Centene Corp (CNC) 2022 Q2 法說會逐字稿

Good day, and welcome to the Centene Corporation Second Quarter 2022 Earnings Conference Call. (Operator Instructions) Please note, today's event is being recorded. I would now like to turn the conference over to Jen Gilligan, Senior Vice President, Finance and Investor Relations. Please go ahead, ma'am.

美好的一天，歡迎參加 Centene Corporation 2022 年第二季度收益電話會議。 （操作員說明）請注意，今天的活動正在錄製中。我現在想將會議轉交給財務和投資者關係高級副總裁 Jen Gilligan。請繼續，女士。

Thank you, Rocco, and good morning, everyone. Thank you for joining us on our second quarter 2022 earnings results conference Call. Sarah London, Chief Executive Officer; Brent Layton, President and Chief Operating Officer; and Drew Asher, Executive Vice President and Chief Financial Officer of Centene, will host this morning's call, which also can be accessed through our website at centene.com.

謝謝你，Rocco，大家早上好。感謝您參加我們的 2022 年第二季度收益結果電話會議。莎拉倫敦，首席執行官； Brent Layton，總裁兼首席運營官； Centene 執行副總裁兼首席財務官 Drew Asher 將主持今天上午的電話會議，也可以通過我們的網站 centene.com 訪問該電話會議。

Any remarks that Centene may make about future expectations, plans and prospects constitute forward-looking statements for the purpose of the safe harbor provision under the Private Securities Litigation Reform Act of 1995.

Centene 可能對未來的預期、計劃和前景發表的任何評論均構成前瞻性陳述，以符合 1995 年《私人證券訴訟改革法案》下的安全港條款。

Actual results may differ materially from those indicated by those forward-looking statements as a result of various important factors including those discussed in Centene's most recent Form 10-K filed on February 22, 2022, and other public SEC filings. Centene anticipates that subsequent events and developments may cause its estimates to change.

由於各種重要因素，包括 Centene 於 2022 年 2 月 22 日提交的最新 10-K 表格和其他公開的 SEC 文件中討論的因素，實際結果可能與這些前瞻性陳述所表明的結果存在重大差異。 Centene 預計後續事件和發展可能會導致其估計發生變化。

While the company may elect to update these forward-looking statements at some point in the future, we specifically disclaim any obligation to do so. The call will also refer to certain non-GAAP measures.

雖然公司可能會選擇在未來某個時候更新這些前瞻性陳述，但我們明確表示不承擔任何這樣做的義務。電話會議還將提及某些非公認會計原則措施。

A reconciliation of these measures can be found in our second quarter 2022 press release, which is available on the company's website under the Investors section. Please mark your calendars for our next earnings conference call scheduled for October 25. With that, I would like to turn the call over to our CEO, Sarah London. Sarah?

這些措施的對賬可以在我們的 2022 年第二季度新聞稿中找到，該新聞稿可在公司網站的“投資者”部分下找到。請在您的日曆上標記我們定於 10 月 25 日舉行的下一次收益電話會議。因此，我想將電話轉給我們的首席執行官 Sarah London。莎拉？

Thanks, Jen, and thank you, everyone, for joining us this morning. Centene entered 2022 with a focus on value creation. As a reminder, value creation at Centene means becoming a better partner by simplifying and strengthening our operations. making it easier for our members and providers to work with us.

謝謝 Jen，謝謝大家今天早上加入我們。 Centene 進入 2022 年，專注於價值創造。提醒一下，在 Centene 創造價值意味著通過簡化和加強我們的運營來成為更好的合作夥伴。讓我們的會員和供應商更容易與我們合作。

It means focusing on our core business and leveraging trusted local relationships to fuel disciplined growth and it means allocating capital to innovation that delivers better outcomes. Value creation is not measured solely in earnings per share, but importantly, in the impact that we have on the members we serve and the communities we support.

這意味著專注於我們的核心業務並利用值得信賴的當地關係來推動有紀律的增長，這意味著將資金分配給能夠帶來更好成果的創新。價值創造不僅僅以每股收益來衡量，更重要的是，以我們對我們服務的成員和我們支持的社區的影響來衡量。

Over the last 6 months, our value creation program has gained momentum and scale with efforts that span our local health plans and enterprise-wide functions. At the same time, the team is executing well on our day-to-day objectives and doubling down on our work to define the long-term trajectory of the organization for 2025 and beyond with a focus on sustainable growth and market leadership.

在過去的 6 個月中，我們的價值創造計劃通過跨越我們當地的健康計劃和企業範圍內的職能的努力獲得了動力和規模。與此同時，該團隊在我們的日常目標上執行良好，並加倍努力確定組織 2025 年及以後的長期軌跡，重點是可持續增長和市場領導地位。

This morning, I'll provide headlines of our quarterly performance and cover a few more recent value creation updates. Before handing the call over to Brent for an update on product line performance, I'd also like to touch briefly on what I've observed over my first few months as CEO about Centene's ability to differentiate in the marketplace.

今天早上，我將提供我們季度業績的頭條新聞，並介紹一些最近的價值創造更新。在將電話轉給布倫特以獲取有關產品線性能的更新之前，我還想簡要談談我在擔任首席執行官的頭幾個月中觀察到的關於 Centene 在市場上的差異化能力。

Let's start with the quarter. Second quarter results were directly in line with the guidance we provided at our June Investor Day. Thoughtful product positioning across lines of business, initiatives to enhance medical management and a more balanced approach to capital allocation, all contributed to our strong first half performance, which provides an excellent foundation to build from as we look to the balance of the year.

讓我們從季度開始。第二季度業績直接符合我們在 6 月投資者日提供的指導。跨業務線的深思熟慮的產品定位、加強醫療管理的舉措以及更平衡的資本配置方法，都促成了我們上半年的強勁表現，為我們展望今年的平衡奠定了良好的基礎。

Today, we once again increased guidance with our full year adjusted EPS outlook now at $5.60 to $5.75, which represents a cumulative $0.20 increase since Q1.

今天，我們再次上調了全年調整後每股收益預期為 5.60 美元至 5.75 美元的指引，自第一季度以來累計增加了 0.20 美元。

You will hear more details about the quarter and this improved full year outlook from Drew shortly. On the value creation front, we are full steam ahead. You've now heard quite a bit about the Myriad in-flight initiatives Jim Murray and his team are tracking and supporting in close partnership with our business leaders.

您將很快聽到有關本季度的更多詳細信息以及德魯改進的全年展望。在價值創造方面，我們全力以赴。您現在已經聽說了很多關於無數飛行中的計劃 Jim Murray 和他的團隊正在與我們的業務領導密切合作跟踪和支持。

We continue to see solid progress on our operating model redesign efforts as well as our work to optimize key process-driven functions like quality and utilization management. Our plan to establish a pharmacy center of excellence across the health plans continues to advance and the PBM RFP process remains on track.

我們繼續看到我們的運營模式重新設計工作以及我們優化關鍵流程驅動功能（如質量和利用率管理）的工作取得了堅實的進展。我們在整個健康計劃中建立卓越藥房中心的計劃繼續推進，PBM RFP 流程仍在進行中。

In the handful of weeks since our June Investor Day, we completed the Panther divestiture, closing out another key milestone in our portfolio review work. As previously announced, a majority of the net proceeds from the sale will be used to repurchase stock and the balance to reduce debt.

自 6 月投資者日以來的幾週內，我們完成了 Panther 資產剝離，結束了我們投資組合審查工作的另一個重要里程碑。正如之前宣布的那樣，出售所得的大部分淨收益將用於回購股票，餘額將用於減少債務。

Yesterday, we announced another important portfolio action with the signing of a definitive agreement to divest our Spanish and Central European assets to Vivalto Santé,which is the third largest private hospital company in France. We believe the Vivalto Santé is well positioned to invest in and grow Ribera Salud, Torrejón and Pro Diagnostics group, while ensuring they continue to provide high-quality care for patients across Europe.

昨天，我們宣布了另一項重要的投資組合行動，簽署了一項最終協議，將我們的西班牙和中歐資產剝離給法國第三大私立醫院公司 Vivalto Santé。我們相信 Vivalto Santé 有能力投資和發展 Ribera Salud、Torrejón 和 Pro Diagnostics 集團，同時確保他們繼續為歐洲各地的患者提供高質量的護理。

Across the remainder of our non-health plan portfolio, the review process remains very active, and the team is leveraging our evolving long-term strategic framework to ensure that we position these assets either through investment, partnership or divestiture to deliver maximum strategic benefit moving forward.

在我們其餘的非健康計劃組合中，審查過程仍然非常活躍，團隊正在利用我們不斷發展的長期戰略框架來確保我們通過投資、合作或剝離來定位這些資產，以提供最大的戰略利益向前。

Consistent with our capital deployment plans, it is worth highlighting that we repurchased $450 million of our common stock since the beginning of Q2 and in part leveraging proceeds from other minor asset sales in the quarter. On the real estate front, we previously described the comprehensive exercise to evaluate our leased and owned real estate portfolio.

與我們的資本部署計劃一致，值得強調的是，自第二季度開始以來，我們回購了 4.5 億美元的普通股，並部分利用了本季度其他小型資產出售的收益。在房地產方面，我們之前描述了評估我們租賃和擁有的房地產投資組合的綜合練習。

Today, we took an important step towards the achievement of run rate savings related to that exercise, recognizing a charge reflecting a material reduction in the company's real estate footprint. This allows us to capture savings associated with the space rationalization beginning in Q3. We continue to expect approximately $200 million of run rate savings for 2023 and beyond.

今天，我們朝著實現與該活動相關的運行率節省邁出了重要的一步，確認了一項反映公司房地產足跡實質性減少的費用。這使我們能夠從第三季度開始獲得與空間合理化相關的節省。我們繼續預計 2023 年及以後的運行率將節省約 2 億美元。

This initiative reflects the high value we place on evolving Centene to meet the needs of our incredible workforce, but it should also serve as a proof point that we will look to pull forward the benefits of our work wherever possible as we progress on this value creation journey.

這一舉措反映了我們對不斷發展的 Centene 以滿足我們令人難以置信的員工需求的高度重視，但它也應該作為一個證明點，即我們將在創造價值的過程中盡可能地推動我們工作的好處旅行。

As you can see, value creation work streams are delivering tangible progress and measurable results. As we move into the second half of the year, we will continue to provide updates on major operational milestones in keeping with our commitment to transparency and to prove that we are building the momentum necessary to carry us through the rest of this year and help us deliver meaningful financial results in 2023 and 2024.

如您所見，價值創造工作流正在帶來切實的進步和可衡量的結果。隨著我們進入下半年，我們將繼續提供有關主要運營里程碑的最新信息，以履行我們對透明度的承諾，並證明我們正在建立必要的勢頭，以幫助我們度過今年餘下的時間並幫助我們在 2023 年和 2024 年實現有意義的財務業績。

Centene's ability to grow, deliver and transform all at the same time is made possible by our most valuable asset, our 80,000 diverse and innovative employees. Their mission-driven dedication to our members powers everything we do in this organization. I've spent quite a bit of time on the actual and virtual road since taking on this new role, meeting with our health plan leaders renewing connections with our key state partners and listening to team members at the front lines of our market operations.

Centene 能夠同時發展、交付和轉型的能力得益於我們最寶貴的資產——我們 80,000 名多元化和創新的員工。他們對我們成員的使命驅動的奉獻為我們在這個組織中所做的一切提供了動力。自從擔任這個新角色以來，我在實際和虛擬道路上花費了相當多的時間，與我們的健康計劃負責人會面，與我們的主要州合作夥伴重新建立聯繫，並聽取我們市場運營前線的團隊成員的意見。

And I want to report back to you that my conviction regarding the power of Centene's local approach has never been greater. Local matters when it comes to growth as our unparalleled business development team improved yet again with the recent win in the state of Delaware.

我想向您報告，我對 Centene 本地方法的力量的信念從未如此強烈。由於我們無與倫比的業務開發團隊最近在特拉華州獲勝，因此在增長方面當地很重要。

Years of boots on the ground, personal visits, relationship building and deep market knowledge were key to securing a contract award in Centene's 30th Medicaid State. Local makes the difference when it comes to outsized impact, as I saw on my visit to our Silver Summit Health Plan in Nevada.

多年的實地考察、個人訪問、建立關係和深入的市場知識是在 Centene 的第 30 個 Medicaid 州獲得合同授予的關鍵。正如我在訪問內華達州的 Silver Summit 健康計劃時所看到的那樣，當地在產生巨大影響時會有所作為。

There, team members realized how many of our new mothers didn't have access to transportation and so they partner with an organization called Baby's Bounty to create a diaper van that could deliver baby essentials, diapers and wipes directly to Southern Nevada's tiniest and most vulnerable residents.

在那裡，團隊成員意識到我們有多少新媽媽無法使用交通工具，因此他們與一個名為 Baby's Bounty 的組織合作創建了一輛尿布車，可以將嬰兒必需品、尿布和濕巾直接運送到內華達州南部最小和最脆弱的地區居民。

Local also makes a difference when it comes to innovation as I experienced firsthand on a recent trip to New Hampshire. Combating the effect of rapidly rising food prices and knowing the risk food and security presents to our Medicaid members, our team at New Hampshire Healthy Families jump started their green to go program, distributing locally sourced fruits and vegetables from food vans strategically positioned across the Granite State.

正如我最近一次去新罕布什爾州旅行時親身體驗的那樣，當地在創新方面也有所作為。為了應對食品價格快速上漲的影響，並了解食品和安全給我們的醫療補助成員帶來的風險，我們在新罕布什爾州健康家庭的團隊開始了他們的綠色出行計劃，從戰略性地定位在花崗岩的食品車上分發當地採購的水果和蔬菜狀態。

So let me tell you where local really makes a difference. Local makes a difference when it comes to caring, the kind of deep personal caring that comes when your customer is also your neighbor. On May 14, when shots rang out in the aisles of a neighborhood grocery store in Downtown Buffalo, our extraordinary colleagues at Fidelis Care in New York State sprang into action. No one from headquarters had to call them and tell them what to do.

因此，讓我告訴您本地真正與眾不同的地方。在關懷方面，當地人會有所作為，當您的客戶也是您的鄰居時，這種深層的個人關懷就會出現。 5 月 14 日，當布法羅市中心附近一家雜貨店的過道裡響起槍聲時，我們在紐約州 Fidelis Care 的非凡同事立即採取了行動。總部沒有人必須打電話給他們並告訴他們該怎麼做。

They knew what to do because they were there inside the community because they were local. Within 24 hours, Fidelis employees mobilized to distribute food and needed supplies into a community whose only grocery store was surrounded in police tape. And with the neighborhood pharmacy inside that top grocery store suddenly closed, our locally based team identified and called every one of the 373 members who had filled their prescriptions at that pharmacy in recent months.

他們知道該做什麼，因為他們在社區內，因為他們是本地人。在 24 小時內，Fidelis 員工動員起來，將食物和所需用品分發到一個社區，該社區唯一的雜貨店被警戒線包圍。隨著那家頂級雜貨店內的附近藥房突然關門，我們當地的團隊確定並打電話給最近幾個月在該藥房配藥的 373 名成員中的每一位。

Within 72 hours, each of those 373 members received a personal call from a Fidelis Care employee checking in on them. Assuring their supply of medication was in order and assisting them in identifying additional pharmacy resources in the area. Neighbors engaging in simple but profound acts of human caring. That's the power of local.

在 72 小時內，這 373 名成員中的每一個都接到了 Fidelis Care 員工的個人電話，他們正在檢查他們。確保他們的藥物供應井然有序，並幫助他們確定該地區的其他藥房資源。鄰居們從事簡單而深刻的人文關懷行為。這就是當地的力量。

We are proud of the progress and the financial performance of Centene year-to-date, and we are proud of the work that our team members do every day. Value creation for members leads to value creation for shareholders, and we will continue to focus on this alignment in the coming months and years as we execute on both value creation and our long-term strategic plan for 2025 and beyond.

我們為 Centene 年初至今的進步和財務業績感到自豪，我們為團隊成員每天所做的工作感到自豪。為會員創造價值會為股東創造價值，我們將在未來幾個月和幾年內繼續關注這種一致性，因為我們將執行價值創造和 2025 年及以後的長期戰略計劃。

With that, I'd like to pass the call to Brent for more detail on our core business line performance during the quarter. Brent?

有了這個，我想將電話轉給布倫特，以獲取有關本季度核心業務線業績的更多詳細信息。布倫特？

Thank you, Sarah, and good morning. I'm happy to talk about the performance of our core business lines during the second quarter. Centene is the leader in Medicaid Managed Care, and I'm pleased to say we continue to grow.

謝謝你，莎拉，早上好。我很高興談論我們核心業務線在第二季度的表現。 Centene 是 Medicaid 管理式護理的領導者，我很高興地說我們繼續成長。

Earlier this month, we were honored to be notified by the state of Delaware of an intent to award Centene contract to serve a Statewide Medicaid Managed Care program. Beginning January 1, 2023, Centene's health plan, Delaware First Health, will provide integrated services for physical and behavioral health and long-term services and supports through the Diamond State Health Plan and Diamond State Health Plan Plus programs.

本月早些時候，我們很榮幸地收到特拉華州的通知，表示有意授予 Centene 合同以服務於全州的醫療補助管理式護理計劃。從 2023 年 1 月 1 日開始，Centene 的健康計劃 Delaware First Health 將通過 Diamond State Health Plan 和 Diamond State Health Plan Plus 計劃為身體和行為健康以及長期服務和支持提供綜合服務。

This is Centene's 30th Medicaid state. It's quite an achievement, and we look forward to this tremendous opportunity in Delaware. In addition to our new estate, earlier in the quarter, we were successful in the reprocurement of our Missouri contract serving TANF, CHIP and Expansion membership. We were also awarded the sole source specialty plant for children and foster care in Missouri. These contracts began July 1, and we're serving nearly 50,000 foster children and children receive an adoption subsea assistance in the state.

這是 Centene 的第 30 個醫療補助州。這是一項了不起的成就，我們期待在特拉華州獲得這個巨大的機會。除了我們的新資產之外，在本季度早些時候，我們還成功地重新採購了我們為 TANF、CHIP 和擴展會員服務的密蘇里合同。我們還被授予密蘇里州兒童和寄養的唯一來源專業植物。這些合同於 7 月 1 日開始，我們正在為該州近 50,000 名寄養兒童和兒童提供收養海底援助。

This is our industry-leading fifth sole source and specialty contract serving children and young adults involved with the Child Welfare System. We are incredibly proud of our innovative programs and outcomes for this membership. In our existing Medicaid membership has increased to 15.4 million members at the end of the second quarter.

這是我們行業領先的第五個唯一來源和專業合同，為參與兒童福利系統的兒童和年輕人提供服務。我們為該會員的創新計劃和成果感到無比自豪。到第二季度末，我們現有的 Medicaid 會員已增加到 1540 萬。

Medicaid growth continues to be aided by the ongoing suspension of eligibility redeterminations. As you're all aware, that PHE is now extended to at least mid-October. As states consider their programs and budgetary needs post redetermination, several states beginning to process to transition new populations into managed care.

資格重新確定的持續暫停繼續有助於醫療補助的增長。眾所周知，PHE 現在至少延長到 10 月中旬。隨著各州在重新確定後考慮其計劃和預算需求，一些州開始著手將新人口過渡到管理式醫療。

The state of Indiana has recently released an RFP for long-term services and supports, and we have recently responded to an RFI in Georgia, where the Medicaid agencies asking MCOs about their ability to serve more medically complex populations. Whenever the PHE comes to a close, we'll continue to work with our state partners to support member transition.

印第安納州最近發布了一份關於長期服務和支持的 RFP，我們最近回應了佐治亞州的一個 RFI，醫療補助機構詢問 MCO 是否有能力為更複雜的醫療人群提供服務。每當 PHE 結束時，我們將繼續與我們的州合作夥伴合作，以支持成員過渡。

We remain confident in our ability to attract eligible membership to our marketplace products in 25 states where we have both Medicaid and Exchange Membership. Speaking of our exchange product, we entered the quarter at over 2 million members. Halfway through 2022, we remain the leader in the marketplace product.

我們仍然有能力在我們擁有醫療補助和交換會員資格的 25 個州吸引符合條件的會員加入我們的市場產品。說到我們的交換產品，我們在本季度擁有超過 200 萬會員。到 2022 年中途，我們仍然是市場產品的領導者。

The quality and consistency of our product offerings and operations has led to continued membership growth and the ability to partner closely with our providers. We continue to monitor the situation in Washington, in regards to enhance advanced premium tax credits and remain cautiously optimistic on the movements of this reconciliation bill.

我們產品和運營的質量和一致性導致會員人數持續增長，並能夠與我們的供應商密切合作。我們將繼續關注華盛頓的情況，以提高預付保費稅收抵免，並對這項和解法案的動向保持謹慎樂觀。

We feel confident in our submitted bids for 2023, and we look forward to targeted geographic expansion and thoughtful expansion of new products that we began to offer in 2022 open enrollment. In Medicare, we ended the quarter at nearly 1.5 million members and are pleased with our continued membership growth of over 18% year-to-date.

我們對 2023 年提交的投標充滿信心，我們期待在 2022 年公開招生中開始提供有針對性的地域擴張和深思熟慮的新產品擴展。在 Medicare，我們在本季度結束時擁有近 150 萬會員，並對我們今年迄今會員人數持續增長超過 18% 感到滿意。

Utilization continues to be steady, and we're seeing the benefit of our focused clinical initiatives. As we look towards annual enrollment, we are concentrated on margin and network expansion and the further penetration of existing states and markets. We continue to see Dulles as an area of growth for our company as our core capabilities position us well to serve this complex population.

利用率繼續保持穩定，我們看到了重點臨床計劃的好處。當我們展望年度招生時，我們專注於利潤和網絡擴張以及現有州和市場的進一步滲透。我們繼續將杜勒斯視為我們公司的一個增長領域，因為我們的核心能力使我們能夠很好地服務於這個複雜的人群。

Midway through 2022, our core products continue to perform well. With that, let me turn the call over to Drew.

到 2022 年中期，我們的核心產品繼續表現良好。有了這個，讓我把電話轉給德魯。

Thank you, Brent. This morning, we reported second quarter 2022 results of $35.9 billion in total revenue, an increase of 16% compared to the second quarter of 2021 and 11% was organic with 5% from M&A.

謝謝你，布倫特。今天上午，我們報告了 2022 年第二季度的總收入為 359 億美元，與 2021 年第二季度相比增長了 16%，其中 11% 是有機的，其中 5% 來自併購。

We reported adjusted diluted earnings per share of $1.77 in the quarter, up 42% from $1.25 in Q2 of 2021. Overall, I'd characterize this as a strong quarter consistent with the update we provided to you at Investor Day on June 17. Let's start with revenue for the quarter.

我們報告本季度調整後的稀釋後每股收益為 1.77 美元，比 2021 年第二季度的 1.25 美元增長 42%。總體而言，我認為這是一個強勁的季度，與我們在 6 月 17 日投資者日向您提供的更新一致。讓我們從本季度的收入開始。

Total revenue grew by $4.9 billion compared to the second quarter of 2021, driven by strong organic growth throughout the last year in Medicaid, primarily due to the ongoing suspension of eligibility redeterminations, strong Medicare membership growth during the annual enrollment period, the acquisitions of Magellan and Circle and the commencement of contracts in North Carolina.

與 2021 年第二季度相比，總收入增長了 49 億美元，這主要是由於去年醫療補助的強勁有機增長，主要是由於資格重新確定的持續暫停、年度註冊期間醫療保險會員的強勁增長、麥哲倫的收購和 Circle 以及在北卡羅來納州的合同開始。

Total membership increased to 26.4 million, up 7% compared to a year ago. Our Q2 consolidated HBR was 86.7%, and Medicaid at 89.1% was a little better than expectations. Medicare at 85.6% was right on track and our commercial business continued to make progress toward our margin goals aided by the results of risk adjustment, which in Marketplace is zero-sum across the industry and tends to settle out pretty quickly in the following year.

會員總數增至 2640 萬，比一年前增長 7%。我們第二季度的綜合 HBR 為 86.7%，醫療補助為 89.1%，略好於預期。 85.6% 的醫療保險走上正軌，在風險調整結果的幫助下，我們的商業業務繼續朝著我們的利潤率目標取得進展，在 Marketplace 中，風險調整是整個行業的零和交易，並且往往會在第二年很快解決。

Given the risk adjustment headwind we experienced in Q2 of 2021, we expected a big year-over-year improvement in HBR, and we got more than we expected. The commercial HBR of 77.5% improved 1,250 basis points year-over-year, also driven by pricing actions and a return to more normalized utilization compared to the second quarter of 2021.

鑑於我們在 2021 年第二季度遇到的風險調整逆風，我們預計 HBR 將同比大幅改善，而且我們獲得的收益超出了我們的預期。商業 HBR 為 77.5%，同比提高 1,250 個基點，這也受到定價行動和與 2021 年第二季度相比恢復更加正常化的利用率的推動。

When we look at our consolidated data, our Q2 COVID costs were down about 2/3 from Q1, which included the Omicron variant. Utilization has largely returned to a more normalized cadence as we have encouraged and facilitated our members to access health care, including preventative care.

當我們查看合併數據時，我們的第二季度 COVID 成本比第一季度下降了約 2/3，其中包括 Omicron 變體。由於我們鼓勵並幫助我們的會員獲得包括預防性護理在內的醫療保健服務，使用率已在很大程度上恢復到更加正常的節奏。

Furthermore, throughout 2022, providers seem to be more resilient to managing COVID and non-COVID simultaneously. There's still a few areas that appear to be suppressed compared to 2019 and such as non-emergent ER visits, we believe Telehealth and improved primary care connectivity have played a role here.

此外，在整個 2022 年，供應商似乎更有彈性地同時管理 COVID 和非 COVID。與 2019 年相比，仍有一些領域似乎受到抑制，例如非緊急急診就診，我們認為遠程醫療和改善的初級保健連通性在這裡發揮了作用。

Moving to other P&L and balance sheet items. Our adjusted SG&A expense ratio was 8.2% in the second quarter compared to 7.3% last year. On a combined basis, the inclusion of Magellan and Circle increased the ratio by approximately 40 basis points compared to the year ago quarter. Additionally, we incurred increased risk adjustment and member engagement costs that accompany the commercial HBR outperformance, higher Medicare broker commissions as we continue to grow and increased variable compensation.

轉到其他損益表和資產負債表項目。我們第二季度調整後的 SG&A 費用率為 8.2%，而去年為 7.3%。與去年同期相比，麥哲倫和 Circle 的合併使該比率增加了約 40 個基點。此外，隨著商業 HBR 的出色表現、更高的醫療保險經紀人佣金（隨著我們的持續增長和可變薪酬的增加），我們產生了更高的風險調整和會員參與成本。

We expect our value creation plan to drive SG&A lower over the next few years, though there will be ROI-based investments along the way. On the topic of the value creation plan, during the second quarter of 2022, we recorded an impairment charge of $1.45 billion related to the reduction in the company's real estate footprint consisting of $744 million related to leased real estate and $706 million related to owned real estate assets.

我們預計我們的價值創造計劃將在未來幾年降低 SG&A，儘管在此過程中會有基於 ROI 的投資。關於價值創造計劃，在 2022 年第二季度，我們記錄了與公司房地產足跡減少相關的 14.5 億美元減值費用，其中包括與租賃房地產相關的 7.44 億美元和與自有房地產相關的 7.06 億美元不動產資產。

This was the lion's share of the charge we discussed at Investor Day in June with approximately $200 million more expected to come over the next couple of quarters related to real estate optimization. Cash flow provided by operations was very strong at $3.4 billion in the second quarter, primarily driven by earnings before the real estate charge and a reduction in receivables partially due to the receipt of state directed payments.

這是我們在 6 月投資者日討論的費用的最大份額，預計未來幾個季度與房地產優化相關的費用將增加約 2 億美元。第二季度運營提供的現金流非常強勁，達到 34 億美元，這主要是由於扣除房地產費用之前的收益以及部分由於收到國家指示的付款而導致的應收賬款減少。

Our domestic unregulated and unrestricted cash on hand at quarter end was $483 million. During the second quarter, we repurchased $344 million of our common stock through our share repurchase program. As a result of the value creation plan year-to-date, we have repurchased $450 million including $106 million executed in July.

季度末，我們手頭的國內不受監管和不受限制的現金為 4.83 億美元。在第二季度，我們通過股票回購計劃回購了 3.44 億美元的普通股。由於年初至今的價值創造計劃，我們已經回購了 4.5 億美元，其中包括 7 月份執行的 1.06 億美元。

Furthermore, on July 14, we completed the divestiture of Panther and expect to recognize an after-tax gain of approximately $400 million in Q3. The majority of the net proceeds of approximately $1.3 billion will be used to repurchase stock and reduce debt as mentioned earlier by Sarah.

此外，在 7 月 14 日，我們完成了對 Panther 的剝離，預計第三季度將獲得約 4 億美元的稅後收益。正如莎拉之前提到的，大約 13 億美元的大部分淨收益將用於回購股票和減少債務。

We are working to close the Magellan Rx transaction by the end of the year. Estimated net deployable proceeds on that transaction would be in the zone of $1.1 billion. And we were pleased to announce the sale of a few of our international businesses yesterday. Debt at quarter end was relatively flat at $18.8 billion. Our debt-to-cap ratio was 41.3%, temporarily pushed up from the real estate charge.

我們正在努力在今年年底前完成 Magellan Rx 交易。該交易的估計可部署淨收益將在 11 億美元左右。昨天我們很高興地宣佈出售我們的一些國際業務。季度末的債務相對持平，為 188 億美元。我們的債務與上限比率為 41.3%，暫時受房地產費用推高。

We continue to target a high 30s debt-to-capitalization ratio longer term. Our debt to adjusted EBITDA came in at 3.1x pretty close to the milestone we are seeking of 3x or less. Our medical claims liability totaled $16.6 billion at quarter end and represents 55 days in claims payable compared to 53 in Q1 of 2022 and 48 in Q2 of 2021.

我們繼續將長期目標定為 30 年代的高債務資本化比率。我們對調整後 EBITDA 的債務為 3.1 倍，非常接近我們正在尋求的 3 倍或更低的里程碑。截至季度末，我們的醫療索賠負債總額為 166 億美元，應付索賠天數為 55 天，而 2022 年第一季度為 53 天，2021 年第二季度為 48 天。

The sequential increase was largely driven by the timing of pharmacy payments and state-directed payments received but not yet paid. As a reminder, on June 17, we lifted our adjusted EPS range by $0.15 to a range of $5.55 to $5.70 million Today, we're adding another $0.05 to guide to a range of $5.60 to $5.75, largely driven by some of the real estate benefit to be realized in the back half of the year net of some investment spending, such as the Delaware win.

環比增長主要是由藥房支付的時間和收到但尚未支付的國家指示支付的時間推動的。提醒一下，在 6 月 17 日，我們將調整後的每股收益範圍上調了 0.15 美元，至 5.55 至 570 萬美元的範圍。今天，我們又增加了 0.05 美元，以引導至 5.60 至 5.75 美元的範圍，主要受一些房地產的推動扣除一些投資支出後，下半年將實現收益，例如特拉華州獲勝。

In aggregate, since issuing initial 2022 guidance in December, we have increased our full year adjusted EPS outlook by $0.28 or 5% at the midpoint. GAAP EPS guidance has been adjusted to reflect the real estate charge and the gain on the sale of Panther. We've also updated the components of guidance, and I know some of you have models to build, so let me touch on some of the other P&L metrics.

總體而言，自 12 月發布 2022 年初始指引以來，我們已將全年調整後每股收益展望中值提高了 0.28 美元或 5%。 GAAP EPS 指導已進行調整，以反映房地產費用和出售 Panther 的收益。我們還更新了指南的組成部分，我知道你們中的一些人需要建立模型，所以讓我談談其他一些損益指標。

Full year premium and service revenue is down $1 billion in cost of services is down approximately 100 basis points due to the divestiture of Panther. We also adjusted our share count and expect interest expense around $660 million, factoring in the deployment of Panther proceeds. We have ticked down HBR by 10 basis points to reflect performance in Q2 and have lifted adjusted SG&A by 20 basis points.

由於 Panther 的剝離，全年保費和服務收入下降了 10 億美元，服務成本下降了約 100 個基點。我們還調整了我們的股票數量，預計利息支出約為 6.6 億美元，其中包括 Panther 收益的部署。我們已將 HBR 下調 10 個基點以反映第二季度的表現，並將調整後的 SG&A 上調 20 個基點。

Approximately 1/3 of that lift is due to Panther, which had a high cost of services ratio but a very low SG&A rate. The remainder reflects the SG&A items I mentioned earlier, slightly offset by the $0.05 net SG&A benefit and guidance. For the full year, we would expect investment in other income in the zone of $400 million excluding the Panther gain and depreciation in the low to mid-600s, and we still assume a November 1 commencement of redeterminations and guidance.

大約 1/3 的提升歸功於 Panther，它的服務成本比率很高，但 SG&A 率非常低。其餘部分反映了我之前提到的 SG&A 項目，略微被 0.05 美元的淨 SG&A 收益和指導所抵消。對於全年，我們預計對其他收入的投資在 4 億美元左右，不包括 Panther 收益和 600 年代中期的折舊，我們仍然假設 11 月 1 日開始重新確定和指導。

Overall, I'm pleased with the tangible results we are showing today, both in terms of performance and value creation. But to be balanced, there are areas that we still need meaningful improvement such as Medicare Stars. Though we have referenced this multiple times, we want to make sure we are explicitly transparent.

總的來說，我對我們今天在績效和價值創造方面所展示的切實成果感到滿意。但為了平衡，有些領域我們仍然需要有意義的改進，例如醫療保險之星。儘管我們已經多次引用了這一點，但我們希望確保我們是明確透明的。

The Star scores that come out in the fall of 2022, and called rating year 2023 Star scores that drive 2024 Medicare revenue are going to be disappointing and unacceptable to this management team. At Investor Day, June -- Investor Day in June, Sarah touched on the why. We've been rebuilding governance fortifying operational areas and making the appropriate investments in people, process and technology over the past 9 months, and that will continue.

2022 年秋季公佈的星級評分，以及推動 2024 年醫療保險收入的 2023 年星級評分，對於這個管理團隊來說將是令人失望和無法接受的。在六月的投資者日——六月的投資者日，莎拉談到了原因。在過去的 9 個月裡，我們一直在重建治理以加強運營領域，並對人員、流程和技術進行適當的投資，而且這種情況將繼續下去。

Execution in 2022 will drive Star scores to be released in the fall of 2023, which drive 2025 revenue, and we expect will create a meaningful rebound from the rating year 2023 Star scores. The senior management team and value creation plan are all over this. While we've made great progress in the first half of this year, this company has plenty of opportunity to improve which will create long-term value for our members, providers, state and federal customers and shareholders.

2022 年的執行將推動 Star 分數在 2023 年秋季發布，從而推動 2025 年的收入，我們預計將從 2023 年的 Star 分數評級產生有意義的反彈。高級管理團隊和價值創造計劃都在這上面。雖然我們在今年上半年取得了很大進展，但這家公司還有很多改進的機會，這將為我們的會員、供應商、州和聯邦客戶和股東創造長期價值。

That's what we're excited about. Our journey is on track, and thank you for being part of it. Operator, you may now open the line for questions.

這就是我們感到興奮的地方。我們的旅程步入正軌，感謝您參與其中。接線員，您現在可以打開線路提問。

(Operator Instructions) Today's first question comes from Josh Raskin with Nephron Research.

（操作員說明）今天的第一個問題來自 Nephron Research 的 Josh Raskin。

I wanted to stay on Medicare Advantage where you ended up, Drew. And if I look at it, your revenues are up. I know you've got a bunch of products in there, but I'm guessing MA is probably up in the low 30% range. The MLR is down I think, about 150 basis points for the first half of the year, and that can be atypical.

德魯，我想留在你最後的Medicare Advantage。如果我看一下，你的收入就會增加。我知道你那裡有很多產品，但我猜 MA 可能在 30% 的低位範圍內。我認為 MLR 下降了，上半年大約下降了 150 個基點，這可能是非典型的。

So I'm curious, what do you think is driving the MLR improvement, especially when a quarter of the book is new members, what metrics are you watching more closely to confirm that MLR? And then lastly, is 2023 still a year where you're targeting further MA margin improvement? Or are you getting some of that this year already?

所以我很好奇，你認為是什麼推動了 MLR 的改進，特別是當本書的四分之一是新成員時，你更密切關注哪些指標來確認 MLR？最後，2023 年是否仍然是您希望進一步提高 MA 利潤率的一年？或者你今年已經得到了一些？

Yes, Josh, thanks for the question. I'd say probably the lion's share of the improvement in what we disclose as Medicare HBR is actually in our PDP business. Though, to your point, the Medicare Advantage book is doing a little bit better year-over-year. We priced -- or the company priced 2022, for stability in HBR back when those bids were filed right around June of 2021.

是的，喬希，謝謝你的問題。我想說的是，我們披露的醫療保險 HBR 的大部分改進實際上是在我們的 PDP 業務中。不過，就您而言，Medicare Advantage 這本書的表現逐年好一些。當這些投標在 2021 年 6 月左右提交時，我們定價 - 或公司定價 2022 年，以確保 HBR 的穩定性。

But for 2023, we expect a meaningful move in margin expansion. We actually have Stars revenue in 2023. And we're going to balance that with more modest growth. You heard Brent at Investor Day mentioned low to mid-single digits. Medicare Advantage growth, which, quite frankly, I think is a good balance when you're pushing margin going into 2023. And then obviously, 2024, we've got a headwind to contend with that we have to think through the structure of the bids for that year with a recovery in Star scores in 2025.

但對於 2023 年，我們預計利潤率將出現有意義的增長。我們實際上在 2023 年有 Stars 收入。我們將通過更適度的增長來平衡這一點。您在投資者日聽到布倫特原油提到低到中個位數。 Medicare Advantage 增長，坦率地說，我認為當您將利潤率推向 2023 年時，這是一個很好的平衡。然後很明顯，到 2024 年，我們有一個逆風要應對，我們必須仔細考慮2025 年的星級評分有所回升。

That all makes sense. But just the PDP business, I'm assuming is roughly 1/10 the size of your MA book, just from a revenue perspective. So were we talking about over about 1,000 basis points of PDP improvement? Is it that big? Is that what we're looking at?

這一切都說得通。但僅從收入的角度來看，我假設僅 PDP 業務大約是您的 MA 書籍的 1/10。那麼我們是在談論超過 1,000 個基點的 PDP 改進嗎？有那麼大嗎？這就是我們正在看的嗎？

PDP is doing quite well. There is -- some of this coming from Medicare Advantage and its clinical initiatives. The metrics we look at, we're -- Jim Murray mentioned this at Investor Day, sort of having dashboards that enable you to react and execute.

PDP 做得很好。其中有一些來自 Medicare Advantage 及其臨床計劃。我們查看的指標是——Jim Murray 在投資者日提到了這一點，有點像儀表板，可以讓你做出反應和執行。

I mean, that's something we've we're not yet at where we want to be, but we've gotten a lot better at that. And connecting organized clinical initiatives from a centralized body across our health plans and then tracking the cost benefit of those initiatives, that's also something that we've gotten better at over the past, call it, 9 or 12 months.

我的意思是，我們還沒有達到我們想要的目標，但我們已經做得更好了。並將來自一個集中機構的有組織的臨床計劃與我們的健康計劃聯繫起來，然後跟踪這些計劃的成本效益，這也是我們過去做得更好的事情，稱之為 9 或 12 個月。

Our next question today comes from A.J. Rice from Crédit Suisse.

我們今天的下一個問題來自 A.J.瑞士信貸大米。

Hello, everybody. Maybe I'll just ask a similar question but directed toward the marketplace, public exchanges. I know this quarter, the reported MLR looks quite low, but I think that's getting benefit from the risk adjustment true-up. Can you just give us a flavor for where you're at, you think, this year in your margin and your normalized HBR.

大家好。也許我會問一個類似的問題，但直接針對市場，公共交易所。我知道本季度報告的 MLR 看起來很低，但我認為這得益於風險調整的修正。你能不能告訴我們你在哪裡，你認為，今年你的利潤和你的標準化 HBR。

And then is this a jumping off point that's sustainable? Do you think you'll give some of that back next year? How do you think about the long-term trajectory of the margins on the exchanges.

那麼這是一個可持續的起點嗎？你認為明年你會回饋一些嗎？您如何看待交易所保證金的長期軌跡。

Yes. I mean I'm really pleased with the execution around member engagement, physician engagement sort of risk adjustment process, which is a lot of nuts and bolts execution. And so that's something I think we can carry forward into future periods and continue to leverage better execution. We're not quite at the stated pretax goal of 5% to 7.5% in marketplace this year, and we expect to push into that next year as we look at the momentum we have in execution and financially and then think about sort of the right pricing and making sure we maintain competitiveness, sort of balancing all those things as we submitted the bids for next year.

是的。我的意思是我對圍繞會員參與、醫生參與和風險調整過程的執行感到非常滿意，這是很多具體細節的執行。所以這就是我認為我們可以延續到未來時期並繼續利用更好的執行力的東西。今年我們還沒有達到既定的 5% 到 7.5% 的稅前目標，我們預計明年會推進這一目標，因為我們會審視我們在執行和財務方面的勢頭，然後考慮正確的選擇定價並確保我們保持競爭力，在我們提交明年的投標時平衡所有這些事情。

So we expect a little bit of an advancement in margins even with the improved performance in Q2.

因此，即使第二季度的業績有所改善，我們也預計利潤率會有所提高。

Our next question comes from Matthew Borsch at BMO Capital Markets.

我們的下一個問題來自 BMO Capital Markets 的 Matthew Borsch。

Yes. I was hoping you could maybe just give us another walk through as you see it today on 2023. I know you're not guiding yet, but can you talk about your latest thinking in terms of what you're seeing as headwinds and tailwinds going into next year, you're obviously looking at few areas of margin improvement that you've made this year. What's your -- what's going to be your jumping-off points for 2023 if you could?

是的。我希望你能像你今天在 2023 年看到的那樣再給我們一次經歷。我知道你還沒有指導，但你能談談你的最新想法，看看你所看到的逆風和順風到明年，您顯然會看到今年實現的利潤率改善的幾個領域。如果可以的話，您的 2023 年起點是什麼？

Yes. Once again, we're pulling levers this year that we expect to bear fruit not just as we pull those levers in '22, but that will set us up for '23, '24 and beyond. But specifically, if you think about the progression, we're sort of in the mid-5s, a little bit, mid-5s plus right now to that low 6s range that we've been targeting for the last 6 or 9 months as we laid that out.

是的。再一次，我們今年正在拉動槓桿，我們希望不僅像我們在 22 年拉動這些槓桿一樣取得成果，而且這將為 23 年、24 年及以後做好準備。但具體來說，如果你考慮一下進展，我們現在處於 5s 中期，一點點，5s 中期加上我們在過去 6 或 9 個月中一直瞄準的低 6s 範圍我們列出了這一點。

Our tailwinds -- thinking back to the Investor Day slide, if you can picture that, we had $300 million plus of SG&A towards our $700 million bucket. Obviously, the real estate execution, that's $200 million of that $300 million on a run rate basis. And then there's other initiatives, as Jim and Sarah laid out at Investor Day sort of giving us that tailwind.

我們的順風 - 回想一下投資者日的幻燈片，如果你能想像一下，我們在 7 億美元的桶中擁有 3 億多美元的 SG&A。顯然，房地產執行，即按運行率計算的 3 億美元中的 2 億美元。然後還有其他舉措，正如吉姆和莎拉在投資者日提出的那樣，給我們帶來了順風。

Gross margin, we just talked about a little bit more move. We made a big move in margin in '22, and that's going well. There's a little bit more we can get in '23, and that's how we constructed the bids. We just talked about Medicare margin. That should be a decent-sized advancement tailwind.

毛利率，我們剛剛談到了更多的舉動。我們在 22 年的利潤率方面取得了重大進展，而且進展順利。我們可以在 23 年獲得更多，這就是我們構建投標的方式。我們剛剛談到了醫療保險保證金。這應該是一個相當大的進步順風。

Then you go over to that third bucket of the value creation plan, the $0.50 bucket -- we'll get the -- we've talked about share buyback. We get the annualization, the benefit of some of that share buyback this year. We've divested a couple of businesses. Those are largely in the neutral zone even though we're deploying those proceeds to both share buyback and to reduce interest expense and debt load, investment income would be another element in that $0.50 bucket.

然後你轉到價值創造計劃的第三桶，即 0.50 美元桶——我們會得到——我們已經討論過股票回購。我們得到了年化，今年部分股票回購的好處。我們剝離了幾家企業。儘管我們將這些收益用於股票回購和減少利息費用和債務負擔，但這些資金大部分處於中性區域，投資收入將是 0.50 美元桶中的另一個要素。

But then there are some headwinds, too. Redeterminations. We talked about it at Investor Day, that's a run rate, $7 billion to $7.5 billion revenue headwind at some point when that annualizes depending on the timing of the commencement of redeterminations, Enhanced APTCs are still outstanding. Jon can probably -- when one of you guys ask that, Jon can answer that a little bit later. And we're always tracking carve-outs of pharmacy in the Medicaid business. And then there's the ever-present Medicaid rates and trend that could go either way. So obviously, it's our job to influence and manage those.

但也有一些不利因素。再決定。我們在投資者日談到了它，這是一個運行速度，70 億美元到 75 億美元的收入逆風在某個時候根據重新確定開始的時間進行年化，增強型 APTC 仍然很出色。 Jon 可能——當你們中的一個人問這個問題時，Jon 可以稍後回答。我們一直在跟踪醫療補助業務中藥房的剝離。然後是永遠存在的醫療補助費率和趨勢，可能會以任何一種方式發展。所以很明顯，影響和管理這些是我們的工作。

And our next question then comes from Justin Lake of Wolfe Research.

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

I wanted to ask you about the Medicaid MLR. Over the last couple of years, you've talked about paying about $1 billion of COVID-related margin corridors back to the states. Wanted to hear what you're seeing here year-to-date and expecting for the year overall, both in terms of the number of states they'll have in these in place and how you expect that to trend going forward? Reason I'm asking is just your MLR is up over 100 basis points year-to-date.

我想問你關於 Medicaid MLR 的問題。在過去的幾年裡，您談到了向各州支付約 10 億美元與 COVID 相關的保證金走廊。想听聽您今年迄今為止在這裡看到的情況以及對今年的總體預期，無論是就他們將擁有的州數量而言，還是您預計未來的趨勢如何？我要問的原因是您的 MLR 年初至今上漲了 100 多個基點。

I'd assume you'd have to eat through on a year-over-year basis, a lot of that $1 billion at the state level before your own MLR will be impacted. So just trying to figure out what's going on there.

我假設你必須逐年吃掉，在你自己的 MLR 受到影響之前，州一級的 10 億美元中有很多。所以只是想弄清楚那裡發生了什麼。

Yes. that's a good question. I think the COVID era in those previous disclosures really isolated the new risk corridors largely that popped up and some acuity adjustments that popped up during the COVID era. That's down to a couple few hundred million as expected because the sun setting of those risk corridors.

是的。這是個好問題。我認為，在之前的披露中，COVID 時代確實隔離了新的風險通道，主要是在 COVID 時代出現的新風險通道和一些敏銳度調整。由於這些風險走廊的日落，這正如預期的那樣下降到了幾億。

But maybe what's more relevant to your question is the total amount by which we expect to be into risk corridors, paybacks, other mechanisms, whether they originate in the COVID era or not. And that's -- we expect to be at about $1.3 billion in payback this year across our portfolio of 29 states.

但也許與您的問題更相關的是我們預計進入風險走廊、回報和其他機制的總金額，無論它們是否起源於 COVID 時代。這就是 - 我們預計今年在我們 29 個州的投資組合中將獲得約 13 億美元的回報。

And that $1.3 billion compares to what last year, Drew, in total?

那 13 億美元與去年的總額相比，德魯？

Well, a couple of billion because the COVID piece of that with the COVID era risk corridors were more present in '20 and '21, and they began sunsetting in '22. Some are still out there, but that was more like a couple of billion.

嗯，幾十億，因為在 20 年和 21 年，COVID 時代風險走廊中的 COVID 部分更多地出現，並且它們在 22 年開始日落。有些仍然存在，但這更像是幾十億。

So Drew, I guess the point is you're at $1.3 billion of what you're paying back. So by definition, I would think your at max margin in all those states where you're paying back. So how is your own MLR up 100 basis points when you're still paying back $1 billion. I would assume your couldn't have changed at all in those states? Or am I thinking about this small?

所以德魯，我想關鍵是你的回報是 13 億美元。所以根據定義，我認為你在所有那些你要還款的州都處於最大的利潤空間。那麼，當您仍然償還 10 億美元時，您自己的 MLR 如何提高 100 個基點。我會假設你在那些州根本就沒有改變？還是我在考慮這個小問題？

Yes. It's not sort of all or nothing when you get into risk corridors. There's different stair steps. There's grades of corridors, and we're not at max in all of our states. There's many states -- there are states that are underperforming that we need rate action in to improve them over the next couple of years. It's the benefit of having a portfolio.

是的。當你進入風險走廊時，這不是全有或全無。有不同的樓梯台階。有等級的走廊，我們並不是在我們所有的州都處於最高水平。有許多州 - 有些州表現不佳，我們需要在未來幾年內採取行動來改善它們。這是擁有投資組合的好處。

And our next question today comes from Kevin Fischbeck of Bank of America.

我們今天的下一個問題來自美國銀行的 Kevin Fischbeck。

Maybe just building on that question from a little bit different angle. I guess one of the reasons why companies have kind of said that redeterminations won't necessarily be a headwind to margins has been kind of these risk corridor dynamics. And I guess it's just kind of -- I struggle with a little bit the thought when companies say things like the risk pool hasn't gotten better during redetermination.

也許只是從不同的角度構建這個問題。我想公司有種說重新確定不一定對利潤率造成不利影響的原因之一就是這些風險走廊動態。而且我想這只是一種 - 當公司說風險池在重新確定期間沒有變得更好時，我有點掙扎。

So it shouldn't get worse when the terms come back in. that risk quarter thing that leaves me a little bit questioning that because if you're at kind of max margin in a number of states, then doesn't that speak to somehow the risk pool being better than average.

所以當條款回來時它不應該變得更糟。那個風險季度的事情讓我有點懷疑，因為如果你在一些州處於最大利潤，那麼這不是在某種程度上說明風險池優於平均水平。

And so then why won't that be a headwind, again, more broadly, either because of the dynamic you mentioned where it's not all or nothing or then be the dynamic that you mentioned where you're not in risk core in every state. Just trying to understand the MLR implications or redeterminations a little better?

那麼，為什麼這不會再次成為逆風，更廣泛地說，要么是因為你提到的動態，它不是全部或全無，要么是你提到的動態，你不在每個州都處於風險核心。只是想更好地理解 MLR 的含義或重新確定？

Yes. I don't know that anyone would characterize or try to minimize losing $7 billion to $7.5 billion of revenue in the associated margin. So that's clearly a headwind. What I pointed out a number of times is that as we exit the fact that if you look at our growth since the first time we actually gave a preview of 2022 revenue, we've grown well beyond that $7 billion to $7.5 billion.

是的。我不知道有人會描述或試圖將相關利潤中 70 億至 75 億美元的收入損失降至最低。所以這顯然是一個逆風。我多次指出的是，當我們退出這樣一個事實時，如果你看看自我們第一次實際預覽 2022 年收入以來的增長情況，我們的增長已經遠遠超過了 70 億美元至 75 億美元。

So when we exit, we'll actually be a bigger company than we originally expected, even though sequentially at some point, we're going to be giving back $7 billion to $7.5 billion of run rate revenue. As to the risk pool underneath that, we spent some time at Investor Day going through a bunch of the analysis because I agree with the hypothesis, but as we look at the data, we looked at the 0 utilizers.

因此，當我們退出時，我們實際上將成為一家比我們最初預期的更大的公司，即使在某個時候，我們將按順序回饋 70 億至 75 億美元的運營收入。至於其下的風險池，我們在投資者日花了一些時間進行了一系列分析，因為我同意這個假設，但是當我們查看數據時，我們查看了 0 個利用者。

And I mean the Medicaid expansion population was actually down from a base period of 2018 and 2019. That was pleasantly surprising. TANF was up a little but there was really nothing alarming, and we jumped to the, okay, let's look at the 0% to 25% HBR population.

我的意思是醫療補助擴張人口實際上比 2018 年和 2019 年的基期有所下降。這令人驚喜。 TANF 上升了一點，但真的沒有什麼可怕的，我們跳到了，好吧，讓我們看看 0% 到 25% 的 HBR 人口。

And that was up slightly to your point, but not alarming, especially in the context of being in payback in some states. So yes, being in the payback position is not a panacea, but it's one of many factors you look at when you assess all right, what could the impact be on this population? And that's sort of -- as we sit here today before we have any data, that's our best assessment.

這與您的觀點略有不同，但並不令人擔憂，尤其是在某些州處於回報期的情況下。所以，是的，處於回報位置並不是萬能藥，但它是您在評估時考慮的眾多因素之一，這會對這個人群產生什麼影響？這有點像——當我們今天坐在這里之前，我們還沒有任何數據，這是我們最好的評估。

What I would just add, I think to Drew's point, it doesn't change all the work that we are doing to prepare the redetermination process, and that includes bringing forward that data in conversations with state partners because I think as we said at Investor Day, we believe that it's manageable, but that still creates the mandate for us to manage it in partnership with the states and supported by data.

我要補充的是，我認為 Drew 的觀點，它不會改變我們為準備重新確定過程所做的所有工作，這包括在與州合作夥伴的對話中提出這些數據，因為我認為正如我們在投資者所說的那樣Day，我們相信它是可以管理的，但這仍然要求我們與各州合作管理它並得到數據的支持。

Maybe just a follow-up on that point, though, I guess, a little more time. The fact that the risk hasn't gotten worse, I guess, redeterminations are suspended, then helping people and sick people stay on the roles. In theory when redeterminations get reimplemented, the healthy people will drop off because they know how to qualify because they got jobs or they don't qualify for the other classifications.

也許只是對這一點的跟進，不過，我想，還有一點時間。事實上，風險並沒有變得更糟，我猜，重新確定被暫停，然後幫助人們和病人繼續擔任職務。理論上，當重新確定重新實施時，健康人會因為他們知道如何獲得資格而放棄，因為他們找到了工作，或者他們沒有資格獲得其他分類。

But the sick people stay on. So I guess, why is that the risk pool hasn't changed a whole lot necessarily mean that it won't change a whole lot, respectively?

但生病的人留下來。所以我想，為什麼風險池沒有發生很大變化必然意味著它不會發生很大變化？

Well, I mean, you're talking a theory, and I'm looking at data. So I mean, we're not going to declare that there won't be any difference whatsoever between the pools or stayers and levers. But when we look at the 0 utilizers. We look at sort of the minimal utilizers, it's that it's not that concerning.

好吧，我的意思是，你在談論一個理論，而我在看數據。所以我的意思是，我們不會宣布游泳池或支撐桿和槓桿之間沒有任何區別。但是當我們查看 0 個用戶時。我們著眼於最小的利用者，它不是那麼令人擔憂。

And the other mitigating factor is that 88% of our membership is in states that we believe not based upon some Kaiser study, but we believe based upon our boots on the ground and the local presence that Sarah talked about that those states will take 10 or more months to redetermine and therefore, that's why we've got sort of this amped-up rate process in place where we're working with the states sort of forewarning them and then are going to be prepared if there is a differential in the risk pool that we need to get compensated for that.

另一個緩解因素是，我們 88% 的成員所在的州我們認為不是基於一些 Kaiser 研究，但我們相信根據我們在當地的靴子和莎拉談到的當地存在，這些州將需要 10 或需要更多的時間來重新確定，因此，這就是為什麼我們已經制定了這種提高利率的流程，我們正在與各州合作，預先警告他們，然後在風險存在差異時做好準備池，我們需要得到補償。

And our next question today comes from Lance Wilkes of Bernstein.

我們今天的下一個問題來自 Bernstein 的 Lance Wilkes。

Yes. Can you talk a little bit about 2023 and 2024 Medicaid pricing, how are the states looking at inflation and I guess in discussions you're having with the states, if you could also talk a little about, in addition to redetermination, what sort of recession planning are the states starting to engage in?

是的。您能否談談 2023 年和 2024 年的醫療補助定價，各州如何看待通貨膨脹，我想在您與各州進行的討論中，如果您還可以談一談，除了重新確定之外，還有哪些各州是否開始參與經濟衰退計劃？

Yes. On the pricing side, we're constantly sharing data with our state partners. I mean we're still in '22, and we still need to get some finality on rates in the back half of the year. So sort of not -- don't yet have visibility on what our forecast will be for 2023 rates will we usually give out that number at the December Investor Day.

是的。在定價方面，我們不斷與我們的州合作夥伴共享數據。我的意思是我們仍處於 22 年，我們仍需要在今年下半年確定利率。所以有點不是——我們還不清楚我們對 2023 年利率的預測，我們通常會在 12 月的投資者日公佈這個數字。

But the discussions are constructive. The states are thirsting for data. That's one of the keys of being able to sort of influence and convince your state partners of what's necessary. Not a lot of movement yet on inflation. I mean we're not seeing a lot yet but we're vigilant there. And once again, forewarning our state partners that to the extent we see those pressures, that's going to have to be reflected in the rates.

但討論是建設性的。各州都渴望數據。這是能夠影響並說服你的國家合作夥伴什麼是必要的關鍵之一。通脹方面還沒有太大的動靜。我的意思是我們還沒有看到很多，但我們對此保持警惕。再次警告我們的州合作夥伴，在我們看到這些壓力的範圍內，這將必須反映在費率中。

Budgets right now are stable. And I would say it's as stable as we've seen for many, many years. And the states are focused on PHE when it ends, and ultimately, states actually want their citizens to have access to health care and health insurance.

現在的預算很穩定。我想說它和我們多年來看到的一樣穩定。當 PHE 結束時，各州將重點放在 PHE 上，最終，各州實際上希望其公民能夠獲得醫療保健和健康保險。

And most of our time is working with the states and help planning for whenever the PHE ends and all the paths so that their citizens can have health coverage, whether it's commercial or the exchange or Medicaid or wherever they qualify. So the recession planning, I would say, is not there yet, but where the planning is, is around the PHE and making sure people have coverage.

我們的大部分時間都在與各州合作，幫助規劃 PHE 結束的時間和所有路徑，以便他們的公民能夠獲得健康保險，無論是商業、交易所、醫療補助，還是他們有資格的任何地方。因此，我想說，衰退計劃還沒有，但計劃在哪裡，圍繞 PHE 並確保人們得到覆蓋。

And just a quick follow-up on that. For the recession, and this might be more of a policy question for you, but would a recession require something different than the existing FMAP increases in the current COVID bill and tied to the PHE or is that really kind of equivalent to what one might normally see during a recession?

並對此進行快速跟進。對於經濟衰退，這對你來說可能更像是一個政策問題，但經濟衰退是否需要與當前 COVID 法案中現有的 FMAP 增加並與 PHE 相關的不同的東西，或者這真的相當於一個人通常可能會做的事情在經濟衰退期間看到？

A state at the point as far as getting a federal match in the time of a recession, which would be different than the public health emergency would be whatever their normal state match is between the state and the federal government.

一個州在經濟衰退時期獲得聯邦匹配，這與公共衛生緊急情況不同，無論州與聯邦政府之間的正常州匹配是什麼。

And our next question comes from Scott Fidel from Stephens.

我們的下一個問題來自斯蒂芬斯的 Scott Fidel。

Obviously, there's going to be a few different moving pieces to modeling revenue impact from the divestiture. So I thought it may be helpful if you can maybe just walk us through the incremental annualized revenue when we think about incremental from Panther, then the sale of Magellan Rx and the sale of the European assets that you talked about yesterday really trying to figure out sort of what's now reflected in the updated revenue guidance versus how we should think about modeling the impact of divestitures when we think about annualized out to 2023.

顯然，將有一些不同的移動部分來模擬資產剝離對收入的影響。所以我認為，當我們考慮 Panther 的增量時，如果您可以引導我們了解增量的年化收入，然後您昨天談到的 Magellan Rx 的出售和歐洲資產的出售，這可能會有所幫助。與我們在考慮到 2023 年的年度化時應該如何考慮對資產剝離的影響進行建模時，現在反映在更新的收入指南中的那種。

Yes. So we reduced our premium and service revenue by $1 billion for the back half of the year. Panther was a little over $2 billion, although it's growing quickly. And the Central and Spain assets were about $700 million in annualized revenue. And we don't expect to close Magellan Rx until late this year, really, I guess, late this year is our best estimate. So it wouldn't impact 2022.

是的。因此，我們在今年下半年將保費和服務收入減少了 10 億美元。 Panther 的市值略高於 20 億美元，儘管增長迅速。中部和西班牙資產的年收入約為 7 億美元。而且我們預計要到今年年底才能關閉 Magellan Rx，我想，今年年底是我們最好的估計。所以它不會影響2022年。

Okay. And still related...

好的。而且還是相關的...

I was just going to add, and when we announced that in conjunction with Panther, think of it as neutral to slightly accretive, the combination of those 2 assets, so minimal, if any, impact on earnings.

我只是想補充一點，當我們宣布與 Panther 一起宣佈時，將這兩種資產的組合視為中性到略微增值，這兩種資產的組合對收益的影響非常小，如果有的話。

Got it. And just a related follow-up. I think as Sarah had mentioned in the prepared comments that you're still pretty actively reviewing the portfolio and looking at other potential divestitures or sort of opportunities for value creation.

知道了。只是一個相關的後續行動。我認為正如莎拉在準備好的評論中提到的那樣，你仍然非常積極地審查投資組合併尋找其他潛在的資產剝離或價值創造的機會。

I know that you've now announced a number of the sort of signature assets that you had identified initially to us as sort of potentially non-core. Just interested, maybe if you can just give us an update on sort of what else maybe you'd be thinking about where you're focused on now where there may still be some continued divestitures?

我知道您現在已經宣布了一些您最初向我們確定為潛在非核心的簽名資產。只是感興趣，也許如果你能給我們一個關於其他什麼的更新，也許你會考慮你現在關注的地方，可能還有一些持續的資產剝離？

Yes. Thanks for the question. We're obviously pleased with the progress to date. We got a lot done in the second quarter, but we still have the other broader portfolio of non-health plan assets, and we're sort of methodically working through those so if you think about the assets that historically have sat within health care enterprises, and some of our other non-health plan businesses, all of those are going through a consistent process.

是的。謝謝你的問題。我們顯然對迄今為止的進展感到滿意。我們在第二季度做了很多工作，但我們仍然擁有其他更廣泛的非健康計劃資產組合，我們正在有條不紊地處理這些資產，所以如果你考慮一下歷史上醫療保健企業中的資產，以及我們的其他一些非健康計劃業務，所有這些業務都在經歷一個一致的過程。

And we're looking to prioritize that work where we're going to have the greatest impact. So there is still a lot of work going on, and you should expect to hear additional announcements about that. But again, and I've hit this a couple of times. The answer in all cases, not necessarily divestiture.

我們正在尋求優先考慮我們將產生最大影響的工作。所以還有很多工作要做，你應該期待聽到更多關於這方面的公告。但又一次，我已經打了幾次。答案在所有情況下，不一定是資產剝離。

In some cases, these are very strategic assets that can be positioned to actually strengthen the core. And so that's part and parcel of the conversation, too, particularly as we think about positioning the company for growth in 2025 and beyond.

在某些情況下，這些是非常具有戰略意義的資產，可以定位以實際加強核心。因此，這也是對話的重要組成部分，尤其是當我們考慮將公司定位為 2025 年及以後的增長時。

Our next question today comes from Nathan Rich at Goldman Sachs.

我們今天的下一個問題來自高盛的 Nathan Rich。

Drew, you had talked about taking price actions in the marketplace business for '23 as you work back toward target margins in that segment. I think across the market, it looks like average premiums will be up in the neighborhood of 10%.

Drew，您曾談到在 23 年市場業務中採取價格行動，因為您努力回到該細分市場的目標利潤率。我認為在整個市場上，平均保費似乎會上漲 10% 左右。

I guess like when you think about your business and enrollment for next year, how are you expecting the consumer to react to type of price increases, I guess, in the current environment? And do you have any kind of preliminary view on what you think enrollment in that business could look like?

我想當您考慮明年的業務和招生時，您希望消費者在當前環境下對價格上漲類型做出什麼反應？對於您認為該業務的註冊情況，您是否有任何初步看法？

Yes. There's a number of moving parts still. We have to see how the enhanced APTCs end up before the August recess because that's a pretty decent size swing factor. We also have to see the timing of the commencement of redeterminations because that's another swing factor.

是的。仍有許多活動部件。我們必須看看增強型 APTC 在 8 月休會前會如何結束，因為這是一個相當不錯的規模波動因素。我們還必須看到重新確定開始的時間，因為這是另一個影響因素。

And then to the extent that the family glitch if that gets improved, so that it's sort of better applicability to marketplace. So too many things moving around at this point. And we're still waiting on Congress on the enhanced APTCs, so can't really predict whether it'll be up a little, down a little or flat.

然後在某種程度上，如果這種情況得到改善，家庭就會出現故障，這樣它就可以更好地適用於市場。在這一點上，太多的事情在移動。而且我們仍在等待國會就增強的 APTC 進行改進，因此無法真正預測它會上升一點、下降一點還是持平。

The pricing, we made a pretty big pricing move coming into 2022. It wasn't quite as high as you referenced in the aggregate on a composite basis. So maybe that's a good thing that we didn't have to increase our rates 10% on a composite basis, and we still are achieving meaningful margin expansion this year.

定價，我們在 2022 年進行了相當大的定價調整。它並沒有你在綜合基礎上引用的那麼高。所以也許這是一件好事，我們不必在綜合基礎上提高 10% 的費率，而且我們今年仍在實現有意義的利潤率擴張。

And next year, not as big of a move in terms of margin expansion because we need to pierce into that 5% to 7.5%, whereas we were jumping off a pretty -- quite frankly, pretty lousy performance in 2021 in marketplace financially.

明年，在利潤率擴張方面並沒有那麼大的變化，因為我們需要突破 5% 到 7.5% 的水平，而我們在 2021 年的市場財務表現上跳出了相當 - 坦率地說，相當糟糕的表現。

Marketplace, we do not see as kind of a generic national approach. We view it very much local like Medicaid. It's a market to market. And we had mentioned earlier that of our 29 states for (inaudible) to be 30 with Delaware, 25 of those states we actually have an overlap of exchange. And so the relationship between provider and potential future insured or insured distribution and knowing the markets I think will play well for us and it actually played out quite well in 2022.

市場，我們不認為這是一種通用的國家方法。我們認為它非常本地化，就像醫療補助一樣。這是一個市場對市場。我們之前提到過，在我們的 29 個州中（聽不清）與特拉華州是 30 個州，其中 25 個州實際上有交流重疊。因此，提供者與潛在的未來被保險人或被保險人分銷之間的關係以及我認為對我們來說會發揮良好作用的市場之間的關係實際上在 2022 年表現得非常好。

Great. Can I just ask a quick follow-up on just cadence of earnings for the back half of the year. Drew, you highlighted the outperformance in the first half. I think you had previously expected 40% earnings in the back half. It seems like that's gone down a little bit.

偉大的。我能否就下半年的收入節奏快速跟進。 Drew，您強調了上半年的出色表現。我認為您之前預計後半部分的收益為 40%。好像下降了一點。

Can you maybe just talk about like the big drivers for the back half of the year. Obviously, the Panther divestiture, but it sounds like some real estate savings would come through. So any other major moving pieces we should be thinking about?

你能不能談談今年下半年的主要驅動因素。顯然，黑豹剝離，但聽起來像一些房地產儲蓄會通過。那麼我們應該考慮其他任何主要的移動因素嗎？

Yes, right, right. At Investor Day, I was pretty explicit that the first half, we expected 64%. I guess that's now 63% now that we printed because we lifted the full year by $0.05 and that $0.05 to your point, it's actually a dime of benefit early benefit on the real estate run rate, minus $0.05 of investment, Delaware is one example, but there's other ROI-based investments we're making in the value creation plan that we intend to make in the back half of the year.

對，對，對。在投資者日，我非常明確地表示，上半年，我們預計為 64%。我想現在我們打印了 63%，因為我們將全年提高了 0.05 美元，而你的點是 0.05 美元，這實際上是房地產運行率的一角收益，減去 0.05 美元的投資，特拉華州就是一個例子，但在我們打算在今年下半年進行的價值創造計劃中，我們還進行了其他基於 ROI 的投資。

So that's why we increased guidance to net nickel. But otherwise, it's the normal progression, HBRs in like the commercial business and marketplace, those sort of rise throughout the year. And it's sort of a normal cadence thereafter.

這就是為什麼我們增加了對淨鎳的指導。但除此之外，這是正常的進展，HBR 就像商業業務和市場一樣，全年都在上升。此後這是一種正常的節奏。

And our next question comes from George Hill with Deutsche Bank.

我們的下一個問題來自德意志銀行的喬治希爾。

Yes is another follow-up on the redetermination process. And I guess I don't know if it will be national or if it's state by state. I guess, could you talk about like the cadence for expectations for redeterminations once the PHE ends?

是的，是重新確定過程的另一個後續行動。而且我想我不知道它是全國性的還是逐個州的。我想，您能談談 PHE 結束後對重新確定的期望的節奏嗎？

Do you expect a lot of these lives to just kind of be dropped at once and then go through the paperwork process -- or will you guys -- or will these lives effectively stay on the Medicaid roles and then you'll go through the process of determining eligibility. I'm trying to think about the slope as I think about modeling redeterminations.

你是否期望這些生命中的很多會立即被放棄，然後通過文書工作流程——或者你們會——或者這些生命是否會有效地留在醫療補助的角色上，然後你會經歷這個過程的確定資格。在考慮重新確定建模時，我正在嘗試考慮斜率。

It's definitely a state-by-state process. So Brent, maybe you want to talk about what we're seeing operationally.

這絕對是一個逐州的過程。所以布倫特，也許你想談談我們在運營方面看到的情況。

And well said, it is definitely state by state. And at the end of the day, all states are waiting to see when the PHE ends, and they're planning from that standpoint. Some states will take many months and that and some will be much faster. And it really depends both on how the state ultimately sees health care coverage and how they want to proceed in their state.

說得好，這絕對是一個州一個州。歸根結底，所有州都在等著看 PHE 什麼時候結束，他們正在從這個角度進行計劃。有些州需要幾個月的時間，而有些州會更快。這實際上取決於該州最終如何看待醫療保健覆蓋面以及他們希望如何在他們的州內進行。

But nonetheless, every state are having working groups and meetings and approaches through communication, through education and really trying to help everybody understand the options they have from that standpoint.

但是儘管如此，每個州都在通過溝通、教育和真正試圖幫助每個人從這個角度理解他們擁有的選擇的工作組和會議和方法。

One thing I would add that we're tracking pretty closely are the ex parte numbers that each state is accumulating, which are those members that would be automatically either dropped or renewed at very different levels of maturity relative to the volume of members that could go through an automated process, but it's actually a helpful proxy for us to understand what would happen in early months versus, as Brent said, the states that are going to take a more measured approach in order not to create member abrasion and also reflective of the fact that the states have staffing issues and want to make sure that they have enough support for the process overall.

我要補充的是，我們正在密切跟踪的一件事是每個州正在積累的單方面數量，即相對於可能去的成員數量而言，這些成員將在非常不同的成熟度水平下自動被刪除或更新通過一個自動化的過程，但它實際上是一個有用的代理，讓我們了解在最初幾個月會發生什麼，而正如布倫特所說，為了不造成成員磨損並反映事實上，各州存在人員配備問題，並希望確保他們對整個過程有足夠的支持。

Our next question today comes from Michael Ha of Morgan Stanley.

我們今天的下一個問題來自摩根士丹利的 Michael Ha。

Firstly, just a quick clarification, following up on A.J.'s question. How much exactly did the favorable 2021 risk adjustment benefit your exchange MLR this quarter?

首先，快速澄清一下，跟進 A.J. 的問題。有利的 2021 年風險調整究竟對本季度的交易所 MLR 有多少好處？

It's obviously a big contributor. We expect that every Q2 so the swing was pretty dramatic because if you'll recall, we actually had a -- we missed our expectation in marketplace in Q2 of 2021. So it's an anticipated driver because that's the quarter in which you get first weekly data and then the final CMS data. So -- but we outperformed that as evidenced by the 1,250 basis point year-over-year improvement.

這顯然是一個很大的貢獻者。我們預計每個第二季度的波動都會非常劇烈，因為如果您回想一下，我們實際上有一個 - 我們錯過了我們在 2021 年第二季度的市場預期。所以這是一個預期的驅動因素，因為那是您第一次每週獲得的季度數據，然後是最終的 CMS 數據。所以 - 但我們的表現優於去年 1,250 個基點的同比增長。

And our next question today comes from Calvin Sternick with JPMorgan.

我們今天的下一個問題來自摩根大通的 Calvin Sternick。

I wanted to circle back to the Medicare HBR comments you made, specifically on PDP I guess, how much of the PDP performance -- outperformance there is intentional in the way the business versus how much is coming in maybe a little bit better than expected?

我想回到您發表的醫療保險 HBR 評論，特別是關於 PDP 的評論，我猜，PDP 的表現有多少——在業務方式上的表現是有意的，而有多少可能比預期的好一點？

And then how are you thinking about the sustainability of those PDP margins in 2023?

那麼您如何看待這些 PDP 利潤率在 2023 年的可持續性？

Most of the year-over-year improvement was planned for in the bids. And plus each year as the yield drops because of the shifting of the responsibility and sort of the benchmarking that's unique in PDP. I mean it's a very low-yielding product. So the HBR has to be low because you have a certain amount of admin to reflected.

大部分的同比改進都計劃在投標中。而且每年由於責任的轉移和 PDP 中獨特的基準測試而導致產量下降。我的意思是它是一種非常低產的產品。所以 HBR 必須很低，因為您需要反映一定數量的管理員。

I think the yield is sort of in the $35 to $45 PMPM range depending on the product. And then there's a little bit, to your point, there's a little bit of outperformance on top of that, but most of that was planned.

我認為根據產品的不同，收益率在 PMPM 的 35 美元到 45 美元之間。然後還有一點，就你的觀點而言，除此之外還有一點表現出色，但大部分都是計劃好的。

And our next question today comes from Gary Taylor at Cowen.

我們今天的下一個問題來自 Cowen 的 Gary Taylor。

I appreciate the way you keep front riding the MA stores. So everybody is on the same page with respect to that. I had a couple smaller knits, I might see if you can force a little bit.

我很欣賞你在 MA 商店中保持領先的方式。因此，每個人都對此意見一致。我有幾件小一點的針織衫，我可能會看看你能不能用力一點。

The first would just be on days claims payable, you talked about a couple of factors that temporarily pushed that up this quarter. Did those reverse right back out next quarter, just so we should be anticipating a couple of days, at least sequentially on DCP.

第一個只是應付索賠天數，你談到了本季度暫時推高這一數字的幾個因素。那些在下個季度就逆轉了，所以我們應該期待幾天，至少在 DCP 上是按順序進行的。

And then the second one would be investment income. So to hit your guide -- is that going to be running $150 million a quarter in the back half, just so we're anticipating higher investment income contribution to earnings in the back half?

然後第二個是投資收益。所以要達到你的指導 - 這是否會在後半部分每季度運行 1.5 億美元，所以我們預計後半部分的投資收入對收益的貢獻會更高？

So yes, on investment income with $400 million. I think we were $94 million or so year-to-date first half. That includes we sort of wrote down the fuel investments, we cleaned up some things that hit other income and investment income in the first half of the year. And we had some equity investments that obviously took a hit with the equity markets.

所以，是的，投資收入為 4 億美元。我認為今年上半年我們的收入約為 9400 萬美元。這包括我們減記了燃料投資，我們清理了一些影響上半年其他收入和投資收入的事情。我們有一些股權投資顯然受到了股市的衝擊。

But yes, we expect around $400 million for full year. So I don't know if it will exactly be $150 million a quarter because there's a ramping up of the Fed rates, obviously, embedded in that. But you're correct there.

但是，是的，我們預計全年約為 4 億美元。所以我不知道它是否會恰好是每季度 1.5 億美元，因為很明顯，美聯儲的利率上升已經嵌入其中。但你是對的。

And your first question DCP. Yes, the state-directed payments element, I would expect that. That's literally we're getting cash from our state, and we've got to push it out to hospitals.

還有你的第一個問題 DCP。是的，國家主導的支付元素，我希望如此。從字面上看，我們正在從我們的州獲得現金，我們必須將其推給醫院。

That typically happens the next quarter. It may take a couple of quarters depending on sort of the detail around that, but that's pretty much in and out. Pharmacy invoices are tough to predict. I mean we don't manage to a DCP. It's actually an output. It's interesting. I'm always looking to see where it came out when we closed the books.

這通常發生在下個季度。這可能需要幾個季度，具體取決於周圍的細節，但這幾乎是進進出出。藥房發票很難預測。我的意思是我們沒有設法建立 DCP。它實際上是一個輸出。這真有趣。當我們合上書本時，我一直在尋找結果。

But often, there are balance sheet elements that impact that, that are just timing, things have stretched over the quarter. But fundamentally, I do believe in strength of reserves and that is a measure, an imperfect one, but it is a measure of the strength of reserves.

但通常情況下，資產負債表的一些因素會影響到這一點，這只是時間安排，事情已經延伸到本季度。但從根本上說，我確實相信儲備實力，這是一種衡量標準，一個不完美的衡量標準，但它是衡量儲備實力的標準。

And our next question comes from Benjamin Flox at Jefferies.

我們的下一個問題來自 Jefferies 的 Benjamin Flox。

I apologize if this was asked already, but I wanted to follow up on Star scores for plan year 2024 revenues. Our understanding is the industry as a whole is going to face some headwinds as some COVID era factors run off. So was the point in the prepared remarks that you kind of expect to underperform that industry headwind?

如果已經問過這個問題，我深表歉意，但我想跟進 2024 年計劃收入的星級評分。我們的理解是，隨著一些 COVID 時代因素的消失，整個行業將面臨一些不利因素。那麼，在準備好的評論中，您是否期望在行業逆風中表現不佳？

And then can you just give us a bit more color on the key pressures you're expecting?

然後，您能否就您所期望的關鍵壓力給我們更多的色彩？

The answer is yes. And if you go back to first time we started talking about this Q3 of 2021, you're absolutely right. There's an industry factor and we benefited from that probably, I'm thinking an outsized amount relative to peers. But for the plan year 2022, so the 2023 revenue were just over 50%. As an example, we're just over 50% of our membership in Forestar that would be less than half of that, absent the disaster relief provision.

答案是肯定的。如果你回到我們第一次開始談論 2021 年第三季度的時候，你是絕對正確的。有一個行業因素，我們可能從中受益，我認為相對於同行而言數量巨大。但對於 2022 年的計劃，2023 年的收入剛剛超過 50%。例如，如果沒有救災條款，我們在 Forestar 的會員中只有 50% 多一點，不到一半。

But on top of that, as we started to see operational execution and indicators from sort of the end of 2020 and then into the first half of 2021 and then look at results throughout 2021 and now some of that's into 2022 in terms of that rating year '23, you're talking about, we believe we're going to underperform.

但最重要的是，當我們開始看到從 2020 年底到 2021 年上半年的運營執行和指標，然後查看整個 2021 年的結果，現在就該評級年而言，其中一些是到 2022 年'23，你在說，我們相信我們會表現不佳。

And what we're driving now is what we can control, this management team can control, which is execution in 2022 and beyond, which will drive rating year 2024 Star scores that result in 2025 revenue and those are the Star scores you'll get publicly in the fall of '23, hopefully attract me there.

而我們現在正在推動的是我們可以控制的，這個管理團隊可以控制的，這是 2022 年及以後的執行，這將推動 2024 年的評分，從而產生 2025 年的收入，這些是你會得到的星分23 年秋天公開發表，希望能吸引我。

Yes. Maybe just to quickly at Wave top sort of rehash the history lesson that we went through at Investor Day on the why. And again, the time period that Drew is pointing to is really that back half of '20 and early part of 2021. And those 21 days of service are what impacted revenue anticipated from Stars in 2024. And so early 2020, we brought Centene and WellCare together a couple of things happen, right?

是的。也許只是為了快速地在 Wave top 上重新討論我們在投資者日上所經歷的歷史教訓。再一次，Drew 所指的時間段實際上是 20 年下半年和 2021 年初。這 21 天的服務影響了 Stars 在 2024 年的預期收入。所以在 2020 年初，我們帶來了 Centene 和WellCare 一起發生了幾件事，對嗎？

We tripled the Medicare book overnight. We brought 2 different parts together that we're operating in fundamentally different models. One was centralized at WellCare and one was decentralized very hard to run an enterprise quality program at our level of size and scale in a decentralized model.

我們在一夜之間將醫療保險書翻了三倍。我們將兩個不同的部分放在一起，我們在根本不同的模型中運行。一個集中在 WellCare，一個非常分散，很難在分散模型中以我們的規模和規模運行企業質量計劃。

And then we send everybody home for COVID. And so what we saw was the degradation of operations and performance in the back half of '20 and first half of '21, which again will impact '24 caught that in the middle of '21 and added new leadership to the quality program in the back half of last year, tuck them under the value creation office in order for that to be sort of unified prioritized initiative.

然後我們將每個人都送回家接受 COVID。因此，我們看到的是 20 年下半年和 21 年上半年的運營和績效下降，這將再次影響 24 年，在 21 年中期抓住了這一點，並在 20 年的質量計劃中增加了新的領導力去年下半年，將他們歸入價值創造辦公室，以使其成為一種統一的優先計劃。

And then this management team, which is different from the past has committed to quality performance is a priority for the whole company, and we've baked it into our short-term incentive for every single employee. And so all of the work that Jim Murray talked about at Investor Day in terms of how we're watching operational performance for 2022 dates of service.

然後這個與以往不同的管理團隊致力於質量績效是整個公司的首要任務，我們將其納入我們對每一位員工的短期激勵。吉姆默里在投資者日談到的所有工作，就我們如何觀察 2022 年服務日期的運營績效而言。

The executive team watches those on a weekly basis because that is what is telling us that we can be looking for a meaningful rebound in revenue year 2025.

執行團隊每週都會關注這些，因為這告訴我們，我們可以在 2025 年尋找有意義的收入反彈。

Let me add one more thing on that. This is a long answer to a short question, but we are still committed to driving and pulling levers to achieve our multiyear plan. So while this is going to be a headwind for in isolated 2024 year, and it will turn around to be a nice tailwind for 2025 based upon our execution.

讓我再補充一點。這是一個簡短問題的長答案，但我們仍然致力於推動和拉動槓桿以實現我們的多年計劃。因此，雖然這將成為孤立的 2024 年的逆風，但根據我們的執行情況，它將成為 2025 年的順風。

Our compensation is still tied to the targets we laid out, as you saw in the proxy, and this organization is going to drive towards executing on the multiyear game plan that we laid out for you.

正如您在代理中看到的那樣，我們的薪酬仍然與我們制定的目標相關聯，並且該組織將推動執行我們為您制定的多年遊戲計劃。

Thank you. And ladies and gentlemen, this concludes our question-and-answer session. I'd like to turn the conference back over to Jennifer Gilligan give for any closing remarks.

謝謝你。女士們，先生們，我們的問答環節到此結束。我想把會議轉回給 Jennifer Gilligan 做任何閉幕詞。

We want to thank everyone for joining us this morning. And if there are any follow-up calls, please feel free to reach out. Thanks very much.

我們要感謝大家今天早上加入我們。如果有任何後續電話，請隨時與我們聯繫。非常感謝。

Thank you, ma'am. This concludes today's conference call. We thank you all for attending today's presentation. You may now disconnect your lines, and have a wonderful day.

謝謝你，女士。今天的電話會議到此結束。我們感謝大家出席今天的演講。您現在可以斷開線路，度過美好的一天。