A 7% year-to-date decline in share price isn't bad enough to cause investors to panic, but it's certainly not a reason for celebration, either. This middle ground is where shareholders of Cigna (NYSE:CI) find themselves so far in 2019. 

The status quo isn't likely to change very much after the big health insurer announced its third-quarter results before the market opened on Thursday. However, investors did receive some good news. Here are the highlights of Cigna's Q3 update.

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By the numbers

Cigna's revenue jumped 236% year over year in the third quarter to $38.6 billion. This figure easily topped analysts' consensus estimate of $34.2 billion.

The company reported net income of $1.35 billion, or $3.57 per share, based on generally accepted accounting principles (GAAP). This reflected a marked improvement from net income of $772 million, or $3.14 per share, reported in the prior-year period.

Cigna announced Q3 adjusted earnings of $1.72 billion, or $4.54 per share. This represented a huge increase from adjusted earnings of $945 million, or $3.84 per share, reported in the year-ago quarter. It also exceeded the average analyst estimate of $4.36 per share.

Behind the numbers

The huge rise in revenue during Cigna's third quarter reflected the strong growth in the company's medical and pharmacy businesses. Health services adjusted revenue skyrocketed to $24.9 billion from $1.1 billion in the prior-year period, driven by the acquisition of pharmacy benefits manager (PBM) Express Scripts at the end of 2018. 

Cigna's integrated medical segment, which includes its U.S. commercial and government business, saw adjusted revenue increase by nearly 12% year over year to $9.1 billion. This growth was fueled by higher commercial sales and premium increases.

The company's international segment adjusted revenue climbed 9% higher in the third quarter to $1.4 billion excluding the impact of currency fluctuations. Cigna reported adjusted revenue of $1.3 billion in Q3 for its group disability and other operations segment, which includes its life insurance business. This represented modest year-over-year growth of 1.7%.

Increased revenue from the Express Scripts acquisition was the primary factor behind Cigna's bottom-line improvement. In addition, the company's buyback of 10.8 million shares through Oct. 30, 2019, contributed to its higher earnings per share in Q3.

Looking ahead

Cigna expects that consolidated adjusted income from operations for full-year 2019 will be between $6.38 billion and $6.46 billion, or $16.80 to $17.00 on a per-share basis. This reflects a $0.15-per-share increase at the midpoint of the range from the company's previous guidance. Cigna also now projects 2019 adjusted revenue of around $138 billion, up by $1.5 billion from its prior outlook.

Some U.S. presidential candidates want to dramatically curtail the role of health insurers and PBMs in the healthcare system. Investing in healthcare stocks like Cigna could be somewhat volatile moving into 2020 with the presidential election and control of the U.S. Congress up for grabs.

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