信諾集團 (CI) 2022 Q2 法說會逐字稿

Ladies and gentlemen, thank you for standing by Cigna's second quarter 2022 results review. (Operator Instructions) As a reminder, ladies and gentlemen, this conference, including the Q&A session, is being recorded.

女士們，先生們，感謝您支持 Cigna 的 2022 年第二季度業績審查。 （操作員須知） 女士們，先生們，本次會議，包括問答環節，正在錄製中。

We'll begin by turning the conference over to Mr. Ralph Giacobbe. Please go ahead, Mr. Giacobbe.

我們首先將會議交給 Ralph Giacobbe 先生。請繼續，賈科比先生。

Great. Thanks. Good morning, everyone. Thank you for joining today's call. I'm Ralph Giacobbe, Senior Vice President of Investor Relations. With me on the line this morning are David Cordani, Cigna's Chairman and Chief Executive Officer; and Brian Evanko, Cigna's Chief Financial Officer.

偉大的。謝謝。大家，早安。感謝您加入今天的電話會議。我是投資者關係高級副總裁 Ralph Giacobbe。今天早上與我同線的是 Cigna 的董事長兼首席執行官 David Cordani；和 Cigna 的首席財務官 Brian Evanko。

In our remarks today, David and Brian are going to cover a number of topics, including Cigna's second quarter 2022 financial results as well as an update on our financial outlook for the year.

在我們今天的講話中，David 和 Brian 將涵蓋多個主題，包括 Cigna 的 2022 年第二季度財務業績以及我們今年財務展望的更新。

As noted in our earnings release, when describing our financial results, Cigna uses certain financial measures, adjusted income from operations and adjusted revenues, which are not determined in accordance with accounting principles generally accepted in the United States, otherwise known as GAAP. A reconciliation of these measures to the most directly comparable GAAP measures, shareholders net income and total revenues, respectively, is contained in today's earnings release, which is posted in the Investor Relations section of cigna.com.

正如我們在收益發布中指出的那樣，在描述我們的財務業績時，Cigna 使用了某些財務指標、調整後的運營收入和調整後的收入，這些指標不是根據美國普遍接受的會計原則（也稱為 GAAP）確定的。這些指標分別與最直接可比的 GAAP 指標、股東淨收入和總收入的對賬包含在今天的收益發布中，該發布發佈在 cigna.com 的投資者關係部分。

We use the term labeled adjusted income from operations and adjusted earnings per share on the same basis as our principal measures of financial performance.

我們使用標有調整後運營收入和調整後每股收益的術語，其基礎與我們衡量財務業績的主要指標相同。

In our remarks today, we will be making some forward-looking statements, including statements regarding our outlook for 2022 and future performance. These statements are subject to risks and uncertainties that could cause actual results to differ materially from our current expectations. A description of these risks and uncertainties and is contained in the cautionary note of today's earnings release and in our most recent reports filed with the SEC.

在我們今天的講話中，我們將發表一些前瞻性陳述，包括關於我們對 2022 年的展望和未來業績的陳述。這些陳述受到風險和不確定性的影響，可能導致實際結果與我們當前的預期存在重大差異。對這些風險和不確定性的描述，包含在今天收益發布的警示說明和我們最近提交給美國證券交易委員會的報告中。

Before turning the call over to David, I will cover a few items pertaining to our financial results and disclosures. Regarding our results, in the second quarter, we recorded after-tax special item charges of $26 million or $0.08 per share for integration and transaction-related costs and $17 million or $0.05 per share related to a strategic plan to further leverage the company's ongoing growth to drive operational efficiency.

在將電話轉給大衛之前，我將介紹一些與我們的財務業績和披露有關的項目。關於我們的業績，在第二季度，我們為整合和交易相關成本記錄了 2600 萬美元或每股 0.08 美元的稅後特殊項目費用，以及與進一步利用公司持續增長的戰略計劃相關的 1700 萬美元或每股 0.05 美元的稅後特殊項目費用以提高運營效率。

We also recorded an after-tax special item benefit of $20 million or $0.06 per share associated with litigation matters.

我們還記錄了與訴訟事項相關的 2000 萬美元或每股 0.06 美元的稅後特殊項目收益。

As described in today's earnings release, special items are excluded from adjusted income from operations and adjusted revenues in our discussion of financial results. Additionally, please note that when we make prospective comments regarding financial performance, including our full year 2022 outlook, we will do so on a basis that includes the potential impact of future share repurchases and anticipated 2022 dividends and excludes the impact of any business combinations or divestitures that may occur after today.

正如今天的收益發布中所述，在我們對財務業績的討論中，特殊項目不包括在調整後的運營收入和調整後的收入中。此外，請注意，當我們對財務業績（包括我們的 2022 年全年展望）發表前瞻性評論時，我們將在包括未來股票回購的潛在影響和預期的 2022 年股息的基礎上這樣做，並且不包括任何業務合併的影響或今天之後可能發生的資產剝離。

As a reminder, we completed the sale of our international life, accident and supplemental businesses to Chubb on July 1, which is contemplated in our prospective statements.

提醒一下，我們於 7 月 1 日完成了將我們的國際人壽、事故和補充業務出售給安達，這在我們的前瞻性陳述中有所考慮。

With that, I'll turn the call over to David.

有了這個，我會把電話轉給大衛。

Thanks, Ralph. Good morning, everyone, and thank you for joining our call today. In the second quarter, our company continued delivering differentiated value for our clients, customers, patients and partners as we execute on our mission to improve the health, well-being and peace of mind of those we serve. And we posted strong results for the quarter and continue to build on our momentum from the first quarter.

謝謝，拉爾夫。大家早上好，感謝您今天加入我們的電話會議。在第二季度，我們公司繼續為我們的客戶、客戶、患者和合作夥伴提供差異化的價值，因為我們履行了改善我們所服務對象的健康、福祉和安心的使命。我們公佈了本季度的強勁業績，並繼續鞏固第一季度的勢頭。

Now today, I'll briefly discuss our quarterly performance and the key strategic drivers of our growth, then Brian will review additional details about our financial results during the quarter, our increased outlook for the rest of [2022] (corrected by company after the call), as well as our strong capital position. And then we'll take your questions. Let's get started.

現在，今天，我將簡要討論我們的季度業績和我們增長的關鍵戰略驅動因素，然後布賴恩將審查我們在本季度的財務業績的更多細節，我們對 [2022 年] 剩餘時間的展望增加（由公司在電話），以及我們強大的資本狀況。然後我們會回答你的問題。讓我們開始吧。

In the second quarter, we delivered total revenues of $45.5 billion and adjusted EPS of $6.22 per share. Our differentiated capabilities and innovative approaches are resonating in the market, and we achieved another quarter of strong performance across our growth platforms.

第二季度，我們實現了 455 億美元的總收入和每股 6.22 美元的調整後每股收益。我們的差異化能力和創新方法在市場上引起了共鳴，我們在增長平台上又實現了四分之一的強勁表現。

In Evernorth, we're pleased with the way our solutions are continuing to gain traction with health plans, large commercial employers, governmental agencies, health care delivery systems and medical professionals. Today, more than 180 million individual customers have access to our Evernorth solutions. We're also encouraged by our progress during the selling season for 2023, and we are on track for another year of high client retention levels.

在 Evernorth，我們很高興我們的解決方案繼續受到健康計劃、大型商業雇主、政府機構、醫療保健提供系統和醫療專業人員的青睞。今天，超過 1.8 億個人客戶可以使用我們的 Evernorth 解決方案。我們也對我們在 2023 年銷售旺季取得的進展感到鼓舞，我們有望再創一年的高客戶保留水平。

In Cigna Healthcare, our disciplined execution is driving a balance of sustained customer growth and continued progress with expanding margins. Our medical care ratio during the quarter was 80.7%, which was better than expected and a substantial improvement over the same period last year. Similar to last quarter, we continue to see a positive impact from the targeted pricing and affordability actions we put in place last year and in early 2022.

在 Cigna Healthcare 中，我們嚴謹的執行力推動了客戶持續增長和持續進步與利潤增長之間的平衡。本季度我們的醫療保障率為80.7%，好於預期，比去年同期有大幅提升。與上個季度類似，我們繼續看到我們在去年和 2022 年初實施的有針對性的定價和負擔能力行動產生了積極影響。

Overall results during the first half of the year, including the strength of our ongoing performance give us confidence in delivering our increased full year 2022 EPS guidance of at least $22.90.

今年上半年的總體業績，包括我們持續表現的實力，使我們有信心實現至少 22.90 美元的 2022 年全年每股收益指引。

Additionally, we recently completed the divestiture of our life, accident and supplemental benefits businesses in 6 markets across Asia Pacific to Chubb, and we launched a $3.5 billion accelerated share repurchase program. At current levels, we view this as an attractive use of our capital. When combined with our previously completed activity, we remain on track to repurchase at least $7 billion of our shares in 2022.

此外，我們最近完成了將亞太地區 6 個市場的人壽、意外和補充福利業務剝離給安達，並啟動了 35 億美元的加速股票回購計劃。在目前的水平上，我們認為這是對我們資本的一種有吸引力的使用。結合我們之前完成的活動，我們仍有望在 2022 年回購至少 70 億美元的股票。

Overall, we delivered a strong first half of 2022, and we are positioned to deliver on our increased outlook for revenue, customer growth and EPS for this year. Our performance is a direct result of our ability to leverage our expertise, capabilities and ongoing commitment to innovation, all focused on the most pressing needs of those we serve.

總體而言，我們在 2022 年上半年實現了強勁的業績，我們有能力實現今年收入、客戶增長和每股收益的增長前景。我們的表現是我們利用我們的專業知識、能力和對創新的持續承諾的直接結果，所有這些都專注於我們所服務的最緊迫的需求。

Affordability remains first and foremost, a top need for all of our stakeholders. In response to this, we continue to drive target innovations, including, for example, a new solution launched in June that leverages our capabilities at eviCore to support post-acute care for Cigna Medicare Advantage patients.

負擔能力仍然是我們所有利益相關者的首要需求。對此，我們繼續推動目標創新，例如，6 月推出的一項新解決方案利用我們在 eviCore 的能力支持 Cigna Medicare Advantage 患者的急性後護理。

As the patient prepares for a discharge from a hospital, our team draws upon the extensive evidence-based guidelines as well as analytics we have to work closely with providers and patients. The result is that we're able to determine the most appropriate site of care and services to support a patient's recovery, which improves health outcomes, drives meaningful cost savings and provides better patient experience and satisfaction.

當患者準備出院時，我們的團隊利用廣泛的循證指南以及我們必須與提供者和患者密切合作的分析。結果是我們能夠確定最合適的護理和服務地點來支持患者的康復，從而改善健康結果，推動有意義的成本節約，並提供更好的患者體驗和滿意度。

We've also launched a number of programs that address the rising costs of vital medications. Cigna Healthcare and Evernorth's Patient Assurance Program is an industry-first innovation capping out-of-pocket costs for insulin. In 2021 alone, we provided more than $42 million of financial relief to approximately 220,000 patients with diabetes.

我們還啟動了一些計劃來解決重要藥物成本上升的問題。 Cigna Healthcare 和 Evernorth 的患者保障計劃是一項行業首創的創新，旨在限制胰島素的自付費用。僅在 2021 年，我們就為大約 220,000 名糖尿病患者提供了超過 4200 萬美元的經濟救濟。

We've continued to broaden the impact of this program by expanding it to other chronic conditions drawing on the strength of our expertise as well as our relationships with pharmaceutical manufacturers.

我們利用我們的專業知識以及與製藥商的關係，將其擴展到其他慢性病，從而繼續擴大該計劃的影響。

Building on the success of this program, last month, our U.S. Commercial business introduced Cigna Pathwell Specialty, a new approach to specialty care. Pathwell Specialty leverages our specialty capabilities in Cigna and Evernorth and provides enhanced support to patients for better outcomes while also controlling rising specialty costs. We plan to extend this offering to additional groups of clients later this year.

基於該計劃的成功，上個月，我們的美國商業業務推出了 Cigna Pathwell Specialty，這是一種新的專科護理方法。 Pathwell Specialty 利用我們在 Cigna 和 Evernorth 的專業能力，為患者提供增強的支持以獲得更好的結果，同時控制不斷上升的專業成本。我們計劃在今年晚些時候將此服務擴展到更多的客戶群體。

At our Investor Day in June, we talked about how we're able to consistently deliver sustained attractive healthy growth even in challenging economic environments. Our company is built to perform in a variety of market conditions, including economic slowdowns. It starts with our growth framework that positions us to expand our addressable markets and capture value in 3 specific ways.

在 6 月的投資者日上，我們談到了即使在充滿挑戰的經濟環境中，我們也能夠持續實現具有吸引力的健康增長。我們的公司旨在適應各種市場條件，包括經濟放緩。它從我們的增長框架開始，該框架使我們能夠擴大我們的潛在市場並以 3 種特定方式獲取價值。

First, foundational growth through our businesses that are mature, scaled and contribute steady predictable results for our company. These businesses currently contribute about 60% of our annual revenue and include Express Scripts, U.S. Commercial and our International Health business.

首先，通過我們成熟、規模化並為我們公司貢獻穩定可預測結果的業務實現基礎性增長。這些業務目前貢獻了我們約 60% 的年收入，包括 Express Scripts、美國商業和我們的國際健康業務。

Second is accelerated growth through our businesses with differentiated capabilities aided by secular trends creating very attractive addressable markets. These businesses represent about 40% of our company's revenues, and we expect to grow these further with momentum from our Specialty Pharmacy and Care Services businesses within Evernorth and our U.S. Government business in Cigna Healthcare.

其次是通過我們具有差異化能力的業務加速增長，並在長期趨勢的幫助下創造出極具吸引力的潛在市場。這些業務約占我們公司收入的 40%，我們預計隨著 Evernorth 的專業藥房和護理服務業務以及我們在 Cigna Healthcare 的美國政府業務的發展勢頭，這些業務將進一步增長。

And third, cross-enterprise leverage, where businesses work together to create value and capture more value than any one of them could achieve on their own.

第三，跨企業槓桿，企業共同努力創造價值並獲得比任何一個人都無法單獨實現的價值更多的價值。

Putting it all together, this growth framework translates into continued strong top and bottom line contributions from Evernorth. Our health services platform continues providing industry-leading pharmacy solutions while also building out our Evernorth Care capabilities to address the growing demand for behavioral services, health coaching and care delivery.

總而言之，這個增長框架轉化為 Evernorth 持續強勁的頂線和底線貢獻。我們的健康服務平台繼續提供行業領先的藥房解決方案，同時還增強了我們的 Evernorth Care 能力，以滿足對行為服務、健康指導和護理服務日益增長的需求。

Evernorth strengthens our ability to support customers and clients with the forces facing and reshaping health care today, including the significant societal shift, bringing widespread and growing recognition of the connection between mental and physical health. This has resulted, for example, in a rising demand for services, and we've continued to expand our traditional network.

Evernorth 增強了我們為客戶和客戶提供支持的能力，這些力量在當今面臨和重塑醫療保健方面，包括重大的社會轉變，使人們對身心健康之間的聯繫得到廣泛和日益認可。例如，這導致對服務的需求不斷增加，我們繼續擴展我們的傳統網絡。

For example, our Evernorth behavioral network has more than doubled in size over the past 5 years. We're also supporting enhanced services by providing virtual care. Recently, we launched Confide Behavioral Health Navigator to improve the way we guide people to the right behavioral care at the right setting at the right time.

例如，我們的 Evernorth 行為網絡在過去 5 年中擴大了一倍多。我們還通過提供虛擬護理來支持增強服務。最近，我們推出了 Confide Behavioral Health Navigator，以改進我們在正確的時間、正確的環境中引導人們獲得正確行為護理的方式。

We also have an extensive and growing portfolio of solutions, supporting both virtual and digital first solutions, including our MDLIVE platform.

我們還擁有廣泛且不斷增長的解決方案組合，支持虛擬和數字優先解決方案，包括我們的 MDLIVE 平台。

For Cigna Healthcare, our growth framework translates into strong performance driven by ongoing customer growth in U.S. Commercial as we continue to improve affordability in key geographies, including through advancing our value-based care and site of care service programs. Also accelerating Cigna Healthcare's adoption of Evernorth solutions, which creates even greater value for our customers and clients and as a driver of attractive sustainable revenue growth for Evernorth.

對於 Cigna Healthcare 而言，我們的增長框架轉化為由美國商業客戶持續增長推動的強勁業績，因為我們繼續提高關鍵地區的可負擔性，包括通過推進我們基於價值的護理和護理服務項目現場。還加速了 Cigna Healthcare 對 Evernorth 解決方案的採用，這為我們的客戶和客戶創造了更大的價值，並成為 Evernorth 有吸引力的可持續收入增長的驅動力。

In International Health, following the divestiture of our international life, accident and supplemental benefits portfolio, we are intensifying our focus on health and health service offerings.

在國際健康方面，隨著我們的國際人壽、意外和補充福利組合的剝離，我們正在加強對健康和健康服務產品的關注。

And in U.S. Government, both for Medicare Advantage and Individual and Family Plans, we are delivering strong value for those we serve while we're investing in markets where we see sustained path for growth and a clear right to win over the long term.

在美國政府中，無論是醫療保險優勢計劃還是個人和家庭計劃，我們都在為我們所服務的人提供強大的價值，同時我們投資於我們看到持續增長路徑和明確長期贏得勝利的市場。

This balanced and diversified approach to growth, together with our substantial capital generation affords us a significant level of strategic and financial flexibility that positions us for sustained, differentiated growth under a variety of scenarios.

這種平衡和多元化的增長方式，加上我們大量的資本創造，為我們提供了顯著水平的戰略和財務靈活性，使我們能夠在各種情況下實現持續、差異化的增長。

Now to wrap up. We delivered on our customer and client commitments in the first half of the year. Looking ahead, we are well positioned to drive continued attractive healthy growth across our Evernorth and Cigna Healthcare platforms by leveraging our portfolio of foundational assets, accelerated growth businesses and fueled by the power of our cross-enterprise leverage.

現在總結一下。我們在上半年兌現了對客戶和客戶的承諾。展望未來，我們有能力通過利用我們的基礎資產組合、加速增長的業務以及我們跨企業槓桿的力量推動我們 Evernorth 和 Cigna Healthcare 平台的持續有吸引力的健康增長。

We are encouraged by our strong retention outlook for the start of 2023 as well as new business wins for the start of the year. We remain on track for continued delivery of our commitments. And as a result, we are increasing our full year outlook to at least $22.90 per [share] (corrected by company after the call), which represents a growth rate of 12%, which is within our long-term average annual adjusted EPS growth target of 10% to 13%.

我們對 2023 年初的強勁保留前景以及年初的新業務勝利感到鼓舞。我們將繼續履行我們的承諾。因此，我們將全年展望至少提高到每股 [share] 22.90 美元（在電話會議後由公司更正），這代表 12% 的增長率，這在我們的長期平均年度調整後每股收益增長范圍內目標為 10% 至 13%。

We're continuing to deliver significant value for our shareholders, and we expect to deliver at least $7 billion through share repurchase in 2022 as well as continue to pay a meaningful dividend. We also continue to make strategic investments to strengthen our capabilities and broaden our reach in both our foundational and accelerated growth businesses.

我們將繼續為股東創造可觀的價值，我們預計在 2022 年通過股票回購實現至少 70 億美元，並繼續支付可觀的股息。我們還繼續進行戰略投資，以增強我們的能力並擴大我們在基礎業務和加速增長業務中的影響力。

With that, I'll turn it over to Brian.

有了這個，我會把它交給布賴恩。

Thanks, David, and good morning, everyone. Today, I'll review key aspects of Cigna's second quarter 2022 results and discuss our updated outlook for the full year.

謝謝，大衛，大家早上好。今天，我將回顧 Cigna 2022 年第二季度業績的關鍵方面，並討論我們對全年的最新展望。

We have delivered strong customer revenue and earnings growth in the first half of 2022. Continuing our momentum from the first quarter, with second quarter earnings per share exceeding our expectations. With that, we are again increasing our full year adjusted 2022 earnings outlook to at least $22.90 per share, representing growth of 12% off of our reported full year 2021 adjusted EPS.

我們在 2022 年上半年實現了強勁的客戶收入和盈利增長。延續第一季度的勢頭，第二季度每股收益超出了我們的預期。因此，我們再次將調整後的 2022 年全年盈利展望提高至每股至少 22.90 美元，比我們報告的 2021 年全年調整後每股收益增長 12%。

This updated outlook reflects the strength of our foundational and accelerated growth businesses, coupled with cross enterprise leverage between Evernorth and Cigna Healthcare.

這一更新的前景反映了我們基礎業務和加速增長業務的實力，以及 Evernorth 和 Cigna Healthcare 之間的跨企業槓桿作用。

Looking at the quarter specifically, some key consolidated financial highlights include total revenues of $45.5 billion, after-tax adjusted earnings of $2 billion, representing growth of 10% over second quarter 2021 and adjusted earnings per share of $6.22. These results reflect a better-than-expected medical care ratio in Cigna Healthcare and continued strong performance within our Evernorth portfolio.

具體來看本季度，一些主要的綜合財務亮點包括總收入 455 億美元，稅後調整後收益 20 億美元，比 2021 年第二季度增長 10%，調整後每股收益為 6.22 美元。這些結果反映了 Cigna Healthcare 的醫療保健比率好於預期，以及我們 Evernorth 投資組合的持續強勁表現。

Regarding our segments, I'll first comment on Evernorth. Second quarter 2022 adjusted revenues grew 7% over second quarter 2021 to $34.9 billion, and pretax adjusted earnings were $1.5 billion in line with our expectations. Evernorth's results in the quarter were driven by the expansion of our accelerated growth businesses, led by our high-performing Specialty Pharmacy as well as a continued focus on affordability by delivering lowest net cost solutions for our clients and customers.

關於我們的部分，我將首先評論 Evernorth。 2022 年第二季度調整後收入比 2021 年第二季度增長 7% 至 349 億美元，稅前調整後收益為 15 億美元，符合我們的預期。 Evernorth 本季度的業績受到我們加速增長業務的擴張的推動，該業務由我們的高性能專業藥房引領，以及通過為我們的客戶和客戶提供最低淨成本解決方案來持續關注可負擔性。

We also continue to make meaningful strategic investments to both sustain and create new sources of differentiation. These include investments which serve to deepen our client relationships, develop new solutions and enhance digital capabilities to expand our services in the Evernorth Care business. Overall, Evernorth continues to deliver strong results, consistent with our expectations.

我們還將繼續進行有意義的戰略投資，以維持和創造新的差異化來源。其中包括用於加深我們的客戶關係、開發新解決方案和增強數字能力以擴展我們在 Evernorth Care 業務中的服務的投資。總體而言，Evernorth 繼續取得強勁的業績，符合我們的預期。

Turning to Cigna Healthcare. Second quarter 2022 adjusted revenues were $11.3 billion, pre-tax adjusted earnings were $1.2 billion, and the medical care ratio was 80.7%. The better-than-expected medical care ratio in the quarter, was the primary driver of Cigna Healthcare's earnings results exceeding our expectations. The strength in our MCR was driven by a combination of strong pricing actions taken over the past 12 months, our continued affordability initiatives to lower cost for our clients and lower-than-expected utilization within the quarter.

轉向信諾醫療。 2022年第二季度調整後收入為113億美元，稅前調整後收益為12億美元，醫療保健比率為80.7%。本季度好於預期的醫療保健比率是 Cigna Healthcare 盈利結果超出我們預期的主要驅動力。我們 MCR 的優勢是由過去 12 個月採取的強有力的定價行動、我們為降低客戶成本而採取的持續可負擔性舉措以及本季度低於預期的利用率共同推動的。

Non-COVID costs in the quarter were better than expectations across most service categories driven by lower levels in inpatient, emergency room care and surgeries, and direct COVID costs were also lower than projected.

由於住院、急診室護理和手術水平較低，本季度的非 COVID 成本優於大多數服務類別的預期，而直接 COVID 成本也低於預期。

Importantly, leveraging our customer engagement model, we are seeing preventive care utilization in line with pre-pandemic levels, including items such as annual exams, colonoscopies and mammograms.

重要的是，利用我們的客戶參與模式，我們看到預防性護理的利用率與大流行前水平一致，包括年度檢查、結腸鏡檢查和乳房 X 光檢查等項目。

Turning to medical customers. We ended the quarter with 17.8 million total medical customers, growth of approximately 725,000 customers or 4% year-to-date. Our Select market segment within U.S. Commercial has already grown 6% year-to-date and remains on track for high single-digit growth in customers by the end of the year. Total medical customers for the quarter were above our expectations as we've seen continued growth and strong retention in our U.S. Commercial and International Health businesses.

轉向醫療客戶。截至本季度末，我們共有 1780 萬醫療客戶，增長了約 725,000 名客戶，或今年迄今增長 4%。我們在美國商業領域的精選細分市場今年迄今已增長 6%，並有望在年底前實現客戶的高個位數增長。本季度的醫療客戶總數超出了我們的預期，因為我們看到美國商業和國際健康業務的持續增長和強勁保留。

Overall, Cigna Healthcare results reflect continued execution against our commitment to increasing both customer relationships and profit margins in 2022. The margin improvement reflects our pricing actions and affordability initiatives taken over the course of the past year.

總體而言，Cigna Healthcare 的業績反映了我們在 2022 年增加客戶關係和利潤率的承諾的持續執行。利潤率的提高反映了我們在過去一年中採取的定價行動和可負擔性舉措。

For Corporate and Other Operations, the second quarter 2022 pre-tax adjusted loss was $168 million. Overall, we delivered strong second quarter financial results that exceeded our expectations, continuing our momentum with contributions across our diversified portfolio.

對於企業和其他業務，2022 年第二季度稅前調整後虧損為 1.68 億美元。總體而言，我們提供了超出預期的強勁第二季度財務業績，繼續保持我們多元化投資組合的貢獻。

Now with respect to our outlook for full year 2022, we are increasing our outlook for full year adjusted revenue and adjusted earnings per share. In Evernorth, we expect continued strong execution driving attractive top and bottom line growth, all while investing in innovation for the future. We are now raising our Evernorth full year adjusted earnings to approximately $6.125 billion.

現在，關於我們對 2022 年全年的展望，我們正在提高對全年調整後收入和調整後每股收益的展望。在 Evernorth，我們預計持續強勁的執行將推動有吸引力的收入和利潤增長，同時投資於未來的創新。我們現在將 Evernorth 全年調整後收益提高至約 61.25 億美元。

In Cigna Healthcare, we are pleased with our performance in the first half of 2022, and we are now updating our 2022 medical care ratio outlook to 81.5% to 82.5%, an improvement from our prior range. We are also raising our expected full year 2022 adjusted earnings outlook to approximately $4.025 billion. And we are raising our medical customer outlook to growth of at least 800,000 customers, which includes strong new business growth and attractive retention levels in our foundational U.S. Commercial and International Health businesses.

在 Cigna Healthcare，我們對 2022 年上半年的表現感到滿意，我們現在將 2022 年的醫療保健比率展望更新為 81.5% 至 82.5%，比我們之前的範圍有所改善。我們還將預期的 2022 年全年調整後盈利前景提高至約 40.25 億美元。我們正在將我們的醫療客戶前景提高到至少 800,000 名客戶的增長，其中包括強勁的新業務增長和我們基礎美國商業和國際健康業務的有吸引力的保留水平。

Turning to enterprise revenue. We now expect full year 2022 consolidated adjusted revenues of at least $178 billion, enabled by continued growth and deepening of customer and client relationships in both Evernorth and Cigna Healthcare.

轉向企業收入。我們現在預計 2022 年全年合併調整後收入至少為 1780 億美元，這得益於 Evernorth 和 Cigna Healthcare 的持續增長和客戶與客戶關係的深化。

Our full year 2022 SG&A ratio is now expected to be in the range of 7.1% to 7.3%, an increase compared to our prior guidance as we continue to make strategic investments in our business.

我們現在預計 2022 年全年 SG&A 比率將在 7.1% 至 7.3% 之間，與我們之前的指導相比有所增加，因為我們繼續對我們的業務進行戰略投資。

Taken as a whole, we are raising our adjusted earnings per share guidance to be at least $22.90 per share, representing growth of 12% over reported full year 2021 adjusted EPS.

總體而言，我們將調整後的每股收益指引至少提高到每股 22.90 美元，比報告的 2021 年全年調整後每股收益增長 12%。

Now moving to our 2022 capital management position and outlook. Our businesses continue to generate strong cash flows and attractive returns on capital. Year-to-date, as of June 30, 2022, we have repurchased 9.7 million shares for approximately $2.3 billion. Additionally, in July, we received an initial delivery of 10.4 million shares of our common stock in accordance with the accelerated share repurchase we announced in June. We also continue to expect to deploy at least $7 billion to share repurchases for the full year 2022.

現在轉到我們 2022 年的資本管理職位和展望。我們的業務繼續產生強勁的現金流和有吸引力的資本回報。年初至今，截至 2022 年 6 月 30 日，我們已以約 23 億美元的價格回購了 970 萬股股票。此外，根據我們在 6 月宣布的加速股票回購，我們在 7 月收到了 1040 萬股普通股的初始交付。我們還繼續預計將部署至少 70 億美元用於 2022 年全年的股票回購。

We have also increased our outlook for full year cash flow from operations to at least $8.5 billion, generating a very attractive cash flow yield. And we now expect full year weighted average shares of 312 million to 314 million shares, representing an increase of 1 million shares at the midpoint from our prior guidance, primarily due to the sale of our international life, accident and supplemental benefits businesses being completed slightly later than we originally had anticipated.

我們還將全年運營現金流的預期提高到至少 85 億美元，產生了非常有吸引力的現金流收益率。我們現在預計全年加權平均股數為 3.12 億股至 3.14 億股，較之前指引的中點增加 100 萬股，主要是由於出售我們的國際人壽、意外和補充福利業務略有完成晚於我們最初的預期。

Our balance sheet and cash flow outlook remains strong, benefiting from our efficient asset-light framework that drives strategic flexibility, strong margins and attractive returns on capital.

我們的資產負債表和現金流前景依然強勁，這得益於我們高效的輕資產框架，該框架推動了戰略靈活性、強勁的利潤率和有吸引力的資本回報。

Now we would be remiss if we didn't acknowledge the macroeconomic environment, which carries potential risks, but also opportunities. We have a strong and resilient enterprise with a diverse service-based framework, spanning broad addressable markets. And our first half [of 2022] (added by company after the call) results demonstrate the resiliency of our portfolio and strength of our execution in a dynamic environment.

現在，如果我們不承認宏觀經濟環境存在潛在風險，但也存在機遇，我們將是失職。我們擁有一個強大而有彈性的企業，擁有多元化的基於服務的框架，跨越廣闊的目標市場。我們 [2022 年上半年]（由公司在電話會議後添加）結果證明了我們投資組合的彈性和我們在動態環境中的執行力。

We continue to proactively prepare with a variety of actions and tools to respond to evolving economic conditions and we remain confident in our ability to continue to grow and deliver strong value to our customers, clients and shareholders.

我們將繼續積極準備採取各種行動和工具來應對不斷變化的經濟狀況，我們對繼續增長並為客戶、客戶和股東創造強大價值的能力充滿信心。

Now to recap; results in the second quarter were above our expectations, reflecting strong fundamentals across our diversified portfolio, with particularly strong performance in Cigna Healthcare. Evernorth continues to deliver attractive results, while Cigna Healthcare continues to grow and expand both customer relationships and margins, giving us the confidence to deliver on our increased 2022 adjusted EPS guidance of at least $22.90.

現在回顧一下；第二季度的業績超出了我們的預期，反映了我們多元化投資組合的強勁基本面，尤其是 Cigna Healthcare 的強勁表現。 Evernorth 繼續提供有吸引力的結果，而 Cigna Healthcare 繼續發展和擴大客戶關係和利潤率，使我們有信心實現我們增加的 2022 年調整後每股收益至少 22.90 美元的指導。

And with that, we'll turn it over to the operator for the Q&A portion of the call.

有了這個，我們將把它交給接線員進行電話的問答部分。

(Operator Instructions) Our first question comes from Mr. Matthew Borsch with BMO Capital Markets.

（操作員說明）我們的第一個問題來自 BMO Capital Markets 的 Matthew Borsch 先生。

Yes. So I was wondering if you could just maybe elaborate a bit on the strong selling season or new sales that you alluded to along with high retention. Is that covering both the U.S. medical large employer group and also the PBM outlook?

是的。因此，我想知道您是否可以詳細說明一下您提到的強勁銷售季節或新銷售以及高保留率。這是否涵蓋了美國醫療大型雇主集團和 PBM 前景？

It's David. So yes, is the simple answer. So relative to my comments on the selling season, more specifically focused on the -- both in the Evernorth side of the house, the large employer, the large health plan side of the business. In the Commercial side, the National Account side of the business.

是大衛。所以是的，這是簡單的答案。因此，相對於我對銷售季節的評論，更具體地關注 - 無論是在房子的 Evernorth 一側，還是大型雇主，以及企業的大型健康計劃方面。在商業方面，業務的國民賬戶方面。

So headline there is on the Evernorth piece of the equation. Another year of strong client retention overall for the portfolio as well as attractive new business wins. I think importantly to underscore as well, we continue to see traction of what we call enterprise leverage.

所以標題就在等式的 Evernorth 部分。投資組合的整體客戶保留率又一年保持強勁，並贏得了有吸引力的新業務。我認為重要的是要強調，我們繼續看到我們所謂的企業槓桿的牽引力。

So opportunities to deepen and expand relationships. First, within the traditional Evernorth portfolio, the successful renewal of the DoD also presented the opportunity to win and secure the exclusive specialty services.

所以有機會加深和擴大關係。首先，在傳統的 Evernorth 產品組合中，DoD 的成功更新也提供了贏得和確保獨家專業服務的機會。

And then beyond that, we're broadening and deepening relationships with key health plan clients by leveraging the best of Evernorth and Cigna Healthcare.

除此之外，我們通過利用 Evernorth 和 Cigna Healthcare 的優勢，擴大和深化與主要健康計劃客戶的關係。

On the Commercial National Account side, we see 2023, looking up to be a very strong retention year and some really attractive new business adds. So good, good performance on both sides of the equation. As Brian noted in his prepared remarks, also just continued strong performance in the Commercial side in the Select segment.

在商業國民賬戶方面，我們預計 2023 年將是一個非常強勁的留存年份，並且會增加一些非常有吸引力的新業務。很好，等式兩邊的表現都很好。正如布賴恩在他準備好的講話中指出的那樣，在精選領域的商業方面也繼續保持強勁表現。

Our next question comes from Mr. Kevin Fischbeck with Bank of America.

我們的下一個問題來自美國銀行的 Kevin Fischbeck 先生。

I want to understand how you guys are thinking about the outperformance on the medical cost side as it relates to kind of getting back to target margins. Are you guys viewing the outperformance so far this year is kind of a new sustainable base? Or is this just kind of fluctuations of COVID hasn't really changed how you thought about moving from 2021 to 2023 pricing and margin expectations?

我想了解你們如何看待醫療成本方面的出色表現，因為這與恢復目標利潤率有關。你們認為今年迄今為止的出色表現是一種新的可持續基礎嗎？還是只是這種 COVID 的波動並沒有真正改變您對從 2021 年到 2023 年定價和利潤率預期的看法？

Kevin, it's Brian. So thanks for the question on the Cigna Healthcare margin trajectory. Just to maybe rewind the clock a little bit. If you look back at 2021, that part of our business generated a margin of 8.1% which was below our long-term margin goal of 9% to 10%. And when we stepped back and thought about where we stood in '21, we decided to intensify a series of pricing actions as well as affordability actions in the middle part of the year and the last 12 months have resulted in the strong performance that we saw here in the second quarter of 2022.

凱文，是布賴恩。因此，感謝有關 Cigna Healthcare 利潤率軌蹟的問題。只是為了讓時鐘倒帶一點。如果您回顧 2021 年，我們這部分業務的利潤率為 8.1%，低於我們 9% 至 10% 的長期利潤率目標。當我們退後一步思考我們在 21 年的立場時，我們決定在年中加強一系列定價行動以及負擔能力行動，過去 12 個月帶來了我們所看到的強勁表現這裡是 2022 年第二季度。

With our increased 2022 outlook, we're now projecting for the profit margin in Cigna Healthcare to run in the high 8%, just south of 9% relative to our long-term margin goal of 9% to 10%. You should view that as a sustainable place to jump off of. And we would expect, as we step into '23 that we'll be able to deliver within our targeted margin range of 9% to 10% for Cigna Healthcare, but likely at the lower end of that range, given the continued long-term margin opportunities we have in the accelerated growth platforms such as Medicare Advantage.

隨著我們對 2022 年前景的展望，我們現在預計 Cigna Healthcare 的利潤率將達到 8% 的高位，相對於我們 9% 至 10% 的長期利潤率目標，略低於 9%。您應該將其視為一個可持續的起點。我們預計，隨著我們步入 23 世紀，我們將能夠在 Cigna Healthcare 的 9% 至 10% 的目標利潤率範圍內交付，但鑑於持續的長期影響，可能會處於該範圍的低端我們在 Medicare Advantage 等加速增長平台中擁有的利潤機會。

But the stronger-than-expected 2022 performance we've seen increases our overall confidence in executing against our margin goals while also reducing a little bit of the year-over-year opportunity for further margin expansion opportunity in comparison to where we stood a quarter ago.

但是，我們所看到的強於預期的 2022 年業績增強了我們對實現利潤率目標的整體信心，同時與我們四分之一的情況相比，進一步減少了進一步擴大利潤率的同比機會前。

Our next question comes from Mr. Josh Raskin with Nephron Research.

我們的下一個問題來自 Nephron Research 的 Josh Raskin 先生。

I just wanted to focus on Medicare Advantage, seeing a little bit of attrition continued this year. And so now with bids submitted, what are some of the action steps directly for 2023 to reverse those losses? Do you think you can grow more in line with the market next year? And specifically, any changes in your network development or thoughts on value-based care and capitation?

我只是想專注於 Medicare Advantage，看到今年繼續出現一些減員。那麼現在提交了投標，2023 年直接採取哪些行動來扭轉這些損失？你認為明年你能成長得更符合市場嗎？具體來說，您的網絡發展或對基於價值的護理和按人頭計的想法有何變化？

Josh, it's David. So our Medicare Advantage business remains a key point of focus for us. And as you recall from our Investor Day conversation, we view it as one of our accelerated platforms. So a platform where we have the opportunity for outsized growth over the long term. We continue to make investments in that business, both in the core aspects of the business as well as in the geographic expansion.

喬希，是大衛。因此，我們的 Medicare Advantage 業務仍然是我們關注的重點。正如您在我們的投資者日對話中所記得的那樣，我們將其視為我們的加速平台之一。因此，這是一個我們有機會實現長期超額增長的平台。我們繼續對該業務進行投資，無論是在業務的核心方面還是在地域擴張方面。

Our 2022 results are not indicative of what we would expect to see over the long term. And importantly, in your question, which I think you touched upon insightfully one of the pieces, we did a bit of network reconfiguration to put us in some key markets in a position for longer-term growth, where we had attractive network positions, but not growth outlook from that standpoint.

我們 2022 年的結果並不代表我們預期的長期結果。重要的是，在你的問題中，我認為你對其中一個部分進行了深刻的探討，我們進行了一些網絡重新配置，以使我們在一些關鍵市場處於長期增長的位置，我們擁有有吸引力的網絡位置，但是從這個角度來看，不是增長前景。

Shifting to '23, we would expect a year of growth to reaccelerate for ourselves in the Medicare Advantage business. As we discussed, that's aided by in geography growth today, existing geographies beginning to leverage the hard work that was done in 2021 and in '22 in terms of geographic expansion. Targeted and further investments in distribution and marketing as well as beginning to harness more yield out of what we think about in terms of our inside or more captive opportunities.

轉移到'23，我們預計一年的增長將在醫療保險優勢業務中重新加速。正如我們所討論的，這得益於今天的地理增長，現有的地區開始利用 2021 年和 22 年在地理擴張方面所做的艱苦工作。對分銷和營銷進行有針對性的進一步投資，並開始從我們對內部或更多俘虜機會的考慮中獲得更多收益。

Those are Commercial age-ins that we talked about before, where we've had a low conversion rate, our PDP conversions or our Med Supp conversions.

這些是我們之前討論過的商業時代，我們的轉化率很低，我們的 PDP 轉換或我們的 Med Supp 轉換。

So headline, yes, some network reconfiguration, a lot of that was addressed in this current year, harnessing the benefit of the geographic expansion work that was done and then harnessing some benefits that we would expect to see out of the channels I made reference to. Therefore, we expect 2023 to be a year of growth for us.

所以標題，是的，一些網絡重新配置，其中很多是在今年解決的，利用已完成的地理擴展工作的好處，然後利用我們期望從我提到的渠道中看到的一些好處.因此，我們預計 2023 年對我們來說將是增長的一年。

Our next question comes from Mr. Dave Windley with Jefferies.

我們的下一個問題來自傑富瑞的戴夫溫德利先生。

A follow-up to Josh there. Wondered if, David, with those expectations for growth in MA you expect to do that while maintaining margin? Or would you -- to stimulate growth, expect margin to back up in MA at all? And then if you could remind us how your Star scores in MA will progress over the next couple of years and if the disaster relief benefits to the calculation were impactful for Cigna or not?

對 Josh 的後續行動。想知道，大衛，您是否期望在保持利潤率的同時做到這一點？或者你會 - 為了刺激增長，期待 MA 的利潤率完全回升嗎？然後，如果您能提醒我們您在 MA 中的 Star 分數在接下來的幾年中將如何進步，以及計算中的救災收益是否對 Cigna 產生影響？

So as Brian made reference to in the prior answer, I think it was to Kevin's point relative to Cigna Healthcare margins. He referred to the Medicare Advantage margins as being below our target margin. So as we grow the margin in the overall portfolio of business. That business is running at below target margins. We would expect to see margin improvement in 2023, to be very specific off of 2022's results and be able to grow although that portfolio will run below our target margins for a variety of reasons, including our investments in growth initiatives looking forward.

因此，正如布賴恩在之前的回答中提到的那樣，我認為這是凱文相對於 Cigna Healthcare 利潤率的觀點。他稱 Medicare Advantage 利潤率低於我們的目標利潤率。因此，隨著我們在整個業務組合中增加利潤率。該業務的利潤率低於目標。我們預計 2023 年的利潤率將有所改善，這與 2022 年的業績相比非常具體，並且能夠增長，儘管由於各種原因，包括我們對未來增長計劃的投資，該投資組合將低於我們的目標利潤率。

But specifically, we expect growth and some margin expansion in that business, yet it will run below our target as we continue to invest in growing that portfolio.

但具體而言，我們預計該業務將實現增長和一些利潤率擴張，但隨著我們繼續投資於擴大該投資組合，它將低於我們的目標。

As it relates to the second part of your question, and Stars, I think you're identifying the phenomenon for 2024. First off of the present, we feel really good about our present Star configuration and the strong value that, that reinforces that we provide. The look for 2024 seems to indicate that the industry as a whole will have some Stars dislocation for the reasons you articulated. The disaster relief configuration, the prolonged impact of COVID, the data transfer that comes across with that and the changes within the disaster relief program.

由於它與您問題的第二部分和星星有關，我認為您正在確定 2024 年的現象。首先，我們對我們目前的星星配置和強大的價值感覺非常好，這強化了我們提供。 2024 年的展望似乎表明，由於您所闡述的原因，整個行業將出現一些明星錯位。救災配置、COVID 的長期影響、隨之而來的數據傳輸以及救災計劃中的變化。

So we would expect to have some adjustment to our Stars consistent with what transpires for the industry at large. And obviously, that will become clearer towards the latter part of this year for the industry as a whole as well as for ourselves.

因此，我們希望對我們的 Star 進行一些調整，以符合整個行業的情況。顯然，對於整個行業以及我們自己而言，到今年下半年，這將變得更加清晰。

Our next question comes from Ms. Ricky Goldwasser with Morgan Stanley.

我們的下一個問題來自摩根士丹利的 Ricky Goldwasser 女士。

This is Michael Ha on for Ricky. I just wanted to get some more comments on your Commercial repricing efforts. Clearly, you're seeing improved MLR performance year-to-date. Membership growth appears healthy, which suggests stickiness, positive receptivity here from pricing. I'm just curious on your thoughts about where is Cigna in your overall targeted repricing efforts?

這是 Ricky 的 Michael Ha。我只是想對您的商業重新定價工作獲得更多評論。顯然，今年迄今為止，您會看到 MLR 性能有所提高。會員增長似乎是健康的，這表明定價具有粘性和積極的接受度。我只是想知道您對 Cigna 在您的整體目標重新定價工作中的位置有何看法？

Michael, it's David. Let me just briefly start and hand it over to Brian. First, to underscore, we're quite pleased with the results. Our teams are executing quite well. And Brian will come across the pricing, but he underscored in his prepared remarks as well, the affordability. It's two dimensions working together. So -- it's getting first and foremost, consultatively the right solutions in place, employer by employer within all of our segments, whether they're Select segment employers, what the market knows as Middle Market employers or National Account employers and then it's executing the right affordability initiatives to be able to give -- deliver the right value and then executing from a pricing standpoint.

邁克爾，是大衛。讓我簡單地開始並把它交給布賴恩。首先，要強調的是，我們對結果非常滿意。我們的團隊執行得很好。布賴恩會看到定價，但他在準備好的講話中也強調了可負擔性。這是兩個維度一起工作。所以 - 它首先是通過協商制定正確的解決方案，在我們所有細分市場中逐個雇主，無論他們是精選細分雇主，市場知道的中間市場雇主還是國民賬戶雇主，然後它正在執行能夠提供正確的可負擔性計劃——提供正確的價值，然後從定價的角度執行。

So I want to underscore, it's both of those pieces coming together to create the sustainability and our attractive underlying both retention and new business growth, coupled with the margins we're quite pleased with.

所以我想強調的是，這兩個部分共同創造了可持續性和我們有吸引力的潛在保留和新業務增長，再加上我們非常滿意的利潤率。

Brian, I'll ask you to speak a little bit more towards the pricing dimension.

布賴恩，我會請你多談談定價方面的問題。

Sure, David. As it relates to pricing in the Commercial book of business, this year's 2022 medical care ratio performance has resulted in a higher margin profile for Cigna Healthcare, and that's driven largely by our Commercial employer book of business.

當然，大衛。由於它與商業業務賬簿中的定價有關，今年 2022 年的醫療保健比率表現導致 Cigna Healthcare 的利潤率較高，這主要是由我們的商業雇主業務賬簿推動的。

So we've recaptured a bit more margin in 2022 than we originally anticipated. The good news is that means there's less correction that's needed on a prospective basis. So we'll certainly be pricing to our forward look at cost trend as we head into 2023, but we don't need a meaningful step change as it relates to the Commercial employer margin profile. The one nuance in that is our stop loss portfolio, as we talked about in our fourth quarter results, did have some pressure in 2021. That pressure has continued at the level we expected in 2022.

因此，我們在 2022 年重新獲得了比我們最初預期的更多的利潤。好消息是，這意味著未來需要的修正更少。因此，隨著我們進入 2023 年，我們肯定會為我們對成本趨勢的前瞻性定價，但我們不需要有意義的步驟變化，因為它與商業雇主的利潤率概況有關。正如我們在第四季度業績中談到的那樣，其中的一個細微差別是我們的止損投資組合，它在 2021 年確實有一些壓力。這種壓力一直持續到我們在 2022 年預期的水平。

So as we step into '23, there will be a little bit of a reprice on some of those clients but we were able to get, again, more margin recapture here in '22 than we had anticipated in the Commercial employer book of business.

因此，當我們步入 23 年時，其中一些客戶將會重新定價，但我們能夠在 22 年再次獲得比我們在商業雇主業務手冊中預期的更多的利潤率。

And this question comes from Mr. A.J. Rice with Credit Suisse.

這個問題來自A.J.先生。瑞信的賴斯。

Maybe just following up on talking about the selling season and what you're seeing out there. I guess employers are faced with a lot of cross currents macroeconomic questions. Obviously, their own labor issues, questions about providers wanting relief on their labor challenges and other inflationary costs.

也許只是跟進談論銷售季節以及您在那裡看到的情況。我猜雇主面臨著很多宏觀經濟問題。顯然，他們自己的勞動力問題，關於供應商希望減輕勞動力挑戰和其他通貨膨脹成本的問題。

How are those playing into the discussions? I wondered what innovative products that are -- what products are particularly resonating. And also, one of your peers said that they were seeing some people postpone full-blown RFPs just given everything that's going on and maybe delaying it for a year. Would you characterize the selling activity as pretty normal? Or are you seeing any of that?

這些人是如何參與討論的？我想知道有哪些創新產品——哪些產品特別能引起共鳴。而且，你的一位同行說，他們看到有些人推遲了全面的 RFP，只是考慮到正在發生的一切，並且可能會推遲一年。您會將銷售活動描述為非常正常嗎？或者你看到了什麼？

It's David. So I think two dimensions to your questions. First on the second piece, we see a very active pipeline. We've seen an active pipeline. As I noted previously, our retention results have been strong and importantly, underscoring even in 2022, commented relative to '23 start. But in '22, our retention results are strong even with the rate execution that Brian made reference to. So good retention within our portfolio, quite an active pipeline across various aspects of our business.

是大衛。所以我認為你的問題有兩個方面。首先在第二部分，我們看到一個非常活躍的管道。我們已經看到了一個活躍的管道。正如我之前提到的，我們的保留結果一直很強勁，而且重要的是，即使在 2022 年也強調了這一點，相對於 23 年開始的評論。但是在 22 年，即使按照 Brian 提到的執行率，我們的保留結果也很強勁。在我們的投資組合中保留得很好，在我們業務的各個方面都非常活躍。

On the first part of your question, it's a really long conversation. Let me boil it down. There's no doubt that the environment remains dynamic, disrupted, challenging from an employer standpoint to be able to attract, retain, have the engagement levels for their coworkers. A couple of phenomena I would underscore to your point.

在你問題的第一部分，這是一個很長的對話。讓我把它煮沸。毫無疑問，從雇主的角度來看，環境仍然是動態的、混亂的、具有挑戰性的，以便能夠吸引、留住並保持其同事的敬業度。我要強調你的觀點的幾個現象。

One, in the prolonged pandemic environment, employers are dealing with, call it, the nomadic lifestyle of more of their employees. So first and foremost, on the Commercial side, truly having a seamless Commercial network for their employees because the higher percentage of the coworkers are consuming care in various locations as opposed to more traditional or centralized locations geographically.

一，在長期的大流行環境中，雇主正在處理，稱之為，更多員工的游牧生活方式。因此，首先，在商業方面，真正為員工提供無縫的商業網絡，因為與傳統或集中的地理位置相比，更高比例的同事在不同地點接受護理。

Secondly, seeking to advance as aggressively as possible, behavioral health services and the connection of behavioral health services with physical health services. And I highlighted several of those in my prepared remarks. That remains front and center.

其次，尋求盡可能積極地推進行為健康服務以及行為健康服務與身體健康服務的聯繫。我在準備好的發言中強調了其中的幾個。這仍然是前沿和中心。

Third, on the cost and the affordability side of the equation, open-mindedness even push to more aggressively adopt whether they're site of care optimization programs. So how do you get better affordability with existing or even improved quality by optimizing site of care for an individual patient or bringing more services closer to the individual, both dealing with the nomadic lifestyle as well as site of care, virtual digital-first, closer intimacy. And those are areas that have been high on strategy for us.

第三，在等式的成本和可負擔性方面，思想開放甚至推動更積極地採用它們是否是護理優化程序的站點。那麼，您如何通過優化個體患者的護理場所或使更多服務更貼近個人（無論是處理游牧生活方式還是護理場所，虛擬數字優先，更接近），從而獲得更好的可負擔性，甚至提高質量親密關係。這些都是我們高度重視的領域。

So you're correct. There's a lot of dynamism in the marketplace today. Being consultative in terms of putting the right solution suite together, mission-critical, having the services between our Evernorth and Cigna Healthcare portfolio is mission-critical right now and then being able to optimize that national network, the site of care optimization kind of the multimodal virtual coordinated care is mission-critical right now. A.J., I hope that helps.

所以你是對的。當今市場充滿活力。在將正確的解決方案套件組合在一起、關鍵任務方面進行諮詢，在我們的 Evernorth 和 Cigna 醫療保健產品組合之間提供服務是目前的關鍵任務，然後能夠優化該國家網絡，即護理優化網站多模式虛擬協調護理現在是關鍵任務。 A.J.，我希望這會有所幫助。

Our next question comes from Mr. Justin Lake with Wolfe Research.

我們的下一個問題來自 Wolfe Research 的 Justin Lake 先生。

I wanted to talk about the $22.90 this year. You've answered some of the questions in terms of the Commercial business specifically. But just in terms of the jump-off point for 2023 earnings, anything we should think about in terms of whether this may or may not be a reasonable starting point versus that 10% to 13% target growth? And then any headwind tailwinds you want us to consider when thinking about that 10% to 13% kind of target digging into next year?

我想談談今年的 22.90 美元。您已經具體回答了商業業務方面的一些問題。但就 2023 年收益的起點而言，我們應該考慮這是否是一個合理的起點，而不是 10% 至 13% 的目標增長？然後，在考慮明年挖掘 10% 到 13% 的目標時，您希望我們考慮的任何不利因素？

Justin, it's Brian. I'll start and then, David, I think maybe will chime in on the headwinds, tailwinds component.

賈斯汀，是布賴恩。我會開始，然後，大衛，我想也許會加入逆風和順風部分。

At a macro level, you should not think of there being massive amounts of nonrecurring items favorable or unfavorable in the 2022 performance. So you should view the $22.90 as a reasonable jump-off point. As we look back at prior year development, which has been largely in line with prior calendar years, the amount of activity we're seeing in the second quarter, Cigna Healthcare book of business as it relates to fundamental strength is quite high.

在宏觀層面上，您不應該認為 2022 年的業績中有大量有利或不利的非經常性項目。因此，您應該將 22.90 美元視為一個合理的起點。當我們回顧上一年的發展時，這在很大程度上與往年一致，我們在第二季度看到的活動量，與基本實力相關的 Cigna Healthcare 業務賬簿相當高。

So meaning there's not any meaningful things we'd call out that are substantial, and that would be 2022 specific for purposes of doing those adjustments at this point in time. That could change as the year unfolds. But broadly speaking, I'd jump off of $22.90.

因此，這意味著我們不會提出任何實質性的有意義的事情，而這將是 2022 年特定的，以便在此時進行這些調整。隨著時間的推移，這種情況可能會發生變化。但從廣義上講，我會跳出 22.90 美元。

David, do you think about headwinds and tailwinds, do you want to jump in on that piece?

大衛，你會考慮逆風和順風嗎，你想參與其中嗎？

Sure, Brian. Thanks. And Brian, maybe underscore your point. Therefore, we seldom talk through about a rebasing framework, Justin. As it relates to headwinds and tailwinds, we would typically go through that in more detail on the third quarter call and then detailed guidance in the fourth quarter call, but maybe a step back to, as you may recall from Investor Day, we talked about a few of the more macro opportunities for 2023.

當然，布賴恩。謝謝。還有布賴恩，也許會強調你的觀點。因此，我們很少談論變基框架，賈斯汀。由於它與逆風和順風有關，我們通常會在第三季度電話會議上更詳細地討論這一點，然後在第四季度電話會議上詳細介紹，但可能會退後一步，正如你可能從投資者日回憶起的那樣，我們談到了2023 年的一些更宏觀的機會。

So first and foremost, think about foundational and fundamental growth across our businesses. As we commented today, we would expect another year of growth for the organization, both on the Cigna Healthcare side of the equation as well as Evernorth side of the equation.

因此，首先要考慮我們業務的基礎性和根本性增長。正如我們今天評論的那樣，我們預計該組織將再增長一年，無論是在等式的 Cigna 醫療保健方面，還是等式的 Evernorth 方面。

Secondly, a topic we have not discussed here, but we discussed previously at Investor Day we would expect to see further contributions from the biosimilar trend, which will begin to accelerate 2023, accelerate further in 2024, but some contribution of the biosimilar trend, of which we are well positioned and configured to deliver value for our clients, customers and patients on as well as benefit for our shareholders.

其次，一個我們在這裡沒有討論過的話題，但我們之前在投資者日討論過，我們希望看到生物仿製藥趨勢的進一步貢獻，該趨勢將在 2023 年開始加速，在 2024 年進一步加速，但生物仿製藥趨勢的一些貢獻，我們的定位和配置都很好，可以為我們的客戶、客戶和患者創造價值，並為我們的股東帶來利益。

On the headwind side, just to give illustrations, we've highlighted setup -- what we call setup costs for very large clients, whether they're very large client renewals or expansions. There's a setup cost in a gestation cycle relative to that.

在逆風方面，只是為了舉例說明，我們強調了設置——我們稱之為非常大客戶的設置成本，無論它們是非常大的客戶續訂還是擴展。與此相關的妊娠週期中存在設置成本。

And then lastly, the rate and pace of our strategic investments that we choose to make given the rapid changes in the environment may create a little bit more headwind year-over-year, which we would highlight. But net-net, we would expect another positive year for 2023, off of what is shaping up to be a very strong year for 2022.

最後，鑑於環境的快速變化，我們選擇進行戰略投資的速度和步伐可能會比去年同期產生更多的逆風，我們將強調這一點。但是淨淨值，我們預計 2023 年將是另一個積極的一年，而 2022 年將是非常強勁的一年。

Our next question comes from Mr. Gary Taylor with Cowen.

我們的下一個問題來自 Cowen 的 Gary Taylor 先生。

Just want to ask a little more about medical loss ratio, which was so favorable. So congrats on that. But just a few different questions, if I could. One, the sequential decline in 2Q is pretty unusual for your book's seasonality. I know we have International Health care in there now, and I'm just wondering if that contributes to any different view of seasonality sequentially from 1Q, 2Q?

只是想多問問醫療損失率，太優惠了。恭喜你。但如果可以的話，只是幾個不同的問題。一，第二季度的連續下降對於你的書的季節性來說是非常不尋常的。我知道我們現在有國際醫療保健，我只是想知道這是否會導致從第一季度、第二季度開始對季節性的不同看法？

Also a year ago, you had highlighted behavioral and substance abuse as putting a lot of pressure on 2Q. I just wondered if that's changed at all?

同樣在一年前，您強調行為和藥物濫用給第二季度帶來了很大壓力。我只是想知道這是否完全改變了？

And then also just on stop loss, you had talked about still believing that would be a pressure all the way through '22 with pricing initiatives having more effect in '23. So just wondering, are you producing this strong MLR on the lower-than-expected utilization still with stop loss being a bit of a headwind inside of it?

然後就止損而言，您談到仍然認為這將是整個 22 年的壓力，而定價舉措在 23 年會產生更大的影響。所以只是想知道，您是否在低於預期利用率的情況下生產這種強大的 MLR，但止損在其中有點逆風？

Gary, it's Brian. I'll do my best to take each of those components of your question. And I appreciated the lead-in that you started with there. We are really pleased with the strength in the medical care ratio in the second quarter. So and it really was a fundamental strength across the portfolio with our U.S. Commercial employer book really being the primary driver of the strength.

加里，是布賴恩。我會盡力回答你問題的每一個組成部分。我很欣賞你從那裡開始的導入。我們對第二季度醫療保健比率的強勁感到非常滿意。因此，這確實是整個投資組合的基本優勢，我們的美國商業雇主書確實是該優勢的主要驅動力。

And as I mentioned earlier in my comments, we saw favorability both in non-COVID and in COVID-related costs in the quarter. So strength in both parts of that portfolio, again, which reflects our affordability initiatives as well as a lesser utilization than we had been forecasting.

正如我之前在評論中提到的那樣，我們在本季度看到了非 COVID 和 COVID 相關成本的優勢。因此，該投資組合的兩個部分的實力再次反映了我們的負擔能力計劃以及利用率低於我們的預測。

As it relates to the sequential decline, you should not think of the International Health business as a material driver of that. This was really a quarter we had favorable cost experience relative to our prior expectations, as opposed to anything unique or nuanced by adding the International book in there.

由於它與連續下降有關，因此您不應將國際健康業務視為其主要驅動力。相對於我們之前的預期，這確實是我們擁有有利成本體驗的四分之一，而不是通過在其中添加國際書籍而帶來的任何獨特或細微差別。

As it relates to behavioral health, you're right, last year, we saw higher than typical cost trends in our behavioral health book of business, which we actually viewed as a good thing from the standpoint of people getting the care that they needed. That's moderated a bit here in 2022, meaning the cost trends we're seeing on behavioral are lower than they were in 2021. And as a result of that, that's provided a little bit of quarter-over-quarter, year-over-year favorability.

由於它與行為健康有關，你是對的，去年，我們在行為健康業務手冊中看到了高於典型成本趨勢，從人們獲得所需護理的角度來看，我們實際上認為這是一件好事。這在 2022 年有所緩和，這意味著我們在行為方面看到的成本趨勢低於 2021 年。因此，這提供了一些季度環比和同比好感度。

And then finally, on your point about stop loss, as I mentioned on the earlier question that Michael asked, the 2022 stop loss MCR performance is largely in line with our expectations. So when we reset the 2021 MCR pick at the end of the year, given the pressure we saw, we had said we would not be able to reprice most of the '22 book just given the timing of when that emerged. And so that's our expectation. That's what we're seeing in the actuals.

最後，關於你關於止損的觀點，正如我在邁克爾之前提出的問題中提到的那樣，2022 年止損 MCR 的表現在很大程度上符合我們的預期。因此，當我們在年底重置 2021 年 MCR 選擇時，鑑於我們看到的壓力，我們曾說過，僅考慮到出現的時間，我們將無法對 22 年的大部分書籍重新定價。這就是我們的期望。這就是我們在實際中看到的。

So the MCR outlook for '22 in stop loss is very similar to the MCR outlook for '21, which gives us a repricing opportunity in 2023. So you kind of step back from all of this and the favorability we're seeing in Commercial is largely not stop loss related. It's largely related to the non-COVID and the COVID-related cost on first dollar coverages and our fully insured and other risk businesses.

因此，'22 止損的 MCR 前景與 '21 的 MCR 前景非常相似，這給了我們在 2023 年重新定價的機會。所以你有點退後一步，我們在商業中看到的好感度是很大程度上與止損無關。它在很大程度上與非 COVID 和第一美元保險的 COVID 相關成本以及我們的完全保險和其他風險業務有關。

Our next question comes from Ms. Lisa Gill with JPMorgan.

我們的下一個問題來自摩根大通的 Lisa Gill 女士。

I just wanted to follow up with a couple of questions around the PBM. So, one. When we think about the selling season, David, you talked about very strong retention. Should I assume that, that's in the very high 90% range? Would be first.

我只是想跟進幾個有關 PBM 的問題。所以，一個。當我們考慮銷售季節時，大衛，你談到了非常強的保留率。我應該假設，那是在非常高的 90% 範圍內嗎？會是第一。

Second, as we think about -- you talked about biosimilars, as we think about plan design for 2023, are you starting to put biosimilars on the formulary in 2023? Where we'll see that impact in '23? Or will this really be more of a '24 opportunity?

其次，正如我們所想的那樣——您談到了生物仿製藥，當我們考慮 2023 年的計劃設計時，您是否開始在 2023 年將生物仿製藥列入處方集？ 23 年我們會在哪裡看到這種影響？或者這真的更像是 24 年的機會嗎？

And then just lastly, there's been some changes on the manufacturing side for 340B. I didn't hear you call that out as a headwind. I'm just curious if you had any headwinds as it pertains to 340B and the Express Scripts book of business?

最後，340B 在製造方面發生了一些變化。我沒有聽到你說這是逆風。我只是好奇您是否有任何與 340B 和 Express Scripts 業務有關的逆風？

Lisa, it's David. You packed a lot in there. So let me try to run through them. First, from a retention standpoint, think about 95-plus. We believe anything in the mid-90s plus is a quite strong result given the diversity of our business for that portfolio. And as I noted on the prior comment, in addition to that, think about us continuing to deepen the relationships we have with broadening of services.

麗莎，是大衛。你在裡面裝了很多東西。因此，讓我嘗試遍歷它們。首先，從留存率的角度來看，想想 95 歲以上。鑑於我們在該產品組合中業務的多樣性，我們相信 90 年代中期以上的任何產品都是相當強勁的結果。正如我在之前的評論中指出的那樣，除此之外，請考慮我們通過擴大服務繼續加深我們之間的關係。

As I noted, whether it's adding specialty exclusive or otherwise as well as the enterprise leverages, we have some relationships that are becoming deeper with leveraging Cigna Healthcare capabilities for legacy Evernorth relationships or vice versa. But think retention, 95-plus is something that we view as quite attractive.

正如我所指出的，無論是添加專業獨家還是其他以及企業槓桿，我們都有一些關係隨著利用 Cigna Healthcare 的能力來建立傳統的 Evernorth 關係而變得越來越深，反之亦然。但是想想留存率，95 歲以上是我們認為非常有吸引力的東西。

As it relates to the biosimilars, your specific question on formulary that finalization typically takes place as we approach the fourth quarter. So there's dynamism being managed through. And as you know, with your background relative to the space, there's a lot of dynamism relative to that as it relates to choice client by client as well. We think about our national preferred formulary finalization more approaching the fourth quarter versus in the current dynamic and time frame.

由於它與生物仿製藥有關，您對處方集的具體問題通常會在我們接近第四季度時進行。所以有活力被管理。如您所知，您的背景與空間相關，與此相關的動態性很大，因為它也與逐個客戶的選擇有關。我們認為我們的國家首選處方最終確定更接近第四季度，而不是當前的動態和時間框架。

And specific to the timing of the opportunity, as we discussed previously, I would think about the biosimilar acceleration. While there's some movement, obviously, in 2022, '23 is a very active year with fixation and focus on Humira and the transition. That will begin to ramp in 2000 -- and contributions will begin to ramp in 2023, but accelerate much further in '24 and obviously going to '25.

正如我們之前討論的那樣，具體到機會的時機，我會考慮生物仿製藥的加速。雖然有一些變化，但顯然，在 2022 年，23 年是非常活躍的一年，我們關注並專注於修美樂和過渡。這將在 2000 年開始增加——貢獻將在 2023 年開始增加，但在 24 年會進一步加速，顯然會到 25 年。

Lastly, relative to 340B. As folks know, 340B is a really important program that a lot of health care delivery systems benefit from as they serve disadvantaged and underserved populations to help them get the right level of affordability. There's been some dislocation in that program and some pharmaceutical manufacturers have unilaterally decided to stop or decrease or create tension for health care delivery systems participation in that.

最後，相對於340B。眾所周知，340B 是一項非常重要的計劃，許多醫療保健提供系統都從中受益，因為它們為弱勢和服務不足的人群提供服務，以幫助他們獲得適當水平的負擔能力。該計劃出現了一些混亂，一些製藥商單方面決定停止或減少參與該計劃的醫療保健服務系統或製造緊張局勢。

As it relates to Cigna specifically through our Evernorth portfolio, it's not a material driver of 2022 results, hence, we didn't call it out. Any change or disruption of that is not a material driver to 2022 results from that standpoint, although there's been some activity, and we've seen some deceleration in volume as some of the data transfer tension has grown.

由於它通過我們的 Evernorth 投資組合特別與 Cigna 相關，因此它不是 2022 年業績的重要驅動因素，因此，我們沒有說出來。從這個角度來看，任何變化或中斷都不是 2022 年的重大驅動因素，儘管有一些活動，而且隨著一些數據傳輸緊張局勢的加劇，我們看到交易量有所放緩。

We've seen that a little bit trough in the second quarter, and we see emergence of some improvement or acceleration in those activities in the beginning of the third quarter here as we work with health care delivery systems to try to help them get the data across that pharmaceutical manufacturers are challenging them to deliver. But again, not a material driver for us thus far, Lisa.

我們在第二季度看到了一些低谷，我們看到第三季度初這些活動出現了一些改善或加速，因為我們與醫療保健提供系統合作，試圖幫助他們獲取數據整個醫藥製造商都在挑戰他們交付。但是，麗莎，到目前為止，這對我們來說並不是一個重要的驅動力。

Our next question comes from Mr. Kevin Caliendo with UBS.

我們的下一個問題來自瑞銀的 Kevin Caliendo 先生。

I guess I'd like to ask about sort of potential drug price legislation. That looks like it may actually pass this time in Congress. So I was wondering if you've taken a look at it and what the potential impact could be on Evernorth, either positively or negatively from what's being proposed?

我想我想問一下潛在的藥品價格立法。看起來它實際上可能會在國會通過。所以我想知道你是否看過它，以及對Evernorth的潛在影響是什麼，無論是積極的還是消極的？

Kevin, it's David. You're correct, there's -- once again, some proposed legislation that's manifesting. And in the bill, there's orientation relative to pharmaceutical pricing. Stepping back, big picture, if you look at the breadth and the shape of our Evernorth portfolio as well as the diversification of services we have, both on the core pharmacy services, the Specialty Pharmacy services, the innovation we've been able to bring to the market, the clinical programs we have, the significant amount of transparency we have with clients of a variety of choices. There is no item that we see currently in any of the proposed legislation that we view as a unique or a significant dislocation to our business. That doesn't mean there's not an environment of change.

凱文，是大衛。你是對的，有 - 再一次，一些擬議的立法正在顯現。在該法案中，有與藥品定價相關的方向。退一步，大局，如果你看看我們 Evernorth 產品組合的廣度和形狀，以及我們在核心藥房服務、專業藥房服務、我們能夠帶來的創新方面的服務多樣化對於市場，我們擁有的臨床項目，我們與各種選擇的客戶的大量透明度。我們目前在任何擬議立法中都沒有看到任何我們認為對我們的業務造成獨特或重大錯位的項目。這並不意味著沒有變化的環境。

But back to managing the portfolio, the breadth of our services, the continued commitment to innovation, the evolution of our clinical programs, the evolution of our financing and funding mechanisms, affording choice to our Commercial clients, health plan clients, et cetera, from that standpoint, positions us as we best see well even with the proposed legislation, and we continue to track the emergence of that day to day.

但回到管理投資組合、我們服務的廣度、對創新的持續承諾、我們臨床項目的發展、我們的融資和籌資機制的發展、為我們的商業客戶、健康計劃客戶等提供選擇，來自即使在擬議的立法中，這一立場也使我們處於我們最清楚的位置，我們將繼續跟踪這一點的出現。

Our next question comes from Nathan Rich with Goldman Sachs.

我們的下一個問題來自高盛的 Nathan Rich。

I just wanted to ask a follow-up on some of the MLR commentary from earlier in the call. And I guess, specifically with regards to the outlook for the back half of the year, I guess, does the raise to the MLR outlook kind of embed any favorability in the back half?

我只是想就電話會議早些時候的一些 MLR 評論詢問後續行動。而且我想，特別是關於今年下半年的前景，我想，對 MLR 前景的提高是否會在下半年嵌入任何有利因素？

And I guess, have you seen any indications of any sort of pent-up demand? Or does sort of the macro environment that we're seemingly in, does that influence your view of how utilization might trend over the balance of the year?

我想，你有沒有看到任何被壓抑的需求的跡象？或者我們似乎所處的某種宏觀環境是否會影響您對今年餘下時間利用率趨勢的看法？

It's Brian. So as it relates to the MLR outlook for the back half of the year, so stepping back again in the second quarter, we saw a very favorable result relative to our prior expectations. And if you recall from our first quarter earnings release, we felt that it was prudent to assume that 2022 medical cost performance would look a lot like 2021 when you look at the all-in combined effect of COVID and non-COVID cost. So the terminology, if you recall, we would use at the time would be above baseline.

是布賴恩。因此，由於它與下半年的 MLR 前景有關，因此在第二季度再次退後，我們看到了相對於我們之前預期的非常有利的結果。如果您從我們第一季度的收益發布中回想一下，我們認為當您查看 COVID 和非 COVID 成本的綜合影響時，假設 2022 年的醫療成本績效看起來很像 2021 年是謹慎的做法。因此，如果您還記得的話，我們當時使用的術語將高於基線。

For purposes of the back half of the year, we have assumed that the medical cost performance will be largely consistent with our previous planning assumptions, meaning we have not assumed the second quarter favorability will run rate or extend through the back half of the year.

就今年下半年而言，我們假設醫療成本績效將與我們之前的計劃假設基本一致，這意味著我們沒有假設第二季度的好感度將持續或延續到下半年。

So obviously, if the remaining two quarters were to run more in line with what we saw in the second quarter, there will be favorability in the second half of the year results from the standpoint of the MCR and as such, the income outlook.

所以很明顯，如果剩下的兩個季度與我們在第二季度看到的情況更加一致，那麼從 MCR 的角度來看，下半年的業績將會有利，因此，收入前景也是如此。

We're not yet seeing on the second part of your question, any meaningful signs of pent-up demand or acuity building in the book of business. So as I mentioned earlier, when we look at blood screenings, preventive exams, mammograms, colonoscopies, all of those on a per capita basis are very much in line with where they were in 2019, and we continue to see things like when cancers present the percentage that are metastatic is very consistent with where it was in 2019.

在您的問題的第二部分，我們還沒有看到任何有意義的跡象表明被壓抑的需求或商業賬簿中的敏銳度。因此，正如我之前提到的，當我們查看血液篩查、預防性檢查、乳房 X 光檢查、結腸鏡檢查時，所有這些按人均計算都與 2019 年的情況非常一致，而且我們繼續看到癌症出現時的情況轉移性百分比與 2019 年的情況非常一致。

And so the favorability we're seeing in the results, we don't attribute to a meaningful amount of care not being consumed that needs to be.

因此，我們在結果中看到的好感度，我們並不歸因於沒有被消耗的有意義的護理量。

Our next question comes from Mr. Stephen Baxter with Wells Fargo.

我們的下一個問題來自富國銀行的斯蒂芬巴克斯特先生。

Just wanted to follow up quickly on the MLR commentary you provided there. When we think about the upside in the quarter, I guess, any sense you can provide on how much of that was driven by favorable intra-year development versus your current period accruals?

只是想快速跟進您在那裡提供的 MLR 評論。當我們考慮到本季度的上行空間時，我想，您能提供什麼感覺，其中有多少是由有利的年內發展與您當前期間的應計收益推動的？

And then as we think about the MLR progression through the balance of the year, I appreciate the commentary that you're expecting consistent with your prior planning cycle for above baseline utilization. Should we also be thinking about potentially a tailwind from midyear renewals that you wouldn't necessarily see in a typical year? And just remind us how much of your employer book reprices midyear?

然後，當我們考慮到今年剩餘時間的 MLR 進展時，我很欣賞您期望的評論與您之前的規劃週期一致，以實現上述基線利用率。我們是否還應該考慮年中續約可能帶來的順風，而您不一定會在典型的年份看到這種情況？只是提醒我們你的雇主在年中重新定價了多少？

Stephen, it's Brian again. So relative to what we saw in the second quarter MCR, as I mentioned earlier, U.S. Commercial was the primary driver of the favorability. Our Government products largely ran in line with our expectations. And within the Commercial employer book of business, we did have some favorability from first quarter reserve development, but that was the minority of the favorability in the experience.

斯蒂芬，又是布賴恩。因此，相對於我們在第二季度 MCR 中看到的情況，正如我之前提到的，美國商業是好感度的主要驅動力。我們的政府產品在很大程度上符合我們的預期。在商業雇主業務手冊中，我們確實從第一季度儲備開發中獲得了一些好感，但這只是經驗中的少數好感。

The primary drivers were second quarter dates of service running favorable to our projections, which, again, is a function of both lower utilization than we expected, but also the affordability initiatives really holding -- or taking hold in the quarter. So we saw a strong site of care optimization in the quarter and other things such as that, helping to contribute to the favorable results in the quarter.

主要驅動因素是第二季度的服務日期對我們的預測有利，這同樣是由於利用率低於我們預期的結果，也是真正持有或在本季度採取的可負擔性舉措。因此，我們在本季度看到了強大的護理優化網站以及其他類似的東西，有助於為本季度的良好業績做出貢獻。

As it relates to repricing for the balance of the year, the smaller part of our business, Select segment tends to have a more even renewal date schedule as compared to our National Accounts business, which tends to be very heavy 1/1. So you should think of on the Select segment, about 2/3 of the clients have 1/1 effective dates and the other 1/3 have effective dates later in the year.

由於它涉及到年度餘額的重新定價，我們業務的較小部分，與我們的國民賬戶業務相比，選擇部分往往有更均勻的更新日期時間表，後者往往非常重 1/1。因此，您應該考慮在 Select 部分中，大約 2/3 的客戶有 1/1 的生效日期，而其他 1/3 的生效日期在今年晚些時候。

So there is some opportunity for us to reprice that business that's been factored into our outlook in terms of the rate actions we have either already secured or intend to secure for the balance of the year. So that's been factored into the outlook and we've been really pleased with the strong execution of our U.S. Commercial team. We're delivering both improved margins and net customer growth in a challenging year.

因此，我們有機會根據我們已經獲得或打算在今年餘下時間獲得的利率行動來重新定價已納入我們前景的業務。因此，這已被納入展望，我們對美國商業團隊的強大執行力感到非常滿意。在充滿挑戰的一年中，我們實現了利潤率的提高和客戶的淨增長。

Our next question comes from Mr. Steven Valiquette with Barclays.

我們的下一個問題來自巴克萊銀行的 Steven Valiquette 先生。

So within Evernorth, you mentioned the 2Q results were in line with our expectations. And I guess, and with both the top line, the bottom line growth year-over-year in Evernorth slowing a little bit -- really showing some slight deceleration year-over-year versus the growth in 1Q. Just wanted to give a little more color around that as far as what was baked in the expectations.

所以在 Evernorth，您提到第二季度的業績符合我們的預期。而且我猜，隨著收入的增長，Evernorth 的收入同比增長略有放緩——與第一季度的增長相比，確實顯示出同比略有放緩。就預期中的烘焙而言，只是想給它更多的色彩。

I know last quarter, you talked about how you were continuing to make some meaningful strategic investments in Evernorth the expansion of client relationships. So I guess I'm just curious how those investments may have progressed and impacted the results in the quarter for Evernorth.

我知道上個季度，您談到瞭如何繼續對 Evernorth 進行一些有意義的戰略投資，以擴大客戶關係。所以我想我只是好奇這些投資可能如何取得進展並影響 Evernorth 本季度的業績。

Steven, it's David. Just to the macro level, two points. One, we remain quite pleased with the overall performance of Evernorth and the sustained performance within Evernorth. Two, to your point, I give you caution in terms of triangulating any one quarterly pattern. You're correct, the rate and pace of the investments we're making. You made a reference relative to the Q-over-Q revenue growth, a little bit of the lumpiness in terms of the way the revenue manifests itself, for example, in Q1 and Q2 of last year. But the overall revenue trajectory and the overall earnings trajectory is quite helpful.

史蒂文，是大衛。就宏觀層面來說，兩點。第一，我們對 Evernorth 的整體表現和 Evernorth 的持續表現感到非常滿意。第二，就你的觀點而言，我在對任何一種季度模式進行三角測量時要小心謹慎。你是對的，我們投資的速度和速度。您提到了 Q-over-Q 收入增長，就收入表現本身而言，例如在去年 Q1 和 Q2 中的收入增長方式有點混亂。但整體收入軌跡和整體收益軌跡非常有幫助。

Lastly, kind of pivoting down into your investment piece, we continue to make accelerated and growing investments within our accelerated platforms, two of those are within Evernorth, specifically the Specialty Pharmaceutical business through both Accredo and CuraScripts, but heavily targeted towards the Evernorth Care piece.

最後，有點轉向您的投資部分，我們繼續在我們的加速平台內進行加速和增長的投資，其中兩個在 Evernorth 內，特別是通過 Accredo 和 CuraScripts 的特種製藥業務，但主要針對 Evernorth Care 部分.

We showcased some of the direction of that at our Investor Day and you should continue to expect to see us continue to ramp relative to that. So if there's any pattern or outside spending or investments that manifest itself beyond the large client setup costs, it's really the strategic investments we're making within our Evernorth Care part of the equation today.

我們在投資者日展示了其中的一些方向，您應該繼續期待看到我們繼續相對於此。因此，如果有任何模式或外部支出或投資表現出超出大客戶設置成本的情況，那麼這確實是我們今天在 Evernorth Care 等式中進行的戰略投資。

Just one add for you, Steven, in terms of the modeling on the revenue side. In 2021, we had relatively steep sequential growth as it relates to the quarterly pattern of Evernorth revenue. A lot of that was driven by the onboarding of specific clients for our specialty programs associated with the Prime Therapeutics relationship. The 2022 pattern is less steep, which is driving a little bit of the top line deceleration you made reference to.

史蒂文，就收入方面的建模而言，只需為您添加一個。 2021 年，我們的環比增長相對陡峭，因為這與 Evernorth 收入的季度模式有關。其中很大一部分是由特定客戶加入我們與 Prime Therapeutics 關係相關的專業項目推動的。 2022 年的模式不那麼陡峭，這推動了你提到的頂線減速。

However, we'll see sequential growth in each quarter this year and we're on track for a strong year from a top and bottom line standpoint being in the range of our long-term goals for Evernorth.

但是，我們將看到今年每個季度的連續增長，並且從頂線和底線的角度來看，我們正朝著強勁的一年邁進，這在我們 Evernorth 的長期目標範圍內。

Our next question comes from Mr. Lance Wilkes with Bernstein.

我們的下一個問題來自伯恩斯坦的蘭斯威爾克斯先生。

I wanted to ask about strategic capital allocation. And in particular, as you're looking at care delivery and value-based care, interested in just updates on the priority of that sort of initiative? And then you look at that as more of an enablement and something that could be cross-sold through Evernorth. Or is that also something that could be a driver for your Medicare Advantage, Cigna Healthcare sorts of businesses?

我想問一下戰略資本配置。特別是，當您關注護理提供和基於價值的護理時，是否對此類計劃的優先級的更新感興趣？然後您將其視為更多的支持，並且可以通過 Evernorth 進行交叉銷售。或者這也可能成為您的 Medicare Advantage、Cigna Healthcare 等業務的驅動力？

It's David. Relative to the capital allocation and specifically coming to value-based care. And I want to, for a moment, just parse value-based care and care delivery ownership. As it relates to value-based care, we have a very longstanding commitment to and proven track record relative to value-based care. And for us, for starters, that means aligning incentives, leveraging clinical capabilities and working hand in glove with medical professionals to be able to deliver higher, more sustainable outcomes and value than otherwise can be done through a fee-for-service relationship.

是大衛。相對於資本配置，特別是基於價值的護理。我想暫時分析一下基於價值的護理和護理交付所有權。由於它與基於價值的護理有關，我們對基於價值的護理有著非常長期的承諾和可靠的記錄。對我們來說，對於初學者來說，這意味著調整激勵措施、利用臨床能力並與醫療專業人員攜手合作，以便能夠提供比通過按服務收費關係實現的更高、更可持續的結果和價值。

So today, we have a variety of programs underway with a little less than 50% of the overall equation in Commercial being in a value-based care or reward-based configuration, conversely approaching 75% in Medicare Advantage.

因此，今天，我們正在進行各種計劃，其中商業整體方程式的不到 50% 處於基於價值的護理或基於獎勵的配置中，相反，在 Medicare Advantage 中接近 75%。

As it relates to the contribution of that, we see that as contributing to the great medical cost performance that Brian made reference to several times during the call.

就其貢獻而言，我們認為這有助於提高布萊恩在電話會議中多次提到的醫療成本效益。

Now to your capital allocation and ownership configuration, our orientation continues to be, our preferred approach is to partner with and enable health care delivery systems for the way I just made reference to.

現在對於您的資本分配和所有權配置，我們的方向仍然是，我們的首選方法是與我剛才提到的方式合作並啟用醫療保健提供系統。

However, in addition to that, if in key geographies, we believe the way in which to deliver the sustained outcome and approach is to own physical delivery of care, we will own, but that will be a geographic configuration for physical ownership.

然而，除此之外，如果在關鍵地區，我們認為提供持續結果和方法的方式是擁有醫療服務的實體交付，我們將擁有，但這將是實體所有權的地理配置。

Added to that, and consistent, we seek to own care delivery assets that we believe are highly differentiated over the long term in terms of clinical capabilities as well as leverageable multi-geographic or nationally. What do I mean by that? Specialty Pharmaceutical, behavioral health care, virtual care delivery are great examples of that.

除此之外，我們始終如一地尋求擁有我們認為在臨床能力以及可利用的多地域或全國范圍內長期具有高度差異化的護理交付資產。我的意思是什麼？專業製藥、行為健康護理、虛擬護理服務就是很好的例子。

And Lance, going to the last part of your question, those services are more likely than not to be Evernorth Care capabilities that are offered to Cigna Healthcare Commercial or Medicare Advantage, but also offered to the open broad marketplace from that same point and customized to the needs of large stand-alone employers, integrated delivery systems and health plan clients.

Lance，關於你問題的最後一部分，這些服務很可能是提供給 Cigna Healthcare Commercial 或 Medicare Advantage 的 Evernorth Care 功能，但也從同一點提供給開放的廣闊市場並定制為大型獨立雇主、綜合交付系統和健康計劃客戶的需求。

So you should expect as those programs continue to grow, they will be Evernorth Care programs offered to Cigna Healthcare, but also offered broadly speaking, to the broad addressable market we have outside of Cigna Healthcare through Evernorth.

因此，您應該期望隨著這些計劃的繼續增長，它們將是提供給 Cigna Healthcare 的 Evernorth Care 計劃，但從廣義上講，也提供給我們通過 Evernorth 在 Cigna Healthcare 之外擁有的廣闊潛在市場。

And could you just comment on your CareAllies and Cigna Medical Group capabilities? Are those in Evernorth? And would those be kind of integrated in with these sorts of efforts? Or are those focused on something else?

您能否評論一下您的 CareAllies 和 Cigna Medical Group 的能力？那些在永北？這些會與這些努力相結合嗎？還是那些專注於其他事情的人？

Yes. It's great and credit to sneak a follow-on there. So take the second part of your piece, Cigna Medical Group is now Evernorth Care. It's an Evernorth Medical Group, it's rebranded as Evernorth, so it's the actions and the words line up from that standpoint.

是的。在那裡偷偷摸摸地跟進真是太好了。所以拿你文章的第二部分，信諾醫療集團現在是 Evernorth Care。這是一個 Evernorth 醫療集團，它被重新命名為 Evernorth，所以從這個角度來看，行動和言語都是一致的。

CareAllies remains currently focused intensely on the Cigna Healthcare portion in the Medicare Advantage portion and the value-based care relationships within our Medicare Advantage are currently in support of the MA only. So two different postures given the gestation of those programs, but the Cigna Medical Group is fully functioning as part of the Evernorth Care platform today.

CareAllies 目前仍高度關注 Medicare Advantage 部分中的 Cigna Healthcare 部分，我們的 Medicare Advantage 中基於價值的護理關係目前僅支持 MA。因此，考慮到這些計劃的醞釀，有兩種不同的姿態，但 Cigna 醫療集團今天作為 Evernorth Care 平台的一部分充分發揮了作用。

Our next question comes from Mr. George Hill with Deutsche Bank.

我們的下一個問題來自德意志銀行的 George Hill 先生。

Yes. David, most of my questions have kind of been answered. I guess I would come back to the Evernorth segment and focus on the pharmacy network relationships. I guess I would ask, is there anything worth noting or any pressure points there as your pharmacy partners always seem to be under pressure and are looking for us to generate value? As it relates to pharmacy services or clinical value? So I guess just -- it seems like we've had stability in pharmacy network relationships for a while. Just wondering if there's anything there to talk about.

是的。大衛，我的大部分問題都得到了解答。我想我會回到 Evernorth 部門並專注於藥房網絡關係。我想我會問，那裡有什麼值得注意的地方或任何壓力點，因為您的藥房合作夥伴似乎總是處於壓力之下並希望我們創造價值？因為它與藥學服務或臨床價值有關？所以我想只是 - 似乎我們在藥房網絡關係中已經穩定了一段時間。只是想知道那裡有什麼可談的。

George, it's David. There's nothing unique I would call out. That doesn't mean it's -- nothing is happening. As you referenced, it's a dynamic environment. But there's nothing unique I would call out, and our team continues to work with our pharmacy partners to make sure we get the right balance of access, accessibility, obviously, servicing clinical quality and affordability for our clients and our patients and customers. But no unique pattern or tension point or formation I would call out.

喬治，是大衛。我沒有什麼特別的。這並不意味著它 - 什麼都沒有發生。正如您所提到的，它是一個動態環境。但我沒有什麼特別的，我們的團隊繼續與我們的藥房合作夥伴合作，以確保我們在訪問、可訪問性、顯然為我們的客戶、我們的患者和客戶提供臨床質量和負擔能力之間取得適當的平衡。但我沒有提到任何獨特的模式、張力點或陣型。

Our last question comes from Mr. Ben Hendrix with RBC Capital Markets.

我們的最後一個問題來自 RBC Capital Markets 的 Ben Hendrix 先生。

I was wondering to what degree the MLR favorability ex-prior year development is unique within your Commercial insured book? I guess I'm wondering if the drivers of that favorability that you noted are also being realized by your ASO customers to the same degree? And to what extent that's helping retention?

我想知道在您的商業保險賬簿中，MLR 前一年的優惠程度在多大程度上是獨一無二的？我想我想知道您提到的這種好感的驅動因素是否也被您的 ASO 客戶實現到相同程度？這在多大程度上有助於保留？

It's Brian. So as I think I mentioned in a prior question, the prior year development was not material to our results in the quarter. So you should kind of take that off of the list here in terms of considerations -- and the majority of the strength in the quarter in the medical care ratio was in the Commercial employer book of business, which, by definition, would be the risk-oriented products.

是布賴恩。因此，正如我認為我在之前的問題中提到的那樣，上一年的發展對我們本季度的業績並不重要。因此，就考慮因素而言，您應該將其從此處的列表中刪除-並且該季度醫療保健比率的大部分優勢都在商業雇主業務簿中，根據定義，這將是風險導向的產品。

To your point, there is extensibility to our self-funded clients of course, because the same programs that are in place for our risk book are also utilized by many of our ASO and self-funded clients and the affordability initiatives span the entire Cigna Healthcare segment in many instances.

就您的觀點而言，我們的自籌資金客戶當然具有可擴展性，因為我們的許多 ASO 和自籌資金客戶也使用了為我們的風險手冊制定的相同計劃，並且可負擔性計劃涵蓋了整個 Cigna Healthcare在許多情況下細分。

David, do you want to pick up on the traction with the marketplace?

大衛，你想抓住市場的牽引力嗎？

Just to reinforce the linkage you created, the favorability, yields, lower medical cost trend and therefore, better affordability for our clients and that is a positive contributor to both retention as well as our ability to get responsible rate increases. It's also importantly not only a contributor to retention, when we're able to validate the value we were able to deliver it puts us in a position to deepen relationships, so to broaden services from that standpoint. But the linkage you created was absolutely correct.

只是為了加強您創建的聯繫、好感度、收益、降低醫療成本的趨勢，從而為我們的客戶提供更好的負擔能力，這對保留率以及我們獲得負責任的費率增長的能力都是一個積極的貢獻。重要的是，它不僅有助於保留，當我們能夠驗證我們能夠交付的價值時，它使我們能夠加深關係，從而從這個角度擴大服務。但是您創建的鏈接是絕對正確的。

I will now turn the call back over to David Cordani for closing remarks.

我現在將把電話轉回給 David Cordani 以作結束髮言。

First, thanks for everybody for joining our call today. And just to reiterate a few pieces, we built good momentum through the first quarter and we carried into the second quarter, and therefore, we're confident in our ability to deliver our increased EPS outlook of at least $22.90 for 2022 as well as our increased revenue and customer growth outlook.

首先，感謝大家今天加入我們的電話會議。重申幾點，我們在第一季度建立了良好的勢頭，並進入了第二季度，因此，我們有信心實現 2022 年至少 22.90 美元的增長每股收益前景以及我們的增加收入和客戶增長前景。

Additionally, before I close, I want to just pause and recognize and express my personal appreciation to our more than 70,000 coworkers who demonstrate through their continued focus and dedication and support our ability to deliver for all those we have the privilege to serve for our customers, our clients, our patients, our partners and ultimately, to convert that for you, our shareholders. We look forward to talking to you again soon about how we continue to advance our mission of improving health, well-being and peace of mind of those we serve and our continued approach to make health care services and solutions more affordable, predictable and simple.

此外，在我結束之前，我想暫停一下，向我們的 70,000 多名同事表達我個人的謝意，他們通過持續的專注和奉獻來證明，並支持我們為我們有幸為客戶服務的所有人提供服務的能力、我們的客戶、我們的患者、我們的合作夥伴，並最終為您，我們的股東轉換。我們期待很快再次與您討論我們如何繼續推進我們的使命，即改善我們所服務的人的健康、福祉和內心的平靜，以及我們繼續致力於使醫療保健服務和解決方案更實惠、更可預測和更簡單。

Thanks, and have a great day.

謝謝，祝你有美好的一天。

Ladies and gentlemen, this concludes Cigna's second quarter 2022 results review.

女士們，先生們，Cigna 的 2022 年第二季度業績審查到此結束。

Cigna Investor Relations will be available to respond to additional questions shortly.

Cigna 投資者關係部將很快回復其他問題。

A recording of this conference will be available for 10 business days following this call. You may access the recorded conference by dialing (800) 934-9697 or (203) 369-3395. There is no pass code required for the replay. Thank you for participating. You will now disconnect.

本次會議的錄音將在本次電話會議後的 10 個工作日內提供。您可以撥打 (800) 934-9697 或 (203) 369-3395 訪問錄製的會議。重播不需要密碼。感謝您的參與。您現在將斷開連接。