Aetna made $1.21 billion and beat Wall Street earnings expectations in the first quarter, as the health insurer moved closer to sealing its roughly $69 billion combination with CVS Health.

The nation's third largest insurer said Tuesday that it swung to a profit after booking a loss in the first three months of 2017 due to costs from another deal, its failed bid to acquire rival Humana. Several months after regulators rejected that combination, CVS Health said it would buy Aetna.

Shareholders of both companies approved that deal earlier this year, and company leaders expect it to close in the second half of 2018. But it still needs government approval.

In the first quarter, Aetna booked earnings of $3.19 per share when adjusted for non-recurring gains. Revenue excluding investment gains and interest income slipped 2 percent to $15.22 billion, mainly due to the sale of some businesses in last year's fourth quarter.

Analysts expected, on average, earnings of $2.97 per share on $15.32 billion in revenue, according to Zacks Investment Research.

Health insurance is Aetna's main product, and most of its enrollment comes from commercial coverage sold through employers or directly to individuals. Total enrollment slipped less than 2 percent to 22.1 million people due mainly to declines in Medicaid coverage and insurance sold through the Affordable Care Act's health insurance exchanges. Aetna and other insurers have backed away from that market after absorbing heavy losses from a sicker-than-expected patient population and facing other challenges.

Leaving the exchanges also helped drop Aetna's benefit expense nearly 8 percent to $10.57 billion in the first quarter.

Aetna hasn't issued a 2018 forecast and isn't holding conference calls with analysts to discuss results due to the pending CVS deal.

CVS Health Corp. wants to use the Aetna acquisition to move deeper into managing customer health, mostly through the company's nearly 10,000 retail stores. The company plans to expand the health services it offers at those locations and get more involved in helping patients stay on their medicines or monitor chronic conditions like high blood pressure or diabetes.

Aetna executive have said the CVS deal offers a chance to simplify health care and make it more responsive to what their customers need.

Aetna Chairman and CEO Mark Bertolini talks frequently the need to change a health care system that essentially waits until people are broken before trying to fix them. Bertolini has pushed for a system that focuses more on a person's individual needs and tries to improve their quality of life instead of waiting for them to show up injured or sick at a doctor's office or hospital.

Shares of Hartford, Connecticut-based Aetna Inc. climbed 95 cents to $180 before markets opened Tuesday.

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Elements of this story were generated by Automated Insights (http://automatedinsights.com/ap) using data from Zacks Investment Research. Access a Zacks stock report on AET at https://www.zacks.com/ap/AET