CVS Health Corp (CVS) 2020 Q1 法說會逐字稿

Good morning and welcome to the CVS Health First Quarter 2020 Earnings Conference Call.

早上好，歡迎參加 CVS Health 2020 年第一季度收益電話會議。

A question-and-answer session will follow CVS Health's prepared remarks.

CVS Health 準備好發言後將舉行問答環節。

As a reminder, this call is being recorded.

提醒一下，此通話正在錄音。

I would now like to turn the call over to Valerie Haertel, Senior Vice President of Investor Relations for CVS Health.

我現在想將電話轉給 CVS Health 投資者關係高級副總裁 Valerie Haertel。

Please go ahead.

請繼續。

Thank you, and good morning, everyone.

謝謝大家，大家早上好。

Welcome to the CVS Health First Quarter 2020 Earnings Call.

歡迎參加 CVS Health 2020 年第一季度收益電話會議。

As a reminder, this call is being recorded.

提醒一下，此通話正在錄音。

I'm Valerie Haertel, Senior Vice President of Investor Relations for CVS Health.

我是 Valerie Haertel，CVS Health 投資者關係高級副總裁。

I am joined this morning by Larry Merlo, President and CEO; and Eva Boratto, Executive Vice President and CFO.

今天上午，總裁兼首席執行官拉里·梅洛 (Larry Merlo) 也加入了我的行列。以及執行副總裁兼首席財務官 Eva Boratto。

Following our prepared remarks, we'll host a question-and-answer session that will include Jon Roberts, Executive Vice President and Chief Operating Officer; Karen Lynch, Executive Vice President and President of Aetna; and Alan Lotvin, Executive Vice President and President of Caremark.

在我們準備好的發言之後，我們將舉辦問答環節，其中包括執行副總裁兼首席運營官喬恩·羅伯茨 (Jon Roberts)； Karen Lynch，Aetna 執行副總裁兼總裁；以及 Caremark 執行副總裁兼總裁 Alan Lotvin。

(Operator Instructions)

（操作員說明）

In addition to this call, our press release and Form 10-Q, we have posted a slide presentation on our website.

除了本次電話會議、我們的新聞稿和 10-Q 表之外，我們還在我們的網站上發布了幻燈片演示。

Please note that during this call, we will make certain forward-looking statements that reflect our current views, including our financial projections and statements related to our future financial performance, future events, industry and market conditions and the future impact of COVID-19 on our enterprise.

請注意，在本次電話會議期間，我們將做出某些反映我們當前觀點的前瞻性聲明，包括我們的財務預測以及與我們未來財務業績、未來事件、行業和市場狀況以及COVID-19 對未來影響相關的聲明。我們的企業。

Our forward-looking statements are based on management's estimates, assumptions and projections and are subject to significant uncertainties and other factors, many of which are beyond CVS Health's control, including the future impact of COVID-19 on our enterprise.

我們的前瞻性陳述基於管理層的估計、假設和預測，並受到重大不確定性和其他因素的影響，其中許多因素超出了 CVS Health 的控制範圍，包括 COVID-19 對我們企業的未來影響。

We strongly encourage you to review the information we file with the SEC regarding these risks and uncertainties, in particular those that are described in the Risk Factors section of our 2019 Annual Report on Form 10-K and the cautionary statement concerning forward-looking statements and risk factor disclosures in our quarterly reports on Form 10-Q.

我們強烈建議您查看我們向SEC 提交的有關這些風險和不確定性的信息，特別是我們2019 年年度報告10-K 表格的風險因素部分中描述的信息以及有關前瞻性陳述和不確定性的警告聲明。我們在 10-Q 表季度報告中披露了風險因素。

You should also review the section entitled Cautionary Statements Concerning Forward-looking Statements in this morning's earnings press release.

您還應該查看今天上午的收益新聞稿中標題為“有關前瞻性陳述的警示性陳述”的部分。

During this call, we will use non-GAAP financial measures when talking about the company's performance and financial condition.

在本次電話會議中，我們在談論公司的業績和財務狀況時將使用非公認會計準則財務指標。

In accordance with SEC regulations, you can find a reconciliation of these non-GAAP measures to the most directly comparable GAAP measures in this morning's earnings press release and the reconciliation document posted on the Investor Relations portion of our website.

根據 SEC 的規定，您可以在今天上午的收益新聞稿以及我們網站投資者關係部分發布的調節文件中找到這些非 GAAP 指標與最直接可比的 GAAP 指標的調節表。

And as always, today's call is being broadcast on our website, where it will be archived for 1 year.

與往常一樣，今天的電話會議將在我們的網站上播出，並將存檔一年。

Now I'd like to turn the call over to Larry.

現在我想把電話轉給拉里。

Well, thanks, Valerie.

嗯，謝謝，瓦萊麗。

Good morning, everyone, and thank you for joining our 2020 Q1 earnings call.

大家早上好，感謝您參加我們的 2020 年第一季度財報電話會議。

These are certainly unprecedented times for us all.

對於我們所有人來說，這無疑是前所未有的時代。

And at CVS Health, our dedicated colleagues have been working on the front lines in the fight against the COVID-19 pandemic, responding in real time with solutions for consumers and patients across the country.

在 CVS Health，我們敬業的同事一直在抗擊 COVID-19 大流行的前線工作，為全國各地的消費者和患者提供實時解決方案。

And I'd like to take a moment to express my sincere gratitude to our colleagues for their work in all parts of our organization.

我想花一點時間對我們的同事在我們組織各個部門所做的工作表示誠摯的謝意。

They are doing a phenomenal job of responding to the needs of our communities, and I could not be more proud of their efforts.

他們在滿足我們社區的需求方面做得非常出色，我為他們的努力感到無比自豪。

Now as we all know, over the last couple of months, the situation has rapidly intensified as the pandemic has spread from coast to coast.

眾所周知，過去幾個月，隨著疫情從一個海岸蔓延到另一個海岸，局勢迅速加劇。

Federal, state and local governments, in partnership with the private sector, have worked to curb the spread of the virus and its impact on our population and the economy.

聯邦、州和地方政府與私營部門合作，努力遏制病毒的傳播及其對人口和經濟的影響。

And CVS Health as one of the largest providers of essential services, we are supporting these efforts through our community reach, local presence, broad health care offerings, digital capabilities and our hardworking colleagues, and we are part of the solution during these difficult times.

CVS Health 作為最大的基本服務提供商之一，我們通過我們的社區影響力、當地影響力、廣泛的醫療保健服務、數字能力和我們辛勤工作的同事來支持這些努力，在這些困難時期，我們是解決方案的一部分。

So let me provide an overview of the actions we've taken in response to COVID-19 with 2 key priorities in mind.

因此，讓我概述一下我們為應對 COVID-19 所採取的行動，並考慮到兩個關鍵優先事項。

First is the well-being and safety of our colleagues, consumers and communities we serve.

首先是我們所服務的同事、消費者和社區的福祉和安全。

Second is maintaining the continuity of our businesses and operations.

其次是保持我們業務和運營的連續性。

Now to do that, we are making investments to support our consumers, clients and members while deepening our relationships and advancing our long-term strategy of being the most consumer-centric health company.

為此，我們正在進行投資以支持我們的消費者、客戶和會員，同時深化我們的關係並推進我們成為最以消費者為中心的健康公司的長期戰略。

Starting with our colleagues, we took swift action designed to keep them safe while we kept our stores and other operations up and running with minimal disruption.

從我們的同事開始，我們迅速採取行動，確保他們的安全，同時保持商店和其他業務的正常運行，將乾擾降到最低。

We implemented social distancing practices, enhanced cleaning protocols, distributed personal protective equipment and outfitted stores with Plexiglass barriers.

我們實施了保持社交距離的做法，加強了清潔規程，分發了個人防護設備，並為商店配備了有機玻璃屏障。

We also provided our colleagues with enhanced benefits and resources, including family support, and announced bonuses for our frontline colleagues for their outstanding work.

我們還為同事提供了更多的福利和資源，包括家庭支持，並為工作出色的前線同事頒發了獎金。

All of these actions have helped ensure the continuity of our operations at a time when they are needed the most.

所有這些行動都有助於確保我們在最需要的時候保持運營的連續性。

For our consumers and members impacted by COVID-19, we are providing them with continued access to quality health care while relieving some of the added costs and stress resulting from the pandemic.

對於受新冠肺炎 (COVID-19) 影響的消費者和會員，我們為他們提供持續的優質醫療保健服務，同時減輕因疫情造成的一些額外成本和壓力。

As previously announced, we waived copays for COVID-19-related diagnostic testing for all of our insured members.

正如之前所宣布的，我們免除所有受保會員的 COVID-19 相關診斷測試自付費用。

For our Commercial and Medicare Advantage members, we waived member out-of-pocket costs for COVID-19-related inpatient admissions and telemedicine visits through early June.

對於我們的商業和 Medicare Advantage 會員，我們在 6 月初之前免除了會員因 COVID-19 相關住院和遠程醫療就診的自付費用。

We have taken a broad approach to helping address the mental and emotional health impacts of the pandemic, including access to telehealth and expanding our employee assistance programs for our members.

我們採取了廣泛的方法來幫助解決這一流行病對精神和情緒健康的影響，包括獲得遠程醫療和擴大我們為會員提供的員工援助計劃。

We're also proactively reaching out to the most at-risk Aetna members to educate them about COVID-19 protection measures and resources available to them.

我們還主動聯繫高危 Aetna 會員，向他們提供有關 COVID-19 保護措施和可用資源的教育。

And we're sending care packages to affected members to show our care and support.

我們正在向受影響的成員發送愛心包裹，以表達我們的關心和支持。

CVS Pharmacy has waived the fees associated with home delivery for prescriptions and accompanying front store products for all consumers.

CVS 藥房已免除所有消費者的處方藥和附帶的前店產品送貨上門的相關費用。

And both Aetna and Caremark have worked with clients and their members to support medication access and adherence by waiving early refill limits and extending previously approved prior authorizations for maintenance medications.

Aetna 和 Caremark 都與客戶及其會員合作，通過放棄早期補充限制和延長先前批准的維持藥物預先授權來支持藥物獲取和依從性。

And for our Aetna-contracted health care providers, we are streamlining processes, easing administrative policies, making timely payments and enhancing telemedicine policies to allow them to focus on patient care.

對於我們與 Aetna 簽約的醫療保健提供者，我們正在簡化流程、放寬行政政策、及時付款並加強遠程醫療政策，使他們能夠專注於患者護理。

To support our communities, we are creating action-based solutions alongside local, state and federal government partners as well as industry peers.

為了支持我們的社區，我們正在與地方、州和聯邦政府合作夥伴以及行業同行一起創建基於行動的解決方案。

For example, across 5 states, we have opened large-scale COVID-19 testing sites.

例如，我們在 5 個州開設了大規模的 COVID-19 檢測點。

And to date, we have administered nearly 90,000 tests with real-time results.

迄今為止，我們已經進行了近 90,000 次測試並提供了實時結果。

We are also working to further expand our testing capabilities, which will continue to play an important role in helping with the reopening of the economy.

我們還在努力進一步擴大我們的檢測能力，這將繼續在幫助經濟重新開放方面發揮重要作用。

We recently expanded our Coram services nationwide, working in partnership with hospitals and providers to help transition eligible IV therapy patients to home-based care, freeing up important hospital capacity.

我們最近將 Coram 服務擴展到全國范圍，與醫院和提供商合作，幫助符合條件的靜脈注射治療患者過渡到家庭護理，從而釋放重要的醫院容量。

And finally, we are well positioned to provide medication therapies and vaccines when they become available at our retail pharmacy locations nationwide.

最後，當藥物治療和疫苗在全國零售藥房上市時，我們有能力提供藥物治療和疫苗。

Now the actions we have taken all point to our strategy of making health care access local and simple while helping people achieve their best health.

現在，我們採取的行動都指向我們的戰略，即讓醫療保健就地且簡單，同時幫助人們實現最佳健康。

And we have worked to accelerate pilots and innovation.

我們致力於加速試點和創新。

And in conjunction with additional actions such as relaxing regulation, we are seeing a new normal emerge.

結合放鬆監管等其他行動，我們正在看到一種新常態的出現。

And in the near future, there will be an evaluation point of what worked and what didn't, and, as a result, we expect that elements of today's new norm will become part of tomorrow's everyday routines.

在不久的將來，將會有一個評估點，評估什麼有效、什麼無效，因此，我們預計今天新規範的要素將成為明天日常生活的一部分。

While the actions we have taken in response to the pandemic come at a cost, we believe these investments in our people and our businesses are the right decisions, and our differentiated offerings have enabled us to play a key role in responding to the pandemic.

雖然我們為應對這一流行病而採取的行動是有代價的，但我們相信這些對我們的員工和業務的投資是正確的決定，我們的差異化產品使我們能夠在應對這一流行病方面發揮關鍵作用。

So what has been the response to the actions we have taken?

那麼我們所採取的行動得到了什麼反應呢？

Well, it is clear our consumer-centric digital strategy has become even more relevant in the current environment as people are using technology more while they stay in place.

嗯，很明顯，我們以消費者為中心的數字戰略在當前環境中變得更加重要，因為人們在留在原地時更多地使用技術。

We've achieved higher levels of engagement across our digital assets in Q1, a trend which began in January and accelerated with COVID-19.

第一季度，我們的數字資產參與度達到了更高水平，這一趨勢始於 1 月份，並隨著 COVID-19 的爆發而加速。

And let me provide you a few examples.

讓我舉幾個例子。

Utilization of telemedicine for virtual visits through MinuteClinic is up about 600% compared to Q1 '19.

與 19 年第一季度相比，通過 MinuteClinic 進行遠程醫療虛擬就診的利用率增加了約 600%。

Retail prescription home delivery is up more than 1,000%.

零售處方藥送貨上門增長了 1,000% 以上。

Additionally, we saw a fourfold increase in the number of consumers adding front store items to their prescription deliveries, let's call it, the front store attachment rate.

此外，我們發現在處方配送中添加前店商品的消費者數量增加了四倍，我們稱之為前店附加率。

We also saw a double-digit percentage increase in app usage across CVS Pharmacy, Caremark and specialty year-over-year.

我們還發現 CVS Pharmacy、Caremark 和專業產品的應用程序使用量同比出現兩位數百分比增長。

And as an example, in specialty pharmacy, digital refills were up approximately 50%.

舉個例子，在專業藥房，數字續藥量增長了約 50%。

Additionally, in our Aetna health app, we engaged more households in Q1 than we did in the first 3 quarters of 2019.

此外，在我們的 Aetna 健康應用程序中，我們第一季度吸引的家庭數量比 2019 年前 3 季度還要多。

And to support our COVID-19 testing sites, our team used our digital platform to quickly launch a streamlined experience, which has enabled online screening and scheduling for testing, with 85% of consumers highlighting a positive experience.

為了支持我們的 COVID-19 檢測站點，我們的團隊使用我們的數字平台快速推出了簡化的體驗，實現了在線篩查和安排檢測，85% 的消費者強調了積極的體驗。

So we are pleased to see higher rates of customer satisfaction and loyalty, thanks to our colleagues' hard work and innovation.

因此，由於我們同事的辛勤工作和創新，我們很高興看到更高的客戶滿意度和忠誠度。

And we will continue to mobilize our resources to support nationwide efforts to combat the virus.

我們將繼續調動資源支持全國抗擊疫情的努力。

So with that, let me quickly touch on our first quarter results and how COVID-19 has impacted our business performance.

那麼，讓我快速介紹一下我們第一季度的業績以及 COVID-19 對我們業務績效的影響。

In the quarter, we delivered adjusted earnings per share of $1.91 with total revenues of nearly $67 billion, up 8%.

本季度，我們實現調整後每股收益 1.91 美元，總收入接近 670 億美元，增長 8%。

Our underlying core performance was strong, and in March, COVID-19-related business activity added approximately $0.10 to our Q1 adjusted earnings per share.

我們的核心核心業績強勁，3 月份，與 COVID-19 相關的業務活動使我們第一季度調整後每股收益增加了約 0.10 美元。

And our performance reflects an acceleration of prescriptions dispensed, strong front store sales and a modest reduction in discretionary medical utilization, all largely driven by COVID-19.

我們的業績反映了處方配發的加速、前店銷售的強勁以及酌情醫療利用率的適度減少，所有這些在很大程度上都是由 COVID-19 推動的。

Now we've been able to maintain an adequate supply of medications to meet the increased demand from our customers, benefiting from the scale and expertise of Red Oak.

現在，受益於紅橡樹的規模和專業知識，我們已經能夠保持充足的藥物供應，以滿足客戶不斷增長的需求。

And setting aside the impact of COVID-19, our Q1 results demonstrate the continued success of our integrated health care strategy, which is resonating with stakeholders across the health care system.

拋開 COVID-19 的影響，我們第一季度的結果證明了我們的綜合醫療保健戰略的持續成功，這引起了整個醫療保健系統利益相關者的共鳴。

Now we are leaving our full year 2020 adjusted EPS guidance range unchanged at $7.04 to $7.17, and Eva will take you through the key considerations on our guidance.

現在，我們將 2020 年全年調整後每股收益指導範圍維持在 7.04 美元至 7.17 美元不變，Eva 將向您介紹我們指導中的關鍵考慮因素。

It is important to note that there are a variety of actions and market forces that will present opportunities as well as risks as we move forward.

值得注意的是，在我們前進的過程中，各種行動和市場力量將帶來機遇和風險。

And rest assured we are diligently working to minimize the adverse effects while harnessing the opportunities to expand access to affordable care and deliver cost saving solutions to our clients and their members.

請放心，我們正在努力減少不利影響，同時利用機會擴大獲得負擔得起的醫療服務的機會，並為我們的客戶及其會員提供節省成本的解決方案。

CVS Health will continue to fight this pandemic on the front lines, and this challenging time demonstrates the importance of our holistic, consumer-centric, enterprise-wide approach.

CVS Health 將繼續在前線抗擊這一流行病，這個充滿挑戰的時刻證明了我們以消費者為中心的整體方法的重要性。

We are committed to supporting the nation so that we come out on the other side stronger together with the communities that we serve.

我們致力於支持國家，以便我們與我們所服務的社區一起在另一邊變得更加強大。

And with that, I will turn the call over to Eva.

然後，我會將電話轉給伊娃。

Thanks, Larry, and good morning, everyone.

謝謝拉里，大家早上好。

Like Larry, I want to take this opportunity to thank all of my colleagues for their hard work, courage and dedication as we navigate this difficult time.

和拉里一樣，我想藉此機會感謝所有同事在我們度過這一困難時期時所付出的辛勤工作、勇氣和奉獻精神。

As Larry mentioned, the onset of the COVID-19 pandemic brought about new challenges to all of us, and CVS has been adapting our business operations to support our key stakeholders.

正如 Larry 提到的，COVID-19 大流行的爆發給我們所有人帶來了新的挑戰，CVS 一直在調整我們的業務運營，以支持我們的主要利益相關者。

Through this pandemic, we've continued to advance our cost reduction priorities, including delivering integration synergy goals and our transformative goals to become a more digital enterprise.

在這場大流行病中，我們繼續推進降低成本的優先事項，包括實現集成協同目標和成為更加數字化企業的變革目標。

The rapid changes across the country in response to COVID-19 have led us to accelerate some of those initiatives.

全國各地為應對新冠肺炎 (COVID-19) 疫情而發生的迅速變化促使我們加快了其中一些舉措的步伐。

In light of the COVID-19 uncertainty, we also took steps to enhance our liquidity and strengthen our capital.

鑑於 COVID-19 的不確定性，我們還採取措施增強流動性並增強資本。

We issued $4 billion in bonds in March as a preemptive measure against cash needs in a severely adverse scenario.

我們在 3 月份發行了 40 億美元的債券，作為在嚴重不利的情況下應對現金需求的先發製人措施。

While this debt will add about $15 million additional interest expense monthly, it puts us in a strong liquidity position to weather potential crises with access to over $5 billion of cash and short-term investments at the end of March as well as $6 billion available by issuing commercial paper we're borrowing under our backup credit facilities and strong operating cash flows.

雖然這筆債務每月將增加約1500 萬美元的額外利息支出，但它使我們處於強大的流動性狀況，可以在3 月底獲得超過50 億美元的現金和短期投資，並在3 月底獲得60 億美元的可用資金，以應對潛在的危機。發行商業票據，我們通過我們的備用信貸額度和強勁的運營現金流進行借款。

Once we return to normalcy, we expect to repay the incremental debt.

一旦我們恢復正常，我們預計將償還增量債務。

We will also continue to prudently manage our operating expenses and will reduce our planned capital expenditures by $200 million this year.

我們還將繼續審慎管理運營支出，並將今年計劃的資本支出減少 2 億美元。

Our long-term leverage target remains unchanged, and we continue to prioritize paying down our debt and maintaining our dividend with no share repurchases planned until we meet our leverage target.

我們的長期槓桿目標保持不變，我們繼續優先考慮償還債務和維持股息，在達到槓桿目標之前不計劃回購股票。

Moving to first quarter results.

轉向第一季度業績。

Adjusted earnings per share was $1.91, nearly 18% higher than prior year.

調整後每股收益為 1.91 美元，比上年增長近 18%。

Consolidated revenues increased 8.3% year-over-year with growth coming from all segments.

綜合收入同比增長 8.3%，增長來自各個部門。

Our business performance exceeded our expectations due in part to strong execution and our ability to meet elevated consumer and member needs resulting from COVID-19.

我們的業務表現超出了我們的預期，部分原因在於我們強大的執行力以及我們滿足因 COVID-19 而增加的消費者和會員需求的能力。

We generated $3.3 billion of cash from operations and returned approximately $650 million to shareholders through cash dividends in Q1.

第一季度，我們通過運營產生了 33 億美元的現金，並通過現金股息向股東返還了約 6.5 億美元。

Turning to our operating results for the quarter by segment, Pharmacy Services total revenue increased 4.2% year-over-year.

從各部門的季度經營業績來看，藥房服務總收入同比增長 4.2%。

Specialty pharmacy revenue increased 19%, reflecting the full benefit of IngenioRx that we started onboarding in Q2 2019.

專業藥房收入增長了 19%，充分體現了我們於 2019 年第二季度開始使用的 IngenioRx 的優勢。

Brand inflation also contributed to the increase.

品牌通脹也推動了這一增長。

Total revenue growth was partially offset by the previously disclosed client losses and continued price compression.

總收入增長部分被之前披露的客戶損失和持續價格壓縮所抵消。

Total adjusted scripts increased 12.4% with approximately 125 basis points related to COVID-19 activity.

調整後的腳本總數增加了 12.4%，與 COVID-19 活動相關約 125 個基點。

Pharmacy Services adjusted operating income increased 24.7% versus last year driven by specialty pharmacy volume, our continued improvement in purchasing economics and an increase in generic dispensing rate.

藥房服務調整後的營業收入比去年增長了 24.7%，這得益於專業藥房銷量、我們採購經濟性的持續改善以及非專利配藥率的提高。

Growth in the quarter was partially offset by the previously mentioned client losses and continued price compression.

該季度的增長被前面提到的客戶損失和持續的價格壓縮部分抵消。

Within Pharmacy Services, there was minimal impact from COVID-19 to operating income during the first quarter.

在藥房服務領域，第一季度 COVID-19 對營業收入的影響微乎其微。

We continue to progress nicely in Pharmacy Services 2021 selling season with more than 70% of renewals complete with a strong retention rate.

我們在 2021 年藥房服務銷售季繼續取得良好進展，續訂率超過 70%，且保留率很高。

Moving to Retail/Long-Term Care.

轉向零售/長期護理。

COVID-19 had a meaningful impact on segment performance with our retail pharmacies meeting essential needs of consumers and patients.

COVID-19 對我們的零售藥店滿足消費者和患者基本需求的細分市場業績產生了重大影響。

Total revenues were up 7.7% with adjusted operating income up 27.7% year-over-year.

總收入同比增長 7.7%，調整後營業收入同比增長 27.7%。

A few key factors drove the results.

一些關鍵因素推動了這一結果。

As Larry mentioned, we delivered strong pharmacy and front store volume.

正如拉里提到的，我們提供了強勁的藥房和前台商店銷量。

Adjusted script growth of 8.2% was primarily driven by the continued adoption of our patient care programs, COVID-19-related volume and leap day.

調整後的腳本增長 8.2%，主要是由於我們的患者護理計劃的持續採用、與 COVID-19 相關的數量和閏日。

We estimate COVID-19 impacted adjusted script growth by about 200 basis points.

我們估計，COVID-19 影響調整後腳本增長約 200 個基點。

Front store total revenues increased 8.5%, of which a significant portion was due to COVID-19.

前台總收入增長了 8.5%，其中很大一部分是由於 COVID-19 造成的。

Before the surge related to COVID-19 began, front store total revenues were up about 2%.

在與 COVID-19 相關的激增開始之前，前台總收入增長了約 2%。

Adjusted operating income growth was driven by strong sales performance, benefit from generics, front store margin improvements and lower SG&A, with SG&A reflecting favorable resolution of legal matters and our ongoing modernization efforts.

調整後營業收入的增長是由強勁的銷售業績、仿製藥帶來的收益、前台利潤率的提高和銷售及一般管理費用（SG&A）的降低所推動的，SG&A 反映了法律問題的有利解決以及我們正在進行的現代化努力。

The growth was partially offset by continued pharmacy reimbursement pressure.

這一增長被持續的藥房報銷壓力部分抵消。

COVID-19 contributed about 40% of the adjusted operating income growth for the quarter, including the impact of additional operating expenses.

COVID-19 貢獻了本季度調整後營業收入增長的約 40%，其中包括額外營業費用的影響。

Moving to Health Care Benefits, total membership increased 2.4% or 554,000 sequentially.

至於醫療保健福利，會員總數比上一季度增加了 2.4%，達到 554,000 人。

Consistent with our strategic focus, we are pleased with our strong sequential Medicare Advantage membership growth of 11.3%, outpacing the industry average.

與我們的戰略重點一致，我們對 Medicare Advantage 會員連續強勁增長 11.3% 感到高興，超過了行業平均水平。

In Medicaid, we're also pleased with the strength of our sequential membership growth driven primarily by the acquisition of IlliniCare.

在醫療補助方面，我們也對主要由收購 IlliniCare 推動的會員連續增長勢頭感到滿意。

Commercial membership is down sequentially primarily due to a decline in public and labor.

商業會員數量環比下降主要是由於公眾和勞動力的減少。

On a year-over-year basis, total revenues increased approximately 7.4% primarily due to strong Government products growth.

總收入同比增長約 7.4%，主要得益於政府產品的強勁增長。

Operating expenses increased versus prior year primarily due to the reinstatement of the HIF and our Government membership growth, including higher cost related to the onboarding of IlliniCare members.

運營費用較上一年有所增加，主要是由於 HIF 的恢復和我們政府會員的增長，包括與 IlliniCare 會員入職相關的成本增加。

This increase was partially offset by savings initiatives, including integration synergies.

這一增長被包括整合協同效應在內的節約舉措部分抵消。

MBR was 82.4%, primarily reflecting an improvement from return of the HIF.

MBR 為 82.4%，主要反映了 HIF 回報的改善。

During the quarter, we also saw reduced discretionary utilization related to COVID-19 that started in mid-March.

在本季度，我們還發現自 3 月中旬開始，與 COVID-19 相關的可自由支配利用率有所減少。

This was partially offset by the growth in our Government business and the impact of leap day.

這部分被我們政府業務的增長和閏日的影響所抵消。

In Medicaid, while we are pleased with the membership growth, we are experiencing pressure on our MBR due in part to a heavier and longer flu season as well as higher-cost claimants in certain states.

在醫療補助計劃中，雖然我們對會員數量的增長感到滿意，但我們的 MBR 正面臨著壓力，部分原因是流感季節更嚴重、時間更長，以及某些州的索賠費用更高。

Health Care Benefits adjusted operating income was slightly lower year-over-year, reflecting all the factors I just described.

醫療保健福利調整後營業收入同比略有下降，反映了我剛才描述的所有因素。

COVID-19 had a modest impact on Health Care Benefits segment for the first quarter as the deferral of discretionary utilization more than offset the impact from lower net investment income, including realized capital losses.

COVID-19 對第一季度醫療保健福利部門的影響不大，因為可自由支配資金的推遲足以抵消淨投資收入下降（包括已實現資本損失）的影響。

The Corporate segment adjusted operating loss increased by $54 million over 2019.

企業部門調整後營業虧損比 2019 年增加了 5400 萬美元。

This was predominantly related to higher legal and transformation costs.

這主要與較高的法律和轉型成本有關。

In addition, the segment recorded realized capital losses related to the capital markets volatility in Q1.

此外，該部門還錄得與第一季度資本市場波動相關的已實現資本損失。

Going below the line, interest expense was lower by approximately $50 million due to the lower average debt for Q1 2020 compared to 2019.

在該線以下，由於 2020 年第一季度的平均債務低於 2019 年，利息支出減少了約 5000 萬美元。

Prior to COVID-19, our underlying core business performance was strong.

在 COVID-19 之前，我們的核心核心業務表現強勁。

While acknowledging the inherent and unprecedented uncertainty surrounding the ongoing COVID-19 pandemic and its impact, we are leaving our full year 2020 enterprise GAAP EPS and adjusted EPS guidance ranges unchanged at $5.47 to $5.60 and $7.04 to $7.17, respectively.

儘管承認當前的COVID-19 大流行及其影響存在固有的、前所未有的不確定性，但我們將2020 年全年企業GAAP 每股收益和調整後每股收益指導範圍保持不變，分別為5.47 美元至5.60 美元和7.04 美元至7.17 美元。

Cash flow from operations guidance for the full year of $10.5 billion to $11 billion is also unchanged.

全年運營指導現金流量為 105 億美元至 110 億美元，也保持不變。

This view is subject to a number of key considerations, including the significant uncertainties that continue to exist around the severity and duration of the COVID-19 pandemic, including its impact on the U.S. and global economies, consumer behavior and health care utilization patterns.

這一觀點受到許多關鍵考慮因素的影響，包括圍繞COVID-19 大流行的嚴重程度和持續時間繼續存在的重大不確定性，包括其對美國和全球經濟、消費者行為和醫療保健利用模式的影響。

Additionally, the timing, scope and impact of stimulus legislation and other governmental responses to the pandemic remains to be seen.

此外，刺激立法和其他政府應對疫情措施的時機、範圍和影響仍有待觀察。

The financial impact of these factors on the company will become clearer in the months to come.

這些因素對公司的財務影響將在未來幾個月內變得更加明顯。

Given the unusual situation this quarter, I will elaborate on what we are seeing for select metrics in April.

鑑於本季度的不尋常情況，我將詳細說明我們在 4 月份看到的選定指標。

Our slides provide the March comps along with the April comps for additional context.

我們的幻燈片提供了三月比較和四月比較，以提供更多背景信息。

Prescriptions are about flattish in both Retail/ Long-Term Care and Pharmacy Services compared to April 2019 as we saw the March pull forward of prescriptions reverse and a drop in new prescriptions related to lower physician visits.

與 2019 年 4 月相比，零售/長期護理和藥房服務的處方量基本持平，因為我們看到 3 月份的處方量出現逆轉，並且與醫生就診次數減少相關的新處方量有所下降。

Front store sales were down about 11% compared to April 2019 as increased basket size was more than offset by a reduction in store traffic as shelter in place took hold.

與 2019 年 4 月相比，前店銷售額下降了約 11%，因為購物籃尺寸的增加被居家隔離期間商店客流量的減少所抵消。

The reduction in discretionary utilization that Health Care Benefits started to see in mid-March continued through April.

醫療保健福利從 3 月中旬開始出現可自由支配使用量的減少，這種情況一直持續到 4 月份。

And based on what we know today, our MBR could be at its lowest level in Q2.

根據我們今天所知，我們的 MBR 可能會在第二季度達到最低水平。

Early data for the month of April suggests decreases in utilization of about 30% across an array of services compared to April 2019.

4 月份的早期數據顯示，與 2019 年 4 月相比，一系列服務的利用率下降了約 30%。

Additionally, we cannot predict what impact delays in utilization will have on its members with chronic conditions as mistreatment could adversely affect their health.

此外，我們無法預測延遲使用會對患有慢性病的成員產生什麼影響，因為虐待可能會對他們的健康產生不利影響。

In addition, Q2 will reflect a significant increase in COVID-19-related operating expenses over Q1 as we recognize the investments we made in business continuity and other initiatives Larry mentioned.

此外，由於我們認識到我們在業務連續性和拉里提到的其他舉措方面所做的投資，第二季度將反映出與第一季度相比，與 COVID-19 相關的運營費用大幅增加。

The quarterly cadence of earnings is likely to vary from historical patterns, and other key performance metrics are likely to play out differently than we expected at the time of our last earnings call.

每季度的盈利節奏可能會與歷史模式有所不同，其他關鍵績效指標的表現也可能與我們上次財報電話會議時的預期不同。

Given all of the moving pieces, we are not providing our more detailed guidance today.

考慮到所有的變化，我們今天不會提供更詳細的指導。

With that, let's open up the line for questions.

接下來，讓我們開放提問熱線。

(Operator Instructions) We'll take our first question from Lisa Gill of JPMorgan.

（操作員說明）我們將回答摩根大通的 Lisa Gill 提出的第一個問題。

And thank you, Larry and team, for all that CVS is doing on the front lines.

感謝 Larry 和團隊，感謝 CVS 在前線所做的一切。

Let me just first start.

讓我先開始吧。

Eva, one of the comments you made is that there was a strong underlying core versus your expectations in the first quarter.

伊娃，您發表的評論之一是，第一季度的基礎核心與您的預期不符。

Can you just maybe talk about what areas performed better on the core side than you were expecting?

您能否談談核心方面哪些領域的表現比您預期的要好？

And I know you're not going to give any incremental guidance, but I just want to understand how we think about the front end and the impact to overall results.

我知道您不會提供任何增量指導，但我只是想了解我們如何看待前端以及對整體結果的影響。

So you talked about the April sales, and I appreciate that being down 10.9% on the front end.

你談到了 4 月份的銷售額，我很高興看到前端下降了 10.9%。

If it stays like that for some period of time, how does that impact the overall results as we think about the core guidance that you gave?

如果這種情況持續一段時間，當我們考慮您提供的核心指導時，這會對整體結果產生什麼影響？

It's Eva.

是伊娃。

Thanks for your question and your comments about everything the company is doing.

感謝您的提問以及您對公司所做的一切的評論。

I think as we commented on the strong underlying core, right, I'll start with the PBM, you saw really strong top line and bottom line growth with specialty leading the way.

我認為，當我們評論強大的基礎核心時，對吧，我將從 PBM 開始，您看到了非常強勁的營收和利潤增長，而專業領域處於領先地位。

We're realizing the benefits of some of the initiatives that we had started last year in underlying sales in the PBM.

我們正在認識到去年在 PBM 基礎銷售方面啟動的一些舉措的好處。

So we're pleased with that and the performance we reported was above our initial expectations.

所以我們對此感到滿意，我們報告的表現超出了我們最初的預期。

Additionally, as you look at the retail business, again strong performance ex COVID.

此外，當你觀察零售業務時，你會發現除新冠肺炎疫情外，零售業務的表現再次強勁。

Pleased with the front store comps of 2% prior to COVID.

對新冠肺炎疫情爆發前 2% 的前台銷售補償感到滿意。

Continued strong script growth, and we reported over 8% script growth.

腳本增長持續強勁，我們報告腳本增長超過 8%。

When you adjust for COVID, you're still above 6%, and that's the continuation of our patient care programs and what have you.

當您針對新冠病毒進行調整時，您的感染率仍高於 6%，這就是我們的患者護理計劃的延續以及您所擁有的。

And from a Health Care Benefits perspective, I'd say our results were largely in line.

從醫療保健福利的角度來看，我想說我們的結果基本上是一致的。

We're pleased with the growth in the government sector.

我們對政府部門的增長感到滿意。

But on the Medicaid front, as I outlined, we have some MBR pressure that we're working through.

但正如我所概述的，在醫療補助方面，我們面臨著一些 MBR 壓力，我們正在努力解決。

Lisa, on the guidance question, there -- I'll say there are a host of assumptions underneath us leaving our guidance unchanged, and it's based on another factor.

麗莎，關於指導問題，我想說的是，我們有很多假設，而我們的指導保持不變，這是基於另一個因素。

As you look at states coming back on board, I don't think it's, I'd say, consistent across the country, right?

當你看到各州重新加入時，我認為全國各地的情況並不一致，對嗎？

It'll be state by state, and we've really tried to factor all the different pieces in.

各個州都會有不同的情況，我們確實嘗試著將所有不同的因素都考慮進去。

And Jon, I don't know if you want to add anything on the front store.

喬恩，我不知道你是否想在前台添加任何東西。

No.

不。

I mean, Lisa, listen, all categories are obviously down in April coming off from the peak in March.

我的意思是，麗莎，聽著，四月份所有類別的銷量都明顯從三月份的峰值下降。

And it's still very early.

現在還很早。

We have very limited data, but we are seeing that as shelter in orders (sic) [shelter-in-place order] are lifting and we return our hours of operation to the normal hours, we're beginning to see sales improve.

我們的數據非常有限，但我們發現，隨著避難令（原文如此）[就地避難令]的解除以及我們將營業時間恢復到正常時間，我們開始看到銷售有所改善。

So still early, but the early view is improving.

現在還為時過早，但早期的觀點正在改善。

And Lisa, it's Larry.

麗莎，是拉里。

Just maybe one final point on it specific to front store sales.

也許只是最後一點，具體針對前店銷售。

Keep in mind front store now represents 8%, 9% of enterprise revenues.

請記住，前台商店現在佔企業收入的 8% 至 9%。

Continues to be important.

仍然很重要。

And team has done a great job in terms of -- you think about the underlying ex COVID, the sales performance was around 2%.

團隊在這方面做得很好——你想想潛在的新冠疫情，銷售業績約為 2%。

So that reflects a lot of the activities that we've talked about in the past around personalization.

這反映了我們過去討論過的圍繞個性化的許多活動。

Lisa, I think one of the things that we're seeing and learning is -- and we talk about things that are happening today that are part of today's norm, but things that will migrate from today's norm to tomorrow's everyday routines.

麗莎，我認為我們看到和學到的事情之一是——我們談論今天正在發生的事情，這些事情是今天常態的一部分，但這些事情將從今天的常態轉變為明天的日常生活。

And as you heard in our prepared remarks, we've seen a dramatic increase in home delivery.

正如您在我們準備好的發言中所聽到的，我們已經看到送貨上門的數量急劇增加。

One of the questions that we've always had is how do we increase the front store attachment rate to prescriptions.

我們一直面臨的問題之一是如何提高前店處方的依附率。

And again, we've seen a fourfold increase in terms of those prescriptions being accompanied with a front store purchase.

而且，我們再次看到，通過前台商店購買的處方數量增加了四倍。

So we think that's an opportunity that we can capitalize on as we begin to return to, I'll say, a new normal environment.

因此，我們認為，當我們開始回歸新常態環境時，我們可以利用這個機會。

Our next question comes from Eric Percher of Nephron Research.

我們的下一個問題來自 Nephron Research 的 Eric Percher。

Eric Percher and Josh Raskin here from Nephron.

來自 Nephron 的 Eric Percher 和 Josh Raskin。

Maybe building on the last question of what a new norm may look like.

也許以新規範可能是什麼樣子的最後一個問題為基礎。

You spoke to some of the shifts occurring in mail, kind of like specialty shift and home infusion.

您談到了郵件中發生的一些輪班，有點像專業輪班和家庭輸液。

How material are these?

這些材料有多重要？

Do you see the shift, I think mail is 5% of all scripts, as being material.

你看到這種轉變了嗎？我認為郵件佔所有腳本的 5%，因為郵件是材料。

And obviously, across your models, you can capture them a couple of ways.

顯然，在您的模型中，您可以通過多種方式捕獲它們。

And I'd love to hear the same on specialty and infusion and whether you think there are share gains from the hospital channel as well.

我很想听到有關專業和輸液的相同信息，以及您是否認為醫院渠道也能帶來份額收益。

Yes.

是的。

Eric, it's Larry.

埃里克，我是拉里。

Maybe I'll start and ask Alan to talk more specifically on mail.

也許我會開始請艾倫更具體地談談郵件。

I think the Coram, the home infusion, is a great opportunity.

我認為 Coram（家庭輸液）是一個很好的機會。

It ties back to something that we've talked about many times when you think about how do we provide care in the right care setting with the variables being convenience as well as cost.

當您思考我們如何在正確的護理環境中提供護理（變量包括便利性和成本）時，這與我們多次討論過的事情有關。

And our infusion nurses have made 60,000 visits since the pandemic began, which is a great example of what we're talking about in terms of we freed up important hospital capacity by working with the hospitals in terms of expediting discharge back into the home for those patients who needed to continue to require IV therapy and were well enough to do that within the comfort of their home, and we're able to provide that service.

自大流行開始以來，我們的輸液護士已經進行了60,000 次就診，這是我們正在談論的一個很好的例子，我們通過與醫院合作來釋放重要的醫院能力，以加快那些患者出院回家的速度。需要繼續接受靜脈注射治療並且身體狀況良好的患者可以在舒適的家中進行治療，我們能夠提供該服務。

So Eric, a lot of this goes back to the strategy that we've been talking about for the last couple of years in terms of what we can do to make health care local and simple, whether it's in the community, in the home or in the palm of your hand.

埃里克，這在很大程度上可以追溯到我們過去幾年一直在討論的戰略，即我們可以採取哪些措施使醫療保健變得本地化和簡單化，無論是在社區、家庭還是在社區中。在你的手掌中。

So Eric, it's Alan Lotvin.

埃里克，我是艾倫·洛特文。

I'll add a couple of points, one on home delivery.

我將補充幾點，其中之一是關於送貨上門的。

We've seen increase in home delivery in mail.

我們看到郵件送貨上門的數量有所增加。

But I think when you think about mail and the power of our enterprise, we have the ability to bring prescriptions to people's home not only through traditional mail but also, as John talked about, through home delivery from retail, and that's also up dramatically.

但我認為，當你想到郵件和我們企業的力量時，我們不僅有能力通過傳統郵件將處方送到人們家中，而且正如約翰所說，通過零售送貨上門，這也大幅增加。

And the last point I would make is that as we talk about the early view into what we're seeing with mail and specialty in April, we're not seeing the same patterns of decline that we're seeing in the retail network.

我要說的最後一點是，當我們談論對 4 月份郵件和專業商品的早期看法時，我們沒有看到零售網絡中看到的相同下降模式。

And along the same lines of early views, are you seeing any change in pre-authorizations on the HCB side relative to that 30% decline, where that may move?

與早期觀點相同，您是否認為 HCB 方面的預授權相對於 30% 的下降有任何變化，可能會發生什麼變化？

It's Karen.

是凱倫。

In April, with pre-auths, we saw almost a 40% decline in prior authorization.

4 月份，通過預授權，我們發現預授權數量下降了近 40%。

And in utilization, it's like down 30% through April.

到 4 月份，利用率下降了 30%。

I would tell you that as states are opening up, however, we have seen an uptick in pre-auths and pre-certs but not dramatic increases yet.

然而，我想告訴您，隨著各州開放，我們看到預授權和預認證有所增加，但尚未大幅增加。

Our next question comes from Ann Hynes of Mizuho Securities.

我們的下一個問題來自瑞穗證券的安·海因斯。

So just for clarification, Eva, I know you said that the Health Care Benefits segment results were in line with your estimates.

因此，為了澄清，伊娃，我知道您說過醫療保健福利部門的結果符合您的估計。

So when I look at your prior guidance for Health Care benefits, the operating profit guidance was up 5% to 6.7%.

因此，當我查看你們之前對醫療保健福利的指導時，營業利潤指導上升了 5% 至 6.7%。

So is that decline of negative 4.5%, was that Q1 decline in line with your expectations going into the year will be my first question.

我的第一個問題是，負 4.5% 的下降是否與您對今年的預期一致？

And my second question is, and you touched this in your prepared remarks, can you just remind us some of the initiatives you did in 2019 in specialty which resulted in such strong results?

我的第二個問題是，您在準備好的發言中提到了這一點，您能否提醒我們一些您在 2019 年在專業領域所做的一些舉措，這些舉措取得瞭如此強勁的成果？

Yes.

是的。

Sure.

當然。

So on the Health Care Benefits, yes, I would say that the results are largely in line, as I said before.

因此，在醫療保健福利方面，是的，我想說，正如我之前所說，結果基本上是一致的。

And as you think about the results, a couple of things are elevated in Q1 as we're onboarding the growth in the Medicare business that we spoke to as well as IlliniCare and bringing that acquisition on.

當你思考結果時，第一季度的一些事情得到了提升，因為我們正在推動我們交談過的醫療保險業務以及 IlliniCare 的增長並進行收購。

And recall I spoke last year to some stranded costs related to the Aetna PDP divestiture.

還記得我去年談到過與 Aetna PDP 剝離相關的一些擱淺成本。

We're aggressively working that down as we go throughout the year.

我們全年都在積極努力降低這一問題。

That said, I did highlight some of the pressure on the Medicaid MBR, and that certainly is something we're working through.

也就是說，我確實強調了醫療補助 MBR 面臨的一些壓力，這當然是我們正在努力解決的問題。

And I'll let Alan provide some additional color on some of the specialty initiatives.

我將讓艾倫為一些專業舉措提供一些額外的信息。

Yes.

是的。

So on the specialty side, Ann, we've expanded a program we call Specialty Expedite, which is a way to simplify the process of getting prescriptions started for both physicians and patients in short of time.

因此，安，在專業方面，我們擴展了一個名為“專業加速”的計劃，這是一種簡化醫生和患者在短時間內開始開處方的過程的方法。

It's been very well accepted in the provider community.

它在提供商社區中得到了很好的接受。

We continue to refine Specialty Connect, our approach to allowing patients to pick up or drop off prescriptions, specialty prescriptions at retail.

我們繼續完善 Specialty Connect，這是我們允許患者在零售店領取或交付處方藥、專業處方藥的方法。

It's a very, very popular approach.

這是一種非常非常流行的方法。

Again, resonates very strongly in the provider community.

再次在提供商社區中引起強烈反響。

And then we've really continued to drive our digital adoption and the ability to interact with our specialty members via text and secure messaging, which again creates just a tailwind for us as we work more closely with these patients.

然後，我們確實繼續推動我們的數字化採用以及通過文本和安全消息傳遞與我們的專業成員互動的能力，這再次為我們與這些患者更密切地合作創造了順風。

And Ann, it's Larry.

安，是拉里。

Just -- maybe just one final point.

只是——也許只是最後一點。

Keep in mind when we talk about 19% specialty growth, that now includes the specialty business within Ingenio in those numbers as well.

請記住，當我們談論 19% 的專業增長時，現在這些數字也包括 Ingenio 內的專業業務。

Our next question comes from Charles Rhyee of Cowen.

我們的下一個問題來自 Cowen 的 Charles Rhyee。

Yes.

是的。

Just a follow-up from an earlier question around -- Jon, I think you were responding to Lisa's question around the experience you're seeing in the reopened states.

只是之前一個問題的後續——喬恩，我認為你是在回答麗莎關於你在重新開放的州所看到的經歷的問題。

Anything -- any more details you can give like a breakdown between not just pharmacy but also front end?

任何事情 - 您可以提供更多詳細信息，例如藥房和前端之間的細分嗎？

And is it foot traffic that is accelerating?

人流量是否在加速？

And talk about maybe how consumers are kind of responding as they're kind of going back to sort of a normal life is first.

並談談消費者可能會如何反應，因為他們首先要回歸正常生活。

And then just going back, I think, earlier in the prepared remarks, you talked about strong retention rate in the PBM business.

然後，我想，在之前準備好的發言中，您談到了 PBM 業務的高保留率。

Maybe talk about what new business activity looks like this year.

也許可以談談今年新的商業活動是什麼樣的。

Is it fair to think that with all the disruptions that employers are seeing, we should expect a lot less new business activity?

鑑於雇主所看到的所有乾擾，我們應該預期新的業務活動會大幅減少，這樣的想法公平嗎？

Charles, this is Jon.

查爾斯，這是喬恩。

I'll start.

我開始吧。

So we are -- I mean, if you look at where most of the COVID positive cases are, we're seeing more of a significant sales impact both in the front and in the pharmacy than we see in other areas that are less impacted.

所以我們——我的意思是，如果你看看大多數新冠病毒陽性病例在哪裡，我們會發現前台和藥房的銷售受到的影響比我們在其他受影響較小的領域看到的要大。

But as the shelter-in-place orders are lifted, we're turning back on our marketing programs with personalization that is a big part of our sales driving programs.

但隨著就地避難令的取消，我們正在重新啟動個性化營銷計劃，這是我們銷售推動計劃的重要組成部分。

We're also returning our hours of operation back to normal.

我們還將恢復正常營業時間。

So as an example, 75% of our stores reduced their front store hours of operation, and it was about 12% of the hours that were turning -- will return those back to normal as the communities open up.

舉個例子，我們 75% 的商店減少了前店營業時間，其中大約有 12% 的營業時間會隨著社區開放而恢復正常。

In pharmacy, we did less of an hour's reduction, about 2%.

在藥房，我們減少了不到一個小時的時間，大約是2%。

But listen, there were -- it's still very early, but we are seeing some positive trends, as I said earlier.

但是聽著，現在還很早，但正如我之前所說，我們看到了一些積極的趨勢。

In pharmacy, we're seeing less of an impact, and I think a lot of that is due to our home delivery program that Larry talked about in his remarks.

在藥房，我們看到的影響較小，我認為這很大程度上是由於拉里在講話中談到的我們的送貨上門計劃。

But I think the biggest headwind we're seeing now in pharmacy is really around new therapy starts.

但我認為我們現在在藥房看到的最大阻力實際上是圍繞新療法的開始。

So you've seen doctor visits are down.

所以你已經看到看醫生的次數減少了。

And as a result of that, we're seeing about 25% less or lower new therapy starts for April than we saw a year ago.

因此，我們發現 4 月份開始的新療法比一年前減少了約 25%。

So this includes new maintenance prescriptions as well as prescriptions for acute events, and they typically grow about 7% each year.

因此，這包括新的維持處方以及針對急性事件的處方，通常每年增長約 7%。

In certain drug classes such as antibiotics, new starts are down 40% to 50%.

在抗生素等某些藥物類別中，新開工數量下降了 40% 至 50%。

So as physicians start seeing patients again, we expect this volume to normalize.

因此，隨著醫生開始再次看診患者，我們預計這一數量將恢復正常。

And so I'll jump in.

所以我會跳進去。

It's on the new business question.

這是關於新業務的問題。

So I'll first talk about retention.

所以我首先談談保留。

As Eva mentioned, we've -- we're about 70% -- a little over 70% of the way through our own book.

正如 Eva 提到的，我們已經完成了我們自己的書的 70% 略多於 70% 的工作。

We're at a 97% to 98% retention rate.

我們的保留率為 97% 到 98%。

So we're very happy with that.

所以我們對此非常滿意。

And with respect to new business, we'll talk more about that next quarter, but I will tell you that RFP activity is consistent with what we've seen over the last 2 years.

關於新業務，我們將在下個季度詳細討論，但我會告訴您，RFP 活動與我們過去兩年所看到的情況一致。

We have not seen much of a slowdown.

我們沒有看到太大的放緩。

Obviously, I can't predict what's going to happen as we get towards the end of the year.

顯然，我無法預測年底會發生什麼。

But as of now, we're seeing roughly consistent with what we've seen in the last 2 years.

但截至目前，我們看到的情況與過去兩年的情況大致一致。

Our next question comes from Ricky Goldwasser of Morgan Stanley.

我們的下一個問題來自摩根士丹利的 Ricky Goldwasser。

Question is focused on your Medicaid comments around some of the higher cost.

問題集中在您對醫療補助計劃對某些較高費用的評論。

But if we look forward -- there was an article yesterday that talked about states that are starting to cut Medicaid rates.

但如果我們展望未來——昨天有一篇文章談到了開始降低醫療補助費率的州。

So what are your thoughts about how prevalent it's going to be this year, next year and the impact on margins?

那麼，您對今年、明年這種現​​象的流行程度以及對利潤率的影響有何看法？

I think your long-term target at Investor Day was long -- low single digit to mid-single digits.

我認為你在投資者日的長期目標很長——低個位數到中個位數。

So how should we think about the potential impact of rate cuts on that?

那麼我們應該如何看待降息對此的潛在影響呢？

It's Karen.

是凱倫。

Relative to your first question on the pressure we're seeing in Medicaid, there's really 2 factors.

相對於你關於我們在醫療補助中看到的壓力的第一個問題，實際上有兩個因素。

One is that we had a longer flu season that impacted Medicaid.

一是流感季節較長，影響了醫療補助。

And the second was really around some unusually high, high-cost claimants in the Medicaid business.

第二個問題實際上是圍繞醫療補助業務中一些異常高額、高成本的索賠人。

Relative to the Medicaid business on a go-forward basis, it's a little early to tell.

相對於未來的醫療補助業務，現在下結論還為時過早。

We are working very closely with our Medicaid states.

我們正在與醫療補助州密切合作。

We expect to see, obviously, improved enrollment in Medicaid as we continue to see unemployment increase over time.

顯然，隨著失業率隨著時間的推移而增加，我們預計醫療補助的入學人數將會增加。

And we haven't had any state come back and cut rates on us yet, but obviously, we would manage to our medical costs and our operating expenses to try to maintain those single margins as appropriate.

我們還沒有任何國家回來降低我們的利率，但顯然，我們將設法控制我們的醫療成本和運營費用，以盡量維持這些單一利潤。

And Ricky, it's Larry.

瑞奇，是拉里。

One final point as you look forward.

最後一點，敬請期待。

I think that your question around Medicaid margins is -- it's really an open question at this point because if you go back and look at the stimulus activity out of Washington, now there's dialogue beginning on a stimulus 4, and some of this is -- could really be framed as a policy question, that the stimulus to date has not addressed the issue of individual subsidies for COBRA, as an example, acknowledging that there's going to be a relationship between what happens to the Medicaid rosters assuming unemployment does increase to some number versus what happens with COBRA if there are subsidies applied for individuals to enroll in COBRA.

我認為你關於醫療補助利潤的問題是——目前這確實是一個懸而未決的問題，因為如果你回頭看看華盛頓的刺激活動，現在就開始就刺激方案 4 進行對話，其中一些是——確實可以被視為一個政策問題，例如，迄今為止的刺激計劃尚未解決COBRA 的個人補貼問題，例如，承認假設失業率確實增加到一定程度，醫療補助名冊上會發生什麼情況之間存在關係數字與如果向個人加入COBRA 提供補貼的話COBRA 會發生什麼。

So that's something that we'll be watching closely and having discussion around.

因此，這是我們將密切關注並進行討論的事情。

So just one follow-up on that.

所以只有一個後續行動。

Do you have any view around what would be the risk profile.

您對風險狀況有何看法？

You can see that uptick in Medicaid enrollment.

您可以看到醫療補助註冊人數的增加。

In past, you used to see sicker population actually signing up to the Medicaid benefit.

過去，您經常會看到病情較重的人實際上簽署了醫療補助福利。

Do you think that given what we're seeing in COVID and how it's impacting cross-section of the population, that you might have a different risk pool and maybe kind of like younger population signing up?

您是否認為，考慮到我們在新冠疫情中所看到的情況以及它對不同人群的影響，您是否可能會面臨不同的風險池，並且可能有點像年輕人註冊？

Just wondering what your thoughts are on that.

只是想知道你對此有何想法。

Ricky, I think if we look at historical patterns when we've seen unemployment, you look back at 2008, 2009 when we saw increases in Medicaid as well, what we saw was a more healthy population come in.

Ricky，我認為，如果我們回顧一下失業率的歷史模式，回顧一下 2008 年和 2009 年，當時我們也看到了醫療補助的增加，我們看到的是更健康的人口湧入。

I would expect to see that as well because we've got Commercial business, relatively speaking, healthy.

我也希望看到這一點，因為相對而言，我們的商業業務是健康的。

So I would think the risk profile would change somewhat and skew to a healthier group.

因此，我認為風險狀況會有所改變，並偏向於更健康的群體。

Our next question is from Justin Lake of Wolfe Research.

我們的下一個問題來自沃爾夫研究中心的賈斯汀·萊克。

A couple of things here.

這裡有幾件事。

First, can you help us understand the $0.10 benefit that you discussed here in terms of how much benefit to the bottom line from incremental revenue that you can talk to us about?

首先，您能否幫助我們了解您在此討論的 0.10 美元收益，即您可以與我們討論的增量收入對底線的收益有多少？

And then thoughts on incremental cost in COVID in March that might have offset some of that benefit and how we should think about the incremental cost from COVID going forward for the rest of the year?

然後是對 3 月份新冠疫情增量成本的思考，這可能會抵消部分收益，以及我們應該如何考慮今年剩餘時間新冠疫情帶來的增量成本？

And then just my follow-up would be that what was the benefit of the legal resolution in the quarter in the pharmacy business that you'd noted in the results?

然後我的後續行動是，您在結果中註意到的本季度製藥業務的法律解決方案有什麼好處？

It's Eva.

是伊娃。

I'll take that question.

我來回答這個問題。

I think if you look at the $0.10 benefit, and we outlined this on our slide, Slide 19, I would think about Q1 -- you could see the benefit really largely coming from the retail segment as the other segments really had a pretty modest impact and there are some puts and takes.

我認為，如果你看看0.10 美元的收益，我們在幻燈片19 中概述了這一點，我會考慮第一季度——你可以看到收益實際上主要來自零售部門，因為其他部門的影響確實相當有限還有一些放和取。

And I think that as you think about the margins, the investments that we've made and that Larry outlined, a lot of those investments are largely going to hit in Q2 given the nature of those underlying investments.

我認為，當你考慮利潤率、我們所做的投資以及拉里概述的投資時，考慮到這些基礎投資的性質，很多投資將在第二季度受到影響。

So think about the benefit.

所以考慮一下好處。

There are some investments but more generally in line with underlying margins as the other investments on compensation and what have you.

有一些投資，但更普遍的是與基本利潤一致，就像其他投資在薪酬和你擁有的東西上一樣。

And the additional protective gear really, really ramped as you came toward the end of the quarter.

隨著季度末的臨近，額外的防護裝備確實非常非常多。

Going back to your other question on the Retail/Long-Term Care segment, you could see year-over-year we have favorability in our underlying cost.

回到您關於零售/長期護理領域的其他問題，您可以看到我們的基本成本逐年有利。

And I'm not going to explicitly break out the legal matter, but year-over-year, we had some costs last year.

我不會明確透露法律問題，但與去年同期相比，去年我們付出了一些成本。

We had some favorability this year.

今年我們有一些好感。

So net-net, it was a positive as you look at that outside growth.

因此，從外部增長來看，這是積極的。

Our next question is from Michael Cherny of Bank of America.

我們的下一個問題來自美國銀行的邁克爾·切爾尼。

I want to kind of summarize a few questions you had.

我想總結一下您提出的幾個問題。

Larry, you went through a lot of details early on some of the benefits you're seeing tied to the increase in telehealth, tied to some of the other dynamics on the ability to deliver at home.

拉里，您很早就詳細了解了一些與遠程醫療增長相關的好處，以及與在家分娩能力相關的其他一些動態相關的好處。

As you think about the pause you're taking on some of the longer-term investments, longer-term strategies and particularly around HealthHUB, is there anything you're learning through this pandemic that can better educate you on how to think about the HealthHUB build-out given that there are a lot of dynamics in place that would appear at this point to have people that want to stay away from the average traditional retail store versus coming into more?

當您考慮暫停進行一些長期投資、長期戰略，尤其是圍繞 HealthHUB 的投資時，您從這次大流行中學到的東西是否可以更好地教育您如何思考 HealthHUB考慮到目前存在很多動態，人們希望遠離普通的傳統零售店，而不是進入更多的傳統零售店，是否會進行擴建？

And so just balancing those dynamics with your approach towards having this incremental differentiated front-end health care service at a time when the entire world is rethinking how much time they want to spend outside their house?

因此，當全世界都在重新考慮他們想要在戶外度過多少時間時，只是平衡這些動態與您提供這種增量差異化前端醫療保健服務的方法？

Yes, Mike, it's a great question, and I touched on this a bit earlier that what we're seeing, we see validating our strategy.

是的，邁克，這是一個很好的問題，我早些時候談到過這一點，我們所看到的，我們看到驗證我們的策略。

And we talked about some of the use cases that we're seeing play out and -- whether it's home delivery, telemedicine, and I'll touch one that absolutely is in the community, and that's testing.

我們討論了我們看到的一些用例——無論是送貨上門、遠程醫療，我會接觸一個絕對存在於社區中的用例，那就是測試。

So Mike, when you think about -- we call it our triad of care in the community, in the home, in the palm of your hand, think about that as what we're defining here as omnichannel for health, and each one plays a role.

所以，邁克，當你想到我們稱之為社區、家庭、手掌中的三重護理時，請考慮一下我們在這裡定義的全渠道健康，每個人都在發揮作用一名角色。

But as individuals, we'll need all 3 in terms of what we do, when we do it and how we do it.

但作為個人，我們需要做什麼、何時做以及如何做這三個方面。

And so back to your question, our -- the learnings and the experience that we're seeing, number one, it validates our strategy.

回到你的問題，我們的學習和經驗，第一，它驗證了我們的策略。

Number two, we're looking to further optimize what we're seeing to become part of an everyday routine.

第二，我們希望進一步優化我們所看到的成為日常生活一部分的內容。

And I'll speak to the role of testing in the community as being an important part of diagnostics that, yes, we're focused on COVID testing today, but there's a broader universe of diagnostics and monitoring that we see becoming an important part of our HealthHUB strategy.

我將談到測試在社區中的作用，作為診斷的重要組成部分，是的，我們今天關注的是新冠病毒測試，但我們看到更廣泛的診斷和監測領域正在成為診斷和監測的重要組成部分。我們的 HealthHUB 戰略。

So look, we're evaluating all of the products and services road map, and I'm sure you're going to see us accelerate some of the things that are on our drawing board as a result of what we're experiencing.

所以看，我們正在評估所有的產品和服務路線圖，我相信您會看到我們由於我們正在經歷的事情而加速了我們繪圖板上的一些事情。

Our next question is from Ralph Giacobbe of Citi.

我們的下一個問題來自花旗集團的拉爾夫·賈科布。

I was hoping you could bifurcate the Commercial risk membership decline between economic factors versus either a loss or just shift to ASO and then how you're viewing the economic backdrop specifically as it relates to the commercial market.

我希望您能夠將商業風險成員資格下降分為經濟因素與損失或只是轉向 ASO 之間的關係，然後您如何看待與商業市場相關的經濟背景。

And then just a follow-up to that, is there any greater appetite to get back into the exchanges in a bigger way at this point?

接下來，是否有更大的興趣以更大的方式重返交易所？

It's Karen.

是凱倫。

Relative to membership, we lost 2 very large folks in labor cases, and they were fully insured cases, which is really reflective -- reflecting the decrease in overall membership.

相對於會員資格，我們在勞工案件中失去了兩個非常大的人，而且他們都是完全保險的案件，這確實很具有反思性——反映出會員總數的減少。

And on a year-over-year basis, as you know, we have been -- we also have a decline, a small decline in small group.

正如你所知，與去年同期相比，我們也出現了下降，小群體的小幅下降。

And as you know, we've been pushing on small groups to move it from insurer to ASO.

如您所知，我們一直在推動小型團體將其從保險公司轉移到 ASO。

We continue to see those trends.

我們繼續看到這些趨勢。

Relative to the question on unemployment in the last 6 weeks, we do expect to see declines in the latter half of the year.

相對於過去六週的失業率問題，我們確實預計下半年失業率會下降。

We already are seeing some membership decline in April in our Commercial book as a result of the economic downturn.

由於經濟低迷，我們已經看到 4 月份商業書籍中的會員數量有所下降。

However, we are seeing an increase in our Medicaid membership as well in April.

然而，四月份我們的醫療補助會員人數也有所增加。

So that's really what we're seeing.

這就是我們所看到的。

But we do expect, depending on what -- how this plays out and what's the duration of this, that we'll continue to see decreases in our Commercial book.

但我們確實預計，根據具體情況——具體情況如何以及持續時間，我們將繼續看到商業賬簿的減少。

And then the exchanges?

然後是交流呢？

I'm sorry?

對不起？

Exchanges.

交流。

Oh, in the exchanges.

呵呵，在交流中。

Yes.

是的。

As you know, we are in the exchanges today, it is something that we continue to evaluate, and we'll continue to look at it.

如你所知，我們今天在交流中，這是我們繼續評估的事情，我們將繼續關注它。

We obviously won't be in, in 2021.

2021 年我們顯然不會參加。

Our next question is from George Hill of Deutsche Bank.

我們的下一個問題來自德意志銀行的喬治·希爾。

Yes.

是的。

I have 2. First for Eva.

我有 2 個。首先是給伊娃的。

I'm wondering if you can unpack the PBM performance a little bit, maybe talk about the benefit of the improved purchasing economics and the cost savings versus lapping Ingenio planning and the negative impact of rebate guarantees.

我想知道您是否可以稍微解釋一下 PBM 性能，也許可以談談改善採購經濟性的好處以及與重疊 Ingenio 規劃相比節省的成本以及回扣保證的負面影響。

And then, I guess a follow-up for Larry strategically, I guess how are you thinking about home delivery versus mail?

然後，我想拉里的戰略後續行動是，我想你如何看待送貨上門和郵寄？

And you talked a little bit about the retail attachment rate.

您談到了零售依附率。

Walmart is launching a 2-hour home delivery service.

沃爾瑪推出2小時送貨上門服務。

I guess do you see this as an answer for CVS to challenge kind of the incursion of online into retail?

我想您是否認為這是 CVS 挑戰在線零售業入侵的答案？

Okay.

好的。

So George, I'll start with your question around the PBM.

喬治，我將從您關於 PBM 的問題開始。

Obviously, as you look at the first quarter growth, right, it's outsized relative to how we spoke about the full year prior to COVID.

顯然，當你看到第一季度的增長時，你會發現，相對於我們談論新冠疫情爆發前全年的情況來說，它的規模是巨大的。

But I think as you look at that in relation, right, the Q1 operating income growth is above what you would think about as a full year given the specialty benefits that Alan spoke about earlier disproportionately benefiting Q1 as we had the annualization of some generics and the new sales initiatives that Alan spoke about.

但我認為，當你從關係上來看，第一季度的營業收入增長高於你想像的全年營業收入增長，因為艾倫早些時候談到的特殊福利對第一季度的好處不成比例，因為我們對一些仿製藥進行了年度化，並且艾倫談到的新銷售舉措。

We also had some timing related to other accruals.

我們還有一些與其他應計費用相關的時間安排。

At the core, though, specialty is performing very, very well.

但從本質上講，專業的表現非常非常好。

On the rebate headwind, I would say we continue to manage that.

就回扣逆風而言，我想說我們將繼續應對這一點。

And the shape of the curve that I've described numerous times that 2019 was the peak, it would come down in '20 and diminishing or be de minimis in 2021, that continues.

我多次描述過的曲線形狀是，2019 年是峰值，它將在 20 世紀下降，並在 2021 年減少或達到最低限度，這種情況還在繼續。

So that continues to be a benefit as well as just cost management and benefit from integration synergies.

因此，這仍然是一種優勢，同時也是成本管理和集成協同效應的優勢。

And then, George, on your home delivery question.

然後，喬治，關於你的送貨上門問題。

George, think about the discussions we've been having probably for the last year in terms of how do we make sure we don't leave any white space for disruption.

喬治，想想我們去年可能一直在討論如何確保不留下任何干擾的空白。

And we started home delivery in a few marks -- in a few markets, and I think it was last fall where we expanded it coast to coast.

我們在幾個馬克內開始送貨上門——在幾個市場，我想是在去年秋天，我們將其擴展到了整個海岸。

So George, you think today about -- you can pick up your prescription inside the store in most of our stores, through the drive-through, in the mailbox at the front door or at the office, and we're experimenting with UPS in terms of maybe on the [lawn] trial.

所以喬治，你今天想一想，你可以在我們大多數商店的店內、通過免下車餐廳、前門的郵箱或辦公室領取你的處方，我們正在嘗試使用 UPS也許在[草坪]審判上。

So it's -- who do you want to be in terms of what makes the most sense for you from a convenience and access point of view at any given point in time?

所以，在任何給定的時間點，從便利和訪問的角度來看，什麼對您最有意義，您想成為誰？

And when you look at our integrated model, we can satisfy all avenues of access and convenience.

當您查看我們的集成模型時，我們可以滿足所有途徑的訪問和便利。

And George, this is Jon.

喬治，這是喬恩。

The only thing I would add to that is the reason our home delivery program was so successful as this pandemic took hold is we have 70% of our retail customers engaged digitally.

我唯一要補充的是，我們的送貨上門計劃在這場大流行病爆發後如此成功，原因是我們有 70% 的零售客戶通過數字方式參與。

So it was very easy for them to make that transition.

所以他們很容易實現這種轉變。

So I think that will help us as people decide how they want to get their prescriptions in the future.

所以我認為這將有助於我們人們決定未來如何獲得處方。

We'll take our next question from John Ramson (sic) [John Ransom] Of Raymond James.

我們將接受雷蒙德·詹姆斯 (Raymond James) 的約翰·拉姆森 (John Ramson)（原文如此）[約翰·蘭塞姆 (John Ransom)] 提出的下一個問題。

I was wondering, and for Karen, what the medical loss ratio would have looked like in the first quarter without COVID.

我想知道，對於凱倫來說，如果沒有新冠疫情，第一季度的醫療損失率會是什麼樣子。

The COVID had minimal impact on the quarter.

新冠疫情對該季度的影響微乎其微。

So you can look at that loss ratio and it's minimal.

所以你可以看看損失率，它是最小的。

Obviously, it will have a big impact on -- in April as we're continuing to see big utilization drops.

顯然，這將對四月份產生重大影響，因為我們繼續看到利用率大幅下降。

Great.

偉大的。

My followup is, when we look at the commercial marketplace, you're able to combine Aetna and the PBM in a single package.

我的後續行動是，當我們關注商業市場時，您可以將 Aetna 和 PBM 結合在一個軟件包中。

Do you think that we would see more what I would call cross-subsidization as you go to market, i.e., maybe using guaranteed rebates or some other such things such that the margin in the 2 businesses is less and less relevant as you sell them as a single package?

您是否認為當您進入市場時，我們會看到更多我所說的交叉補貼，即，可能使用有保證的回扣或其他類似的東西，這樣當您將這兩項業務出售時，它們的利潤越來越不相關單個包？

Yes.

是的。

When we -- well, we do that today.

當我們——好吧，我們今天就這麼做了。

We obviously will price the whole case, and we'll look at the whole case and price it to get a margin that we would want to get on that total case.

顯然，我們會對整個案例進行定價，並且我們將查看整個案例並對其進行定價，以獲得我們希望在整個案例中獲得的利潤。

So maybe not necessarily subsidizing one for the other.

因此，也許不一定要補貼其中之一。

We look at the whole case and what we want to write it at.

我們會審視整個案例以及我們想要寫的內容。

So -- and Karen, just to add to that, right, we'll look at the value that can be generated across the enterprise as we move forward.

那麼，凱倫，補充一下，我們將研究隨著我們的前進，整個企業可以產生的價值。

Yes.

是的。

Our next question is from Lance Wilkes of Bernstein.

我們的下一個問題來自伯恩斯坦的蘭斯·威爾克斯。

Yes.

是的。

And again, thanks a lot for everything that the CVS team has doing out there in the community.

再次，非常感謝 CVS 團隊在社區中所做的一切。

Just wanted to talk on HealthHUB a little bit and wanted to focus on 2 particular aspects.

只是想談談 HealthHUB，並希望重點關注兩個特定方面。

One is if you can talk a little bit about how telehealth is integrated in or how separate it is within MinuteClinic and now the HealthHUB structures and what your thoughts are going forward with that.

一是您是否可以談談遠程醫療在 MinuteClinic 中如何集成或如何獨立，以及現在的 HealthHUB 結構以及您對此的想法。

And I guess the follow-up is given some of the instability in the physician practice and urgent care environment today with the drop-off in volumes, those are going to become much more significant acquisition targets going forward.

我想後續行動是考慮到當今醫生實踐和緊急護理環境的一些不穩定以及數量的下降，這些將成為未來更重要的收購目標。

Is acquisition an important part of how you're going to build out capabilities as you look at HealthHUB and maybe the expanded care delivery in retail?

當您考慮 HealthHUB 以及擴大零售護理服務時，收購是否是您增強能力的重要組成部分？

Yes.

是的。

Lance, this is Jon, and I'll take telehealth and MinuteClinic.

蘭斯，我是喬恩，我將選擇遠程醫療和 MinuteClinic。

So we have the capability to do telehealth in MinuteClinic in every state that we operate in.

因此，我們有能力在我們開展業務的每個州的 MinuteClinic 中進行遠程醫療。

And Larry spoke about the significant increase, I think it was 600%, in telehealth visits.

拉里談到了遠程醫療就診的顯著增加，我認為是 600%。

So it's going to be an integral part of how we go to market moving forward.

因此，這將成為我們未來進入市場的不可或缺的一部分。

And we just got some recent consumer research, and that compares last year consumer sentiment to this year's consumer sentiment, and this is one example.

我們剛剛得到了一些最近的消費者研究，將去年的消費者信心與今年的消費者信心進行了比較，這就是一個例子。

Where would they prefer to get their flu vaccines?

他們更願意在哪裡接種流感疫苗？

And we saw a significant uptick in consumers that are interested in getting their flu vaccines in their local pharmacy as opposed to their doctor's office.

我們發現，有興趣在當地藥房而不是醫生辦公室購買流感疫苗的消費者顯著增加。

So it's a good example how MinuteClinic will be able to provide services like that plus telehealth and provide the convenience and choice that consumers are looking for.

因此，這是 MinuteClinic 如何能夠提供此類服務以及遠程醫療並提供消費者所尋求的便利和選擇的一個很好的例子。

Great.

偉大的。

And just on how you're looking at maybe the opportunities that could present themselves with respect to the practices that are out there.

就你如何看待可能在現有實踐中出現的機會而言。

And I guess a follow-up on the telehealth.

我想這是遠程醫療的後續行動。

Are you actually having telehealth deployed using the MinuteClinic clinicians?

您是否真的使用 MinuteClinic 臨床醫生部署了遠程醫療？

Or is it in a centralized format?

還是採用集中式格式？

Yes, Lance, we actually have both where the telehealth is integrated with MinuteClinic as well as telehealth with physician is accessed through our digital applications.

是的，蘭斯，我們實際上既有與 MinuteClinic 集成的遠程醫療，也有通過我們的數字應用程序訪問醫生的遠程醫療。

And we talked about the percent increase.

我們討論了百分比增長。

Aetna is seeing about 60,000 telehealth engagements on a daily basis, which is a dramatic increase as well.

Aetna 每天都會接到約 60,000 次遠程醫療諮詢，這也是一個顯著的增長。

And it's not just -- one of the things we were looking at is it COVID related.

這不僅僅是——我們關注的事情之一是與新冠病毒相關。

And the answer is no.

答案是否定的。

We're seeing an increase in, I'll say, PCP utilization as well as an increase in, let's call it, behavioral health concerns and other type of specialist services.

我想說的是，我們看到 PCP 利用率的增加，以及行為健康問題和其他類型的專業服務的增加。

So we do believe that it plays a complementary role to what we're doing with our HealthHUBs, and it brings us right back to community, home and hand.

因此，我們確實相信它對我們在 HealthHUB 上所做的事情起到了補充作用，它讓我們回到了社區、家庭和手上。

We'll take a question from A.J. Rice of Crédit Suisse.

我們將回答 A.J. 的問題。瑞士信貸銀行的大米。

Glad to hear everyone's safe.

很高興聽到大家都安全了。

Appreciate all the comments that were made about the economic impact on the health benefits business.

感謝所有關於健康福利業務的經濟影響的評論。

I wonder if we could broaden it out.

我想知道我們是否可以擴大範圍。

Obviously, it's been 10 years since the last economic downturn.

顯然，距離上次經濟衰退已經過去十年了。

How does -- how do you think the other businesses respond?

您認為其他企業如何應對？

And how are they maybe positioned differently today versus the last time we went into an economic downturn?

與上次經濟衰退時相比，它們今天的定位有何不同？

Yes.

是的。

A.J., it's Larry.

A.J.，是拉里。

A.J., look, it's probably premature and a difficult comparison because, to your point, a lot has changed over the last 10, 12 years, and there are still an awful lot of uncertainties as to where we're going to be in the latter part of this year.

A.J.，你看，這可能還為時過早，而且是一個困難的比較，因為就你而言，過去10 年、12 年發生了很多變化，而且對於我們將在後者的位置仍然存在很多不確定性今年的一部分。

I will say that the nature of our business is, to a degree, recession resistant.

我想說的是，我們業務的本質在某種程度上是抗衰退的。

I wouldn't describe us as recession proof and whether it's what you're looking at around the role of our retail asset.

我不會將我們描述為抵禦經濟衰退的公司，也不認為這就是您所關注的我們零售資產的作用。

And you think about our strategy that we've talked a lot about, the triad of community, home and the hand and the fact that as you think about the provision of health care in a more challenging economic environment, cost will become a bigger issue, and we believe that we have the assets and the capabilities when you think about the cost associated with care provision and the offerings that we have with our integrated model.

你想想我們已經討論過很多次的戰略，即社區、家庭和手的三位一體，以及當你考慮在更具挑戰性的經濟環境中提供醫療保健時，成本將成為一個更大的問題，並且當您考慮與護理提供相關的成本以及我們通過集成模型提供的產品時，我們相信我們擁有資產和能力。

And Larry -- if I could just add, A.J. As you -- looking back at the past, this is an unprecedented situation and so many, so many unknowns.

還有拉里——如果我可以補充的話，A.J.當你回顧過去時，這是一個前所未有的情況，有很多很多的未知數。

But as Larry highlighted, we're a different business.

但正如拉里所強調的，我們是一家不同的企業。

We have a lot of diversified assets.

我們擁有大量多元化資產。

Karen got some questions on Medicaid.

凱倫有一些關於醫療補助的問題。

In our PBM, we have a very large Medicaid.

在我們的 PBM 中，我們有一個非常龐大的醫療補助計劃。

We have a very large Medicaid.

我們有非常大的醫療補助。

You saw and you heard in Larry's prepared remarks around the health services that we're offering and expanding and accelerating some of our diagnostic testing.

您在拉里準備好的有關我們提供的醫療服務以及擴大和加速我們的一些診斷測試的講話中看到並聽到了。

So there's a tremendous amount of moving pieces, and we're going to work to really drive -- to drive the business forward in these challenging times.

因此，有大量的變化，我們將努力真正推動業務在這個充滿挑戰的時期向前發展。

We'll take our final question from Steven Valiquette of Barclays.

我們將接受巴克萊銀行的 Steven Valiquette 提出的最後一個問題。

I hope everyone's staying safe.

我希望每個人都保持安全。

Hopefully, you can hear me okay.

希望你能聽到我的聲音。

Just a quick follow-up question regarding the -- those April prescription trends.

只是一個關於四月份處方趨勢的快速後續問題。

I'm curious if there is any way from your analytics capabilities to determine how much of the slowdown in April was tied to the pull forward in March versus the reduction in physician visits.

我很好奇是否有任何方法可以從您的分析能力中確定 4 月份的經濟放緩在多大程度上與 3 月份的就診人數的減少有關。

And you mentioned that 30% reduction in utilization of an array of health care services in April.

您提到 4 月份一系列醫療保健服務的利用率下降了 30%。

Are in-person physician visits in particular down in line with that 30%?

親自就診的人數是否特別低於這 30%？

Or is it higher or lower from your view just separate from telehealth, obviously?

或者從您的角度來看，與遠程醫療分開，顯然是更高還是更低？

Yes.

是的。

Let me just -- I'll give you a couple of the pieces in April relative to utilization.

讓我來說一下——我將在四月份向您提供一些與利用率相關的內容。

We saw pharmacy about flat.

我們看到藥店大約是平的。

We saw inpatient down over 30%.

我們看到住院人數下降了 30% 以上。

Outpatient was down about 25%, and our physicians were down almost 35%.

門診人數減少了約 25%，我們的醫生人數減少了近 35%。

And then all other, which would be our lab and our radiology and home health kinds of services, they were down about almost 50%.

然後所有其他服務，即我們的實驗室、放射學和家庭健康服務，下降了近 50%。

So that just gives you sort of a broad array of the pieces that contributed to the 30% reduction in utilization.

因此，這只是為您提供了導致利用率降低 30% 的一系列廣泛的因素。

And then, Steve, this is Jon.

然後，史蒂夫，這是喬恩。

We saw a lot of 30- to 90-day conversions in March in pharmacy.

3 月份，我們在藥房看到了大量 30 至 90 天的轉化。

So that did take some prescriptions out of the April pipeline.

因此，這確實從四月份的渠道中剔除了一些處方。

And I would say the -- when I talked about the new therapy starts being down, I think that is -- we think about it as being in line with physician visits.

我想說的是——當我談到新療法開始下降時，我認為——我們認為它與醫生就診是一致的。

So as physician offices start to open and patients start coming back, we expect that volume to normalize.

因此，隨著醫生辦公室開始開放和患者開始回來，我們預計這一數量將恢復正常。

And Steve, the one thing that I do want to emphasize because I'm proud of the work that we've done at CVS, and quite frankly, I'm proud of the work that our industry has done, the continuity of the pharmaceutical supply chain is not something that you've seen a lot in the news, and everyone has worked hard to make sure those with chronic disease are staying adherent to their medications and not compounding this problem that we have today with COVID with another problem that would just gridlock our health care system.

史蒂夫，我確實想強調的一件事是因為我為我們在 CVS 所做的工作感到自豪，坦白說，我為我們行業所做的工作以及製藥的連續性感到自豪供應鏈並不是你在新聞中經常看到的東西，每個人都在努力確保慢性病患者堅持服藥，而不是將我們今天與新冠病毒相關的問題與另一個問題複雜化。只是讓我們的醫療保健系統陷入僵局。

So it's really been a job well done in that regard.

因此，在這方面，這確實是一項出色的工作。

So with that, let me just wrap up.

那麼，讓我總結一下。

And again, we're very pleased with our underlying business performance in the quarter.

再次，我們對本季度的基本業務表現感到非常滿意。

We believe, as you've heard from the dialogue we've had in the Q&A, that our integrated, innovation-driven health care model is proving to benefit participants across the health care system in these unprecedented times, and it will continue to do so both through the crisis and well into the future.

我們相信，正如您從我們在問答中進行的對話中所聽到的那樣，事實證明，在這個前所未有的時代，我們的綜合、創新驅動的醫療保健模式正在使整個醫療保健系統的參與者受益，並且它將繼續這樣做因此，無論是度過危機還是展望未來。

And we remain focused on growing CVS as an integrated health care enterprise, and we'll continue to invest for sustainable, long-term growth.

我們仍然專注於將 CVS 發展為一家綜合醫療保健企業，並將繼續投資以實現可持續的長期增長。

So thanks again for joining us this morning and please stay safe and healthy, and we'll talk to you soon.

再次感謝您今天早上加入我們，請保持安全和健康，我們很快就會與您聯繫。

This does conclude today's CVS Health First Quarter 2020 Earnings Call and Webcast.

今天的 CVS Health 2020 年第一季度收益電話會議和網絡廣播到此結束。

Please disconnect your line at this time and have a wonderful day.

請此時斷開您的線路，祝您度過美好的一天。