Elevance Health (NYSE:ELV) edged lower pre-market Wednesday after the company projected a lower-than-expected earnings outlook for 2023 with only ~1% membership growth, while Medicaid and Medicare Advantage drove its 2022 performance.

During 2022, Elevance (ELV) added 2.2M members taking the total medical membership to ~47.5M with ~5% YoY growth as Medicaid business and organic growth in Medicare Advantage lifted the government business.

The company’s Q4 2022 memberships grew 248K, driven by organic growth in Medicaid due mainly to the suspension of eligibility recertification and the acquisition of Vivida Health which brought 29K members to Elevance (ELV).

For 2023, the company expects its medical enrollment to reach 47.4K – 48.5K, implying ~1% YoY growth at the midpoint.

However, the health insurer beat Street forecasts with its Q4 2022 financials as operating revenue climbed ~10% YoY to $39.7B, and government business met Wall Street estimates, adding $24.6B revenue with ~13% YoY growth.

The full-year revenue rose ~14% YoY to $155.7B as premium revenue grew ~14% YoY to $133.2B, even as quarterly premium revenue missed estimates to reach $33.6B with ~9% YoY growth.

For 2023, Elevance (ELV) expects premium revenue to reach $140B, taking operating revenue to $164B, in line with the consensus.

Meanwhile, the company’s commercial & specialty business added ~$10.4B missing the Wall Street forecasts. At the same time, its pharmacy benefits manager CarelonRx previously known as IngenioRx, topped estimates to bring $7.5B in revenue with ~11% YoY growth.

The benefits expense ratio during the quarter and full year fell 10bps to 89.4% and 87.4%, respectively, driven by certain adjustments to reflect recent regulatory requirements. Elevance (ELV) posted a ~12% SG&A expense ratio for the quarter, indicating a decline of 20bps as adjusted earnings per share improved ~2% YoY to $5.23 to exceed estimates.

Read: Seeking Alpha contributor Samuel Petersson issues a Buy rating on Elevance (ELV), citing the company’s financial performance, balance sheet, dividends, and share buybacks.