Centene Corp (CNC) 2024 Q4 法說會逐字稿

Good day, and welcome to the Centene Corporation fourth-quarter and full-year 2024 earnings conference call.

大家好，歡迎參加 Centene Corporation 2024 年第四季和全年財報電話會議。

(Operator Instructions) Please note today's event is being recorded.

（操作員指示）請注意，今天的活動正在被記錄。

I would now like to turn the conference over to Jennifer Gilligan, Head of Investor Relations.

現在，我想將會議交給投資者關係主管 Jennifer Gilligan。

Please go ahead.

請繼續。

Thank you, Rocco, and good morning, everyone.

謝謝你，羅科，大家早安。

Thank you for joining us on our fourth-quarter 2024 earnings results conference call.

感謝您參加我們 2024 年第四季收益業績電話會議。

Sarah London, Chief Executive 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.

莎拉倫敦 (Sarah London)，執行長； Centene 執行副總裁兼財務長 Drew Asher 將主持今天早上的電話會議，您也可以透過我們的網站 centene.com 存取。

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 對未來預期、計劃和前景所作的任何評論均構成 1995 年私人證券訴訟改革法案下安全港條款的前瞻性陳述。

Actual results may differ materially from those indicated by those forward-looking statements as a result of various important factors, including those discussed in our fourth-quarter 2024 press release, which is available on the company's website under the Investors section.

由於各種重要因素，包括我們在 2024 年第四季新聞稿中討論的因素，實際結果可能與這些前瞻性陳述所示的結果有重大差異，該新聞稿可在公司網站的「投資者」部分下找到。

Centene anticipates that subsequent events and developments may cause its estimates to change.

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 the forward-looking statements at some point in the future, we specifically disclaim any obligation to do so.

儘管公司可能選擇在未來某個時間點更新前瞻性陳述，但我們明確表示不承擔任何這樣做的義務。

The call will also refer to certain non-GAAP measures.

電話會議也將參考某些非公認會計準則指標。

A reconciliation of these measures with the most directly comparable GAAP measures can be found in our fourth-quarter 2024 press release.

在我們 2024 年第四季的新聞稿中可以找到這些指標與最直接可比較的 GAAP 指標的對帳。

With that, I would like to turn the call over to our CEO, Sarah London.

說到這裡，我想把電話轉給我們的執行長莎拉倫敦 (Sarah London)。

Sarah?

莎拉？

Thanks, Jen, and thanks, everyone, for joining us this morning.

謝謝， Jen，也謝謝大家今天早上加入我們。

As an enterprise, Centene is stepping into 2025 with a clear strategy, compelling embedded earnings power, and positive momentum within each of our lines of business.

作為一家企業，Centene 正以清晰的策略、強大的內在獲利能力以及各業務線的積極勢頭邁進 2025 年。

We have delivered significant operational improvements and see exciting opportunity ahead as we continue to modernize our platform, automate our administrative processes through the deployment of AI, and leverage our unparalleled data to create insights that make our business better, improve the quality of healthcare for our members, and transform how the healthcare system serves millions of Americans.

隨著我們繼續實現平台現代化、透過部署人工智慧來實現管理流程自動化以及利用我們無與倫比的數據來創造洞察力，從而改善我們的業務、提高我們會員的醫療品質並改變醫療保健系統為數百萬美國人服務的方式，我們已經實現了重大的營運改進並看到了令人興奮的未來機遇。

Today, we reported fourth-quarter adjusted diluted EPS of $0.80 and full-year 2024 adjusted diluted EPS of $7.17, strong results that demonstrate the durability of our earnings power and position the company to execute against our strategic goals in 2025.

今天，我們報告了第四季度調整後攤薄每股收益為 0.80 美元，2024 年全年調整後攤薄每股收益為 7.17 美元，強勁的業績證明了我們盈利能力的持久性，並使公司能夠在 2025 年實現我們的戰略目標。

Driven by better-than-expected results during the Medicare annual enrollment period and a program expansion in Medicaid, we are lifting our full-year 2025 revenue guidance by $4 billion.

受醫療保險年度登記期間業績優於預期以及醫療補助計劃擴展的推動，我們將 2025 年全年收入預期上調 40 億美元。

Our outlook for full-year 2025 adjusted diluted EPS remains unchanged as greater than $7.25. And we are pleased with the trajectory we are on at this early stage in the year.

我們對 2025 年全年調整後攤薄每股收益的預期保持不變，仍超過 7.25 美元。我們對今年初期的發展軌跡感到滿意。

To that end, let's talk about the opportunities in each of our business lines and how we are positioned for 2025.

為此，讓我們來談談每個業務線中的機會以及我們為 2025 年所做的定位。

First, Medicaid.

首先，醫療補助。

Today, we serve 13 million Americans across our Medicaid portfolio, offering critical access to vital medical services and support for some of this country's most vulnerable and complex populations.

今天，我們透過醫療補助計劃為 1300 萬美國人提供服務，為美國最脆弱和最複雜的群體提供關鍵的醫療服務和支援。

Post-COVID era eligibility redeterminations generated significant membership transition within the Safety Net Program, but that chapter is now coming to a close.

後疫情時代的資格重新確定導致了安全網計畫內會員資格的重大轉變，但這一篇章現已即將結束。

In 2025, we expect improved membership stability and a gradual return toward equilibrium with respect to rates and the risk profile of our members.

到 2025 年，我們預計會員穩定性將提高，會員的利率和風險狀況將逐步恢復平衡。

We continue to have constructive dialogue with our state partners, providing us with confidence in our ability to command rates that will support a return to target Medicaid margins.

我們繼續與我們的州合作夥伴進行建設性的對話，這使我們對我們有能力控制支持恢復到目標醫療補助利潤的費率充滿信心。

This is visible through a strong result for 1125 effective rates, where we were able to achieve a mid-4% composite rate adjustments.

從 1125 個有效利率的強勁結果可以看出，我們能夠實現 4% 中等水準的綜合利率調整。

We continue to expect a full-year 2025 composite rate adjustment of 3% to 4%.

我們繼續預期 2025 年全年綜合利率調整幅度為 3% 至 4%。

While we have been focused on supporting our members and state partners through the redetermination process, Centene's local Medicaid teams never stopped working to develop innovative care programs and solutions to promote access for our unique member base.

雖然我們一直致力於透過重新確定過程為我們的會員和國家合作夥伴提供支持，但 Centene 的當地醫療補助團隊從未停止努力開發創新的護理計劃和解決方案，以促進我們獨特的會員群體獲得醫療服務。

For Centene, transforming the health of the communities we serve means bringing care to our members, ensuring it is local, integrated, and sustainable, and working to influence positive health outcomes for our members as early as possible in the care journey, in some cases, before they are even born.

對於 Centene 而言，改變我們服務社區的健康狀況意味著為我們的會員提供護理，確保護理是本地化的、綜合的和可持續的，並努力在護理過程中儘早（在某些情況下甚至在他們出生之前）為我們的會員帶來積極的健康結果。

To this end, in Nevada, we are actively working to address the challenges of rural healthcare access for expectant moms.

為此，在內華達州，我們正在積極努力解決農村準媽媽獲得醫療保健的挑戰。

Our SilverSummit team is distributing tablets to support increased prenatal and postpartum telehealth visits for mothers in rural counties.

我們的 SilverSummit 團隊正在分發平板電腦，以支援增加農村縣母親的產前和產後遠距醫療訪問。

We have also sponsored telehealth training, with a particular focus on postpartum behavioral health support.

我們也贊助遠距醫療培訓，特別著重產後行為健康支援。

Another great example of innovative programming comes from our Meridian team in Illinois, where we are taking a food-as-medicine approach to supporting members with uncontrolled high blood pressure.

創新計劃的另一個很好的例子來自我們位於伊利諾伊州的 Meridian 團隊，我們採用食物作為藥物的方法來為患有無法控制的高血壓的會員提供支持。

Members have access to a 12 comprehensive program that includes nutrition counseling along with four weeks of medically tailored meals, followed by four weeks of healthy food boxes, followed by four weeks of fresh produce vouchers.

會員可以享受 12 項綜合計劃，其中包括營養諮詢、四周的醫學客製化膳食、四周的健康食品盒，以及四周的新鮮農產品券。

The goal is to build and sustain the changes in eating habits that will support long-term hypertension control.

目標是建立並維持有助於長期控制高血壓的飲食習慣的改變。

As we move through 2025, we are looking forward to turning the page on the determinations era, returning to overall Medicaid program stability and working closely with our state partners on innovations that deliver not only healthcare but also better health within our communities.

隨著我們進入 2025 年，我們期待著翻開自主決定時代的新篇章，恢復整體醫療補助計劃的穩定，並與我們的州合作夥伴密切合作，進行創新，不僅提供醫療保健，而且還為我們的社區提供更好的健康。

Turning to Medicare, we are pleased to be generating material progress within our Medicare business.

談到醫療保險，我們很高興在醫療保險業務中取得了實質進展。

The most recently released Star results published during fourth-quarter 2024 and applicable to benefit plan year 2026, are an excellent window into our notable advancement.

2024 年第四季發布的最新 Star 結果適用於 2026 年福利計畫年度，是了解我們顯著進步的絕佳窗口。

Within these results, 55% of our members are associated with 3.5-star plans or better, up from 23% last year.

在這些結果中，55％的會員與 3.5 星或更高的計劃相關，高於去年的 23％。

We continue to operate and execute with increased precision throughout 2024, driving year-over-year improvement in many of our core administrative measures.

我們將在 2024 年繼續以更高的精度運作和執行，推動許多核心管理措施逐年改善。

We also continue to make progress closing care gaps for our members, with year-over-year performance improvement in our HEDIS rates as well as medication adherence.

我們也繼續在縮小會員照護差距方面取得進展，我們的 HEDIS 率以及藥物依從性逐年提高。

And in a credit to our team's leadership and effort around continuous improvement, 1125 go-live for Medicare was the smoothest I've ever seen at Centene.

由於我們團隊的領導力和持續改進的努力，Medicare 的 1125 上線是我在 Centene 見過的最順利的。

We expect these and other advancements in our processes and key metrics to support Star's results as we take on 2025.

我們期望這些以及我們流程和關鍵指標的其他進步能夠支持 Star 在 2025 年的成果。

As you've heard from us before, we pruned our Medicare Advantage footprint coming into 2025 to better align with our Medicaid presence and capabilities, enhancing our ability to leverage Centene's size, scale, and expertise.

正如您之前所聽到的，我們將在 2025 年精簡我們的 Medicare Advantage 足跡，以更好地與我們的 Medicaid 存在和能力保持一致，增強我們利用 Centene 的規模、範圍和專業知識的能力。

With this refined footprint and refreshed products, we produced very good results relative to our expectations during the 2025 annual enrollment period.

憑藉這一完善的足跡和更新的產品，我們在 2025 年度招生期間取得了超出預期的良好成績。

We now expect Medicare enrollment in the low to mid-900,000.

我們現在預計醫療保險登記人數將達到 90 萬左右。

Product design, successful management of our distribution channels, and local market knowledge contributed to the better-than-expected results.

產品設計、成功的分銷管道管理以及對本地市場的了解促成了好於預期的業績。

It is still early, but based on things we can know today, such as demographics and retention levels, we are pleased with the membership mix we are carrying into 2025, including a duals mix around 40%.

現在還為時過早，但根據我們今天所知的信息，例如人口統計和保留水平，我們對 2025 年的會員結構感到滿意，其中包括 40% 左右的雙重組合。

Amid program changes related to the Inflation Reduction Act, Medicare Part D presented Centene with a nice growth opportunity in 2024.

在與通貨膨脹削減法案相關的計劃變化中，醫療保險 D 部分為 Centene 在 2024 年提供了良好的成長機會。

And the team executed well against that strategic plan.

並且團隊很好地執行了該戰略計劃。

Part D or PDP is positioned to be a larger business for us once again in 2025, both by revenue and membership.

無論從收入或會員數量來看，D 部分或 PDP 在 2025 年都將再次成為我們的一項規模更大的業務。

During open enrollment, we went to market with a deliberate focus on value for our members, including premium affordability.

在開放註冊期間，我們專注於為會員提供市場價值，包括保費的可負擔性。

This plan, complemented by the CMS demonstration program, yielded strong AEP results that are expected to generate 2025 revenue of approximately $16 billion better than our previous expectations.

該計劃與 CMS 示範項目相輔相成，取得了強勁的 AEP 業績，預計 2025 年營收將達到約 160 億美元，高於我們先前的預期。

Here, too, we are early relative to observed experience.

在這裡，我們也比觀察到的經驗還要早。

But as we look at factors such as member demographics and product selection, we remain confident in the financial objectives we set forth at December's Investor Day, including a 1% target margin for the PDP business in 2025.

但是，當我們考慮會員人口統計和產品選擇等因素時，我們仍然對 12 月投資者日制定的財務目標充滿信心，包括 2025 年 PDP 業務 1% 的目標利潤率。

Finally, a brief comment on the Medicare Advantage advance rate notice released last month for the 2026 revenue year.

最後，簡要評論一下上個月發布的 2026 收入年度的 Medicare Advantage 預付利率通知。

While the information is not final, we are pleased to see the potential for a positive directional shift in funding for this important program, including the incorporation of a higher level of base rate medical cost trend.

雖然資訊還不是最終版本，但我們很高興看到這項重要項目的資金有可能發生積極的方向性轉變，包括納入更高水平的基本醫療成本趨勢。

Final rates are expected in April, and we will continue to assess the various program changes anticipated for 2026 and the funding necessary to maintain compelling plans and create value for seniors as we build out our preliminary 2026 strategy.

最終費率預計在四月公佈，我們將繼續評估預計在 2026 年出現的各項計劃變化，以及在製定 2026 年初步戰略時維持引人注目的計劃和為老年人創造價值所需的資金。

Within our Medicare segment's 2024 performance as a strong jump-off point, we are excited to build upon the operational progress we made last year while taking important steps on our path towards breakeven in Medicare Advantage in 2027.

在我們的醫療保險部門 2024 年表現作為一個強勁的起點的情況下，我們很高興能夠在去年取得的營運進展的基礎上再接再厲，同時在 2027 年實現醫療保險優勢收支平衡的道路上邁出重要一步。

Finally, Marketplace.

最後，市場。

Across our footprint, our Marketplace team has demonstrated consistently strong results through disciplined pricing, strong distribution relationships, as well as unmatched local knowledge of the Marketplace population; and better delivered an outstanding performance in 2024 and carried that momentum into their 12th open enrollment period, once again executing well on fundamentals and positioning our portfolio of products for another year of strength in 2025.

在我們的業務範圍內，我們的市場團隊透過嚴格的定價、強大的分銷關係以及對市場人口無與倫比的本地知識，持續取得了強勁的業績；並在 2024 年取得了出色的表現，並將這一勢頭帶入了第 12 個開放註冊期，再次在基本面上表現良好，並為我們的產品組合在 2025 年再次強勁發展做好了準備。

According to CMS, enrollment across the ACA market grew roughly 13%.

據 CMS 稱，ACA 市場的入學人數增加了約 13%。

But given the program integrity changes such as FTR or failure to report and the agent-of-record lock, our focus has been on effectuated membership.

但考慮到 FTR 或未報告以及代理記錄鎖定等計劃完整性變化，我們的重點一直放在有效的會員資格上。

For Ambetter, January effectuated enrollment turned out to be a little stronger than what we had incorporated into our outlook for the business at our Investor Day in December, driven by strong member retention.

對於 Ambetter 而言，由於會員保留率較高，1 月份的實際註冊人數比我們在 12 月份投資者日的業務前景中預期的要稍微強勁一些。

Overall, effectuation rates to date are directly in line with historical norms for Ambetter, which positions us for a peak Marketplace membership during the first quarter, slightly above five million members.

總體而言，迄今為止的實施率與 Ambetter 的歷史標準一致，這使我們在第一季的市場會員數量達到頂峰，略高於 500 萬會員。

Looking down one level deeper, the demographic of our effectuated membership is similar to the member mix in 2024.

進一步深入來看，我們實際會員的人口結構與 2024 年的會員結構相似。

Our book is expected to be roughly 51% female with an average age of 39.4, continuing a year-over-year trend of slightly younger membership.

預計我們的會員中女性佔比約為 51%，平均年齡為 39.4 歲，延續會員人數逐年略微年輕的趨勢。

At the same time, our metal tier shifted slightly towards Silver.

同時，我們的金屬等級略微向銀級傾斜。

While we have been near 70% Silver over the last few years, in 2025, we expect to have nearly 75% of our membership in Silver plans, consistent with earlier years of the program.

雖然過去幾年我們的銀卡會員比例接近 70%，但到 2025 年，我們預計銀卡會員比例將接近 75%，與該計劃前幾年的比例一致。

As a reminder, our outlook continues to provide for an anticipated return to the pre-COVID era membership seasonality, with net attrition down to the mid-four million by year-end.

提醒一下，我們的預期是，會員人數將恢復到疫情前的季節性，到年底淨流失人數將降至 400 萬左右。

Overall, we are pleased with the early indicators around our Marketplace business and believe that we positioned ourselves well in 2024 by being the first carrier to introduce an agent-of-record lock.

總體而言，我們對我們的 Marketplace 業務的早期指標感到滿意，並相信作為第一家引入代理記錄鎖的運營商，我們在 2024 年佔據了良好的地位。

Our views through January suggests a more muted impact to membership from the program integrity changes than originally anticipated.

根據我們 1 月的觀點，專案完整性變更對會員資格的影響比最初預期的要小。

But we believe some may require a longer tail to play out and that it will be a few months until effectuated enrollment results are fully understood.

但我們認為，有些可能需要更長的時間才能發揮作用，而且需要幾個月的時間才能完全了解實際的招生結果。

As you would expect, we will continue to closely monitor effectuation rates, voluntary member terminations, and other trends within our book as we move through the first quarter.

正如您所期望的，在第​​一季度，我們將繼續密切關註生效率、自願會員終止以及我們帳簿上的其他趨勢。

As we think about future trends in the individual market, I did want to call out the strong results we saw during open enrollment in our Georgia market.

當我們思考個人市場的未來趨勢時，我確實想指出我們在喬治亞州市場公開招生期間看到的強勁業績。

We were pleased to be able to support Commissioner King and the state of Georgia as they made their transition to being a state-based exchange.

我們很高興能夠支持金委員和喬治亞州向州級交易所的轉型。

And we are excited to see how Georgia Access provides a model for advancing the growth of the individual market, both on and off exchange, which includes access to ICRA.

我們很高興看到 Georgia Access 如何提供一個推動個人市場（包括場內和場外）成長的模型，其中包括造訪 ICRA。

As we shared in December, we continue to view ICRA as the future of health insurance for working Americans and is an important part of Centene's future earnings power.

正如我們在 12 月所分享的那樣，我們繼續將 ICRA 視為美國工人醫療保險的未來，也是 Centene 未來盈利能力的重要組成部分。

In January, we announced the addition of Alan Silver to our leadership team.

今年一月，我們宣布艾倫·西爾弗 (Alan Silver) 加入領導團隊。

Alan is now President of Ambetter Health Solutions, which focuses on ICRA or individual coverage health reimbursement arrangements.

艾倫現在是 Ambetter Health Solutions 的總裁，該公司專注於 ICRA 或個人保險健康報銷安排。

Alan previously led retiree medical and ICRA initiatives at Willis Towers Watson, and we are thrilled that he has joined our team.

艾倫 (Alan) 之前曾在 Willis Towers Watson 領導退休人員醫療和 ICRA 計劃，我們很高興他加入我們的團隊。

As we turn the page to a new year, it is important to acknowledge the incredible amount of hard work and tenacity from the Centene team that enabled Centene to deliver on our financial commitments in 2024.

當我們翻開新的一年之際，我們必須承認 Centene 團隊的辛勤工作和毅力，這使得 Centene 能夠在 2024 年履行我們的財務承諾。

Countless obstacles and macro-level challenges faced by our team and our industry at large require focus and execution by colleagues from across our organization.

我們的團隊和整個行業面臨的無數障礙和宏觀挑戰需要整個組織的同事的關注和執行。

As a result of staying tightly aligned to our strategic goals and our mission, we are now well positioned to capitalize on the important opportunities that we see ahead of us in 2025 and beyond.

由於緊密結合我們的策略目標和使命，我們現在已做好準備，可以利用 2025 年及以後面臨的重要機會。

In 2025, we expect to collaborate with our state partners to achieve better alignment for Medicaid rates and member acuity.

2025 年，我們希望與州合作夥伴合作，實現醫療補助費率和會員敏銳度的更好協調。

Our Medicare Advantage business, following successful execution during AEP, will focus on key operational initiatives to drive us forward on our journey to breakeven in 2027.

我們的醫療保險優勢業務在 AEP 期間成功執行後，將專注於關鍵營運舉措，推動我們在 2027 年實現收支平衡。

And as the category leader, our Marketplace team will once again offer access to high-quality and affordable healthcare this year to approximately five million Americans.

作為類別領導者，我們的市場團隊今年將再次為大約五百萬美國人提供高品質且負擔得起的醫療服務。

There is significant earnings power embedded in this business.

這項業務蘊含著巨大的獲利能力。

With between $3 and $4 of adjusted EPS opportunity to unlock over time, we are eager to achieve our next set of enterprise milestones, deliver on our commitments to our members, and generate shareholder value in 2025 and beyond.

隨著時間的推移，調整後每股盈餘有機會達到 3 至 4 美元，我們渴望實現下一組企業里程碑，履行對會員的承諾，並在 2025 年及以後創造股東價值。

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

說完這些，我會把話題交給德魯。

Thank you, Sarah.

謝謝你，莎拉。

Today, we reported fourth-quarter 2024 results, including $36.3 billion in premium and service revenue, and adjusted diluted earnings per share of $0.80 in the quarter.

今天，我們報告了 2024 年第四季的業績，其中包括 363 億美元的保費和服務收入，以及本季調整後每股攤薄收益 0.80 美元。

For the full year, we reported $7.17 of adjusted EPS, well ahead of our previous guidance.

我們報告的全年調整後每股收益為 7.17 美元，遠高於我們先前的預期。

In addition to ending the year strong, our results include a $0.29 net benefit for a Marketplace cost sharing reduction or CSR settlement related to prior years.

除了以強勁的業績結束今年的業績之外，我們的業績還包括與前幾年相關的市場成本分攤減少或 CSR 結算的 0.29 美元淨收益。

Our Q4 consolidated HBR was 89.6%, while our full-year consolidated HBR was 88.3%, consistent with our previous guidance range.

我們第四季的合併 HBR 為 89.6%，而全年的合併 HBR 為 88.3%，與我們先前的指導範圍一致。

Our Q4 Medicaid HBR was 93.4%, up 30 basis points from Q3.

我們第四季的醫療補助 HBR 為 93.4%，比第三季上升了 30 個基點。

We were expecting a couple of late-year 2024 retro adjustments that did not come in by year-end.

我們原本預計 2024 年底會進行一些追溯調整，但到年底並沒有實現。

Medicaid trend story is similar to our last discussion, stable trends overall, now that we are essentially through redeterminations other than behavioral health and some pockets of home health costs consistent with past commentary.

醫療補助趨勢故事與我們上次討論的情況類似，總體趨勢穩定，現在我們基本上透過除了行為健康和一些家庭保健成本之外的重新確定與過去的評論一致。

Our full-year 2024 Medicaid HBR at 92.5%, temporarily high driven by redeterminations, presents us meaningful earnings power over the next couple of years as we turn the page on 2024 and better match rates and acuity going forward.

我們 2024 年全年的醫療補助 HBR 為 92.5%，受重新確定的推動暫時處於高位，隨著我們翻開 2024 年的新篇章，未來幾年我們將擁有有意義的盈利能力，並且匹配率和敏銳度也將更高。

Case in point, we are yielding around the mid-4s in net rate increases for the 1125 cohort, which now represents about 40% of our annual Medicaid premium.

舉個例子，我們為 1125 名群體帶來了約 4% 左右的淨費率增幅，這部分人口目前約占我們年度醫療補助保費的 40%。

The Medicaid membership settled out right in that 12.9 million to 13 million zone we had targeted.

醫療補助計劃的會員人數正好位於我們所設定的1,290萬至1,300萬範圍內。

And our 2025 guidance is predicated on staying in this membership zone throughout 2025.

我們的 2025 年指導目標是建立在 2025 年全年保持在這個會員區的基礎上。

Medicare segment performance was strong in Q4, including a very good overall 2024 performance in PDP, as a few of you were concerned with the inflation Reduction Act at the beginning of 2024.

醫療保險部門在第四季度表現強勁，其中 PDP 在 2024 年的整體表現非常好，因為你們中的一些人擔心 2024 年初的通貨膨脹削減法案。

The Q4 PDR-related cost in Medicare Advantage were consistent with what we last told you.

Medicare Advantage 中第四季的 PDR 相關成本與我們上次告知的情況一致。

Commercial segment results were strong in Q4 due to the CSR settlement.

得益於企業社會責任的解決，商業部門第四季業績強勁。

Otherwise, they were right on track.

否則，他們就走在了正確的軌道上。

Overall, exiting 2024 in a position of strength should bode well as we enter 2025.

總體而言，如果我們在 2024 年結束時保持強勁勢頭，那麼進入 2025 年將是一個好兆頭。

And continued Medicaid rate action as well as execution on initiatives designed to improve quality and the affordability of healthcare should enable us to achieve our 2025 Medicaid goals.

持續的醫療補助費率行動以及旨在提高醫療品質和可負擔性的措施的實施，應該能夠讓我們實現 2025 年的醫療補助目標。

Moving to other P&L and balance sheet items.

轉到其他損益表和資產負債表項目。

Our adjusted SG&A expense ratio was 8.9% in the fourth quarter compared to 9.7% last year, a continued blend of business mix and discipline.

我們第四季的調整後銷售、一般及行政費用率為 8.9%，而去年同期為 9.7%，這是業務組合和紀律的持續整合。

Cash flow provided by operations was only $154 million for the full year, driven by the timing of pharmacy rebate collections, the reduction in risk adjustment payables, and the buildup of state premium payments receivable.

受藥局回扣收取時間安排、風險調整應付款項減少以及應收州保費付款增加的影響，全年經營活動提供的現金流僅為 1.54 億美元。

As these items normalize in future periods, it sets us up for stronger operating cash flow in 2025.

隨著這些項目在未來期間正常化，我們將在 2025 年實現更強勁的營運現金流。

Our unregulated and unrestricted cash on hand at quarter-end was $248 million.

我們季度末的不受監管和不受限制的現金餘額為 2.48 億美元。

During the fourth quarter, we repurchased 14.4 million shares of our common stock for $930 million.

第四季度，我們以 9.3 億美元回購了 1,440 萬股普通股。

For the full-year 2024, we repurchased 42 million shares for $3 billion.

2024 年全年，我們以 30 億美元回購了 4,200 萬股。

We have taken out over 100 million shares in the past few years.

我們在過去幾年已經賣出了超過1億股。

At the same time, our debt to adjusted EBITDA was only 2.9 times at year-end.

同時，我們年底的債務與調整後 EBITDA 比率僅為 2.9 倍。

Our medical claims liability totaled $18.3 billion at year-end and represents 53 days in claims payable compared to 51 in Q3 of 2024 and 54 in Q4 of 2023.

截至年底，我們的醫療索賠負債總額為 183 億美元，索賠應付天數為 53 天，而 2024 年第三季為 51 天，2023 年第四季為 54 天。

One DCP note looking ahead, given the meaningful growth in PDP in 2025, largely driven by the inflation Reduction Act, and the fact that pharmacy claims complete very quickly compared to medical claims, this should lower our consolidated DCP by a few days in 2025.

展望未來，DCP 的一條注意事項是，鑑於 2025 年 PDP 的顯著增長（這主要受到《通膨削減法案》的推動），以及藥房索賠與醫療索賠相比完成得非常快的事實，這將使我們在 2025 年的合併 DCP 降低幾天。

While 2024 was certainly a challenging year, we still grew adjusted EPS over 7%, powered through redeterminations, made some great progress in Medicare Stars, and seized new growth opportunities in Marketplace and PDP.

雖然 2024 年無疑是充滿挑戰的一年，但我們的調整後每股收益仍增長超過 7%，透過重新確定，我們在 Medicare Stars 方面取得了重大進展，並抓住了 Marketplace 和 PDP 中的新增長機會。

Let's turn the page and look ahead.

讓我們翻開新的一頁，展望未來。

As you heard from Sarah, our Marketplace open enrollment period reflects very good execution by our team and keeps us on track for our 2025 forecast elements covered at Investor Day.

正如您從莎拉那裡聽到的，我們的市場開放註冊期反映了我們團隊的良好執行力，並使我們有望實現投資者日所涵蓋的 2025 年預測要素。

We expect to peak right above five million Marketplace members during Q1 and then a trip, the remainder of the year, back to the mid-4s, consistent with pre-COVID enrollment patterns, where Q1 was typically the annual peak of membership.

我們預計，第一季市場會員數量將達到 500 萬以上的峰值，然後，在今年剩餘時間內，會員數量將回到 4% 左右，這與新冠​​疫情之前的註冊模式一致，而第一季通常是會員數量的年度峰值。

And we need to see the pattern of membership throughout Q1 2025 before we touch commercial revenue guidance of $34 billion.

在我們達到 340 億美元的商業收入預期之前，我們需要了解 2025 年第一季的會員模式。

In our Medicare business, 2025 volume has started out stronger than expected, driven by the annual enrollment period results, notably driven by stronger retention.

在我們的醫療保險業務中，2025 年的業務量開局強於預期，這得益於年度註冊期結果，尤其是更強的保留率。

And our PDP business was over 7.5 million members as we entered 2025.

到 2025 年，我們的 PDP 業務會員數量已超過 750 萬。

Accordingly, we expect the Medicare segment to be about $2.5 billion higher in premium revenue in 2025 than what we discussed at Investor Day in December.

因此，我們預計 2025 年醫療保險部門的保費收入將比我們 12 月投資者日討論的金額高出約 25 億美元。

In addition to that $2.5 billion, there's another expected $1.5 billion in Medicaid revenue from program change, adding behavioral health coverage in one of our state contracts.

除這 25 億美元外，預計還將從計劃變更中獲得 15 億美元的醫療補助收入，在我們的一項州合約中增加了行為健康保險。

So we are increasing our consolidated 2025 premium and service revenue guidance range by $4 billion to a range of $158 billion to $160 billion of premium and service revenue.

因此，我們將 2025 年綜合保費和服務收入預期範圍提高 40 億美元，至 1580 億美元至 1600 億美元的保費和服務收入範圍。

This is good news as you think about the long-term earnings power of Centene.

當您考慮 Centene 的長期盈利能力時，這是個好消息。

At this very early point in the year, we are reiterating our 2025 adjusted diluted EPS guidance floor of greater than $7.25.

今年年初，我們重申 2025 年調整後攤薄每股收益指引底線將超過 7.25 美元。

A quick comment on 2026 Medicare rates.

對 2026 年醫療保險費率的簡短評論。

The preliminary percentage rate change for us is in the low to mid-3s, including the positive impact of Stars from the work we did in 2023 and 2024.

對我們來說，初步的百分比變化在 3% 左右，其中包括我們在 2023 年和 2024 年所做工作對 Stars 的正面影響。

It's great to have 2024 behind us and have earnings power consistent with our Investor Day discussion in front of us.

很高興 2024 年已經過去，我們的盈利能力與我們面前的投資者日討論的一致。

As importantly, we are really excited about the number of initiatives in flight and in our sites designed to make healthcare simpler, more accessible, and more affordable, just like we've been able to help shape the Marketplace, which has been a great solution for over 23 million Americans.

同樣重要的是，我們對正在進行的和我們的網站中提出的許多旨在使醫療保健變得更簡單、更容易獲得和更實惠的舉措感到非常興奮，就像我們能夠幫助塑造市場一樣，這已經為超過 2300 萬美國人提供了一個很好的解決方案。

We are proud and honored to serve members, states, and the federal government in Medicaid, Medicare, and Marketplace programs into 2025 and beyond.

我們非常自豪和榮幸能夠在 2025 年及以後為會員、州和聯邦政府提供醫療補助、醫療保險和市場計劃服務。

Thank you for your interest in Centene.

感謝您對 Centene 的關注。

Rocco, let's open up the line for questions.

羅科，讓我們開始提問吧。

(Operator Instructions) Josh Raskin, Nephron Research.

（操作員指示）Josh Raskin，Nephron Research。

Hi, thanks.

嗨，謝謝。

Good morning.

早安.

I heard the 13% on the exchanges.

我聽說交易所的費率是 13%。

But maybe you could speak to your expectations around total exchange market growth when all is said and done in 2025 and maybe a little bit more color on what you're seeing around that subsidy verification process.

但也許您可以談談對 2025 年整體外匯市場成長的預期，也許可以更詳細地介紹一下您對補貼驗證流程的看法。

And then maybe you can just walk us through the mechanics of how that works at the member level and when you think you'll know your full effectuated membership totals?

然後，也許您可以向我們介紹會員層面的運作機制，以及您認為何時會知道全部實際會員總數？

Yeah, absolutely.

是的，絕對是如此。

Thanks, Josh, for the question.

謝謝喬希提問。

So CMS put out 13 million -- or sorry, 13% as the -- January-to-January enrollment growth.

因此，CMS 的 1 月入學人數增加了 1,300 萬，或者說，13%（抱歉，成長了 13%）。

As we've talked about before, our view was that effectuated membership was going to be sort of the important number to track, partly because of the program integrity changes that were being put in place.

正如我們之前談到的，我們認為有效會員人數將成為需要追蹤的重要數字，部分原因是正在實施的計畫完整性變更。

And we referenced what we are seeing at December Investor Day in terms of slower throughput relative to over enrollment because of the agent-of-record lock that we saw improved as we move through OE.

我們參考了 12 月投資者日看到的情況，由於記錄代理人鎖定，相對於超額註冊而言，吞吐量較低，而隨著我們通過 OE，我們看到記錄代理人鎖定的情況有所改善。

But we still think there's probably a little bit of backlog that is being worked through there.

但我們仍然認為，那裡可能還有一些積壓工作需要處理。

And then, again, the FTR, failure-to-report process, I think we had anticipated a little bit more impact in the OE period.

然後，再次，FTR，未報告流程，我認為我們預計在OE期間會產生更多的影響。

That appears to be more muted.

這似乎更加低調。

But that's where we also think there is potentially a longer tail for that to play out.

但我們也認為，這種情況可能會持續更長的時間。

And so to your point, sort of the step doing that -- stepping through that as an illustrative process, what happens there is a notification to the member of the need to file taxes and sort of notification sent to the members relative to the impact that that would have on enhanced APTCs.

對於您的觀點，請按照這個步驟來做 — — 作為一個說明性的過程，會向成員發出需要申報納稅的通知，並向成員發送有關這將對增強型 APTC 產生的影響的通知。

Consumers have the opportunities to attest having filed taxes.

消費者有機會證明已經申報了稅金。

And then there's a process of multiple checkpoints as we move through February and March, and ultimately, into the April window.

然後，我們會經過二月、三月以及最終進入四月的多個檢查點。

And so that's part of why we think there may be additional impact that we see in Q2.

這就是我們認為第二季可能會產生額外影響的原因之一。

And so we're continuing to hold our view relative to impact on effectuated enrollment, but we're going to need to see how that plays out.

因此，我們將繼續堅持對實際入學率的影響的看法，但我們需要觀察其結果如何。

So a little bit stronger in terms of our effectuation in January, which means we're starting from a good place, which is great.

因此，從一月份的效果來看，我們的業績會更強勁一些，這意味著我們有一個好的開端，這很好。

But we want to see a couple more months play out until we know where that's going to settle.

但我們希望再觀察幾個月的情況，才能知道最終結果。

And I think you said the effectuation levels are similar to what you've seen in the past.

我認為您說的效果程度與您過去看到的類似。

So what is that delta?

那麼該增量是多少？

If there's 13% total growth, what do you think that translates into effect rate?

如果總成長率為 13%，您認為這轉化為有效率是多少？

Or should we say, well, if effectuation is the same percentage, then 13% market growth is 13% of effectuated growth?

或者我們應該說，如果效果是相同的百分比，那麼 13% 的市場成長就是效果成長的 13%？

There's usually a delta between enrollment and effectuation.

註冊和生效之間通常存在一個差異。

And again, our -- what we're seeing from an effectuation standpoint is, as you said, directly in line with historical norms.

再說一次，從效果的角度來看，我們所看到的，正如您所說，與歷史規範是一致的。

So our -- the growth that we saw was a little bit stronger than the 13%.

所以我們看到的成長比 13% 稍微強勁一些。

And the effectuation then, that retention from our book, is putting our membership at slightly above five million.

然後，我們的書籍保留效果將使我們的會員人數略高於五百萬。

But again, I think we need to see how the program integrity impacts play out in Q2 to know what the net market growth post effectuations will look like.

但同樣，我認為我們需要觀察專案完整性的影響在第二季如何發揮作用，才能知道實施後的淨市場成長。

Justin Lake, Wolfe Research.

賈斯汀·萊克（Justin Lake），沃爾夫研究公司。

Thanks.

謝謝。

Good morning.

早安.

Just a couple of quick numbers questions.

只要問幾個簡單的數字問題。

First, it looks like the PYD in the quarter was north of $400 million, up about $300 million year over year.

首先，本季的 PYD 看起來超過 4 億美元，比去年同期增加了約 3 億美元。

Can you tell us what drove that?

你能告訴我們是什麼原因造成的嗎？

And Drew, I know it doesn't all hit the bottom line, so maybe you could tell us the net benefit there.

德魯，我知道這並不全都影響到利潤，所以也許你可以告訴我們那裡的淨收益。

And then just quickly on the Medicaid retros that didn't hit in the fourth quarter, anything you could share on the size there?

然後快速談談第四季未實現的醫療補助追溯，您可以分享其規模嗎？

And is it just a timing issue where they'll hit in Q1, or did they just not happen at all?

這只是一個時間問題，他們會在第一季實現這個目標，還是根本沒有實現？

Thanks.

謝謝。

Yeah.

是的。

Why don't I hit the retros, and then if you want to talk about PYD.

我為什麼不先回顧一下，然後再談論 PYD。

So as you heard from Drew, we had rate action expected late in the quarter.

正如您從德魯那裡聽到的，我們預計本季末將採取利率行動。

It didn't come through.

但事與願違。

We're not counting on that in 2025.

我們不指望 2025 年就能實現這一目標。

So to the extent that any of that does materialize, it would be a benefit to '25.

所以只要這些變成現實，就會對‘25’有利。

We did see positive movement in the 1-1 rates.

我們確實看到 1-1 匯率出現了正面變化。

And in some cases, those are sort of linked.

在某些情況下，它們是有關聯的。

And so that's where you saw the mid-4 composite rate for 1-1.

這就是您所看到的 4 個中間綜合比率為 1-1 的地方。

So very consistent with the theme that we've seen throughout this process, which is I think we've made great progress in terms of being able to influence states with data and get to the right level of rates.

與我們在整個過程中看到的主題非常一致，我認為我們在利用數據影響各州並達到正確的利率水平方面取得了巨大進展。

We just aren't always perfect in predicting the timing.

我們並不總是能夠完美地預測時間。

Justin, you're right, with the prior-year development.

賈斯汀，你是對的，考慮到前一年的發展。

If you look on the last page of the press release, we had about a little over $2.4 billion for the full year, including strength in Q4.

如果你看新聞稿的最後一頁，你會發現我們全年的收入約為 24 億美元，其中包括第四季度的收入。

That includes the CSR.

其中包括企業社會責任。

That's a medical expense item of over a couple of hundred million.

這可是一筆上億的醫療費用。

So that leaned into, probably, that differential you're referring to in Q4.

因此，這可能傾向於您在第四季度提到的差異。

Stephen Baxter, Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

Hi, thanks.

嗨，謝謝。

Just wanted to ask about the Medicaid rate assumptions.

只是想詢問有關醫療補助費率的假設。

I mean, based on the rates that you're getting for 1-1, it seems like the rest of the year placeholder something probably in the zone of 2%, 2.5%.

我的意思是，根據您獲得的 1-1 利率，似乎今年剩餘時間的佔位符可能在 2%、2.5% 之間。

And logically, it seems like every rate update you get going forward should be better informed, both from a cost and acuity perspective.

從邏輯上講，無論從成本還是敏銳度的角度來看，您今後獲得的每個費率更新似乎都應該更加明智。

Is there anything structurally different about the dislocation in the rest of the book, that suggest that a lower rate update would really be kind of a sensible base case at this point?

本書其他部分的錯位在結構上是否有什麼不同，從而顯示較低的利率更新在目前確實是合理的基本情況？

Or how should we think about the conservatism potentially of the assumptions you're making in Medicaid rates for the second half of the year?

或者我們應該如何看待您對今年下半年醫療補助費率所做的假設的潛在保守性？

Thank you.

謝謝。

Yeah.

是的。

I mean, again, we continue to expect the full-year 2025 composite rate between 3% and 4%, obviously, a little bit stronger in that 1-1 cohort.

我的意思是，我們繼續預計 2025 年全年綜合利率將在 3% 至 4% 之間，顯然，在 1-1 組中利率會略高一些。

I think you're right that coming into all of these conversations with more robust data, just as time has rolled forward and being able to really see the run out and move forward sort of the prior period from an actuarial standpoint.

我認為您說得對，隨著時間的推移，在所有這些對話中都需要更加可靠的數據，從精算的角度來看，我們能夠真正看到前一時期的結束和發展。

So I think that is part of why we saw some of the strength in the 1125 rate.

所以我認為這就是我們看到 1125 匯率有一定強勢的原因之一。

Again, really constructive conversations with the state partners and really database, and how we're looking at everything.

再次，與國家合作夥伴和資料庫進行真正建設性的對話，以及我們如何看待一切。

So I don't think there's anything structurally different.

所以我認為從結構上來說沒有什麼不同。

I will point out that as we've gone through the back half of '24, the degree to which states are open to things like retros midyear adjustments and just understanding that we need to get to a place where the programs are funded sufficiently in order to make sure that we are supporting members the way that they want to, I think, is probably different than we've seen in the past.

我要指出的是，當我們經歷 24 年下半年時，各州對諸如年中調整之類的事情的開放程度以及對我們需要找到一個項目獲得足夠資金的地方以確保我們以成員想要的方式支持他們的理解程度，我認為，這可能與我們過去所看到的不同。

And so again, I think that makes us feel good about how we're positioned moving into 2025.

因此，我認為這讓我們對自己邁向 2025 年的定位感到滿意。

But as you heard, it is a question of getting the timing to line up.

但正如你所聽到的，這是一個時機把握的問題。

And that's why we think that we'll make progress in 2025 toward that equilibrium in terms of long-term margin.

這就是為什麼我們認為我們將在 2025 年朝著長期利潤的平衡邁進。

But it may play out through the course of the year.

但這趨勢可能會在今年內逐漸顯現。

AJ Rice, UBS.

瑞銀的 AJ Rice。

Hi, everybody.

大家好。

Maybe just ask about two things.

也許只問兩件事。

One, on the Medicaid side, when you look at the underlying utilization trend, trying to normalize, which I know it's probably hard for redetermination impact, are you seeing it return to sort of your normal low single-digit cost trend?

首先，就醫療補助方面而言，當您查看潛在的利用率趨勢並試圖使其正常化時，我知道這可能很難重新確定影響，您是否看到它恢復到正常的低個位數成本趨勢？

Or is it still somewhat elevated on just an apples-to-apples year-over-year basis?

或者只是按年比較的話，它是否仍然有所增加？

And then on the Medicare medical loss ratio ended up being better than expected.

然後，醫療保險的醫療損失率最終好於預期。

And I know there's reference to an adjustment to the premium efficiency reserve.

我知道其中提到了保費效率儲備金的調整。

I'm just trying to understand what are you seeing there on the cost trend versus the adjustment that you made relative to the premium deficiency reserve?

我只是想了解您在成本趨勢方面看到了什麼以及您針對保費不足準備金所做的調整是什麼？

Yeah.

是的。

On Medicaid, I think as you heard from Drew, no new trends to report.

關於醫療補助，我想正如你從德魯那裡聽到的，沒有什麼新的趨勢可以報告。

And we continue to look at that cohort of continuous members to evaluate how sort of apples-to-apples trend is evolving.

我們會繼續關注這群持續會員，以評估同類趨勢是如何演變的。

Nothing alarming there.

沒有什麼值得擔憂的。

So it's really the same story that we've been sharing over the last couple of quarters.

這其實和我們過去幾季所分享的故事是一樣的。

Also felt good about the run rate medical expense that evolved in Q4 and exiting the quarter better than we started.

對第四季度的醫療費用運行率也感到滿意，並且本季末的情況比開始時更好。

So nothing has really shifted there.

所以那裡實際上什麼都沒有改變。

And then from a Medicare standpoint, Drew, do you want to talk about Q4 and full year?

然後從醫療保險的角度來看，德魯，您想談談第四季和全年的情況嗎？

Yeah.

是的。

Medicare finished strong.

醫療保險表現強勁。

The performance -- the outperformance in the quarter was largely driven by PDP.

本季的優異表現主要得益於 PDP。

So we finished PDP very strong, which is good to see and sort of the first major year of the IRA changes in 2024, sort of getting the bids and the execution and the cost structure, right?

因此，我們非常順利地完成了 PDP，這是令人欣慰的，2024 年也是 IRA 變革的第一個重要年頭，可以獲得投標、執行和成本結構，對吧？

So that gives us some confidence as we enter 2025 with further changes in the IRA as reflected in the guidance we laid out at Investor Day.

因此，這給了我們一些信心，因為我們將在 2025 年進入 IRA 的進一步變化，正如我們在投資者日制定的指導方針所反映的那樣。

Adam Ron, Bank of America.

美國銀行的亞當‧羅恩 (Adam Ron)。

Hey.

嘿。

Thanks for the question.

謝謝你的提問。

You guys didn't really touch on seasonality for 2025, at least, not on this call.

你們並沒有真正談及 2025 年的季節性，至少在這次電話會議上沒有。

So I'm curious in terms of Medicaid MLR, if you still expect sequential Medicaid MLR declines in every quarter throughout the year; and if there's any indication you can give us, like, where you think Q1 will end and what the slope of that curve looks like.

所以我對 Medicaid MLR 的情況很好奇，您是否仍預計全年每季的 Medicaid MLR 都會連續下降；如果您能給我們任何跡象，例如，您認為第一季將在何時結束以及該曲線的斜率是多少。

It'd be very helpful.

這將會非常有幫助。

Thanks.

謝謝。

Yeah, that's a good question.

是的，這是個好問題。

As we think about -- so think about our three segments, commercial -- consistent with the past, you expect the HBR to start low and tick up throughout the year, as members satisfy deductibles and so on.

當我們思考 - 思考我們的三個商業部分 - 與過去一致時，您預計 HBR 將從低處開始，並在全年上升，因為會員滿足免賠額等等。

In Medicare, pretty big difference.

在醫療保險方面，差別很大。

Instead of sloping down through the year, it should start out lower in the Medicare segment and slope up through the year.

它不應該在全年呈下降趨勢，而應該從醫療保險部分開始下降，然後在全年呈上升趨勢。

And that's really driven by what's now about half of our Medicare segment revenue coming from PDP and the IRA changes.

這實際上是由於目前我們大約一半的醫療保險部門收入來自 PDP 和 IRA 變化。

So that's something to watch out for as we go through the year, once again, a sloping upward Medicare HBR.

因此，當我們度過這一年時，我們需要注意這一點，因為醫療保險 HBR 將再次呈現上升趨勢。

And then Medicaid, as we said at Investor Day, back half should be better than the front half.

然後是醫療補助，正如我們在投資者日所說的那樣，後半部分應該比前半部分更好。

In terms of HBR, the front-half HBR of 2025, certainly, expect that to be better than the back half of 2024 HBR.

就 HBR 而言，2025 年上半年的 HBR 肯定會比 2024 年下半年的 HBR 更好。

So you put all those things together, and what we said at Investor Day was about 60/40 in terms of earnings per share first half versus second half, probably should be better than 60% or greater than 60% in the first half of the year relative to the back half.

所以把所有這些因素綜合起來，我們在投資者日所說的是上半年和下半年每股收益的比例大約是 60/40，相對於下半年，上半年可能應該會好於或超過 60%。

Sarah James, Cantor Fitzgerald.

莎拉詹姆斯 (Sarah James)，費茲傑拉領唱者。

Thank you.

謝謝。

I'm hoping you can help us bridge the old to the new guidance a little bit.

我希望您能幫助我們稍微銜接一下新舊指南。

So you've got $4 billion more in revenue.

所以你的收入增加了 40 億美元。

EPS stayed the same.

每股收益維持不變。

Is there any other moving pieces, or is it just conservatism?

還有其他因素嗎，還是只是保守主義？

And then, specifically, to how you're thinking about now for exchanges and Part D, would those merchants be flat up or down year over year?

然後，具體來說，對於交易所和 D 部分，您現在的想法是，這些商家的數量與去年同期相比是持平還是下降？

Thanks.

謝謝。

Yeah.

是的。

So I would say, we haven't yet closed January.

所以我想說，我們還沒結束一月。

So it's a little bit early.

所以現在還有點早。

And I think we've pointed to some solid early results but wanting to see how those play out in terms of membership and experience.

我認為我們已經指出了一些可靠的早期成果，但希望看看這些成果在會員和經驗方面如何發揮作用。

And then in terms of PDP margin, we said we're still targeting that 1% for the PDP book.

然後就 PDP 利潤率而言，我們表示我們仍將 PDP 利潤率定為 1%。

And relative to Marketplace, we've said and continue hold that we would be well into the 5% to 7.5% range for Marketplace.

相對於 Marketplace，我們已經說過並繼續堅持 Marketplace 的份額將保持在 5% 到 7.5% 的範圍內。

And that includes what we've seen so far.

其中包括我們迄今所見的一切。

You're right to point out the $4 billion, that's earnings power for the future.

您說得對，40 億美元是未來的獲利能力。

It's just real early to sort of endpoint exactly how much of that will show up in 2025.

現在預測 2025 年會出現多少這樣的情況還為時過早。

But we're really excited as we create additional revenue sources that bodes well for long-term earnings power for the company.

但我們真的很高興，因為我們創造了額外的收入來源，這對公司的長期獲利能力來說是一個好兆頭。

Scott Fidel, Stephens.

史考特菲德爾、史蒂芬斯。

Hi, thanks.

嗨，謝謝。

Good morning.

早安.

I was hoping, just given some of the moving pieces that we saw in 2024 on operating cash flow, whether you'd be comfortable maybe just giving us a bit more of a sort of fine-tuning on your expectations for operating cash flow in 2025.

我希望，考慮到我們在 2024 年經營現金流中看到的一些變化因素，您是否願意對 2025 年經營現金流的預期進行一些微調。

And then just related to that, maybe sort of your updated thinking around what's embedded at this point for buybacks in terms of full-year buybacks, and then any sort of pacing around that?

然後與此相關的是，也許您對目前回購的具體內容有什麼新的想法，例如全年回購的內容，以及圍繞回購的節奏有什麼新的想法？

Just curious on whether sort of 2024 operating cash flows influence the trajectory of that.

只是好奇 2024 年的營運現金流是否會影響這一軌跡。

But at the same time, you ended the year at a pretty solid spot in terms of unregulated cash at the parent.

但同時，就母公司不受監管的現金而言，你們在今年底的業績表現相當穩健。

Thanks.

謝謝。

Good questions.

好問題。

And I'm sure you understand this.

我相信你明白這一點。

And those that understand the HMO industry understand that there's a difference between the cash flow operations on the cash flow statement, which is really the activity of receivables and payables down embedded in the statutory entities.

了解 HMO 行業的人都知道，現金流量表上的現金流量操作與法定實體中嵌入的應收帳款和應付帳款活動是有區別的。

But when that rolls up, if you look at the last actually three to five years, we've averaged 1.3 to 1.4 times adjusted net income.

但如果你回顧過去三到五年，你會發現，我們的平均調整後淨收入為 1.3 到 1.4 倍。

So that's -- if you sift through any given year of satisfying risk adjustment payables or building up pharmacy rebate receivables and look at an extended time period, that's a pretty good indicator of a multiyear view.

因此，如果您仔細研究任何一年滿足風險調整應付款項或建立藥局回扣應收款項的情況，並查看一段較長的時間段，這就是多年期觀點的一個相當好的指標。

Underneath that, what really matters, as you point out appropriately, is the cash you're able to dividend up to the parent from the subs.

在這之下，正如您恰當地指出的那樣，真正重要的是您能夠從子公司中分紅給母公司的現金。

And we've got no change in view compared to what we rolled out at Investor Day, where we expect about $2 billion of share repurchase that's embedded in our guidance for 2025.

與投資者日期間推出的計劃相比，我們的觀點沒有變化，我們預計 2025 年股票回購金額約為 20 億美元，這包含在我們的指引中。

So the fact that we had, let's say, weak cash flow from operations on the cash flow statement in 2024 because of those shifts in receivables and payables, that had no bearing in our ability to go buy back 3 billion of shares -- $3 billion worth of shares in 2024.

因此，事實上，由於應收帳款和應付帳款的變化，我們在 2024 年現金流量表上的經營活動現金流較弱，但這與我們在 2024 年回購 30 億股（價值 30 億美元的股票）的能力無關。

But it's something to track.

但這是值得追蹤的事情。

And we'll keep you updated as we move through '25 on sort of having some of those payables and receivables turn in the underlying cash flow from operations.

隨著我們進入25年，我們將持續向您通報這些應付帳款和應收帳款轉換為經營活動現金流的情況。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

Hi, good morning.

嗨，早安。

Quick clarification, and then a question.

快速澄清，然後提出一個問題。

I think you mentioned that ACA effectuated enrollment turned out to be a little stronger than you expected.

我記得您提到過，ACA 實施後的入學人數比您預期的要多一些。

But I didn't hear how much better it came in.

但我沒有聽到它有多好。

So can you clarify that point first?

那麼您能先澄清這一點嗎？

And then, secondly, I want to revisit your assumption that ACA membership could be down 20% to 30% if enhanced APTCs expire.

其次，我想重新審視你的假設：如果增強 APTC 到期，ACA 會員人數可能會下降 20% 至 30%。

Are buydowns contemplated within that assumption?

在這個假設中是否考慮了買斷？

And can you walk us through the impact that buydowns would have and how your products are positioned relative to the market if there is a shopping event next year?

您能否向我們介紹一下這次買斷將產生的影響，以及如果明年有購物活動的話，你們的產品相對於市場的定位如何？

Thanks.

謝謝。

Sure.

當然。

So let me sort of take a step back because there -- this was sort of a unique open enrollment period because of the program integrity checkpoints that were added to the process.

所以讓我退一步來說，因為這是一個獨特的開放註冊期，因為在流程中添加了程序完整性檢查點。

And so when we think about what was expected versus what we saw, you also have to think about the degree to which our assumptions in terms of the impact of those programs came into play during the various time periods.

因此，當我們思考預期結果與實際結果時，還必須考慮在各個時間段內，我們對這些計劃的影響的假設發揮了多大作用。

So when we talked in December about our expectations, it was overall market enrollment growth then muted by the agent-of-record lock and failure to report periodic data matching, things like that.

因此，當我們在 12 月談到我們的預期時，整體市場入學人數的成長受到代理人鎖定和未能報告定期數據匹配等因素的影響。

What we're seeing in January is a more muted impact of those program integrity checkpoints.

我們在一月份看到這些程序完整性檢查點的影響更加溫和。

And so the effectuation rates, which are in line with historic norms for us, are slightly higher than what we had been expecting.

因此，實施率與我們的歷史標準相符，但略高於我們的預期。

That's leading to the five million -- slightly above five million peak that we're expecting.

這就是我們預期的五百萬高峰——略高於五百萬。

But as we look through the rest of Q1 and into Q2, particularly on the FTR process, which is going to hinge on that tax filing date and then post-tax filing reconciliation, we still think that there is potential membership impact that will play out in Q1 and Q2.

但是，當我們回顧第一季的剩餘部分和第二季時，特別是 FTR 流程（這將取決於報稅日期以及稅後申報對帳），我們仍然認為會員人數可能會受到影響，這種影響將在第一季和第二季顯現出來。

So we're tracking ahead of what we expected that may end up being a benefit full year, that may end up just being a delay in terms of the impact of those programs.

因此，我們正在提前追蹤我們預期的結果，這可能最終會成為全年的收益，也可能最終只是這些計劃的影響有所延遲。

And that's why we want to wait and see kind of how the next couple of months play out.

這就是為什麼我們要拭目以待接下來幾個月的情況。

And obviously, we'll make sure to keep you all posted on what we see as those shifts -- as those programs kind of shake out and settle as we get to midyear.

顯然，我們一定會及時向大家通報我們所看到的變化——隨著這些項目進入年中，它們將會逐漸穩定下來。

And then relative to overall impact of enhanced APTCs, we talked about in December the idea that without sort of major mitigation efforts, if enhanced APTCs were to go away or not be renewed in their entirety, that could be somewhere between a 20% and 30% membership hit to our book.

然後，相對於加強型 APTC 的整體影響，我們在 12 月討論過這樣的想法：如果不採取重大的緩解措施，如果加強型 APTC 取消或不全部續簽，我們的會員人數可能會受到 20% 到 30% 的打擊。

The reality is that the iterations anything less than full drop-off of the enhanced APTCs are numerous.

實際情況是，增強型 APTC 的迭代次數不計其數。

And so whether there's a cap at 400% FPL or 350%, or we think about different mechanisms to create more kind of investment of membership and participation in the program, there are lots of different alternatives that have been discussed and explored.

因此，無論聯邦貧困率的上限是 400% 還是 350%，或者我們是否考慮採用不同的機制來吸引更多類型的會員投資和參與計劃，我們都已經討論和探索了許多不同的替代方案。

And we run scenarios across all of those and think about what the buydown implication might be, what product design will matter, what the different price sensitivities are of our members along the FPL continuum.

我們對所有這些情況進行情境模擬，思考買斷可能產生什麼影響、哪些產品設計很重要、我們的會員在 FPL 連續體中對價格的敏感度有何不同。

So you can be sure that our team has been spending many hours running those over, frankly, the year and looking forward to getting more clarity as we move over the next couple of months about how to prepare for the next OE cycle, including potentially filing two sets of bids.

因此，您可以肯定，我們的團隊在過去一年中花費了大量時間來運行這些問題，並期待在接下來的幾個月中更加清楚地了解如何為下一個 OE 週期做準備，包括可能提交兩套投標。

So lots more to play out there.

還有很多事情可以做。

And again, that's one we'll continue to keep you posted as we start to understand kind of what the trajectory will be there.

再次重申，當我們開始了解那裡的軌跡時，我們會繼續向您通報最新情況。

Lance Wilkes, Bernstein.

蘭斯威爾克斯、伯恩斯坦。

Great, thanks.

太好了，謝謝。

Can you talk a little bit about pipeline and appeals process in the Medicaid space?

您能談談醫療補助領域的流程和上訴程序嗎？

And in addition to that, talking a little bit about what your strategic priorities are for investments, capability enhancements, and M&A as it relates to either Medicaid or other areas like [MA] vertical integration, et cetera?

除此之外，您能談談您在投資、能力提升和併購方面的策略重點嗎？

Thanks.

謝謝。

Yeah, absolutely.

是的，絕對是如此。

So as you all well know, it's very busy last couple of years in terms of the RFP pipeline and really working through a backlog that came through post-COVID. 2025 will be returned to a more normal pre-COVID cadence.

大家也都知道，過去幾年，我們在 RFP 管道方面非常忙碌，而且確實在處理 COVID 之後的積壓工作。 2025 年將恢復到新冠疫情前的正常節奏。

So we have a handful of states and programs that are going through normal course procurements.

因此，我們有少數州和項目正在進行正常採購。

And then our team is, obviously, always evaluating net new opportunities and sort of positioning for growth.

然後，我們的團隊顯然一直在評估新的淨機會和成長定位。

Relative to our protest, we have -- the Texas issue will continue to make its way through the legislature and the courts through the remainder of 2025.

相對於我們的抗議，我們—德州問題將在 2025 年剩餘時間內繼續在立法機構和法院進行審議。

I think as you know, the potential impact to 2025 of that was minor to begin with.

我認為如你所知，這對 2025 年的潛在影響一開始就很小。

But we think that that will kind of play out here, and we'll get more clarity through the rest of the year.

但我們認為這將在這裡發揮作用，並且我們將在今年剩餘時間內獲得更多清晰度。

And then we are still in process on the Georgia protest.

目前我們仍在處理喬治亞州的抗議活動。

And I think given the complexity of that process, we expect it will be a number of months before we hear any feedback.

我認為，考慮到該過程的複雜性，我們預計需要幾個月的時間才能收到任何回饋。

So more to come on that front.

因此，在這方面還有更多工作要做。

And then relative to investments, I think we're -- as we've said over the last year to 1.5 years, as we've gotten more oxygen relative to operating bandwidth as we move through sort of the core of the value creation plan, we started to turn our attention to surveillance relative to inorganic growth and M&A.

然後關於投資，我認為——正如我們在過去一年到一年半所說的那樣，隨著我們在營運頻寬方面獲得了更多的氧氣，隨著我們逐漸完成價值創造計劃的核心，我們開始將注意力轉向與無機增長和併購相關的監控。

And that continues to be something that we're watching.

這是我們持續關注的事情。

Also, evaluating where there are interesting opportunities for investment in capabilities for our business lines.

此外，我們還將評估哪些業務線有有趣的能力投資機會。

I would say, ICRA is a place that we are very interested in and thinking about what the market may need, relative to overall infrastructure to mature and how we could support that through various partnerships and investments.

我想說，我們對 ICRA 非常感興趣，並且正在思考市場可能需要什麼，相對於整體基礎設施的成熟，​​以及我們如何透過各種合作夥伴關係和投資來支持這一點。

So I think those are sort of the major areas of focus.

所以我認為這些都是主要關注的領域。

And of course, always looking at the relative use of capital and thinking about sort of the value it can create, including the value of Centene at these prices.

當然，我們始終關注資本的相對使用情況，並思考它所能創造的價值，包括 Centene 在這些價格下的價值。

Michael Ha, Baird.

麥可·哈，貝爾德。

Hi, thank you.

你好，謝謝。

Just another one on your exchange growth for this year.

這只是您今年外匯成長的另一個例子。

Great to hear that effectuation rate was consistent with your historical norms.

很高興聽到實施率與你的歷史規範一致。

I know you mentioned it will still take a few months until the full changes are well understood.

我知道您曾提到，要徹底理解這些變化還需要幾個月的時間。

But based on all the visibility you have sitting here today in February, I'm curious how much of a potential difference do you think there could be now versus the next few months as you hit those checkpoints?

但是，基於您在二月今天所看到的所有情況，我很好奇，您認為現在與未來幾個月到達這些檢查點時相比，可能存在多大差異？

What is the likelihood, basically, of a materially negative surprise in April that could compromise your exchange marks and targets for the year?

基本上，四月出現重大負面意外，影響今年的匯率和目標的可能性有多高？

So I think the question of timing of impact is a good one.

所以我認為影響時間的問題是個好問題。

And that's part of why we said we want to see how the rest of Q1 and part of Q2 play out, again, particularly relative to the FTR process and the fact that that is anchored in the April filing date.

這就是為什麼我們說我們想看看第一季的剩餘部分和第二季的部分情況如何，尤其是相對於 FTR 流程，以及它以 4 月的提交日期為基準。

So the message that we're trying to kind of make sure you all hear is that we built in assumptions around the impact of those programs.

因此，我們試圖確保大家都能聽到的訊息是，我們對這些計畫的影響做出了假設。

And we are carrying those assumptions into the next couple of months to let that play out so that, ideally, there are no major negative surprises relative to what that impact might be.

我們將在接下來的幾個月繼續執行這些假設，以便理想情況下不會出現相對於可能產生的影響的重大負面意外。

So I think we're being prudent in terms of how that tail may extend into Q1 and Q2.

因此，我認為，我們對這種尾部如何延伸到第一季和第二季持謹慎態度。

But baked into that are all the original assumptions of what the impact would be.

但其中仍包含對影響的所有原始假設。

And what we've seen thus far is more muted than that.

而我們迄今所看到的情況卻比這更為平靜。

One thing to add to that.

還有一件事要補充。

The FTR implications, so let's say someone doesn't file a tax return and they lose or enhanced APTC in May.

FTR 的影響，假設某人沒有提交納稅申報表，並且他們在五月損失或增加了 APTC。

That's a prospective investment as opposed to what we got after in February of 2024, which was the broker -- the record -- lock for broker of record.

這是一項前瞻性投資，與我們在 2024 年 2 月之後獲得的記錄相比，這是經紀人——記錄——記錄經紀人的鎖定。

So that's something to think through as we get through the next quarter or so with the FTR.

因此，當我們在接下來的一個季度左右進行 FTR 時，這是需要考慮的事情。

But certainly pleased on how we started the year strong, and it's good to enter February and then March in a position of strength.

但我們對自己今年的開局感到很高興，並且很高興能夠以強勁的勢頭進入二月和三月。

George Hill, Deutsche Bank.

德意志銀行的喬治·希爾。

Yeah.

是的。

Good morning, guys, and thanks for taking the question.

大家早安，謝謝你們回答這個問題。

And, Sarah, this is just kind of a point of clarification.

莎拉，這只是一種澄清。

On the effectuation rate, I thought that you had said there could be some upside in Q1 if the FTR hits later in the year and get back towards the normal guidance range.

關於實施率，我認為您曾說過，如果 FTR 在今年稍後達到並回到正常指導範圍，那麼第一季可能會有一些上行空間。

Is that correct?

那正確嗎？

Or I guess, what I'm trying to worry about is, will this create any downside to the exchange membership outlook or guidance?

或者我想，我擔心的是，這是否會對交易所會員前景或指導造成任何負面影響？

Yeah.

是的。

What we said in my script, where I said, it's just too early to touch the $34 billion of commercial revenue.

我在劇本裡說過，現在觸及 340 億美元的商業收入還為時過早。

That's basically saying -- indicating that we're enthusiastic about our start.

這基本上是在說——表明我們對我們的開始充滿熱情。

But we really want to look at the sloping of the next few months of membership before we consider any potential raise on that revenue.

但在考慮任何潛在的收入增加之前，我們確實希望看看未來幾個月會員人數的成長趨勢。

So we're sticking with the $34 billion for now.

因此我們暫時維持 340 億美元。

It's early, and we'll see how really the next three or four months of membership play out.

現在還為時過早，我們將拭​​目以待未來三、四個月的會員狀況如何。

But once again, starting from a position of strength is a good position to be in.

但再次強調，從實力出發是一種好的開始。

David Windley, Jefferies.

傑富瑞（Jefferies）的戴維·溫德利（David Windley）。

(inaudible - microphone inaccessible)

（聽不清楚 - 麥克風無法使用）

Hello, Mr. Windley, is your line muted, perhaps?

您好，溫德利先生，您的線路是不是被靜音了？

It happens to be.

正好是。

Yes, it is.

是的。

Thank you.

謝謝。

Thanks for taking my questions.

感謝您回答我的問題。

I wondered on the exchange market, if you have, Drew, done a zero utilizers analysis in your plans, maybe particularly in some of the red states or federally facilitated Marketplace states, to see where potential pockets of, call it, abuse of enrollment -- over-enrollment program integrity issues might be.

我想知道，在交易市場上，德魯，你是否在你的計劃中做過零用戶分析，特別是在一些紅色州或聯邦政府促進的市場州，看看潛在的濫用招生——過度招生計劃的完整性問題可能存在在哪裡。

We did pricing for 2025.

我們已經為 2025 年制定了定價。

We thought about -- first of all, we got a lot of the broker, let's say, disruption out of the way beginning in February of '24.

我們考慮過——首先，從 24 年 2 月開始，我們已經擺脫了許多經紀人的干擾。

And then as you know, CMS ultimately adopted our idea, which is great.

然後正如你所知，CMS 最終採納了我們的想法，這很好。

And it puts everyone on the same playing field coming into the open enrollment period for 2025.

這讓每個人都能在 2025 年開放註冊期到來時處於同一個競爭環境中。

So actually, incurred some of that membership attrition pressure into 2024.

因此實際上，部分會員流失壓力會延續到 2024 年。

So that's behind us.

這已經是過去的事了。

As we thought about pricing for 2025, we did think about the mix of business around failure to report and quite frankly, put a pricing load in for that program integrity measures.

當我們考慮 2025 年的定價時，我們確實考慮了未報告的業務組合，並且坦率地說，為該計劃的完整性措施增加了定價負擔。

So we'll see how that plays out.

我們將看看結果如何。

But once again, feel good about what we're seeing so far, even though it's very early.

但再一次，我們對目前所看到的情況感到滿意，儘管現在還為時過早。

And as Sarah said, we haven't closed January yet.

正如莎拉所說，我們尚未結束一月份的工作。

It's only day two of the month of February.

這才是二月的第二天。

So like the way we're starting, but there's more of the year to play out.

就像我們開始的方式一樣，但今年還有更多的事情要做。

John Stansel, JPMorgan.

摩根大通的約翰·斯坦塞爾。

Great.

偉大的。

Thanks for taking my question.

感謝您回答我的問題。

Just one quick one on PDP.

關於 PDP，我只想簡單說一句。

Just can you give a bit more color on what played out during AEP kind of driving the above expectations enrollment growth?

您能否詳細說明 AEP 期間發生的事情，以推動入學人數實現上述預期的成長？

And then just thinking longer term, how you see kind of the demo component within standalone PDP kind of contributing over the next couple of years?

然後從長遠來看，您認為獨立 PDP 中的演示組件在未來幾年將有何貢獻？

Thank you.

謝謝。

Yeah, no, good question.

是的，不，好問題。

We ended the year at 6.9 million members.

截至今年年底，我們的會員數為 690 萬。

And as we said earlier, we're over 7.5 million.

正如我們之前所說，我們已經超過 750 萬。

So I think it's, once again, the positioning of our product.

所以我認為這又是我們產品的定位。

This is a business we focus on, not everybody does.

這是我們專注的業務，但不是每個人都會這麼做。

I mean, it's good to have both the Medicare Advantage and MAPD business, as well as a PDP business.

我的意思是，同時擁有 Medicare Advantage 和 MAPD 業務以及 PDP 業務是件好事。

There's some complementary and overlap nature to those.

它們之間具有一定的互補性和重疊性。

So I think activeness of our products, which is driven by our underlying cost structure, which I think is excellent, and that's reflected in the value that we can pass on to members and consumers.

因此，我認為我們產品的活躍度是由我們的基礎成本結構所驅動的，我認為這非常好，這反映在我們可以傳遞給會員和消費者的價值上。

With respect to the demo, you had to elect into a multiyear demo.

就演示而言，您必須選擇進行多年的演示。

But obviously, CMS can modify the premium support each year.

但顯然，CMS 每年都會修改高級支援。

But once again, when you have a product that's driven by what we believe is an outstanding cost structure, then we should be able to sort of sustain that business regardless of what level of premium support makes its way into the demo over the next couple of years.

但是再說一次，當你擁有一款由我們認為優秀的成本結構驅動的產品時，那麼無論未來幾年演示中採用何種級別的優質支持，我們都應該能夠維持這項業務。

Ryan Langston, TD Cowen.

瑞安·蘭斯頓（Ryan Langston），TD Cowen。

Hi, good morning.

嗨，早安。

This is Christian Borgmeyer, on for Ryan Langston.

這是 Christian Borgmeyer，取代 Ryan Langston。

Could you quantify where PDP margins ultimately ended in 2024?

您能否量化 2024 年 PDP 利潤率最終達到多少？

It would be helpful as we think about the year-to-year progression in the PDP margin guidance for 2025 and bridging for the

這將有助於我們思考 2025 年 PDP 利潤率指引的逐年變化，以及

[IRA]?

[愛爾蘭共和軍]？

Well, certainly higher than the 1% or so that we had indicated coming into Q4, and that's the strength in the full-year performance captured in the reported period of Q4.

嗯，肯定高於我們在第四季度時預測的 1% 左右的水平，這是第四季度報告期內全年業績的強勁表現。

So like how that bodes well for '25, but you have to think about also each year from a bid standpoint stand in its own.

所以這對 25 年來說是個好兆頭，但你也必須從競標的角度考慮每一年的情況。

And there's almost a reset in terms of the assumptions that you use and then pricing for the changes in the IRA.

而且，您所使用的假設以及 IRA 變更的定價幾乎都進行了重置。

So certainly, I like the way we ended.

所以我確實喜歡我們的結局。

You can't just map that exactly into '25.

您不能將其精確映射到’25。

But that should bode well as we think about execution and performance in 2025 and what's now a $16 billion business for us.

但當我們考慮2025年的執行和表現，以及我們現在160億美元的業務時，這應該是個好兆頭。

Thank you.

謝謝。

This concludes our question-and-answer session.

我們的問答環節到此結束。

I'd like to turn the conference back over to Sarah London for closing remarks.

我想將會議交還給莎拉倫敦 (Sarah London) 做結束語。

Thanks, Rocco, and thanks, everyone, for your time and interest this morning.

謝謝，羅科，也謝謝大家今天早上的時間和關注。

While it is early, we feel good about the progress that we've made in Medicaid matching rates and acuity, and how we're positioned coming into 2025.

雖然還為時過早，但我們對醫療補助匹配率和敏銳度所取得的進展以及我們在 2025 年的定位感到滿意。

We feel good about our Marketplace execution once again in open enrollment and feel good about our Medicare segment overall.

我們對我們的市場在開放註冊過程中的再次表現感到滿意，並且對我們的整體醫療保險部門感到滿意。

And so really looking forward to executing in 2025 and continuing to keep this group updated on our progress as we move through the first quarter.

因此，我們非常期待在 2025 年執行，並在第一季繼續向該小組通報我們的進展。

Thank you.

謝謝。

This concludes today's conference call.

今天的電話會議到此結束。

We thank you, all, for attending today's presentation.

感謝大家參加今天的演講。

You may now disconnect your lines, and have a wonderful day.

現在您可以斷開連接，享受美好的一天。