Aetna's first-quarter net income fell 4 percent as acquisition-related costs and rising health care expenses more than offset government business gains for the health insurer.
But earnings still topped analyst expectations, and the Hartford, Conn., company raised its forecast for 2013, a year in which it will add business from Coventry Health Care once it completes the acquisition of that insurer.
In the first quarter, Aetna earned $490.1 million, or $1.48 per share. That's down from $511 million, or $1.43 per share, in last year's quarter.
Adjusted earnings totaled $1.50 per share, not counting items like capital gains. That trumped average analyst expectations for earnings of $1.38 per share, according to FactSet.
Operating revenue, which also excludes capital gains and interest income, climbed 7 percent to $9.51 billion. That was short of analyst expectations for $9.56 billion.
Its shares rose 13 cents to $56.29 in premarket trading.
Aetna is the nation's third-largest health insurer, trailing only UnitedHealth Group Inc. and WellPoint in enrollment. Health insurance is Aetna's main product, but the company also sells dental, group life and disability coverage.
Aetna recorded in the first quarter $24.6 million in costs tied to its pending, $5.7 billion Coventry acquisition, a deal it expects to finish by the middle of the year.
Health care costs, or the amount Aetna paid in medical claims, also jumped 9 percent to $6.38 billion in the quarter. That is, by far, the company's largest expense.
Higher health care premiums from Aetna's Medicaid and Medicare businesses helped revenue climb to partially counter the higher expenses.
The insurer also recorded a larger gain of $325 million in this year's quarter because claims leftover from previous quarters came in lower than expected, and it could release money it had held in reserve. That compares to a $169 million gain it recorded in last year's quarter.
Enrollment climbed 2 percent to 18.3 million, largely on gains in the company's Medicare business. That includes Medicare Advantage, which is a subsidized version of the federal government's coverage for the elderly and disabled, and supplemental coverage for people with Medicare.
Aetna now expects 2013 earnings to range between $5.50 and $5.60 per share, up from its previous forecast for at least $5.40. Analysts expected $5.53 per share.