Anthem's fourth-quarter earnings tumbled 64 percent as the Blue Cross and Blue Shield insurer saw several expenses climb in a performance that fell well short of Wall Street's profit expectations.

Anthem's fourth-quarter earnings tumbled 64 percent as the Blue Cross and Blue Shield insurer saw several expenses climb in a performance that fell well short of Wall Street's profit expectations.

The Indianapolis company said Friday that it earned $180.9 million in the final quarter of 2015, down from $506.7 million in the previous year's quarter.

Adjusted results totaled $1.14 per share in the most recent quarter, and operating revenue grew more than 6 percent to around $20 billion.

Analysts expected per-share earnings of $1.21 per share on $19.91 billion in revenue, according to a survey by the data firm FactSet.

Anthem reaffirmed its forecast for 2016 adjusted earnings per share of greater than $10.80.

The company runs plans in several big markets, including California, New York and Ohio.