities working with other Blue Cross and Blue Shield plans. Within Carelon, our focus remains on delivering integrated whole health solutions that improve quality outcomes and consumer experience while bending the cost curve for health plan clients. Carelon is focused on a large, attractive, and fast-growing markets. Today, spanning advanced analytics, behavioral health, care delivery and enablement, and pharmacy management, including our recent acquisition of BioPlus Specialty Pharmacy.
All of these assets working together synergistically to create a virtuous cycle, strengthening our health benefits business while delivering integrated whole health solutions to consumers, enabling Elevance Health to continue to grow adjusted earnings per share at a compound annual growth rate in the range of 12%- 15% over the long term. Before we shift our focus to our future, I'd like to discuss where we are today. We've come a long way since we first introduced our enterprise strategy at our 2019 investor conference. Last year, we changed the name of our holding company to Elevance Health to better reflect the company that we've become. The name Elevance Health brings together the concepts of elevate and advance, embodying our commitment to elevate whole health and advance health beyond healthcare.
Today, we are much more than a health insurance company. Our new name and our rebranding represents an important step in this journey. While our corporate name change was a first step, you'll see us continue to optimize and streamline our portfolio of over 30 brands into just 3 core brands. These include Anthem Blue Cross and Blue Shield, a highly recognized health benefits brand and an integral part of our portfolio of health plans in our current 14 blue states. Wellpoint for our non-blue health plan business, and Carelon, which unifies our diverse set of healthcare services businesses. Our continued brand evolution will provide clarity in the marketplace and a better experience for our customers while allowing us to build greater brand equity and enhance efficiency in reaching our stakeholders.
Elevance Health is the largest insurer by U.S. medical membership, equipped with a robust suite of services assets, digital capabilities, data and resources. This makes us uniquely well-positioned to build and rapidly scale a services business that enhances the competitive positioning of our health benefits products while diversifying and growing revenue and earning streams for our company. We are all driven by our shared purpose to improve the health of humanity. We have aligned our culture to our strategy with a laser focus on performance and results. I'm really proud that last year, our annual employee engagement survey showed that nearly 90% of our associates strongly agree that our company has a positive corporate culture that supports our future success.
Elevance Health also received external recognition when it was named as a great place to work for the third consecutive year and introduced on the 2022 Fortune Best Companies to Work For and People magazine's Companies That Care lists. These results would not be possible without the dedication of our nearly 100,000 associates, the commitment of our leadership team, and the deep bench and talent that we've assembled across a broad range of skill sets. We've been successful in retaining and recruiting top talent, which is a testament to our culture and our values, the deep ties that we have in our communities, and our leadership position within our industry. Focused execution of our strategy has driven broad-based growth across our organization. Industry-leading organic membership growth on our health benefits businesses.
Since 2018, our health plans have grown to serve nearly 7.6 million more consumers, a compound annual growth rate of over 4%, while Carelon has grown from a mere concept into a $41 billion business. In total, we've grown consolidated operating revenue and adjusted earnings per share by compound annual growth rates of greater than 14% and greater than 16% respectively. While we're pleased with this performance, what excites us even more is the opportunity to positively impact the lives of more consumers. This, in turn, is what will drive growth for Elevance Health in socially responsible ways, furthering health equity while meeting the unique needs of consumers of all ages, regardless of their source of coverage.
Over the next five years, we will continue to grow Elevance Health, building on the strengths that we have in each of our businesses, driving membership growth in our health benefits business that translates to growth for Carelon, which also remains focused on growing external business. We will accelerate organic growth through M&A, targeting capabilities and services for Carelon and bolt-on acquisitions for our health plan business. The more consumers we serve in our health benefits business, the more opportunity that we create for Carelon, maximizing the impact for Elevance Health. Our recently announced acquisition of Blue Cross and Blue Shield of Louisiana is a great example. In addition to the impact Blue Cross and Blue Shield of Louisiana will have on our health benefits business, we have the opportunity to create even more value through integration with Carelon.
Carelon remains central to our strategy and a key component of our commitment to delivering whole health to consumers. Today, Carelon is made up of four distinct pillars. Carelon Insights, Carelon Behavioral Health, our care delivery business, and CarelonRx. We have exciting organic growth opportunities in each to expand both the scale and scope of the services we provide, both to our own and to third-party health plans. We're doing both, and with speed and agility, on track to hit our target of having Carelon comprise more than 30% of total enterprise operating earnings in 2027. Meanwhile, we're scaling digital platform capabilities. We're working to enhance consumer and care provider experiences while driving deeper engagement, leveraging our data to mitigate cost trend and enhance administrative efficiency inside of our organization.
When we last met for our last investor conference, we set an ambitious goal of achieving 90% of all of our interactions with consumers through digital channels. Last year, we were at 82% and are expected to reach our goal of 90% in 2024. This transformation is important because it illustrates the enhancements to the consumer experience while improving our efficiency as the marginal cost of each digital interaction is close to zero. Carelon has made significant progress since our last investor day, achieving our goal of managing at least 20% of our health plans, consolidated benefit expense by 2025, three years ahead of schedule.
Much of Carelon's revenue is risk-based. We remain focused on growing capitated risk arrangements, initially by serving the needs of our Anthem and Wellpoint employer, individual Medicaid and Medicare plans, and via commercialization with third-party payers, including other Blue Cross and Blue Shield plans. Carelon will continue to look for ways to expand the proportion of the healthcare dollar it manages at risk. An effort Peter Haytaian, President of Carelon, will expand on shortly. Carelon's growth is fundamental to our effort to continue evolving the healthcare system to pay for value over volume. Our commitment to drive more spend through value-based arrangements is rooted in evidence that it leads to better outcomes, higher patient care and higher care provider satisfaction, and ultimately more predictable costs for our health plans. We are also working strategically to leverage value-based contracts to advance health equity through targeted contract provisions and incentive structures.
Today, over 60% of our consolidated medical spend is tied to value-based arrangement. Our primary goal over the coming years will be to transition more of our spend into arrangements where we share downside risk. With approximately 119 million people served by our enterprise, including over 47.5 million medical members, we know we can't get there on our own. Later this morning, you'll hear from Bryony Winn, President of Health Solutions, who's responsible for executing our care provider strategy. She'll discuss our multipronged approach for achieving our value-based care targets and the progress that we have made to date in helping to transition the care delivery system towards value.
Beyond the benefits of our health, our health plans are seeing from these relationships, we're also increasingly working to pull through opportunities into Carelon, notably through carve-outs of behavioral and home health management, in-home palliative care through our Aspire business as well. There is significant opportunity still to come, including the area of care provider enablement. We will continue to collaborate and partner across our diverse set of businesses to identify and develop synergistic strategies that accelerate growth for the enterprise. Across our health benefits business, we're focused on optimizing our performance and investing in high growth opportunities. Commercial continues to meet the unique needs of employers and individuals. Customers in the commercial market continue to prioritize affordability, experience, and simplicity.
We're winning on these fronts, leveraging our competitive advantages, including our differentiated cost to care position and leading care provider networks, digital advocacy and clinical offerings, and our diverse suite of capabilities housed inside Carelon. In the past 2 selling seasons, we were selected by 23 existing employer clients representing more than 750,000 members to become their sole strategic partner for medical benefits after previously managing a portion of their employees alongside competitors. These wins, in addition to the strongest client acquisition and retention rates in the history of our company, demonstrate the distinctive value that we're delivering. We're also making steady progress enhancing the productivity and profitability of our fee-based commercial business. We're doing this by cross-selling CarelonRx into our fee-based book of business, enhancing sales effectiveness across our specialty products, and marketing the unique services and capabilities that Carelon offers beyond pharmacy.
Since 2008, we've grown total company earnings from fee-based customers by more than 60% and are targeting to grow the total by at least 50% through 2027. We've also made significant progress repricing certain areas of our risk-based business to better reflect the underlying cost structure, which is helping our margins recover from pandemic era lows. With Medicaid eligibility redetermination set to begin next month, we're also well prepared to support those consumers shifting to individual ACA exchange and employer-sponsored plans. Overall, we're targeting low single-digit membership growth annually through 2027, with significantly faster growth in earnings. Later today, Morgan Kendrick, who leads our Commercial and Specialty Health business, will discuss all of this in more detail.
In our Medicare business. We remain focused on continuing to grow our Medicare Advantage health plan membership for the long term, with an emphasis on our Blue-branded commercial states. In these markets, we expect to continue taking share by leveraging our competitive advantages associated with deep local presence, including strong care provider partnerships and an embedded growth pipeline from our commercial business as consumers age into Medicare. We will continue to deliver integrated solutions and simple, personalized consumer experiences as we aim to keep members Blue for life. Our supplemental benefits go well beyond traditional healthcare to address social drivers as well as consumers' whole health needs, and have been key to our growth in the dual-eligible market, where we anticipate strong growth for years to come. We've also made significant progress on Medicare Advantage Star Ratings in recent years.
For payment year 2024, the proportion of our members on 4-star or higher-rated plans will be 17 percentage points higher than in 2018, compared with a 1-point decline for the industry overall for the same period of time. Our goals are set considerably higher though, and our progress to date supports that we are on the right path. In our Medicaid business, we remain intensely focused on meeting the unique needs of our states, members, and communities, which go well beyond traditional healthcare to include health equity and social drivers of health. We do this by drawing on our expertise in managed Medicaid, our deep roots in our communities, and Carelon's whole health and high-touch care capabilities. Increasingly, we are utilizing digital tools to track and measure our impact.
Our proprietary Whole Health Index tracks the health of local populations inside our markets, helping identify opportunities to advance the current ecosystem of care delivery by addressing physical, behavioral, and social needs while allowing us to measure the impact we're having on the health of our communities. As a result, we're increasingly centralizing and coordinating member engagement, outreach, and support with an emphasis on health equity. We're also integrating health equity measures into value-based contracts with care providers. Taken together, these actions are allowing us to reimagine the ecosystem of care delivery for our most vulnerable members to support viable communities in which people can thrive. We anticipate growth in Medicaid membership long term, given a robust pipeline of opportunities to expand our footprint into new markets and populations, both through organic and inorganic growth.
We are proud that Elevance Health ranks among the top plans for successful Medicaid RFP submissions with an 83% win rate since our last Investor Day. These dynamics will drive growth for our health plans while creating opportunities for Carelon to scale its existing arrangements and expand the scope of what it provides. While the resumption of eligibility redeterminations will present unique challenges for the Medicaid managed care ecosystem in the short term, we are prepared to help consumers maintain access to care wherever possible through our full suite of products and plans. For example, for 2023, we expanded our exchange-based products to cover nearly all markets in our 14 Blue commercial states and priced our plans strategically by market. We are uniquely well-positioned to serve consumers regardless of their coverage options in the future.
Long term, we're targeting to drive mid-single-digit top-line growth in our Medicaid health benefits business, driven by high-needs populations once eligibility has been redetermined for the existing population. Felicia Norwood, who leads our Medicare and Medicaid health benefits business, will discuss all of this in more detail later today. Looking out over the next five years, we expect each of our businesses to grow, enabling us to produce a compound annual growth rate in adjusted earnings per share in the range of 12%-15%, driven by focused execution. We will optimize our commercial and Medicaid health benefits business by scaling our digital platform for health to enhance consumer experiences, health outcomes, increase efficiencies, and convert data into actionable insights. We will leverage these insights internally and share them with our care provider partners in support of our mutual goals that we are embedding into our value-based arrangements.
We will invest in high-growth opportunities over the long term, namely Medicare Advantage, dual-eligibles, and specialized Medicaid populations, both within our health benefits business and across Carelon. We expect to accelerate growth by expanding Carelon to better support consumers on our own and third-party health plans, including fellow Blue Cross and Blue Shield plans, as we further diversify our services businesses to address a growing proportion of the healthcare dollar. We will do all of this concurrently across our enterprise, continuing a virtuous cycle that strengthens our core, drives growth, and enables us to deliver on our strategy to become a lifetime trusted health partner. We've been on this path for some years now, and we have delivered compound annual growth in adjusted earnings per share in excess of our 12%-15% target range since we began our journey in 2018.
These results reflect the potential of our organization, our culture, and our people. It illustrates what we can achieve through the focused execution of our strategy and our unwavering commitment to improving the health of humanity. We are excited about the opportunities ahead to continue to deliver on the promise of Elevance Health, and we are committed to meeting the needs of all of our stakeholders, clients, consumers, care providers, business partners, communities, and shareholders alike. I hope you'll leave here today inspired and as excited and optimistic about our future as we are. Now I'd like to welcome Pete Haytaian, President of our Carelon business, to tell you more about our strategy and vision for Carelon. Pete?
Thank you, Gail. Good morning, everyone. I appreciate the opportunity to share our Carelon strategy and roadmap for long-term success and accelerated growth for Elevance Health. As many of you know, I assumed the leadership of this business about 18 months ago. Since our last investor conference, Carelon has undergone quite a transformation. We not only have a new name, but we also have a new leadership team, a new strategy, and a powerful platform to compete in the healthcare services space. I am more excited now by the opportunity that lies ahead for us to drive profitable growth and deliver meaningful value for consumers, our customers, our care provider partners, and for Elevance Health.
As you'll hear today, we have runway to extend our growth with existing assets and are actively evaluating new capabilities to drive further competitive advantage for our health plan businesses as we diversify Carelon into high-growth areas. While we will not share specifics on our M&A roadmap, we remain acquisitive to accelerate and have ample capital available to deploy against our strategy. We are now in a strong position to help deliver on our enterprise strategy to become a lifetime trusted health partner. Carelon today is a $41 billion business comprised of Carelon Services and CarelonRx, our pharmacy service business formerly known as IngenioRx. Carelon Services include our advanced analytics and insights, behavioral health, and care delivery and enablement businesses. Two years ago at our investor conference, we set a goal of managing at least 20% of the company's consolidated benefit expense by 2025.
As Gail mentioned, we reached 21% last year, achieving our goal three years ahead of schedule. Services represents a huge opportunity for Elevance Health. To capture this market, Carelon's strategy is built around integrating physical, behavioral, social, and pharmacy services to deliver whole health affordably. Focusing first on the needs of Elevance Health, we are contracting for risk with our own health plans, where we can execute to achieve better outcomes, which creates predictable, stable, and lower cost of care for our health plan partners. We are especially focused on serving members with complex health needs, where costs are escalating rapidly, where the patient experience is fragmented across many care providers, where quality and outcomes matter, and where we believe we can have a meaningful and positive impact.
A powerful example is within our Medicare business, where 10% of our members with complex care needs account for more than 60% of our medical spend. Carelon can deliver solutions to address complex health conditions, providing the care, support, and resources needed to improve quality and outcomes, enhance the patient experience, and bend the cost curve. By executing on our strategy, we will diversify Elevance Health's overall earnings and cash flow while improving the competitive positioning of our market-leading health benefits business. This virtuous cycle of activity is really what makes this all so exciting. We're now competing in the healthcare services space in ways we never did before. Our key differentiating strategy and competitive advantage is Elevance Health. We have the advantage of membership.
Elevance Health operates the largest health benefits business by U.S.-based medical membership with more than 47 million members, including 21 million on risk-based health plans. This breadth of membership provides a powerful platform to scale our services quickly, to have a meaningful, positive impact for consumers at scale, and on our health plan's quality and cost of care. We have the advantage of local market density. Elevance Health has the leading local market share in its traditional health benefits business, which allows us to identify the greatest needs of our members and our health plans and develop and deliver solutions rapidly and at scale.
We capitalized on this advantage last year with the introduction of our post-acute management solution, which supports members' care journeys from hospital admission back to the home with a high-tech, high-touch approach to ensuring appropriate care affordably and with high-quality outcomes. Within eight months, we went from concept development to deployment across 19 Medicare markets covering 1.2 million lives. The solution is now deployed across the majority of our Medicare markets, and we expect it to derive significant revenue growth for us this year. I really love this example because it shows how quickly we can scale our solutions across our health plans to positively impact the lives of millions of consumers, enhancing the member experience, improving quality and health outcomes, and changing the trajectory of healthcare spending in the process.
Our ability to rapidly deploy new products at scale across our risk-based businesses stands in contrast to other services businesses that need to sell by the ones, whether they're third-party health plans or self-insured employers. We also have the advantage of our enterprise strategy. Elevance Health has evolved beyond traditional health insurance to focus on serving people across the entire care journey, connecting them to the care, support, and resources they need. Much of that is due to our diverse portfolio of services and capabilities that enable us to take a more holistic approach to health and address the physical, behavioral, and social drivers that impact health to make whole health a reality.
Later, you'll hear from Bryony Winn, who will speak about our value-based care and enterprise provider strategy and how we will leverage our Blue assets, including a network that spans more than 1.7 million physicians and hospitals, both to partner to improve consumers' whole health and to create new business opportunities for Carelon. She'll also discuss how our digital platform is another advantage that will not only fuel our growth, but create a connected and cohesive experience across our integrated solutions. Our history as a Blue partner is yet another distinct competitive advantage. In addition to Elevance Health, we are also well-positioned to scale our services business rapidly within the Blue system, a market of more than 110 million members across the country.
In 2022, Carelon's revenue from external Blues continued to grow, which reflects a deep partnership and alliance that we built over with numerous Blues plans. We spent much of last year refocusing our external sales efforts, infusing the team with top talent, and the early results are very promising. Carelon's external sales pipeline is growing rapidly, and we are confident that our external growth rate will accelerate over the next 5 years and contribute meaningfully to our overall growth with significant runway to expand revenue from existing clients, partnerships, and alliances. The breadth and depth of our broad portfolio of solutions is itself another distinct advantage. We are well-positioned to address healthcare's most complex challenges and to deliver and enable whole health across the entire healthcare continuum on behalf of consumers.
Our services strategy is built to leverage the tremendous foundation of our health benefits business with scale, local market density, and an opportunity to deepen engagement with our customers and care providers. In the next five years, we expect Carelon to grow in three primary ways. First, we intend to expand and develop new solutions within each of our existing assets, focusing on our risk-based arrangements. This will show up as growth in revenue per consumer served. In 2022, Carelon Services generated approximately $117 of revenue per consumer served, and we have line of sight to growing that number approximately 50% by 2027 with our existing assets alone. Second, we will leverage the success of our solutions within risk-based Elevance Health plans to meaningfully grow our external revenue.
Third, we will collaborate with our health plan and internal business partners to identify partnership and acquisition opportunities to put forth innovative solutions that can be scaled to tackle some of the most challenging problems in healthcare. Putting all this together, we expect Carelon to increase Elevance Health's exposure to high-risk growth pools in the healthcare industry while managing a growing proportion of the overall healthcare dollar. Carelon's evolution to address a growing proportion of healthcare spending with a suite of best-in-class services in support of our health benefits business is at the core of our journey from a traditional health benefits company to a lifetime trusted health partner.
Today, Carelon manages key categories of medical spend, such as behavioral health, high-cost claim categories like home health, outpatient costs for specialty care and pharmacy, as well as whole person health costs in geographies where we have healthcare provider ownership. We envision a future state in which we accelerate growth by taking whole person medical risk focused on chronic and complex populations through an expanded care provider enablement strategy. We talked about the runway we see in the services space and our unique opportunity to compete. Let's dig in a little deeper into how we will execute, deliver value, and drive growth. Our strategy is built around integrating physical, behavioral, social, and pharmacy services to derive whole health.
It's built around putting people at the center of everything we do and ensuring they receive the right care, support, and resources at the right time, in the right place, in the moments that matter. It's about moving from a disjointed system of care to a connected, cohesive, simple experiences across integrated solutions powered by data-driven insights and digital capabilities. It's about enhancing the member experience, improving quality and health outcomes, and changing the trajectory of healthcare spending while improving people's lives. Let's take a look at what this looks like from a perspective of a member enrolled in one of our Medicaid health plans supported by Carelon solutions.
I was in just a bad cycle. I would do really well, you know, then really bad. One thing I notice about being in homelessness, basically, you end up just getting used to everything. Once you get used to it, you don't try as hard to get out of it. I tried to stay outside as much as I could, 24/7. I knew I wasn't gonna make it back to the shelter in time, and it got really, really cold, and I started a fire. This night was different. I mean, I woke up, you know, basically on fire. I lost my left leg.
James was in need of case management. I outreached to James, you know, in a cold call, basically. When you're reaching out to somebody, you have to see them as a person, as the center of a life.
When Tina got involved, it made everything work a little bit better. She was treating me like a person.
To be able to have everything all under one umbrella of Carelon, it definitely makes things a lot more efficient. I was able to address the whole person, help him with his physical health needs by getting him to more connection with his primary care physician. I was able to help him grow in his mental health as well by getting him in touch more with his therapist, getting him stable with taking medications regularly, and then also to address the housing needs.
If I wouldn't have been involved in the programs I was in, there's no way that I could be at where I'm at now, basically. They just fought hard for me to get the right kind of programming. Here's where it pays off doing something like that is I don't go to the hospital anymore. I don't have nearly as many physical problems like I did before.
To see who he is today compared to who he was then, it's hard for me to come up with the words. It's just nice to see somebody succeeding.
This is how we connect members to the right care, support, and resources they need. It's how we create a differentiated consumer experience, how we improve health outcomes, and improve lives. That is really what it's all about. With Carelon's impact in mind, let's take a closer look at the four pillars of Carelon today, starting with our analytics capabilities. Carelon Insights helps make care more effective, affordable, and accessible, leveraging data aggregated from millions of people over many years to align care with proven best practices to deliver personalized care solutions and improve health outcomes, simplifying the healthcare journey for patients and care providers in the process. Carelon Insights and its businesses deliver core capabilities that include Carelon Medical Benefits Management, which provides clinical utilization management and pathways and redirection services.
Carelon Post Acute Solutions, which optimizes the care members receive at home in post-acute care settings and during transitions. Carelon Subrogation, which maximizes health plans' recovery of their healthcare spending when another party is liable. Carelon Payment Integrity, which offers payment accuracy and integrity solutions to our own health plans today. Carelon Advocacy, which encompasses advocacy and navigation solutions, including our concierge cancer care program, virtual second opinion, and inclusive care program. Today, we are leveraging our Carelon Insights capabilities to deliver a broad range of solutions to drive whole health, simplify the healthcare journey, enhance patient, consumer, and care provider experience, and manage health spend across a variety of different medical cost categories on behalf of Elevance Health's commercial, Medicare, and Medicaid members.
Last year, we expanded our medical benefits management risk contract with our risk-based commercial health plans to perform focused management on select clinical conditions, such as oncology and musculoskeletal, to cover our 14-state commercial footprint. Today, we have further runway as we expand that risk arrangement to other lines of business. We plan to continue to scale our post-acute care management solution, expanding from Elevance Health's Medicare markets to various Medicaid and commercial markets in 2023. Carelon Post Acute Solutions also expects to launch products to screen for and address social needs, close gaps in care, and deliver Durable Medical Equipment and wound care at home. Let me now turn to Carelon Behavioral Health, formerly Beacon Health Options, which manages behavioral health services for over 56 million consumers today. We believe behavioral health is integral to whole health.
With the nation's growing mental health needs and demands for behavioral health support, we believe our strong capabilities, solutions, and strategy will be key to our long-term success. Improving access to behavioral health care is a priority, we're focusing in on expanding our network through partnerships with innovative care provider groups as well as direct contracting. Empowering patients to access timely care on their own terms with in-person, virtual, and tech-enabled options designed to meet them where they are. Delivering innovative offerings that address whole health needs and that resonate across commercial, Medicaid, and the Medicare lines of business. Carelon Behavioral Health serves 32 million Elevance Health members with comprehensive behavioral health management.
While spend for behavioral health services is itself not typically a large percentage of total benefit expense, our health benefits business spend more than $11 billion caring for patients with a primary diagnosis of complex behavioral health. Expanding our contracts to take total cost of care risk for special needs populations with behavioral health comorbidities will be a key growth driver for us in the coming years. We're also focused on differentiating ourselves as a leader in crisis services and continue to expand our footprint on both the national and state level. Last year, Carelon Behavioral Health became one of the largest text and chat backup centers for 988, the National Suicide and Crisis Lifeline. Additionally, we now hold crisis contracts for six individual states.
We believe our crisis program platform has the potential to advance how behavioral health is managed more broadly across the healthcare system, improving access and guiding those in need of care, support, and resources in critical moments in their healthcare journey. The third and final pillar of Carelon Services is our Carelon care delivery solutions. This is where we manage fully capitated Medicare spending from our affiliated health plans and shared savings arrangements by serving Elevance Health Medicaid members in select markets. We focus on driving value through innovative care models and whole health solutions that reduce hospital admissions, readmissions, and bed days, while providing a more personalized patient experience that improves health outcomes and consumer satisfaction.
As we look to the future, we see an opportunity to be a key contributor to advancing our value-based care strategy and assuming risk through enablement capabilities that help care providers move toward value-based care, including real-time bi-directional member information, simplified contract governance structures, and a seamless integration with a suite of expanding Carelon assets. As Carelon assumes a greater share of medical cost risk, we will rely on both owned and network care providers and continue to build upon our current provider assets to help us effectively manage cost of care through value-based arrangements. Our approach to care provider ownership is targeted and strategic, taking an ownership stake when doing so can improve outcomes for our members and our health plan business.
As you can see, our current portfolio of services and solutions provides us with a robust platform from which we can develop, deliver, and scale new products and solutions. We have a clear strategy to grow, scale, and realize the full potential of our current assets, providing a long runway of opportunity with our own and third-party health plans to fuel our future growth. By capitalizing on these opportunities, we are targeting Carelon Services to grow revenue at a compound annual growth rate in the upper teens to low 20s through 2027. Let's turn now to pharmacy. I'll turn the floor over to Paul Marchetti, President of CarelonRx, to give you a sense of the opportunities ahead, which we are pursuing through a focus on integration, driving greater affordability, and delivering whole health for our members. Paul?
Thanks, Pete, and good morning, everyone. When we first launched our IngenioRx pharmacy solution, we envisioned a new future for pharmacy care, not just another PBM. We built what is known as CarelonRx with a focus on creating a new approach to care, a modern, integrated pharmacy model. We believe that managing pharmacy is a critical component of advancing whole health, and that remains a foundational principle for us as we work with Elevance Health's affiliated health plans and fee-based customers to address the pharmacy, physical, behavioral, and social needs of our consumers. Since assuming leadership of CarelonRx in mid 2021, we've further refined our strategy with a focus on owning the strategic levers that create differentiation. We've made considerable progress in this time as we've built out capabilities and products that position us to win in all markets.
Today, we manage pharmacy benefits for more than 17 million consumers, representing over $28 billion in revenue for Elevance Health, and contribute meaningfully to operating earnings for the company. In 2023, we expect to grow revenue by more than $2 billion, building on double-digit revenue growth in 2022. Going forward, we will remain focused on driving growth in attractive market segments, addressing areas of high cost for our clients through the lens of whole health, notably specialty pharmacy, and improving consumer experiences, particularly through our CarelonRx pharmacy offering. To support our long-term growth, we are laser-focused on growing membership while increasing penetration and upsell opportunities across our membership base. We are pleased to report that our win rates continue to climb, and our capabilities are being recognized in the market.
Fueling our growth is a robust pipeline of products that address what our clients need most, affordability, predictability, and better outcomes, in particular, around managing specialty pharmacy costs. Our current solutions help drive value for clients, significant savings, deepened relationships, and better engagement, as well as value for their members. These products create opportunities to upsell ancillary solutions that add value for our clients while delivering needed services to consumers and growing revenue per member for CarelonRx. Over the coming five years through 2027, we are targeting revenue growth at a compound annual rate in the low double-digit % range. We remain intensely focused on driving innovation and delivering value to the market, which will continue to drive growth and operating gain.
Consistent with our new business segment reporting structure, we will provide adjusted prescription volumes as a measure of our progress. As we've grown and built new capabilities, our value proposition has gained strength in the market. Our growing scale, in turn, enables us to execute new strategic steps. This year, those steps include expanding our footprint in the specialty pharmacy space and moving directly into the dispensing of drugs, which began with our recent acquisition of BioPlus Specialty Pharmacy and will continue with the launch of our new CarelonRx pharmacy offering. Let's talk about specialty pharmacy. Expanding our specialty capabilities and footprint is a key part of advancing our Carelon strategy. Specialty pharmacy is a critical driver of value for customers and consumers, and it's a space where we feel we can have a significant positive impact. Specialty drug costs are escalating rapidly.
Quality in this area is critical, and we see opportunities to simplify the healthcare experience and deliver solutions that advance whole health. Specialty medicines represent a large and fast-growing area of medical spend, largely driven by growth in autoimmune and oncology treatments. For CarelonRx, specialty represents less than 1% of pharmacy script volume, but nearly 40% of pharmacy spend. In addition, members who take specialty medications represent roughly 38% of total medical spend, and about 20% of them have a behavioral condition. Moving up the supply chain to work directly with manufacturers to control and directly impact affordability, along with the ability to improve the member experience while integrating with other Carelon Services, is what guided our strategy.
When you consider the dynamics of the specialty landscape and the opportunities for CarelonRx to positively impact cost of care and customer experience, the strategic rationale behind our recent acquisition of the BioPlus Specialty Pharmacy is clear. BioPlus will help us deliver whole health by increasing our ability to provide end-to-end pharmacy services and promote access and affordability. BioPlus was the largest independent specialty pharmacy provider prior to becoming part of CarelonRx, offering a complete range of specialty pharmacy services for rheumatology, cancer, and autoimmune diseases. It is licensed in 50 states and has access to over 100 limited distribution drugs that represent approximately 3/4 of all of CarelonRx's specialty script volume. Recently, BioPlus was recognized by Forbes Health as one of the best online pharmacies. The specialty pharmacy business starts with the patient, and it's crucial that they get their medications quickly.
We call this time to therapy. This is an area where BioPlus excels, leveraging industry leading capabilities to deliver a time to therapy guarantee that is two to four times faster than the market. This drives greater patient satisfaction as consumers start their course of treatment more quickly, which in turn drives greater care provider satisfaction. That better positions BioPlus with specialty drug manufacturers who prefer to work with specialty pharmacies that have high satisfaction rates. That, in turn, better positions BioPlus to distribute more of their products with a focus on access, affordability, and health equity. All of this leads to greater value for our clients and payers. With BioPlus, CarelonRx will be able to serve members with complex needs in a more holistic way, and our intention is to scale this, their best-in-class service model.
Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we will deliver an elevated experience, enhanced affordability, and personalized support throughout the consumer's treatment journey. New specialty medications are enabling people with complex conditions to live healthier, more productive lives. Over the next five years, the rise of biosimilars, particularly in oncology drugs, will create a huge opportunity for us. We're preparing to harness these new therapies along with our rich clinical data to ensure a patient-centered approach and better outcomes for consumers. Today, BioPlus delivers nearly 250,000 prescriptions a year to patients, while Elevance Health has more than 2 million prescriptions for similar therapies for its members, providing a huge opportunity for internal expansion.
Finally, as consumers who require specialty medications tend to have complex and chronic conditions, we have the opportunity to work across Carelon. For example, to connect and integrate services like behavioral health, simplify the patient experience, improve quality and health outcomes, and drive whole health, all while bending the cost curve and diversifying our earning streams. By delivering best-in-class service to care providers and helping them take care of their patients more effectively with excellent time to therapy, we expect BioPlus to become a preferred specialty pharmacy for more care providers, attracting more script volume and thereby growing our dispensing arm. With this growth, we'll garner more purchasing power with drug manufacturers, delivering even more value for clients and consumers.
In addition to the acquisition of BioPlus, the launch of our new CarelonRx Pharmacy will deepen our presence in pharmacy dispensing. Again, with the goal of owning the strategic levers that matter for differentiation. CarelonRx Pharmacy is our new home delivery offering integrated into Sydney, our digital front door for health, which will deliver medications straight to a patient's door after ordering from an innovative consumer-facing app that lets patients track their prescription, check the status of their delivery, and chat with a pharmacist in real time. We plan to launch CarelonRx Pharmacy offering later this year and see substantial opportunity for growth by increasing home delivery pharmacy penetration rates as we move to a new differentiated experience, creating value for CarelonRx through capturing dispensing margin while improving quality, access, and consumer experience.
Our CarelonRx Pharmacy offering will build on our ZipDrug program, which is also integrated into Sydney. Through ZipDrug, we use data and artificial intelligence to connect members with complex needs to pharmacy care offered by community and independent pharmacies in our retail networks. Pharmacists are equipped to provide specialized clinical counseling and connections to our case management team. They provide concierge service, digital and phone engagement, personalized fulfillment through multi-dose packaging, and scheduled doorstep delivery at no additional cost to members. Through these pharmacy partnerships, CarelonRx supports high-risk, hard-to-reach members, many of whom are in rural areas or have other environmental or economic barriers to care. Together, our moves into specialty pharmacy and pharmacy dispensing will allow us to address pain points in the consumer and care provider journey, better control costs end to end, and more fully meet the needs of our clients and members.
I wanna close by emphasizing that we are demonstrating the value of integration. Our ability to control trend and improve health outcomes through integrated benefits. The value of integrated benefits is clear when we look at our efforts to lower overall cost of care across pharmacy and medical benefits. In a recent study, our members with integrated benefits taking specialty drugs showed per member, per month, overall medical cost savings of $105, 6.3% lower hospitalizations, and a 12% lower hospital outpatient claim rate. This strong performance is driven by an integrated approach to managing pharmacy and medical through targeted strategies with a focus on the member's whole health and total cost of care. This, in turn, allows us to offer a competitive financial proposition to employers with creative whole case underwriting considerations where appropriate.
Our whole health solutions are driving value for a growing number of clients and consumers. We look forward to updating you on our progress in the coming quarters and years. With that, I'll turn it back to Pete, who will summarize our overall Carelon strategy. Thank you.
Thank you, Paul. As you can see, we are very excited about the momentum and strategy of our pharmacy business, and how it supports our commitment to delivering whole health solutions that improve the lives and health of our consumers affordably. While the range of opportunities in the market is broad, we are focused on business models that can have a positive impact on consumers, that we understand and operate well, that we can scale by driving synergies through our affiliated health plans, and that are fiscally responsible and a financially attractive use of capital. We'll continue to lean into opportunities that satisfy these criteria while putting consumers at the center of everything we do, fueling growth for Elevance Health, both organically and inorganically. We are in a strong position as we look out over the next three to five years.
Carelon is aligned to Elevance Health's commitment to advancing whole health and improving consumer and care provider experiences, leveraging our collective competitive advantages. We have the strategy, assets, and vision to drive meaningful growth with Elevance Health's family of health plans first, and with third-party payers as well. Much of this becomes a story of execution, moving with speed towards our vision of a comprehensive services offering at scale. We are confident we know what to do, how to do it, and where the future opportunities lie. We have the team and the talent to deliver on our objectives and are attracting talented people with diverse experiences that wanna help build something great here. In short, we are prepared to continue executing on our vision for Carelon, and we are excited about what the future holds.
Over the next 5 years through 2027, we are targeting a compound annual growth rate in Carelon's overall revenue in the mid-teens % range, with operating margins in the mid to upper single-digit range in 2027. At which point, Carelon will represent more than 30% of Elevance Health's consolidated operating earnings. Now I'd like to turn the floor over to Bryony Winn, President of Health Solutions, who will discuss our enterprise care provider strategy, Carelon's role, and how we're contracting for outcomes, collaborating for success, and connecting for health. Bryony?
Thank you, Pete. Good morning, everyone, and thank you for the opportunity to discuss our care provider strategy. I could not be more excited to share with you how Elevance Health is improving the health of humanity by working in partnership with our care providers. Together, we are having a positive impact on the lives of tens of millions of people, and really, the best is yet to come. For those unfamiliar, Health Solutions is responsible for our care provider network, clinical, provider operations, and analytics functions. It is our collective passion and privilege to maintain, grow, and build upon one of the company's biggest advantages, our care provider network. As you know, our company's history is deeply rooted in the Blues system.
We began in 1944, 79 years ago, and the fact that one-third of all Americans are insured by the Blues today is the result of decades of investment made in local communities, in building trust with care providers, and in cultivating relationships with the consumers who we are both privileged to serve. Through the broader Blue Cross and Blue Shield care provider network, Elevance Health members have access to more than 8,000 hospitals of all shapes and sizes, close to 700,000 specialists, over 350,000 primary care physicians, and nearly half a million behavioral health providers. It is the broadest network in the industry. Beginning in 2021, we began to curate more explicitly for quality with the Blue Cross Blue Shield Association to develop high-performing networks, which have been highly successful for our commercial health benefits business.
Actually, in the process, we learned there was so much more we could do across all lines of business. Our unique combination of both national scale and local density results in our affiliated health plans holding the number one cost position in more than 70% of our markets. In more than a third of them, we have what's considered a material advantage. It's why, just a few weeks ago, the website insure.com ranked Anthem as the best health plan for care provider networks, and also helps explain why we outperform our competition in objective measures like care provider satisfaction and Net Promoter Scores. Our focus now is building upon our advantages to develop the largest, highest performing, digitally powered care provider networks in the country, and to radically simplify the relationships we have with our care provider partners.
Such networks will position us to serve more members. They will drive measurable improvements in whole health and equity outcomes. They will enable 4-star plus Medicare Advantage performance for a growing majority of our members. They will help to curb the escalation of healthcare costs. They will continue to empower our fellow Blues, and they will create a flywheel of growth for our health benefits and Carelon businesses. While our traditional competitive advantages persist, our newer ones, embedded in a digital platform for health, are having an impact too. The potential of our assets and how we can capitalize on them across our synergistic set of businesses, Anthem, Wellpoint, and Carelon, gets us really excited. To that end, the rest of my time today will be broken into three themes. First, contracting for outcomes.
This is about aligning incentives and rewarding our care providers for delivering high quality, cost-efficient care and exceptional consumer experiences. Specifically, I'll speak to how we're doubling down on value-based care. Collaborating for success. We are simplifying processes through sharing data, improving administrative functionality, and partnering with care providers on clinical programs. Lastly, connecting for health. This is about deeply integrating our services, capabilities, and platforms through distinctive collaboration to drive health beyond medical care. Let's begin with how Elevance Health is contracting for outcomes to better serve the needs of our more than 47 million medical members. We are utilizing our contracting levers to raise the bar for care providers, using value-based arrangements to drive quality and affordability and experience and, increasingly, equitable health outcomes. I'm very excited to tell you that it's working.
Today, our value-based care arrangements are unequivocally driving better outcomes across our continuum of businesses. When compared to fee for service, our flagship value-based program in the commercial space has shown 5.6% higher breast cancer screening rates, equally impressive improvement in well care visits for teens and young adults, and more than 3% higher performance on childhood immunizations. In Medicaid, our value-based programs are achieving nearly 15% improvement when it comes to childhood obesity prevention, and are also moving the needle on diabetes measures like eye exams and hemoglobin A1C testing. In our Medicare Advantage population, we are seeing 12.5% higher frequency of annual planned visits, with even higher rates by 3 percentage points for those in downside risk arrangements. Also, results for controlling blood pressure and blood sugar have been astonishing, with improvements approaching almost 30%.
Advancements like these have a measurable impact on the health of our members and our Star Ratings. This is proof that value-based care is leading to better health outcomes across all lines of business. To the point of reducing costs, our value-based groups have saved an average of 3%-6% on per member per year total healthcare costs across commercial, Medicare, and Medicaid health plans. These achievements are the result of a relentless focus on driving whole health and greater affordability through a steadfast commitment to changing our country's payment paradigm away from volume towards value. It is bolstered by the industry's strongest brand, one of the broadest and deepest datasets, robust analytical tools, market knowledge, and a deep community-based understanding of our consumers' whole health needs.
Today, 63% of our healthcare reimbursement for risk-based members is tied to value-based care, and we are well on track to meeting the goals we shared with you previously. We will continue to utilize our vast capabilities to guide consumers to high-performing and increasingly value-based care providers. That includes web and mobile guidance, training nurses in our care management programs, proactive digital outreach, helping consumers access high-quality care, and more. In 2022, the number of consumers seeing high-performing care providers in our network surged, with around 1/3 of that growth being driven by our strategic value-based care provider partners.
By 2027, we are targeting 80% of our medical spend in value-based care and 40% of total medical spend in downside risk arrangements, which is especially important because as you just heard in the Medicare Advantage example I just gave, we know downside risk agreements drive substantial value. As we chart the path to reach these goals, we have opted for a capital-light, flexible approach that will allow us to accelerate or pivot as needed. Some of our competitors have made substantial commitments to specific areas of care delivery, and in some cases, associated with large brick-and-mortar retail businesses, or in other cases, focusing on a single patient population. Our approach is rooted in our communities, our mission, and in partnership. It crosses all coverage types, and it's built to be scaled, all the while tailored to local market needs, which we know is what drives value.
It's why we will build on our deep relationships with some of the most innovative primary care organizations. We will expand our pioneering value-based program designs with specialists, and we will take an even greater ownership stake in enabling the care delivery system. Selectively, where doing so benefits our health benefits members and our Carelon businesses. To make these relationships successful, and to support our care providers as they take on increasingly mature forms of risk, we'll be proactive and ready to support our partners and enable them along the way. Contracting, while a massively important lever, is only one step in the process, and that brings me to our next theme. Reaching cost, quality, access, experience, and equity outcomes requires collaborating with care providers in a meaningfully different way.
To that end, we are investing in numerous tools and resources needed to be both better business partners and better clinical partners to our care providers. To be better business partners, we're simplifying our care provider processes. Our goal is to reduce administrative interactions and help our care providers focus on what matters most, the health of their patients, our consumers. Let me give you 2 examples. First, in 2021, we ramped up an effort with local health systems to allow shared access to electronic medical records or EMRs. With such access, our clinical staff can review patient records and find the information they need to authorize care, avoiding what can honestly be a painful back and forth. Today, Elevance Health has EMR access to over 1,500 hospitals in 24 markets, and the impact has been significant.
Participating care providers have seen 60% fewer requests for clinical information and a 79% lower appeal rate. In collaboration with Carelon Digital, we are making constant progress digitizing our work with care providers. An example is helping care providers still using fax machines to utilize a more modern digital solution. In our commercial business, we have more than doubled the amount of provider documents we receive digitally from 23% in 2021 to almost 50% today. We have also created a patent-pending tool for accelerating decision-making that takes pages of faxed clinical information and uses artificial intelligence to match it automatically to the corresponding medical policy criteria. This helps expedite review and authorization by our medical staff while continuing to offer care providers optionality in how they want to share clinical information.
Innovations like this power accurate decision-making, accelerate the review experience, improve care provider experiences, and more. I'd like to switch gears from being better business partners to our work with our care providers being better clinical partners. This includes providing direct clinical support, sharing more actionable data, and integrating Carelon capabilities into our relationships. Let me give you an example related to improving maternity outcomes. Today, Elevance Health-affiliated plans cover about 12% of all babies born in America, allowing us the profound opportunity to improve the health of our nation's moms and babies. We take this incredibly seriously, especially given the disturbing national trends of increased maternal mortality and morbidity and inequitable outcomes we see in this space. We are doing something about it.
Specifically, we have built a team of OB practice consultants serving over 2,400 care providers in 21 Medicaid markets, including 9 in which we serve commercial consumers too. These consultants, each licensed clinicians in their own right with obstetric expertise, meet with care provider practices, linking the care they deliver to patients and payers to enhance the delivery of evidence-based care. They also support care providers by facilitating engagement in our value-based care programs to help close care gaps. So far, the results are incredibly promising. When an OB practice consultant supports a value-based care provider, we have seen a 91% increase in postpartum visit compliance, a 22% increase in vaginal birth after cesareans, and a 9% reduction in primary C-section rates, all contributing, which is to a 5% savings in total birth and first-year maternal costs.
Such results demonstrate precisely what we mean when we say collaborating for success. They are proof that when payers and care providers work together as partners, everybody wins. These are just a few examples of our commitment to building trust with care providers by being better partners. Before I move on, I just want to note that so many programs like this are derived from direct feedback. We constantly seek input from our care providers, and over the last year, they have expressed interest in capabilities that support behavioral health, especially the growing needs of America's youth, home health solutions, palliative care, end of life, streamlined utilization management, and more. Much of this feedback has played a key role in informing the development of Carelon, which ties nicely into the third theme of our care provider philosophy, connecting for health.
Connecting for health is about being a convener for health and providing solutions that go beyond medical care. It is about deeply integrating all of the capabilities at our disposal in an orchestrated manner to improve consumers' whole health. Carelon's portfolio of solutions does this in so many ways, including for advanced analytics and solutions, behavioral health, pharmacy, to name a few. In Health Solutions, we are increasingly leveraging those capabilities into our own clinical work across all lines of business. To illustrate how, I'd like to build upon an example Pete touched on earlier relating to the spectrum of post-acute care, a critically important and fast-growing opportunity to advance both the consumer and care provider experience. Over the last year, our team's clinical leadership worked closely with Carelon to manage post-acute care more efficiently and effectively for consumers, starting with our Medicare Advantage members.
Our care providers now have access to a new portal that enables real-time approvals. The impacts of this are significant because it leverages synergies in a continuum of complex needs following a patient's discharge from an acute facility, whether it be approvals for home health or nursing facilities. We've seen efficiencies for care providers due to real-time approvals, comfort for consumers who get home faster due to better process and planning, and with portal adoption at over 75% and the program rolled out across most of our Medicare markets, we are seeing positive outcomes in consumer satisfaction, care provider engagement, and ultimately affordability. This is just one example of how Carelon is providing integrated solutions in the post-acute space and will continue to expand its solutions. Providing new Durable Medical Equipment and specialty wound care programs.
Connecting for health is also about going beyond the traditional definition of medical care. It's about the bigger picture of curating health and about helping consumers address unmet social needs like transportation challenges, housing instability, and access to nutritious food, all of which have a profound impact on health and carry financial implications for consumers regardless of their form of coverage. We know that each health-related social need is associated with a cost of between $55 and $130 per member per month, depending on the need and population, and we are turning those insights into action. Later, Felicia Norwood will tell you about our Community Connected Care model, which utilizes social data and analytics to power engagement, helping our consumers connect with the local resources needed to address their everyday needs.
The model is already having an impact in identifying social needs and then empowering consumers through an action plan. These types of interventions are member-facing and work with our community partners, different types of care providers. I am very excited by these partnerships and really many others. The collaboration with Carelon and the curation of best-in-class capabilities across Elevance Health ecosystem is strong and growing. There is the opportunity for so much more. Today, we work closely with Carelon on data and analytics, program integrity, advanced care delivery, home health, and more. Over the next few years, we see the opportunity to grow the penetration of these and adjacent offerings and to continue to refine the use of offerings from Carelon Digital in our clinical and provider services work, with Carelon playing an increasingly larger role in our value-based care strategy specifically and enabling our care provider relationships.
By 2027, we expect much deeper clinical collaboration, curating more sophisticated care delivery services with the significant areas of need seen by our health plans, as well as in spaces that drive health beyond traditional healthcare. What is most exciting for me, and I believe truly differentiating for Elevance Health, is that the Carelon businesses are specifically built on meeting the needs of our health plans, our consumers, our care providers, and curating solutions that we know from nearly 80 years of experience will drive sustainable value for Elevance Health and our care providers for the long term. To sum up, the Elevance Health approach to improving healthcare delivery rests on what I've discussed today. Contracting for outcomes, collaborating for success, and connecting for health.
While each theme of this philosophy makes a real difference and is powerful on its own, their collective impact results in how they reinforce one another. It's the same concept that Gail started our day with. That is, a virtuous cycle that strengthens and grows our health benefits business while accelerating growth synergistically through Carelon, all the while delivering on our strategy to become a lifetime trusted health partner. We are positioned to make our strategy even more of a reality because we're starting from a position of strength. With the largest base of U.S. consumers as our health plan members, the industry's most robust network because of our deep Blue community roots, our strong brand, because of a growing suite of capabilities within Carelon tailored towards real needs, and because we are serious about building a differentiated value proposition with care providers.
We are committed to going beyond the contract to drive substantial impact for Elevance Health, its consumers, and its investors. We are also at the crossroads of where technology and healthcare meet. We are so excited by the possibilities this creates for our members and for their health. Now, our Chief Medical Officer, Dr. Anthony Winn, will discuss how we're leveraging our digital assets to deliver better outcomes and exceptional experiences for our consumers and our care providers.
Thank you, Bryony. It's great to be here with you today to share from a clinical point of view how we're making our digital platform come to life for our care providers and our members. The digital platform for health is a key component of our strategy to become a lifetime trusted health partner. The platform connects our health plan members to the care they need, whether digital, virtual, in person, or at home, leveraging our deep network of care providers. It also connects and equips care providers with solutions that reduce administrative burden and enables value-based care ultimately to create exceptional experiences for care providers and consumers. Health OS is our solution for connected care experience for payers and care providers.
It's an industry-leading platform that changes the way care providers deliver care by deploying data, connectivity, tools, and digital solutions to enable better care coordination while reducing administrative burden. Today, Health OS connects nearly 150 million clinical records for 20 million of our members. Together with care provider partners, we've driven a 12% improvement in member adherence to HEDIS measures and a 25% improvement in medication adherence for chronic diseases or conditions such as diabetes, high cholesterol, and hypertension for members connected through Health OS. Health OS has also delivered over 47 million admit, discharge, transfer, or ADT notifications. Based on a recent study we conducted, we saw a 15% increase in primary care physicians reaching out in a timely fashion to their patients post-discharge to close gaps in care and avoid readmissions.
Lastly, Health OS has transformed operational processes such as prior authorization. For health systems participating in our pilot, we have digitized over one-third of their prior authorization requests since October 2021, greatly improving efficiency and also improving the member and provider experience. All the efficiencies created by Health OS mean that care providers can spend more time with our members, driving better care and outcomes, and ultimately improving consumers' whole health. Let's take a closer look at how we're using digital to create exceptional experiences for consumers. Health OS is integrated into Sydney, our digital front door for consumers on our health plans. Leveraging Health OS, Sydney delivers predictive, proactive, and highly personalized digital-first experiences to meet members where they are, which is often on their smartphone, while helping to manage cost of care via virtual care and enhanced member engagement.
16 million individuals have registered for Sydney, and 5 million unique individuals are using it every quarter. One of the things that can be accessed through Sydney is virtual care. Sydney has proven to be a convenient and effective way for members to receive care. Virtual care is often more accessible due to members' geographic location and convenience. We're investing in virtual to enable 24/7 access to care at lower costs and integrating it alongside our care provider network to enhance affordability in our offerings and improve access to high-performing care providers. We've integrated the virtual care experience seamlessly into Sydney to offer both urgent as well as primary care. In 2022, we hosted over 850,000 visits. We've consistently seen patients who originally used the tool for an urgent care need return to use it for more routine care.
We can see our members leveraging Sydney Health for primary care, urgent care, and behavioral health services. Many are successfully managing their chronic conditions, such as high blood pressure, without the need for in-person office visits. This illustrates that our members have transitioned from using virtual care mainly for urgent needs to using and trusting the offering for other services today. In addition to improving member experiences, preliminary findings suggest an average cost of care savings of over $50 on every virtual urgent care visit compared to traditional brick-and-mortar for low acuity episodes. Today, our primary care offering is available to more than 7 million members. We plan to increase access to over 9 million members by the end of this year. We're also rolling this out to our Medicare and Medicaid members under a program called concierge care, which Felicia Norwood will touch on later.
In 2023, we're improving Sydney's customer service offerings to further differentiate our capabilities, which we expect will result in improved consumer satisfaction and sales. Doing this with a focus on whole health requires connecting data and insights across various engagement points, as well as with the care they're receiving through traditional care providers. To that end, we will also be integrating Sydney with multiple electronic record apps, which will enable our members to access all their medical charts in one place directly through Sydney. This is just one of the many ways we're simplifying the often fragmented healthcare landscape. I hope this gives you a better appreciation of how we're using our digital assets to deliver connected, seamless experiences for consumers, convert data into actionable insights, and increase operating efficiency across the enterprise as we transition from investing to scaling solutions for greater impact.
Thanks for your time and attention. Now we're gonna take a short break before Felicia Norwood and Morgan Kendrick take the stage to discuss our health benefits business.
Ladies and gentlemen, we will take a short break and resume at 10:00 A.M. Thank you. Our program will resume momentarily. Please turn cell phones on vibrate. Please welcome to the stage Executive Vice President and President of Government Health Benefits, Felicia Norwood.
Good morning. Thank you all for joining us today. It's a pleasure to be here with you to discuss our government business, which includes the second-largest Medicaid business in the nation and the fourth-largest Medicare Advantage footprint, including the third-largest Medicare Advantage dual special needs population. Since our last Investor Day, our government business grew market share in Medicare Advantage from 9.3%- 11.8% at the end of last year, and Medicaid membership from 8.4 million members to 11.6 million, all while delivering an average annual operating margin of approximately 4% over these past two years.
Today, I will share how we plan to build on our solid foundation to continue to drive growth, optimizing our health plan business, and investing in high-growth opportunities as we advance our mission of improving lives and communities for the people we are privileged to serve. Government health plans provide access to care and solutions to meet the needs of the most vulnerable consumer populations while delivering on the promises that we make to our state and federal partners. It is our duty to deliver on our commitments, helping to improve the lives of consumers by ensuring access to timely, high-quality healthcare and community-based safety and outreach networks to help address nontraditional drivers of whole health.
We are focused on three key areas to deliver value to our stakeholders, supported by all the assets and capabilities of Elevance Health in close partnership with our Carelon businesses: growing membership, delivering whole health and health equity, and providing exceptional experiences. Let's start with Medicare. Medicare Advantage has reached an important milestone, with more than 30 million seniors and people with disabilities now choosing Medicare Advantage plans, nearly 50% of all Medicare eligibles. They choose Medicare Advantage for better service, care, and value. When consumers choose one of our health plans, they place their trust in us. That's right.
They trust us with their health and their well-being, and to ensure that when they need care, they will be able to have access in a timely and satisfactory fashion. Many of them trust us even more to support their needs through supplemental benefits that address a diverse set of health-related social needs, ranging from transportation to their medical appointments, healthy food, and home retrofitting for physical impediments, and for even more. Today, we have more than $2 million Medicare Advantage members, up more than 40% from $1.4 million at the end of 2020. Elevance Health is now the 4th-largest Medicare Advantage plan in the country, despite not offering products nationwide. Across the 26 markets that we serve, we are in the number 3 position. Since our last Investor Day, we delivered growth in excess of the market, including in our 14 Blue states.
Through market expansion and competitive positioning, we ranked in the top 3 market share position in 6 of our 14 Blue states at the end of last year and are confident that the foundation we have built will allow us to reach a top 3 position in 9 of our 14 Blue states by the year 2027. Our integrated approach within our government business remains key to growth in the dual-eligible market. We have made significant inroads here in the past few years. Since 2018, we have more than tripled our Medicare Advantage dual special needs plans members. This was driven by strong organic growth, transitioning members into our full duals products, and the acquisition of MMM, which together solidified Elevance Health's position as the 3rd-largest health plan serving dual-eligible populations and number 2 across our footprint.
We are well-positioned to enhance whole health for more dual-eligible consumers, given approximately 370,000 Long-Term Services and Supports members in our Medicaid plans. These members often benefit from transitioning into Medicare Advantage dual special needs plans that offer added supplemental benefits to address their social needs. Earlier this month, we were pleased to have been recommended for an award for a new contract to serve Indiana's Long-Term Services and Supports program, known as Indiana PathWays for Aging. This opportunity will allow us to expand our impact and demonstrates the trust that our state partners place in Elevance Health and in our ability to improve health outcomes and the lives of consumers in need.
With respect to 2024, while the Advance Notice was below our expectations, the difference was driven by a one-time proposed revision to the industry risk model that we will be prepared to implement if included in the final rule. We believe this change may negatively impact supplemental benefits that our beneficiaries value while challenging care providers who take risk, especially those who are focused on underprivileged populations with chronic conditions. If finalized as proposed, we would expect a slower year of membership growth for the industry before the market returns to its long-term trend rates in 2025 and beyond. With that said, we remain committed to serving seniors through Medicare Advantage for the long term and will continue to offer the most attractive benefit packages that the funding environment can support to meet their unique whole health needs.
As for the recently finalized Risk Adjustment Data Validation Final Rule, we look forward to learning more from the Centers for Medicare and Medicaid Services related to their audit and sampling methodologies. Above all, we are committed to scaling our Medicare Advantage business significantly over the long term, utilizing our competitive advantages to grow our share of the pie. 40% of Medicare Advantage members have annual incomes less than $25,000. Affordability and comprehensive benefits are key to supporting these members. Our approach to Medicare Advantage plan design, especially our supplemental benefit offerings, continues to put people's needs at the center of everything we do, prioritizing long-term stability of benefits and affordability for our members while ensuring our plans are competitive in the marketplace to grow membership while producing operating margins in the range of 3%-5%.
Through competitive products and easy customer experience and embedded and supplemental benefit solutions that meet the needs of our members, our goal is to capture switchers, commercial agents, our employer group opportunity, and the dually eligible population to retain and grow our fair share of the nearly 11,000 consumers who age into Medicare every day. We are uniquely capable of keeping our members Blue for life by helping our commercial members seamlessly age into our portfolio of Medicare products. In recent years, we've leveraged digital solutions and analytics to shift from a one-size-fits-all engagement model to a personalized and targeted approach to illustrate the value of our Medicare Advantage plans that deliver continuity of clinical care and provide outstanding consumer experiences, beginning with the warm touch.
We continue to optimize our approach and anticipate converting around 35% of our own Blue commercial agents into our Medicare products in 2023, with the goal of capturing more than 40% in the years to come. We also recognize beneficiaries' preferences to shop and compare their plans with an objective third party. Accordingly, we are continuing to deepen our relationships with brokers through targeted joint efforts and aligned incentives while strengthening our own internal sales capabilities. Our aligned incentives across our distribution channels support and improve member experience, including proactive outreach to new members to enroll them in their supplemental benefits that are tailored to their unique needs, while gauging our members' health risk, their potential needs for home delivery of prescriptions, and scheduling their annual wellness visits with their primary care physicians.
This includes the high-quality care providers that Bryony talked about earlier, those that have demonstrated strong success in improving outcomes while enhancing consumer experiences and driving down overall healthcare costs by practicing value-based care. More often than not, these care providers assume downside risk, and in 2022, 72% of our Medicare Advantage spending was subject to value-based care arrangements, with approximately 54% on which we share downside risk. As you can see on this slide, the impact has been tremendous. Members in value-based arrangements where providers share downside risk are showing substantial improvement in controlling blood pressure and blood sugar and are utilizing more preventive care, including colorectal cancer screenings relative to members that are not subject to value-based care arrangements.
As you can see, our products and services are designed to not only attract and grow membership, but to help deliver on our purpose to improve the health of humanity. We recently began an effort to measure our impact on the health of populations at the local level through our Whole Health Index. Our Whole Health Index is helping to identify opportunities by isolating local, social, and other non-traditional drivers of health. Armed with these insights, we take action to advance the current ecosystem of care delivery, often integrating with community-based social resources while centralizing and coordinating member engagement, outreach, and support, ultimately to improve the whole health of our members and, by extension, our shared communities.
As part of our Whole Health Improvement Now program, we leveraged individual and community data from our Whole Health Index to identify 174,000 members who could benefit most from specialized care management and social support. We brought together multiple stakeholders across the organization to reimagine how we identify, engage, and treat different patient populations. We created partnerships between our health plans, our care providers, and community health organizations that help to bridge clinical and social programs to increase member engagement and take a whole health approach to care delivery. We have conviction that reimagining health and health equity will deliver higher quality metrics, improve health outcomes, while also supporting our financial goals.
As we continue our journey of improving consumer experiences for our Medicare members, we know that our care providers play a significant role and are particularly impactful to what I like to think of as the industry's report card, Medicare Advantage Star Ratings. In Star Ratings, there are over 40 measures, but nearly 60% of a planned score is tied to a member's experience. Needless to say, there is no one silver bullet to improving STARS. We have made progress on Star Ratings in recent years, in part by leveraging our digital platform. Since 2018, we have increased the percentage of our Medicare Advantage members in 4-star plans or higher by 17 percentage points, compared with the 1-point decline for the industry.
We deliver better STAR outcomes in markets where we have higher % of value-based arrangements. In Florida, 94% of our spend is value-based, with 90% in downside risk. Compared to fee for service contracts, providers outperform significantly on Star Ratings, member retention, and MLR performance. In fact, our Florida Health Sun contract earned a 5-star rating for the 6th year in a row in 2022, which demonstrates how thoughtfully designed strategic care provider partnerships have the potential to deliver exceptional experiences while supporting strong financial performance. We are working closely with our Health Solutions and Carelon teams to further innovate and align incentives with hospital systems, care providers, and our physician aggregator partners. This includes taking an even greater whole health approach by incorporating health equity measures into our value-based contracts.
Much of the work you hear about today across Health Solutions, Carelon Services, and digital platforms, and within our Medicare business, is what will drive us collectively towards our goal in 2027 of having at least 85% of our Medicare Advantage benefit expense in value-based arrangements, including more than two-thirds with downside risk. As Pete mentioned earlier, Carelon is already managing post-acute spend at risk on behalf of our Medicare population in most markets, in addition to home health and behavioral health. We will extend this partnership next year to cover management of Durable Medical Equipment spend, specialized wound care, and close gaps in care to improve our overall performance and to improve our Star Ratings. We'll continue to partner closely with Carelon as they take on more risk for complex populations.
Looking to 2027, we remain committed to growing Medicare Advantage membership at a compound annual growth rate, at least in line with the overall market, driving market share gains in our Blue states and with particularly strong growth in dually eligible health plan members. Let's shift to Medicaid. We have been in an extraordinary time since the beginning of the public health emergency. National Medicaid enrollment has grown by over 20 million beneficiaries since March of 2020 as redeterminations were paused. In 2023, as redeterminations resume, we expect Medicaid membership will decline.
By 2025, the Centers for Medicare & Medicaid Services projects total program expenditures will return to mid-single digit growth, which they project will persist in the years thereafter, driving total Medicaid expenditures to over $1 trillion in 2028, up from $741 billion in 2021. Today, we are privileged to serve more than 11 million members across 26 markets, and we continue to see a robust pipeline to expand our footprint into new markets and populations through both organic and inorganic growth. We are proud that Elevance Health ranks amongst the top plans for successful Medicaid RFP submissions with an 83% win rate since our last investor conference.
Since the end of 2019, we have grown our overall Medicaid membership by more than 4 million lives, including approximately 2.8 million that we attribute to the suspension of eligibility redeterminations. We are well-positioned to navigate the return of redeterminations given the balance of our health benefits business. In our 14 Blue commercial states alone, the growth in total Medicaid beneficiaries topped over 8 million, including approximately 1.5 million on our own Medicaid plans in the states in which we offer commercial and Medicaid plans, and another 6.5 million Medicaid beneficiaries who are not on Elevance Health's Medicaid plans.
Our teams have been partnering closely across the enterprise to ensure that we do all that we can to keep those individuals that are still eligible for Medicaid on our plans and to enroll consumers who are no longer eligible for Medicaid, regardless of whether they are on our health plans or not, into our individual subsidized exchange plans, employer group plans, or Medicare programs where appropriate. In our Medicaid business, we have been preparing for well over a year and a half, demonstrating thought leadership with our state partners and continuing to partner with them on communication strategies, sharing accurate personal data to help reduce unnecessary loss of coverage due to administrative reasons. Our integrated dashboards and near real-time monitoring platforms track acuity and experience and will deliver actionable insights to our states to support actuarially sound rates.
While the scale of the upcoming coverage shifts is certainly unprecedented, the balance and resilience of our health benefits business affords us confidence. We have the best catcher's mitt in this industry. Said another way, for consumers losing Medicaid health insurance, the upcoming redetermination cycle affords us the opportunity to really demonstrate what we mean when we say we want to be a lifetime trusted partner in health to all of our consumers, regardless of their form of coverage. Soon, you will hear from Morgan Kendrick regarding the opportunity he sees for our commercial business and the strategies he will deploy to capitalize on it. In Medicaid, we expect 2024 to be a stabilizing year as states complete their unwinding processes.
In 2025 and beyond, we see significant opportunity for organic growth through RFP wins, population expansions, deeper integration with other lines of business, and additional bolt-on health plan acquisitions. Organic growth will be de-delivered by achieving best-in-class solutions, offering differentiated capabilities, most importantly, demonstrating a track record of quality advances to the whole health of our country's most vulnerable populations. To that end, I am proud to note that our capabilities led Elevance Health to earn Health Equity Accreditation for 21 wholly owned Medicaid plans last year. Our submission went above the provisional 1-year approval to be the first and only company to achieve the full 3-year accreditation. Over 90% of our Medicaid members are now covered by Health Equity Accredited plans, differentiating Elevance Health from our competitors. This accreditation also solidifies our commitment and alignment with our state regulators in advance of future RFPs.
Our health equity by design approach is a direct reflection of Elevance Health's purpose. It's an approach that facilitates growth and realizes the full potential of our role in driving more equitable health. This extends beyond the traditional race-exclusive view of health equity to optimizing health at the individual level for all, prioritizing efforts and investments that deliver on that outcome, and elevating our consumers and communities that are socially and/or economically marginalized. Driven by our purpose to improve the health of humanity, we recognize that unique life circumstances and experiences impact every individual and their health. We are able to demonstrate better outcomes through innovative ways in how we approach whole health and health equity, leveraging technology and our digital platform for help. This next video helps bring to life our work.
We have an opportunity to make healthcare more personalized and equitable, to help people live healthier, more enjoyable lives. We all deserve to be healthy with the right care and resources. At the intersection of humanity and technology, we can positively impact the lives of everyone we touch by considering the whole health of the person and the physical, behavioral, and social factors that impact them. Social drivers of health, access to food, transportation, and shelter, have a massive impact on a person's overall well-being. At Elevance Health, we use our vast data resources and the power of AI and analytics to identify the areas where those needs are the greatest, and we're taking action. Armed with a more accurate picture of the factors surrounding members in our affiliated health plans, we begin to see parallels with their individual health and identify opportunities where more support is needed.
Using digital tools, we can remove the obstacles to better health by meeting people where they are and partnering in our communities to connect them to the resources they need, breaking down the barriers to access quality, equitable care. By collaborating within the health system with shared data-driven insights and synthesized health records, we create a simplified experience where healthcare consumers receive more proactive care management, cost transparency, and targeted engagement. Care providers are empowered with new sources of meaningful information that can revolutionize the provider-patient relationship. At Elevance Health, we're connecting the care experience and improving health outcomes for those we serve one zip code, one community, one individual at a time.
As you can see, through our data and technology, we have a powerful platform to connect with our members in truly meaningful ways. Our new Community Connected Care program is a social impact model we developed to address members' social needs, such as food insecurity, transportation, and housing assistance. Leveraging our data and our care managers, we engage with our members to offer solutions spanning community resources, Elevance Health plan products and benefits or customized interventions. Through this program, we screened 185,000 members for their social needs and offered a multimodal response. We measured the impact through improvement in cost, quality, and health outcomes. A large segment of the screened population resides in households with multiple risk-based Elevance Health beneficiaries, demonstrating opportunities for further impact.
Our Concierge Care program is another example that evolved a traditional telephonic management program into a digital tool available to our care managers and our members 24/7, using multiple data sources to access both the breadth and depth of potential social interventions. Following a successful initial rollout across 14 markets, we are now expanding the Concierge Care program to all of our Medicaid markets. Carelon solutions like the Concierge Care program provide a differentiated experience while delivering improved outcomes and more affordable care for our members. 1 in 5 Medicaid beneficiaries has a diagnosed behavioral health condition. Today, the needs of our 11 million members are being managed through Carelon Behavioral Health. All states expect innovation around behavioral health and shifting more care to value-based arrangements, and we are delivering on both fronts, with 9 million of our members paid under a risk-based arrangement with Carelon Behavioral Health today.
In the future, Carelon will expand services to go beyond managing behavioral health to include physical health, using a whole person care approach to take risks for certain members with behavioral health conditions. This will create more predictable medical costs for our health plans while advancing the delivery of more integrated care. We will also be partnering with Carelon as they begin to manage spend on Durable Medical Equipment for our Medicaid population and further evolve our models of care for members with complex conditions. Given the market dynamics and the resumption of eligibility redeterminations next month, we expect some headwinds in the near term, driven by membership attrition. Once the unwinding process is complete, we expect growth in Medicaid to return to more normal long-term patterns. Although Medicaid membership expected to decline during the unwinding period, we anticipate growth in our commercial membership.
In 2025 and beyond, we are targeting to grow Medicaid revenue in the mid-single-digit rate annually, organically. Our government business is strong. We will continue to collaborate across the enterprise to achieve greater alignment, increasingly with the shared vision of success for Elevance Health, leveraging all of our assets and competitive advantages. Execution will remain paramount. We will work hand in hand with Carelon and our care provider partners to deliver on our three overarching priorities: membership growth, maintaining our leadership position in delivering whole health and health equity, and achieving exceptional experiences for our members with Carelon and our strategic value-based care provider partners in support of improved quality, outcomes, and lower costs. I would like to introduce Morgan Kendrick to discuss our commercial health benefits business. Morgan?
Welcome, Felicia. Well, thank you, Felicia. Good morning, everyone. It's a real pleasure to be with you today and talk about our commercial and specialty health benefits business. I wanna start by talking about our growth since our last investor day. We've grown our medical business by 1.3 million lives and our specialty business by another 2.9 million lives. Also throughout alternative economic conditions, we have delivered consistent membership growth, and we are well-positioned to deliver strong growth in both operating gain and margin improvement. Today, I will share with you how we will grow and optimize our commercial business, including our recently announced acquisition of Blue Cross and Blue Shield of Louisiana.
We're winning in our markets by leveraging our competitive advantages, including our differentiated cost of care position, leading care provider networks, advocacy and digital products, as well as our diverse suite of offerings provided by Carelon. Across all segments of our commercial business, our customers expect three things from us. First, the right cost structure to make healthcare more affordable. Secondly, they want a terrific experience for both employers and their employees. Lastly, an administratively simple way of doing business with us. Let's start with affordability. Customers want lower medical costs while ensuring high-quality healthcare. As a result of our Blue Advantage, we deliver on both. In our 14 Blue states, we leverage our unmatched scale and density to create material unit cost advantage.
We're fortunate that the broader Blue Cross and Blue Shield system allows our customers to benefit from leading unit cost advantages across the entire country. Beyond discounts, we are innovating through network and plan design, leading the industry in value-based care. We currently have over 50% of our commercial risk-based benefit expense in value-based care arrangements and nearly a quarter of the total positioned with care providers sharing in downside risk. As Bryony discussed earlier, we know that downside risk drives substantive value. We're observing a 4% cost of care savings in our commercial population. In starting with the broadest national network, together, the blues are curating for additional value. We have deployed blue high-value networks in over 75 major U.S. markets, reaching more than 80% of the U.S. population. These results have exceeded our expectations with customers realizing over 15% savings on average.
We continue to see increased interest in Blue high-value networks and have more than doubled the number of customers utilizing these networks as part of their benefit strategy since their initial rollout. Given the growing interest in value-based care from both employers and government payers, we are confident we will achieve our enterprise objective of having 40% of our consolidated medical spend in downside risk arrangements by 2027. Growth in our commercial value-based care arrangements is a key component of how we'll get there. Another competitive advantage that's critical to how we approach affordability is our close partnership with Carelon. Carelon's advanced analytic services have enhanced our ability to optimize site of care, subrogation, and payment integrity, all of which help us better manage medical costs. As Pete discussed, Carelon will be taking on additional cost of care risk, beginning with post-acute spend.
For example, Carelon assumes risk for some of our most complex members. This will curtail both cost and aid in meeting our goal of elevating whole person health. This brings me to my next point. We must deliver exemplary consumer experiences. As we know, navigating the healthcare system can be incredibly challenging for the average consumer. This is precisely why our customers are demanding more. Coupling our strong operational foundation with our digital assets, it enables us to be a true end-to-end partner in our consumers' cares. These efforts are observed in action through the success of our advocacy programs and how we engage with consumers according to their preferences. One such example is our Total Health Connections model housed within the Sydney consumer app. This platform takes a personalized approach in helping consumers navigate the complexities of the healthcare system.
Powered by artificial intelligence, our solution creates a unified, multidisciplinary engagement platform built around the consumer. By knowing more about our customers, it aids us in meeting people where they are in a way that matters to them most. We have grown membership in our advocacy platform over 50% over the past 2 years because we are consistently delivering better experiences for our consumers and overall lower costs for our employer partners. Now let's take a look at a video at how our advocacy solution has both driven value and strengthened our partnership for one of our employers with this quick video.
Chargers worked with Anthem Blue Cross and Blue Shield since 2007. We're a Fortune 100 company, 100,000 employees strong. It's really, for us, all about the member experience, making sure it's easy for people to navigate healthcare. It's complex enough without adding a lot of administrative burden onto our members.
Our advocacy solutions are really framed around what our partners' needs are. Really listening and observing and understanding their long-term strategies and goals, and then applying our capabilities to help them really is truly what we're striving for.
I remember what it was like before we had advocacy solutions. For us, we felt like it was most important to have that solution with Anthem because of the Health Guide nurses. It's not just an advocacy solution that can't take that next step and help you with the care that you need. It's all in one. An example that we had recently was around a member that just walked out of the doctor's office and found out they had an advanced stage of cancer. Obviously that's pretty devastating, and they didn't know where to go, but I'm thankful that they called the Anthem Health Guide. They got them with a Health Guide nurse, and they helped explain, "This is your condition, this is what you can expect next.
Let me help you find a facility that's nearby." They were really there by their side, helping them at a time of need.
When we think about our purpose to improve the health of humanity, it happens by doing the little acts of kindness. If we put ourselves in the shoes of a family member watching their loved one in a hospital bed, where they don't know how to get their healthcare questions answered, knowing that we've created an advocacy solution that really empowers them, they have someone in their corner.
It's important because for us, if our members are, especially our employees, if they feel well and they're being cared for, we know that they're gonna bring theirself best self to work every day, and that helps to make sure we're taking care of our customers out in the marketplace.
I never get over those. It's really incredibly rewarding to see how the positive impact we make on both our employers and our employees. We remain committed to product design and investment decisions focused on whole health, powered by advanced analytics. Another solution designed around the consumer experience is our virtual primary care offering. In January of this year, we launched a Virtual -First HMO product. This product offers $0 virtual primary care visits, but still enables brick-and-mortar doctors through integrated data sharing. We're seeing early signs of success in our exchange market in Nevada. This product is gaining traction with consumers who value the convenience and affordability of virtual care. In July, we'll be expanding this product built in the same proven capabilities of telehealth, clinical data integration in a seamless digital experience integrated into our Sydney app.
This product further incents members to see a virtual primary care provider through plan design. From something as simple as issuing an ID card all the way through receiving great care, experiences start with strong execution. The investments we've made to simplify and digitize our operations have resulted in improved consumer experience service metrics across the board. Notably, we've earned a 15 percentage point increase in our Net Promoter Score year-over-year. Our Customer Effort Score is at 88% today, up from the low 80s just 24 months ago. That brings us to our third expectation of our markets, simplicity. We have to make healthcare more affordable. We have to deliver exceptional experiences. Those are table stakes.
Our true differentiator is that we make it simple to do business with us by offering a full suite of integrated, best-in-class solutions packaged in a way that results in a demonstrable cost of care advantage. Our specialty and ancillary products strengthen our value proposition and create loyalty with customers. Currently, one-third of our commercial employers have one or more specialty benefits products. We expect to grow penetration materially through 2027. Rounding out our integrated portfolio are the Carelon assets that drive measurable improvement in outcomes. CarelonRx has been a cornerstone for our business. The BioPlus acquisition further enhanced our ability to impact the total cost of care. We're also very excited to be further integrating Carelon Behavioral Health capabilities. Their clinical expertise has been instrumental in developing advanced behavioral health solutions, which will be integrated by members through Sydney, our digital front door.
The objective here is to both expand access and to improve affordability. Ultimately, the true value of our integrated solutions is in how we bring them together. Our client information insights tool is our single reporting gateway for our employer partners. They receive the curated, actionable insights they need to identify areas of opportunity across both medical and pharmacy. For example, if their employees are more likely to have or develop a particular chronic condition, we will be able to offer a solution from our integrated health benefits and Carelon portfolio to aid these members. This not only empowers us to take a consultative approach with our customers, it also allows them to observe the integrated solutions and the impact that they are providing, all of which are anchored on affordability, clinical outcomes, and consumer experience.
We present solutions collectively with a unified front in support of whole health and our strategy of expanding the scope of services offered to fee-based customers. We continue to have meaningful opportunities to grow both fee and premium revenue in our health benefits business in close partnership with Carelon. This is how our business enables the virtuous cycle that Gail referred to earlier this morning. We believe in putting customers first, and our results prove it. Affordability, experience, and simplicity play through in every aspect of the commercial business. When I think about the overall health of our assets, I look at the performance of our national business, which represents our most sophisticated and discerning buyers.
In the past two selling seasons, we were selected by 23 employers representing over 750,000 members to become their single strategic partner after previously managing a slice of their business alongside competitors. In partnering with one of our largest customers, we were able to deliver a meaningful cost of care reduction upon working with us as a sole partner. Our whole health solutions, including Total Health Complete, all worked together to achieve our aligned affordability goals. These wins, in addition to the strongest customer acquisition and retention rates in our history, punctuate the distinctive value that we're delivering to the employer market. Yet another noteworthy segment that I really wanna highlight today is our individual business. In the last two years, we've expanded our market presence to cover over 95% of our total addressable exchange market.
This is up from just 44% five years ago. We've expanded in a profitable and sustainable way. Our focus is on delivering economic value and superior consumer experiences. This has resulted in an outstanding 2023 open enrollment season. Year to date, we have grown our individual ACA membership by 19% in our geographies, compared to 5% growth for the market across that exact same footprint. These efforts position us well for the upcoming resumption of Medicaid eligibility redeterminations. As Felicia noted, our teams are tightly aligned to retain consumers in one of our health benefits products wherever possible, be it Medicaid, an employer group, ACA, or Medicare. We are leveraging digital tools and investing in customer service to simplify the transitions across our products. That is the hallmark of being a lifetime trusted health partner.
In 2023, we're poised for another year of solid growth in our fee-based businesses. We have executed well on our 5-to-1 to 3-to-1 initiative to date. Since 2018, we have grown enterprise-wide earnings from fee-based members by over 60% through cross-selling value-add products and services. We remain intently focused on driving further growth in fee-based earnings. We are targeting to grow the enterprise-wide earnings contribution of our fee-based book by at least another 50% over the next five years, and we will do so by delivering a diverse set of solutions offered by our health benefits businesses and increasingly by Carelon. We are also very excited to expand upon our commitments and strengthen our scale through the planned acquisition of Blue Cross and Blue Shield of Louisiana, which will become our fifteenth Blue state when the acquisition closes later this year.
This will add approximately 1.6 million new medical members. As a reminder, there are more than 350,000 members presently accounted for in our Blue Alliance joint venture. We're looking forward to offering additional industry-leading solutions to the Louisiana market through Carelon's broad and diversified assets and capabilities. In summary, our focus is squarely on the future and on driving attractive and sustainable margins in each of our sub-segments. We are targeting relatively modest membership growth in our large group risk-based business as we maintain our pricing posture to effect a margin recovery off pandemic era lows. The rates that we are pricing today are setting us up for sustainable success. We remain committed to achieving margin targets in our underlying commercial product lines. Our confidence is unwavering because our customers are at the center of everything we do.
The strength of our core, enhanced by Carelon and digital partners, enables us to deliver the superior economics, consumer experience, and administrative simplicity that our customers demand. I am incredibly excited to be able to meet the needs of our customers both today and to continue to build upon their expectations for the future. We have the right assets, we have the right talent, and we have the right strategy to continue to drive growth. Thank you again for your time today. I would now like to introduce John Gallina, who will discuss with us how everything that you've heard this morning will translate into shareholder value. John?
Thank you, Morgan, and thanks to all of you who have joined us today in person and on the webcast. I hope each of you are as excited as I am about the long-term potential of our company. You've heard from Gail and her senior leadership team on the momentum of each of our businesses and how we are executing on our strategy to become a lifetime trusted health partner. Everything we do starts with the member. The better job we do at serving the member, the better job we can do at serving all of our stakeholders. Now I'm going to discuss how executing our strategy will drive top-line and bottom-line growth for our organization, creating shareholder value for years to come.
First, I'd like to begin with a quick state of the union, a look at what we have achieved and how we have performed against key financial targets that we shared at our last two investor days. I'm pleased to report we grew adjusted earnings per share in excess of our 12%-15% targeted compound annual growth rate since 2018, while also compounding revenue greater than 14%. We delivered industry-leading organic membership growth, which not only drove growth for our health benefits business, but also produced strong operating revenue for Carelon as we scaled best-in-class services to our health plans while producing better outcomes and experiences for our members. This strong performance further diversified the business mix of Elevance Health and increased our exposure to faster-growing end markets.
With respect to efficiency, we reduced our legacy claims processing systems to 2, down from 6 in 2018, reaching the target that we had set for 2022, excluding systems we've acquired via acquisitions. Simply put, we have delivered on our targets while executing at a high level. Did you know that Elevance Health has not only led the industry in organic membership growth in terms of absolute net new members? Since 2018, we are the only company in our sector to have delivered a compound annual growth rate in excess of 15% in adjusted earnings per share. We have a track record of meeting and often exceeding our commitments. It's results like these support my commentary when I talk about having the most balanced and resilient benefits business in the entire industry.
We've come a long way since we first discussed our vision for Carelon at our investor conference back in 2019. Back then, one of our primary motives was to enhance the competitive positioning of our health plans, including with respect to the cost of drugs. Since the beginning of what is now CarelonRx, the most capital-efficient PBM in the sector, we have returned more than $3 billion of pharmacy savings to our health plan customers annually relative to our prior cost structure, helping to address the affordability issues of healthcare. We accomplished this while building CarelonRx into a $29 billion business serving more than 17 million customers. With a now competitive pharmacy offering, we will continue to capitalize on opportunities to grow CarelonRx, focusing on our health plans and our fee-based clients.
We will continue to add capabilities that will enable us to add more value for our members, including, most recently, specialty pharmacy through our acquisition of BioPlus. In 2019, we also knew that our health plans would continue to require third-party services to better manage increasingly complex and specialized populations, especially given the rapid growth in our dual-eligible Medicare and Medicaid health plan members and other high-acuity populations. Enter Carelon Services. In what is today a diversified set of businesses providing everything from high-touch primary care for chronically ill and underprivileged populations to specialized benefit management to data analytics and so much more.
What was merely a concept just five years ago is now more than a $12 billion business serving 105 million customers across a diverse array of products, all of one key attribute in common: They exist to serve health benefits businesses. As in any competitive market, our health plans can only be customers of Carelon if doing so enhances their competitiveness, meaning Carelon must deliver best-in-class services to our health plans across all of its products and services. From near zero in 2018, we have grown Carelon overall to be a $41 billion revenue business in 2022, split roughly 2/3 in CarelonRx and 1/3 in Carelon Services, focusing first on serving the needs of our affiliated health plans.
Recall that at our 2021 investor conference, we targeted managing at least 20% of our consolidated benefit expense in 2025. We achieved that goal last year, 3 years ahead of schedule, as Carelon managed more than 21% of our consolidated benefit expense. As you heard today, we remain committed into building 2 distinct businesses. Our health insurance or health benefits businesses, our healthcare services division, Carelon. It has become apparent that the similarities between our commercial and government health plans outnumber the differences. They function in similar ways. They are subject to similar and often the same sets of rules and regulations. They're governed by the same regulatory bodies. They earn money in most of the same ways. Importantly, are consumers of many of the same healthcare services.
That is why we are continuing to build Carelon around the needs of our health plans and their members. To better represent how we evaluate our performance and our vision for Elevance Health, we are adapting our segment reporting structure beginning with the first quarter of this year, as we announced on our fourth quarter earnings call. Going forward, we will report our health benefits segment, and it's going to be the exact combination of our prior commercial and specialty and government business divisions in Carelon, which we will further report as CarelonRx and Carelon Services. We will continue to separately disclose intersegment eliminations and corporate and other. Our health benefits segment will be comprised of employer, individual, federal health benefits, Medicare, and Medicaid risk and fee-based products and services, in addition to related specialty products. Importantly, we remain committed to achieving our prior financial targets.
In the spirit of candor and transparency, this slide shows how the margin targets we set at our 2021 investor conference for the prior commercial and government business divisions for 2025 translate in the margin target for the combined health benefits segment now in 2025-2027. We will no longer disclose margins on a business-by-business basis, we do intend to discuss progress against our prior goals going forward. Before discussing our 2027 targets in more detail, I'd like to spend a moment on the interim period, including our guidance for 2023. In 2023, we anticipate adjusted earnings per share to be greater than $32.60, implying growth of at least 12% over 2022, consistent with our long-term target range.
Delivering on this commitment would still result in a five-year earnings per share compounded annual growth rate in excess of 15%. We expect the optimization of our health benefits businesses, including the margin recovery of our commercial and Medicare health plans from pandemic era lows and the ongoing momentum of Carelon to drive strong growth in earnings, more than offsetting a decline in Medicaid earnings driven by membership attrition associated with the resumption of eligibility redeterminations. Although 2023 introduces new uncertainties and large-scale changes in coverage related to Medicaid redeterminations, we are confident that the balance, resilience, and growing diversification of our enterprise positions us to navigate the environment and deliver another year of strong growth. We have delivered strong results over the past five years, regardless of the economic backdrop.
I think this slide clearly displays the consistent earnings per share growth we have produced through focused execution of our strategy. You know, the last two years by segment did not play out exactly as we had scripted. We ended up absorbing higher costs due to COVID than we had anticipated, notably in our commercial and Medicare health plans, which drove temporary margin compression in these businesses in 2021 and 2022. However, strong growth in Medicaid underscored the value of having a balanced and resilient mix of business, and when you couple that with the rapid growth of Carelon, that enabled strong earnings growth for the entire enterprise. My point?
Every business will not perform exactly as we expect every year, the diversification of our enterprise helps balance the ups and downs, keeping us from overreacting to news on any one line of business and allowing us to deliver through on our enterprise targets through focused execution of our strategy. In 2023, we anticipate margin recovery in our commercial and Medicare lines of business, driven by recalibration of large group commercial risk-based pricing, improved reimbursement for member acuity in our Medicare business, and enhanced Medicare Star quality revenue. We also anticipate commercial membership growth associated with the coverage shifts out of Medicaid, notably in our fee-based employer business and on our individual health insurance exchange plans, and mid-single-digit growth in our Medicare Advantage membership. Strong growth in these businesses will be partially offset by Medicaid, where we anticipate membership attrition associated with the resumption of redeterminations.
Through 2027, we are targeting our health benefits business to produce a five-year compound annual growth rate in revenue in the upper single digit range while driving 100 to 200 basis points of operating margin expansion to reach the range of 5.5%-6.5%, consistent with pre-pandemic levels. Carelon, on a combined basis, has performed exceptionally well since our last Investor Day. CarelonRx has grown with our risk-based health plans and our commercial fee-based customers, while continuing to optimize its cost structure and contracting. Through 2027, we are targeting a low double-digit compound annual growth rate in revenue driven by growth in members served along with drug mix and rate.
This should allow us to compound operating earnings at a low double-digit rate with stable operating margins in the range of 6% - 6.5%, supported by service line expansions into key value drivers. We continue to invest in our pharmacy-related capabilities and are especially excited to have entered the specialty pharmacy fulfillment business with our recent acquisition of BioPlus. Carelon Services is expected to grow revenue in the low double-digit range organically in 2023 and achieve an operating margin of roughly 4% at the midpoint of our guidance range. Well on its way to achieving our prior 2025 target of an operating margin in the mid to upper single-digit range, even as we have substantially outperformed the revenue target we had set for the business at that time.
Through 2027, we are targeting an upper teens to low 20s compound annual growth rate in revenue driven by expanding the services we are providing to existing internal and external health plan customers, growing new customers and expanding our service lines in target markets. We are targeting a mid to upper single-digit operating margin in 2027. For Carelon overall, what that means is we are targeting a mid-teens compound annual growth rate in revenue through 2027 and a mid to upper single-digit operating margin for that year. The enterprise and business-level strategies we have shared with you today will drive continued evolution of our company and the diversification of our revenue and earnings stream. This slide shows how over the past 15 years we have evolved from a commercial health plan to a balanced, more diversified enterprise.
By 2027, Carelon overall is targeted to contribute greater than 30% of our consolidated enterprise operating earnings, with potential for upside that could be driven by product line expansions and future M&A. Through focused execution of our strategy to become a lifetime trusted health partner, we will deliver on our promise of improving the health of humanity through an integrated approach to whole health. The opportunities ahead of Elevance Health to more deeply serve a growing number of Medicare, Medicaid, and commercial members through our health benefits and Carelon businesses is truly exciting.
When you put it all together for Elevance Health, we are targeting an upper single digit to low double-digit compound annual growth rate in revenue through 2027, and a 100 to 150 basis points of operating margin expansion to get into the range of 6.5%- 7%. To supplement strong organic growth, we also anticipate staying programmatic in our approach to M&A. We will remain focused on acquiring key capabilities and services for Carelon that can be scaled across their health benefits business, and opportunistic with respect to bolt-on health plan acquisitions that help us solidify our existing footprint or establish deep new local roots in new markets. We continue to target deploying approximately 50% of our free cash flow towards strategic M&A and reinvestment into our business.
We target returning the other 50% to our shareholders, with approximately 30% for share repurchases and approximately 20% for dividends. We remain committed to maintaining a debt-to-capital ratio below 40% long term, but have the ability to flex above that range temporarily for the right opportunity. For our debt investors and creditors, note this corresponds to a debt-to-adjusted EBITDA ratio of approximately 2.5. Rest assured, we remain firmly committed to maintaining our strong investment grade rating and extending our track record of raising our dividend, which we have done each of the last 12 years since we began paying a regular quarterly dividend. The growth we expect across our business segments affords us the confidence to extend our 12%-15% long-term adjusted earnings per share compounded annual growth rate target through 2027.
As you have come to expect of Elevance Health, this growth will be driven primarily by growth in core operating earnings, which we expect to contribute approximately 2/3 of that growth, with the balance coming from capital deployment. One important point is that we remain most focused on optimizing and growing operating earnings, not percentage margin rates. For example, the mix of business within Carelon Services or the health benefits segment can have an impact on its percentage margin rate. In practice, we anticipate growing market share in our health benefits business through 2027, while our health plans expand the scale and scope of services procured from Carelon. These powerful dynamics will create a cycle of synergistic growth for Elevance Health for years to come. As you can see, we are increasingly managing the enterprise as 2 separate yet symbiotic businesses consistent with our enterprise strategy.
We are focused on achieving our long-term financial targets by optimizing our health benefits businesses, investing in high-growth opportunities, and accelerating growth through Carelon. As you heard from Gail and others today, Elevance Health has evolved from a traditional health insurance company to become a lifetime trusted health partner. We have built capabilities that are critical to addressing whole person health, advancing health equity, and that position us to achieve our purpose of improving the health of humanity. Through disciplined execution of our strategy and prioritized investments, we have created platforms for growth across each of our businesses that give us the confidence in our ability to achieve the long-term financial targets we shared today while delivering best-in-class value for our clients and customers. Thank you for your continued support and your engagement.
I would now like to welcome Gail and her leadership team back to the stage for the question and answer portion of today.
Thank you.
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Okay. All right, guys. Well, thank you guys all for your interest. AJ's hand went up already, so why don't we get AJ a mic? We have about 40 minutes, so we'll try to address as much as we can. AJ's right here at this table. I was asking, if you don't mind standing up to ask your question, that'd be great as well.
I won't take the full 40 minutes. Two things. As Felicia was talking about the MA rate notice, there's been a lot of studies that have come out that say this is gonna hurt, particularly the chronically ill patients, D-SNPs otherwise, and it may actually favor, you know, the younger, healthier. It sounds like as you're describing the way you're gonna approach it and maybe the way you think the industry will approach it, if it's necessary, reset benefits for the related to the chronically ill to deal with the cut, if there's a cut, and not really change the strategy to skew it more to the healthier or whatever, but maybe just expand a little more on that. Then maybe just to talk about Carelon, I was gonna ask about the post-acute initiative. Where is that gonna focus?
How big an opportunity might that be to manage that more actively?
Thanks, AJ. Felicia, you wanna get started?
AJ, thank you for the question. You know, as you heard today, our focus is certainly on taking care of the most complex populations with a particular focus in the Medicare Advantage space on individuals that are dually eligible. When we take a look at the advance rate notice, we've had an opportunity to share with CMS our perspective in terms of the advance rate notice in person and in writing. When we take a look at that, what we see is certainly a preliminary notice that places a disparate impact on the supplemental benefits that I talked about today that certainly are meaningful for individuals who are dually eligible, have chronic conditions, and are most in need of the services that we're talking about. I used a statistic earlier about individuals on Medicare Advantage. 40% have incomes that are $25,000.
When you take a look at individuals that are dually eligible, their incomes are at 100% of the federal poverty level, which is $14,579. CMS has been a supporter and a proponent of health equity, and we have certainly applauded those efforts. At the end of the day, I think the changes that are specifically proposed for those populations will set back efforts around health equity. We would have to take a look at our overall benefit structure to determine what the rate environment will allow as we think about benefits for the upcoming cycle. We are hopeful that they certainly want to continue to advance the work that's been going on. Particularly when you think about the work that they are focused on around health equity in underserved and underrepresented populations.
I think it's an opportunity for all of us to step back and have clarity around what the impact of the preliminary reduction changes in the risk model represent and give them an opportunity to see the perspective that we have, which is really around the people that we are trying to serve. Those individuals, I think, merit consideration when you think about the disparate impact that these changes could have.
Thanks, Felicia. Pete, do you want to talk about post-acute?
Yeah, sure. No, I appreciate the question, AJ. I think I'm really glad you asked it because it's really representative of a big part of our strategy. That is, you know, driving risk at scale and supporting the Elevance Health, you know, health plans. Like I mentioned in my prepared remarks, what was extraordinary about this is we really sort of worked on this over a 9-month period of time, from the development of it, sort of the ideation, the development of it, to then launching it, just in over a year and covered all the Medicare Advantage members, basically, you know, 1.2 million of our members over a very short period of time at risk.
It's going very, very well. As we engaged, we saw expansion opportunities, to your question, with Durable Medical Equipment, which is the next phase of the launch, as well as social drivers of health. The focus out of the gate was in Medicare Advantage. Again, which makes this so exciting is now we have other product lines that we can deploy the same service to. As Morgan talked about, as Felicia talked about, in both commercial and Medicaid we'll evolve the strategy. But it's a really good representation for the crowd here of what we're trying to do in Carelon in terms of driving capitated risk at scale with speed.
Sweet. I think Scott had his hand up, and then we can go to Lance, and maybe we'll stay in the middle here. Quite a few of you guys there. Great. Go ahead, Scott.
Thanks. Scott Fidel with Stephens. Interested if you could maybe just drill in a little bit more on the health benefits revenue targets that you just laid out, and John sort of refreshed for through 2027. Was impressed to see that, you know, you still expect to drive at least upper single digit growth in revenues and health benefits. Obviously, Felicia talked about some of the near-term headwinds in both Medicaid and Medicare Advantage the industry is gonna be dealing with for 2023 into 2024. Interested maybe if you could talk about some of the offsets to that, clearly would imply commercial's probably gonna be strong. Obviously, you have a lot of specialty growth targets that you have as well.
Maybe give us some more insights into how you build to that overall revenue growth target for health benefits.
Thanks. John, why don't you get started?
Yeah, sure. No, thank you for the question, Scott. As you really, again, a comment that you heard me say multiple times, you know, balance and resilience of our health benefits businesses, it really does boil down to that. I think there is a, maybe an increased focus on, gee, Medicaid redeterminations and the headwind that has. It's obviously very clear. I think the better question is, where do all those members go, not how many do you lose. You look at our health benefits business. In our 14 states, the Medicaid program has increased for all carriers by 8 million members since the start of the PHE. About 1.5 million are within our Medicaid plans, but there's 8 million new members, or I'm sorry, yeah, 8 million new members in Medicaid.
They, not only will they get redetermined, the entire Medicaid block will be redetermined. Those members will go somewhere. We have leading market share in commercial. We have just an excellent individual ACA book of business. We now have products in, what, 95% or 97% of the total addressable market. Very good, strong product offerings. We expect very nice growth in those areas associated with where those 8 million members go. Again, you know, we're gonna lose not even 1.5 million of them because a portion of them will stay on Medicaid, we feel very good overall about it. That's maybe the short-term answer to your question. Quite honestly, we expect to continue to take share. We've been taking share for several years. We'll continue to take share for the next several years as well.
That's how you get to 2027. Thank you, Scott.
Yeah, I guess I'd add to John's just to put a finer point specifically. I mean, we shared a couple of areas of growth that I think are important. One, the fee-based business, growing that, continuing to grow 50% input on that. We, you know, we already showed 60%. We think we've got a lot of runway. A lot of that will come through some of the capabilities that Pete has in Carelon. You talked about one just a minute ago, and certainly Rx is a big opportunity for us. Once we get through the redeterminations on Medicaid, you saw the chart that Felicia shared, which is just, you know, the projections for long term. We see a real opportunity in the specialized populations.
Finally, you know, we expect to continue to grow Medicare Advantage at equal equivalent to the market rate with a real focus on the agents in the markets where we serve, where we have deep penetration in our health benefits business. I think it really does bring together this focus on a diversified, balanced portfolio in our health benefits business that really works very synergistically with what Pete's trying to accomplish in the Carelon Services.
Thanks, Gail. Go ahead, Lance. You have the mic.
Thanks. Was interested in how you talked about the opportunity to sell into the other Blues, and it seemed to be a little bit of an elevated topic compared to some prior discussions. Could you talk about 3 things with that? 1 would be sort of the pipeline and opportunity with the Carelon Services. 2 would be the pipeline and opportunity with Medicaid and Medicare Advantage and the other sort of government partnerships you've had. Lastly, if you could talk a little bit about the Synergy Collective and what you're looking at from a opportunity to collaborate with the other Blues, from your overall PBM strategy? Thanks.
Thanks, Lance. Gail, why don't you get started on the strategy, and maybe Pete could talk to Carelon?
Sure. We got a couple of questions there, Lance. We forgot our first line, which is 1 per, I guess that's good. No, it's a very comprehensive question. I guess I would say as you think about our overall strategy, it has been to prove the benefit inside of Elevance Health first and our own health benefits businesses. Carelon does, and Pete will share this, already has deep relationships across many of our existing products in the Carelon Services business. Fundamentally, a lot of the new things we're bringing to market, first and foremost, we think if we can prove it works at Elevance Health, that's a huge opportunity for us with other Blues. Synergy is a really good example, I'll let Pete talk specifically about his pipeline and kinda what we're doing.
We've always talked about the power of the collective opportunity we have within the Blues. We're thrilled about Blue Cross and Blue Shield of Louisiana and our opportunity to bring them potentially in as our 15, as our 15th Blue state, and what that will do for Carelon as well. Synergy is a great example because it brings us together over 100 million lives in an area we need to drive greater affordability and think about scale very differently. We have a lot of scale. You saw that from just where we are at Elevance Health.
The power of the collective Blues, over 100 million members, patients served in terms of medical specialty, we believe we can drive greater affordability and leverage scale in a very different way than we have in the past, and again, for the benefit of our consumers. I think that's a really positive sign for us as a system, which is our goal, to drive greater health equity, drive greater affordability, and make sure that we're using scale for the benefit of the people we serve. In terms of the pipeline, maybe, Pete, you can talk more directly.
Sure.
about that 'cause I think You're starting to see a lot of momentum there.
Yeah, no, definitely. Like Gail said, if we can prove it, you know, in Elevance Health, it really does give us a great benefit in terms of how we're talking to the Blues. I would say just a, you know, couple of finer points on some things. We've spent a lot of time on focusing in on the external sales organization. We've built a much better infrastructure. We've got a new sales leader. We've got a lot more formality to our pipeline and from a sales execution perspective, thinking about things much differently. I would say one thing that's interesting that's developed over the year for me personally, it's less about the number of Blues we're gonna work with. I think we'll end up working with most of the Blues for the most part. It's more about what you heard today.
It's about bringing integrated solutions at risk in a much more comprehensive way. I mean, I can sell a product or two to a Blue. That's interesting, and we can really prove ourselves, or I can bring more comprehensive solutions and do that across the spectrum at risk. That's where we can really see, I think, a greater generation of revenue growth, you know, more quickly. That's what we're oriented to over the next several years.
Great. Thanks, Pete. Let's see, there's Josh right there if you wanna get a mic. Get a mic after that.
Sorry, I'm gonna say it real quick. I'm gonna cheat, too. I had two questions. The first is just definitional. I just wanna make an understanding on what is the definition of value-based care when you talk about, you know, targets of 60% or, you know, 63%, say, going 80 and then 40. What is downside risk? That doesn't sound like that's full capitation. My real question is just sort of how do you coordinate the engagement of the patient across all of these services? Are they interacting with many different people at Elevance? Is there a quarterback? Is this through the provider? What is the touch point for the individual?
Yeah. Bryony, you wanna get started?
Thank you so much for the question. When we talk about value-based care, we're really talking about aligned incentives in the upside version. The 63% that we're in today means you have aligned incentives based on cost, quality, and experience, and then increasingly equity. From 2024, that'll be a component of our value-based care arrangements. Downside risk is not full capitation. It is still, you have often material financial consequences aligned across those incentives. One thing we didn't talk about today that, you know, that Steve asked me to share as well, is when we look at our downside risk penetration now, we're looking at being in the upper 20s by the end of 2023. That's the baseline target for the 40% by 2027.
Yeah. It would include global cap, to be clear, Josh?
Correct.
It's broader than that. I think I identified Mike. Go Justin, and then Lisa on the button.
I have a question.
Yes, go. Thanks, Aaron.
Thank you. Yes, I wanted to come back to the Synergy Collective specialty drug GPO with the Blues. I mean, it significantly improves your purchasing power. It's over 100 million members. Just any sense on how much savings you can generate from this, timing of when this could materialize? Just one more question on BioPlus. How should we think about the pace of growth as you scale from 250,000 specialty scripts to all 2 million, and how does that align with the opportunity from Humira biosimilars? Thank you.
Paul's probably best positioned there.
Yeah. No, thanks for the question. First on the Synergy Collective, just to be clear, it's starting with medical specialty, that will be implemented starting 1/1/2024. you know, to Gail's point, comments $100 million, you know, lives gives aggregated purchasing power. I'm not gonna give specifics in terms of the incremental value at this point. It's still unofficial. As it relates to BioPlus, you know, we couldn't be more excited about, you know, now being part of the specialty pharmacy business for a few reasons. One, we think, as I mentioned in my prepared remarks, the company has a differentiated service model. It enables us now to focus on the areas of cost and drive affordability.
Over the course of the next 12 months, 12 plus months, we will scale the operations to support the migration of our script volume onto that platform. That will extend, you know, into the end of 2024 into 2025, we're really excited about what it means. It also presents an opportunity as we think about Patients and members that are on those medications, there's an opportunity, as I mentioned, 20% of members who are on specialty medications also have a behavioral condition, there's an opportunity to integrate behavioral services with Beacon targeting that member. There's also a direct overlap with home delivery. As I mentioned, our new CarelonRx pharmacy that'll be rolled out at the end of this year. All of those services integrated, we're looking at creating a much better consumer experience than what exists today.
But it gives us, you know, a lot of, you know, investments that we're making now to ramp that up, pretty quickly over the next 12-24 months. Thanks for the question.
yep. I think Justin. There you go.
Just follow up here on the PBM side, maybe you can give some timing on when, you know, theoretically you could take care of those 2 million scripts. I don't know if you answered that previously. Specifically, you have a PBM contract that's up, I believe, for 2025. Any kind of update there in terms of what you're thinking, putting an RFP out into the market? Gail, just anything on the... You know, you talked about the company's number four in Medicare Advantage. The three ahead of you have, you know, made significant investments and are making significant investments in owning provider assets, specifically primary care. Curious as to your view there on ownership versus potentially maybe making investments to bulk up your partnership capabilities there going forward. Thanks.
All right. Gail, you wanna start?
Why don't we start with the pharmacy, and then I'll finish with the second part of Justin's question.
On the BioPlus, it'll be on a multi-year basis. I think we have an opportunity to embrace. Now, the 2 million wouldn't be absorbed all out of the gate. We have an opportunity to, you know, over the next several years, take on all those scripts, but it'll be, you know, on a multi-year basis. As Paul said, we're building out the infrastructure for that. We're very optimistic. We feel very confident about that. As it relates to your other question, I think you've heard pretty clearly, you know, over the last year that we're absorbing the strategic levers that really matter in the business. You heard, I think, two really significant examples today on specialty pharmacy and advanced home delivery. We will continue on that journey.
I mean, you know, we, Justin, we understand the market strength of $28 billion in revenue, $30 billion in revenue in terms of total script volume, and we're gonna leave our options, you know, open with regard to that. We will continue on this journey of owning those strategic levers that really matter.
Yeah. Thanks, Pete. Justin, I think your question's a really important strategic one, and I think it's important to start to frame it first with the entirety of Elevance Health. Our benefit strategy, as you heard from Bryony earlier, is very much focused on our network care provider strategy. I'll start there because I think that's really one of the most important pieces, and that part of our strategy is about driving value-based care and then driving much more downside risk because that's the synergistic component of what we're trying to do. Our target, 80% in value-based care across all of our benefits businesses, 40% in value-based care.
Inside of that, I think the other thing that's really important, to understand as you think about, you know, whether we own providers or how we go about this, is that we are trying to solve this for all of our benefits businesses. It's not around a single business, but it's around Medicare, Medicaid, commercial, with very deep local market penetration and a focus on provider partnership, again, as we shared about how we can drive true outcomes. The other issue is our geographies are very different. We do not fundamentally believe a single model will solve this across the breadth of our businesses and across the breadth of our geographies. With that said, what you heard from our discussion on Carelon today is that we're building and we're investing in care enablement capabilities that will help us manage whole person risk.
I think that's hugely important because that drives an important control mechanism for us in the health benefits business to be able to understand our benefit expense better and manage it, but it also drives significant growth for Carelon and ability to participate in the TAM of those markets that we see growing. I think the other opportunity within that strategy, again, is this focus on chronic and acute patients, and there's an opportunity for care enablement specifically within the specialty part of the business. We think there's a big opportunity where we've already started. We've got our assets that we're currently deploying. We think there's opportunities to take other assets, again, to both grow and have a better outcome and more control on our health benefits side, but also to grow our Carelon business.
I think those two things coming together is what we see. It's very targeted. you know, we do own assets in certain areas where it makes sense, and these are very targeted things. Our strategy is quite different than our competitors, again, because we are looking at very different markets and trying to solve this not just for one single business, but across all of our benefits business. Again, synergistically, when our health benefits business grows, Carelon grows. We've got this, I think, incredible opportunity to grow both and to really grow, I think, the earnings and the potential for all of Elevance Health. That's where we focused our strategy, and it really is very different. We see care enablement with the assets we have as really driving opportunities for both businesses.
Thanks, Gail. Let's go to Lisa next here.
Sorry. No problem.
Oh, not sure if I can. I'm really surprised no one's commented on the sock shed, so I just wanna say both to Pete and John that I like your socks.
Thank you.
Cheers.
Caroline.
We have to talk about the fashion side of things. First, I just really wanna start when we think about CarelonRx and the growth rate. Talking about, you know, a double-digit growth rate in an industry where growth is low single digits, can you maybe talk about, you know, the opportunity that you currently see in your book of business and where the growth is coming from? Paul, one of the things that really stood out to me when you talked about biosimilars is that you didn't talk about Humira, but talked about oncology. Can you talk to us about, you know, how you see oncology, and is that really Today, most oncology, as I understand it, is paid through the medical benefit.
Mm-hmm.
you know, how do you see that opportunity, and?
Yeah.
you know, BioPlus bring any incremental benefits, when we think about the oncology side?
Oh, thank you.
Great question.
Yeah.
Pete, do you wanna start on the first part of that, or?
What was the first part again?
You're such a...
The growth in the pharmacy.
Oh, the growth. Yeah. No, no. I would say that, and, you know, we've talked about this before, but the growth opportunity is huge. When you look at Elevance Health and our ASO book of business and the opportunity there, it's still very large. As we've said, I think what we're most excited about is in terms of the integrated value proposition, we're seeing a lot of engagement in that below 10,000 range. They're embracing it. They like it. The brokers understand it, and we continue to penetrate that business. That is a highly profitable book of business where we're performing, you know, really well. As we look up market, we will be strategic about that.
I would say that, you know, we're gonna be disciplined in that regard. We wanna make sure that as we go up market, that it makes a lot of good strategic sense, and we're gonna be disciplined. There is a lot of runway with respect to that ASO book of business and where we're penetrating today.
Yep.
That middle market. We're very confident in these growth rates relative to the runway we have there.
Yeah. No, I would add to that. Thanks for the question, Lisa. The... We're having a really good selling season right now in 2023. You know, as Pete mentioned, our win rates continue to increase. You know, our offering is resonating in the marketplace, we're doing well there. As well as now we're also, you know, really focused on 2024 business. You know, we expect again this year-over-year, net new membership growth. Really good stuff and exciting in terms of the opportunities going forward. Your second question about, you know, biosimilars. We do see right now, you know, BioPlus as part of their therapeutic class that they cover includes oncology as well as, you know, autoimmune, rheumatology, you know, MS.
We do see it as an opportunity, you know, to engage manufacturers more directly, strategically, work, you know, in alignment with our formulary strategy, with our network strategies. Even as we think about the future of Carelon Services, even configuring specialty networks that align, you know, end to end, you know, drug manufacturing all the way through total cost of care in alignment with our value-based and Carelon strategy. As more biosimilars, you're right that a lot of the oncology is on the medical side, but there will be more drugs coming to market in the pipeline in the oncology space. We think we're well positioned to drive affordability for the point of sale, it's for the consumer as well as for the employer going forward, working along that spectrum end to end.
Hopefully that helps.
Okay. Thanks, Paul. I think David, a question next. Dave, you mind maybe stand up and get to your mic? There you go. Thank you.
Hi. Thanks. Dave Windley. Kind of a 2-parter on Carelon, and related to Lisa's. Do you have a view or do you care about the internal versus external growth? Perhaps it's kind of a signal of maturation of Carelon services and how that will play out over the next 5 years? Then, Pete, your margin in that business, is maybe approximately doubling?
Yeah.
What would be the drivers of that? Is that scale? Is that risk-taking? Is it mix? You know, what are the drivers of the margin expansion in services? Thanks.
Yeah. I'll start with the margin side. I think you said it. I mean, we're sort of at the low end of the margin range right now at 3.7%. We think based upon the mix of our membership, the assets that we're gonna deploy, what we have visibility on in terms of our white space, that we're gonna be well within, you know, that margin range. It's largely, you know, the mix of the business going forward. In terms of prioritization and growth, as I think, you know, we sort of, we were clear today in terms of our focus, our first focus is Elevance Health. We have a tremendous opportunities, you know, still here. The runway, the white space is very broad.
When we look across each one of the assets that we have in our portfolio and that which we've penetrated, the upsell and the cross-sell opportunity, the innovation that we can create within the portfolio that exists today, there's a tremendous opportunity in Elevance Health. That is our priority. That creates that virtuous cycle of activity that we've talked about so much today. I am optimistic, as I talked about, you know, in Lance's question. I am optimistic about the external opportunity as well. If we can prove it here, the Blues and others, you know, will purchase it. I hope that's helpful. Sure. Whit?
Yeah.
Thank you. I don't know if you're gonna answer the question, but just as I think about the long-term targets of Carelon Services, call it 20%, sort of at the midpoint, any way to think through how much of that is organic over the long term and how much you think about as being inorganic over the long term? Maybe remind me, and I think I've asked this before, but how much of your MA spend today is post-acute, and sort of where are you in the delegation of that towards Carelon, and where do you think the targets are over the long term?
Great questions. John, did you want to get started on that?
Yeah, sure. No, thanks for the question, Whit. You know, I will say that first of all, our 12%-15% CAGR, we are very comfortable achieving that, reaffirming that, regardless of how the capital allocation plays out. However, within that capital allocation, we said about one-third of the earnings would come from that, and that would be focused really significantly on Carelon Services, CarelonRx. When you look at the revenue targets that you've asked about at the 20% at the midpoint, yeah, we're in the low to mid double digits organically, the remainder being inorganic, part of the M&A.
If you look at the track record of our acquisitions for the last few years, if we just continue down that programmatic approach, that's not a problem at all in terms of achieving those. We actually feel very good about the overall construct of the guidance and how it all fits together. In terms of the revenue, you know, low to mid-single digits organically.
Low to mid double.
In terms of the post-acute care offering, we've covered in the initial launch, we've covered most of the Medicare, you know, members. That does not include the new DME product offering. It does not include the social drivers of health. That'll be deployed across, you know, all the Medicare members as well. As we said, that's just Medicare. We haven't deployed the post-acute offering yet in the commercial book of business or the Medicaid book of business, so there's an opportunity there as well.
Thanks, guys. Here you go, Steve.
Yeah. Hi. Thanks for the question. Maybe this is a bit of a clarification off Whit's question. You're talking about, you know, high single-digit to low double-digit revenue growth. I think you're still targeting 8% to 10% operating growth inside that EPS guidance. It seems like with the margin expansion you're looking for, that you potentially could even be doing a bit better than that. I guess just help us think about what that means in terms of whether, you know, margin for safety, opportunity for, you know, reinvestment, I guess, or whether that gives you more flexibility on capital deployment. Thanks.
There are ranges for a reason. John, go ahead.
You know, that would be a wonderful thing to have even more upside. You know, as I stated, we have a 12%-1 5% compound annual growth rate target. We've delivered in excess of 16% since 2018. The only company in the sector to have exceeded 15% compound annual growth rate over that time. To the extent that there's upside, that'd be wonderful. Shareholders get to participate in it. In all reality, you know, it's a very competitive market. There's headwinds, there's tailwinds. We're trying to manage all these things consistently, and we feel very good about the commitments that we've laid out. 12%- 15% as part of that, two-thirds of that being core operations as part of that's our guidance. Thank you.
All right. Yeah. Nate?
Yeah. Thanks. Great. Thank you. On the target to grow spend of fee-based customers by 50%, what are the biggest drivers of that? How much comes from pharmacy and how much is services? Then if I could ask a separate question on margins in the health benefit segment. John, you talked about 100-200 basis points of improvement versus 2022. I think you have 25-50 basis points in the guidance for 2023. How does that trend and then in 2024 and then beyond that? Thank you.
Thanks, Nate. John?
I'll start with the second half of your question first, in terms of overall margin targets. Again, we do have a health benefit segment. We're not going to talk about specific margins on a product by product or line by line, but as I said, we will continue to provide updates against our prior goals. If you think about commercial, we certainly expect, with some of the repricing being done here in 2023 to better reflect the underlying cost structure of the commercial line of business, we expect some margin improvement in 2023, towards our 2025 target. In 2024, we would expect the continuation of that pricing discipline as well as the fee-based revenue. 2025 is mostly just the fee-based revenue.
More heavily weighted to 2023, then a little bit less in 2024, and then a little bit less in 2025. You know, on the other hand, you've got Medicare Advantage. You know, we unfortunately have been at the low end and even slightly below our target margin range during the pandemic. We expect some margin opportunities there. Of course, we did talk about the headwinds associated with the preliminary rate notice. All in, we expect to get back into the target margin range over the next few years.
You know, we do think that there is a very clear path to hitting those target margin ranges, and it's really over the next 3 years, essentially, and then, and then maintaining those ranges after 25, further penetrating Carelon, the overall enterprise margins then improve due to the interaction of Carelon and the pull-through of Carelon through the health benefits businesses. Hopefully all that makes sense, but thank you for the question.
If you wanted to talk a bit about the 50% of the fee-based growth over the next 5 years, you know, we would use the traditional assets that we've used so far to grow 60% since 2018, which would be the specialty, the traditional dental, vision lines of business, the pharmacy lines of business. Most notably, we've been growing continually in program integrity, different value-add where we serve, you know, rewards with customers for what we do for them. There'll be increasingly more of that with the Carelon organization, and a lot of it's sort of built for purpose. How do we work together to create things that the market needs and wants and creates value that we can both share in?
That sort of pay for value, initiative has really caught on and, served us well. To Pete's point, you know, there's still an opportunity for us with Carelon penetration, both downmarket and, as Pete noted, selectively in the right opportunities upmarket.
Yes. Steve. I'm gonna go Steve right there.
Hi, Steve Valiquette from Barclays. One quick follow-up from that last question. Just for the overall Medicaid members that you may pick up, you know, in your commercial segment in your 14 states from redeterminations. I know you're not breaking this out, but just remind us of any expectation you have for just the, you know, the average operating margin profile for these members versus the average operating margin for your commercial book currently. Just curious going in whether you expect it to be in line or, you know, above or below, just any high level thoughts. Not looking for a specific number, obviously. Thanks.
Thanks, Steve. John?
No, thank you for the question, Steve, and I, and I appreciate your clarification at the end. Yeah, you know, associated with the members, you know, first of all, let's just take a step back and look at the overall construct of Medicaid. There are collars and corridors and mechanisms that have been in place for the last several years, many of which were put in place during the pandemic to ensure that, you know, there's not overearning, if you will, on a particular line of business. You know, as we sort of look at that, you know, our Medicaid has a stated target margin range of 2.2%-4%. You know, we have been operating very well within the Medicaid range and feel very good about that.
You look at our say, our individual ACA business, where many of those folks would go, that has a target margin range of 3%-5%. There is a little bit of shifting there. If we get a member out of Medicaid into individual ACA, it could be slightly accretive from that perspective. On the other hand, if they go to ASO, the target margins are very high, double digits, the EBITDA dollars are much lower. There's a clear mix of business issue going on here that has to be reflected in terms of the overall modeling, which is why, as we talk about having the most, you know, balanced and resilient benefits business, you know, we are looking at, you know, how many go to individual ACA? How many go to employer-sponsored, fully insured?
How many go to employer-sponsored ASO? The answer is different on all of them. At the end of the day, it's all been factored into our thought process, our reaffirmation of the $32.50 for 2023, and the 12%-15% for the next 5 years. We feel pretty good. Hopefully those percentages give you a sense of what we're looking at. Thank you.
The guidance squared in $32.60. Why don't we go to Rob there?
Yeah.
Hi. Good morning. Rob Cottrell. Just curious if you can talk on near-term utilization trends? Anything to spike out through March, either inpatient, outpatient, medical, pharmacy? Thank you.
John?
Sure. You know, we don't necessarily provide a lot of mid-quarter updates in general. What I will say is that, you know, there are a whole multitude of assumptions that go into trend. There's a lot of drivers, a ton of factors. One that's been in the news a lot that's very real is, you know, the weight loss drugs, the diabetes drugs. You know, they're a bit hotter than we had expected. On the other hand, we have many other things that are looking a bit better than expected.
While we're not gonna provide a specific point estimate on trend, I will say that as we look at the entire block of business holistically, again, we are very comfortable with what we've seen after 2 months in terms of the overall cost structure, and which has allowed us again to reaffirm all of our 2023 targets. Hopefully that helps.
Thanks, John. Questions? Are we out of questions? We might be out of questions. Does anybody have a question?
Perfect. On your left.
Right there.
That one.
I'm gonna go to Kai.
It's going, gone.
One last time.
Hi. Maybe this is for Pete or Paul. Can you comment on the potential impact of the PBM Transparency Act?
Why don't we talk about transparency broadly first, Gail?
No, I actually think it's a very important question. We have been incredibly supportive of transparency in pharmacy as well as in medical. In terms of the medical transparency which came first, we have made that available. You saw a little bit of our Sydney app, also bi-directional data sharing with our care providers. Overall, we think it's a positive. It's about affordability. We're very focused on consumers being way more engaged in healthcare. Overall, we support transparency across the board. We feel that the more that we can embed it in our programs, that's gonna be a positive for both of us. We've seen it, quite frankly, work quite well as we work with provider partnerships in particular.
Good.
Okay.
Okay. Thanks, Gail. Anybody else? There's somebody in the back. Sorry.
It's hard to see with the lights.
It's a little dark back there.
You got the light?
Thank you. This will probably be our last question here.
Hi. A question for Felicia, if you don't mind. Just on the Medicare Advantage market, I think you've outlined leadership in, I think it was six of the states right now, passed in nine of the 14 Blue states. Just curious what the constraint to growth might be there. Like, why not all 14 in the next, like, sort of 5-ish years? Maybe on the age and capture rate, you outlined 40%. Like, could you just give us some historical context on that? Like, how much that may have improved by and what the ambition is? Like, could you get it up to 50%, 60%? Like, are you seeing better rates in certain states versus others?
I, you know, when we take a look at where we are from an overall geographic perspective, there is still the opportunity for us to go deeper in our footprint, and that's where we've been very focused on from an overall enterprise perspective. While I mentioned, you know, the opportunity to further penetrate our blue markets, that is where we have been clearly aligned with Morgan and the team, as you think about the opportunity around, you know, agents and others that we can capture. We also pay close attention to the geographic footprint as well when you think about Medicaid. Our Medicaid footprint and our Medicare footprint gives us the opportunity to be very focused on our dually eligible membership.
Strategically, those are the areas where we see opportunities to continue to penetrate and drive growth very thoughtfully around where we want to be and how we advance our overall value proposition strategically between Medicare and Medicaid. In terms of agents, Morgan and I and our teams have been working for some period of time, and I think one of the things that I referenced is that we wanted to capture individuals in our Medicare products. Early on, what we see happening is that many of our commercial members wanna age into a Medicare supplement product, and we wanna be able to capture members with the product that really meets their preferences. After a while, those individuals want to migrate from Medicare supplement into a Medicare Advantage product.
We're trying to make sure that we have the benefits and portfolios that best meet the needs of the consumers that we're trying to serve. For us, it's a win if our members wanna transition from their commercial products right into a Medicare supplement product, because for many of them, that's the comfort zone in that first transition. Then be there over time to continue to communicate the value of Medicare Advantage when they're ready to make that change. The 35% certainly represents improvement over where we've been. We've been, you know, in the mid-twenties, but we're now at 35, and certainly the opportunity to go to 40 by 2027 is something that we think we are very confident in our ability to do.
You're not taking credit for it, Felicia, but I remember when I was in the crowd four years ago, it was about half the mid-twenties we're already at, so.
Yeah.
In any case, it's up a lot. Now why don't we turn it over to Gail for some closing remarks. Thank you all.
Thank you.
Well, thank you again for being with us today. I hope our time together this morning has provided an even deeper look into the power and promise of Elevance Health, a growth company at scale, focused on whole health, and driven by our purpose to improve the health of humanity. As you heard from our leadership team today, our future success will be built on our strong foundation, a balanced and resilient health benefits business that will remain focused on meeting the unique needs of consumers and customers in all of our businesses. Over the next five years, we will continue to drive membership growth in our health plans that translates to growth for Carelon, which will also remain focused on growing external business.
We plan to accelerate organic growth through M&A, targeting capabilities and services for Carelon, and bolt-on acquisitions for our health plan business that offer synergistic growth opportunities for Carelon. The businesses that we've assembled and the focused execution of our strategy should continue to drive the virtuous cycle of earnings growth you heard about today, enabling us to continue growing adjusted earnings per share by 12%-15% through 2027. Over this period of time, we expect to optimize our health benefits businesses for sustainable long-term growth and margins, invest in high-growth opportunities, namely Medicare Advantage, dual eligibles, and specialized Medicaid populations, both within our health benefits businesses and across Carelon, and accelerate growth through the expansion of Carelon to better support consumers on our own and third-party health plans as we further diversify our services businesses to address a growing proportion of the healthcare dollar.
We will do all of this as one Elevance Health, delivering on the whole health needs of consumers today, tomorrow, and for many years to come. We are guided by our culture, which serves as a strategic lever to drive performance, business results, outcomes, and most importantly, our collective success. We will continue to execute across our enterprise, strengthening our core, driving growth, and powering our strategy to become a lifetime trusted health partner. On behalf of our leadership team, thank you again for joining us today and for your continued interest in Elevance Health. I look forward to providing you updates on our journey and progress on our quarterly earnings calls. Thank you again for joining us. Safe travels.