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Here's How CVS' Improving Balance Sheet Supports Deleveraging

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Key Takeaways

  • CVS Health generated about $10.6B in YTD operating cash flow and ended Q2 with roughly $2.7B in cash.
  • CVS expects leverage to improve from about 3.5x as it executes its 2026 outlook and reduces leverage.
  • CVS assumes no 2026 buybacks and limited 2027 repurchases, keeping balance-sheet improvement a priority.

CVS Health (CVS - Free Report) maintained a strong balance sheet throughout the first half of 2026, supported by robust cash generation and disciplined capital deployment.

The company has generated approximately $10.6 billion in operating cash flow year to date, reflecting strong earnings and improvements in working capital. It ended the second quarter with roughly $2.7 billion of cash at the parent company and unrestricted subsidiaries. The company reported a leverage ratio of approximately 3.5 times in the second quarter and expects the ratio to improve further as it executes against its 2026 outlook. CVS raised its full-year operating cash flow outlook to at least $11.5 billion, providing additional capacity to reduce leverage and strengthen financial flexibility. 

CVS also remains committed to shareholder returns, having distributed more than $1.7 billion through dividends year to date. However, the company is maintaining a cautious approach toward share repurchases. Its current 2026 outlook assumes no share buybacks, with additional capital deployment opportunities to be evaluated as leverage improves.

This trend extends into 2027, with repurchases assumed to be limited to offsetting share dilution rather than supporting incremental buybacks. This suggests that balance-sheet improvement remains a near-term capital allocation priority.

Peer Update

With no debt on Align Technology’s (ALGN - Free Report) balance sheet, it looks quite comfortable from the liquidity point of view. The company’s cash and cash equivalents totaled $1.10 billion at the end of second-quarter 2026. Second-quarter operating cash flow totaled $192.8 million, while free cash flow was $157.1 million after $35.7 million of capital expenditures. ALGN repurchased about 393,400 shares for $67 million during the quarter at an average price of $169.45. As of June 30, $733.3 million remained under the $1 billion authorization announced in April 2025.

Cardinal Health (CAH - Free Report) ended fiscal 2026 with $4.9 billion of cash and $5.0 billion of adjusted free cash flow. The company repurchased about $1.4 billion of shares during the year and received a $5.0 billion increase to its repurchase authorization. This liquidity supports ongoing investment, tuck-in acquisitions and shareholder returns while preserving financial flexibility.

CVS’ Price Performance, Valuation and Estimates

Over the past year, CVS Health shares have risen 31.1% compared with the industry’s 10.8% growth. 

 

Zacks Investment Research
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CVS shares are trading at a forward five-year price-to-sales ratio of 0.29, lower than the industry average of 0.50. The stock has a Value Score of A.

 

Zacks Investment Research
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The consensus estimate for the company’s 2026 earnings has been showing a bullish trend. 

 

Zacks Investment Research
Image Source: Zacks Investment Research

CVS currently carries a Zacks Rank #2 (Buy). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

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