CVS Health Corp (CVS) 2024 Q4 法說會逐字稿

Good morning, and thank you all for attending the CVS Health Q4 2024 earnings conference call.

早安，感謝大家參加 CVS Health 2024 年第四季財報電話會議。

My name is Brika, and I will be your moderator for today's call.

我的名字是 Brika，我將擔任今天電話會議的主持人。

(Operator Instructions)

（操作員指令）

I would now like to pass the conference over to your host, Larry McGrath, Chief Strategy Officer.

現在，我想將會議交給主持人、首席策略長拉里·麥格拉斯 (Larry McGrath)。

Thank you.

謝謝。

You may proceed, Larry.

你可以繼續，拉里。

Good morning, and welcome to the CVS Health fourth-quarter and full year 2024 earnings call and webcast.

早上好，歡迎參加 CVS Health 2024 年第四季和全年收益電話會議和網路廣播。

I'm Larry McGrath, Chief Strategy Officer.

我是首席策略長拉里·麥格拉斯。

I'm joined this morning by David Joyner, President and Chief Executive Officer; and Tom Cowhey, Chief Financial Officer.

今天早上與我一起參加的是總裁兼執行長戴維喬伊納 (David Joyner)；以及財務長 Tom Cowhey。

Following our prepared remarks, we'll host a question and answer session that will include additional members of the leadership team.

在我們準備好發言之後，我們將舉辦問答環節，其他領導團隊成員也將參與其中。

Our press releases slide presentation have been posted to our website along with our Form 10-K while this morning with the SEC.

我們的新聞稿幻燈片簡報已於今天上午與美國證券交易委員會 (SEC) 一起發佈到我們的網站上，以及我們的 10-K 表格。

Today's call is also being broadcast in our website, where it'll be archived for one year.

今天的電話會議也會在我們的網站上播出，並會保存一年。

During this call, we'll make certain forward-looking statements.

在本次電話會議中，我們將做出一些前瞻性的陳述。

Our forward-looking statements are subject to significant risks and uncertainties that could cause actual results to differ materially from currently projected results.

我們的前瞻性陳述受重大風險和不確定性的影響，可能導致實際結果與目前預測的結果有重大差異。

We strongly encourage you to review the reports we filed with the SEC regarding these risks and uncertainties, in particular, those that are described in the cautionary statement concerning forward-looking statements and risk factors in our annual report on Form 10-K filed this morning, and on our recent filings on Form 8-K, including this morning's earnings press release.

我們強烈建議您查看我們向美國證券交易委員會提交的有關這些風險和不確定性的報告，特別是我們今天上午提交的 10-K 表年度報告中有關前瞻性陳述和風險因素的警示聲明中所述的報告，以及我們最近提交的 8-K 表文件，包括今天上午的收益新聞稿。

During this call, we'll use non-GAAP measures when talking about the company's financial performance and financial conditions and you can find a reconciliation of these non-GAAP measures in this morning's press release and in the reconciliation document posted to the investor relations portion of our website.

在本次電話會議中，我們將使用非公認會計準則指標來談論本公司的財務績效和財務狀況，您可以在今天早上的新聞稿中以及在我們網站投資者關係部分發布的對帳文件中找到這些非公認會計準則指標的對帳。

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

說完這些，我想把電話轉給大衛。

David?

戴維？

Thank you, Larry, and good morning everyone.

謝謝你，拉里，大家早安。

This morning we reported fourth-quarter adjusted earnings per share of $1.19 and adjusted operating income of $2.7 billion.

今天上午，我們報告了第四季度調整後每股收益為 1.19 美元，調整後營業收入為 27 億美元。

We also provided our initial full year 2025 guidance for adjusted EPS in the range of $5.75 to $6.00.

我們還提供了 2025 年全年初始調整後每股收益指引值，範圍為 5.75 美元至 6.00 美元。

Our initial expectations reflect meaningful recovery in our Aetna business, particularly in Medicare Advantage as well as continued growth in health services.

我們的初步預期反映了 Aetna 業務的顯著復甦，尤其是 Medicare Advantage 以及健康服務的持續成長。

Tom will provide a more detailed overview of the components of this guidance as well as a breakdown by segment.

湯姆將更詳細地概述該指南的組成部分並進行分部細分。

I'd like to spend some time taking a step back and sharing with you my observations during my first 100 days as CEO.

我想花點時間回顧一下，與大家分享我擔任執行長的頭 100 天的觀察。

During this time I have connected with shareholders, customers, and clients.

在此期間，我與股東、顧客和客戶建立了聯繫。

I have met with and heard from elected officials, and importantly, I have spent a great deal of time listening to our consumers and colleagues.

我會見了民選官員並聽取了他們的意見，更重要的是，我花了大量時間傾聽消費者和同事的意見。

I've come away inspired from these conversations and with a clear and strengthened understanding of what we need to do to realize the tremendous promise to CVS Health.

這些對話讓我深受啟發，讓我更清晰、更深刻地理解了我們需要做些什麼才能實現對 CVS Health 的巨大承諾。

We can be America's leading and most trusted healthcare company.

我們可以成為美國領先和最值得信賴的醫療保健公司。

The company that measures itself by its ability to improve outcomes, increase access, and lower the cost of care, while ensuring a consumer experience that we can be proud of.

該公司以改善結果、增加機會和降低護理成本的能力來衡量自己，同時確保消費者獲得值得我們驕傲的體驗。

The combination of these measures will ultimately deliver greater shareholder value.

這些措施的結合最終將為股東帶來更大的價值。

What makes me confident that we can deliver on this promise one.

是什麼讓我有信心我們能夠兌現這個承諾呢？

CVS Health's collection of assets, its reach, its connection with 185 million Americans, whether in our stores or clinics.

CVS Health 的資產集合、影響力以及與 1.85 億美國人的聯繫，無論是在我們的商店還是診所。

Through a health plan or by managing the pharmacy benefits, CVS Health is unlike any other company in the United States, and with that comes opportunity and a responsibility to make a difference.

透過健康計畫或管理藥局福利，CVS Health 與美國的其他公司不同，隨之而來的是機會和責任，從而有所作為。

We take this responsibility seriously and have shown that throughout our history.

我們嚴肅對待這項責任，並在我們的整個歷史中證明了這一點。

We did this 10 years ago when we removed tobacco from our stores.

十年前，當我們從商店中移除煙草時，我們就這樣做了。

We did this with urgency when the country needed us during the pandemic.

當疫情期間國家需要我們的時候，我們緊急採取了這項行動。

And we do this today as we fight rising drug prices as we create a viable biosimilar market and as we innovate the pharmacy model to reduce frictions in the health care system, to name a few.

今天，我們在應對藥品價格上漲的同時，也在創造可行的生物相似藥市場，並在創新藥房模式以減少醫療保健系統中的摩擦，等等。

We will continue to deliver on this responsibility by being innovative and bold to do what's right for our consumers and customers.

我們將繼續履行這項責任，勇於創新，為我們的消費者和客戶做正確的事。

Two, our over 300,000 colleagues who reflect the backgrounds and experiences of all Americans and the communities we serve.

二是我們的30多萬同事，他們反映了所有美國人和我們所服務的社區的背景和經驗。

I can say every day that our colleagues come to work dedicated to making health care in America better for those we serve.

我可以說，我們的同事每天都致力於為美國人民提供更好的醫療保健服務。

In my conversations with our colleagues, I'm proud to say that there are many thousands of inspiring stories for everyone where we could have done better.

在與同事的交談中，我很自豪地說，有成千上萬個鼓舞人心的故事值得每個人借鑒，我們可以做得更好。

Three, while there are external factors that pose near term challenges, there are also many reasons to be excited.

三、雖然外在因素對短期內帶來挑戰，但也有許多令人興奮的理由。

The broader demographic trends of an aging population, advances in AI and technology.

人口老化、人工智慧和技術進步等更廣泛的人口趨勢。

The need for more personalized care and the expectations of the American public to create an improved consumer experience or opportunities where we are best positioned to lead.

需要更個人化的護理，並且美國公眾期望創造更好的消費者體驗或機會，我們處於最佳領導位置。

How will we realize this over the short and long term?

短期和長期內我們如何實現這一目標？

My leadership team and I have spent our time together developing a clear set of priorities.

我和我的領導團隊一起制定了一套明確的優先事項。

Collectively, we are committed to delivering on the promise of CVS Health.

共同努力，我們致力於兌現 CVS Health 的承諾。

We believe that aligning the power of our employees and the CVS Health Enterprise behind four specific priorities will deliver on our potential and ultimately the results and experiences that we can all be proud of.

我們相信，透過整合員工和 CVS 健康企業的力量以實現四個具體目標，我們將充分發揮我們的潛力，並最終獲得令我們引以為傲的成果和經驗。

First, ensuring that each one of our business is best in class for strong execution.

首先，確保我們的每項業務都達到最佳水平，並且具有強大的執行力。

Most importantly, we need to deliver on our turnaround at Aetna and restore this business to target margins.

最重要的是，我們需要扭轉安泰的頹勢，並將業務恢復到目標利潤率。

Second, continuing to develop our integrated capabilities where it matters in order to make health care better, more affordable, and more accessible.

第二，繼續在重要領域發展我們的綜合能力，以使醫療保健變得更好、更實惠、更容易獲得。

Third, advancing our leading digital strategy and investing in emerging technologies that drive simplicity and efficiency, while delivering better experiences for the people we serve.

第三，推進我們領先的數位策略，投資於推動簡化和高效的新興技術，同時為我們服務的人提供更好的體驗。

And finally, ensuring that we are disciplined stewards of capital as we continue to strengthen our balance sheet, manage our portfolio of businesses and the capital to create value for our shareholders.

最後，確保我們是自律的資本管理者，我們將繼續加強我們的資產負債表，管理我們的業務組合和資本，為我們的股東創造價值。

I'm working closely with my team to ensure we have the right talent, structures and collaboration across our enterprise to execute and deliver on these important priorities.

我正在與我的團隊密切合作，以確保我們整個企業擁有合適的人才、結構和協作來執行和實現這些重要優先事項。

CVS Health operates in some of the most critical areas of health care, and our connections to the people we serve across the country has never been more important because of the challenges we see throughout the US health care system.

CVS Health 從事醫療保健領域中一些最關鍵的業務，由於我們看到整個美國醫療保健系統面臨的挑戰，我們與全國各地服務對象的聯繫從未如此重要。

Rising health care costs put pressure on consumers as they see increasing challenges with affordability.

醫療費用上漲給消費者帶來壓力，因為他們發現負擔能力越來越差。

These rising health care costs also put pressure on employers and the government, who largely pay the bill for health care.

不斷上漲的醫療費用也給雇主和政府帶來了壓力，因為醫療費用主要由他們支付。

To be clear, health care costs are increasing because of the combination of greater utilization, rising provider costs, labor shortages and dramatic price hikes for branded pharmaceuticals.

需要明確的是，醫療保健成本的增加是因為醫療利用率的提高、供應商成本的上升、勞動力短缺以及品牌藥品價格的大幅上漲等因素所造成的。

Our teams are focused on delivering on our mission, and we are working hard to directly address the challenges in the health care system.

我們的團隊專注於完成我們的使命，我們正在努力直接應對醫療保健系統中的挑戰。

We are using tools across our enterprise to deliver exceptional value and differentiated experiences to our customers and clients.

我們在整個企業中使用工具為我們的客戶和客戶提供卓越的價值和差異化的體驗。

One of the most powerful courses helping to offset rising health care costs are PBMs like Caremark.

幫助抵消不斷上漲的醫療成本的最強大的課程之一是像 Caremark 這樣的 PBM。

These entities remain the only part of the drug supply chain entirely focused on lowering cost, but have erroneously been subject to deceptive rhetoric and misinformation.

這些實體仍然是藥品供應鏈中唯一完全專注於降低成本的部分，但卻錯誤地受到欺騙性言論和錯誤訊息的影響。

For more than three decades, PBMs have been a proven, unequivocal mechanism to negotiate down the price of drugs for payers and consumers, while promoting better adherence and better health.

三十多年來，PBM 已被證明是一種明確的機制，可以為付款人和消費者協商降低藥品價格，同時促進更好的依從性和更好的健康。

In drugs that have no rebates where PBM tools are limited, we've seen egregious price hikes with prices for those drugs increasing more than twice as fast as drugs where we can secure rebates.

在沒有回扣、PBM 工具有限的情況下，我們看到了價格大幅上漲，這些藥品的價格上漲速度是我們能夠獲得回扣的藥品價格上漲速度的兩倍多。

In the first three weeks of January alone, branded drug manufacturers added $21 billion of annual gross drug spend through their price actions.

僅在 1 月的前三週，品牌藥品製造商就透過價格行動增加了 210 億美元的年度藥品總支出。

Our work is a critical counterbalance to the monopolistic tendencies of drug manufacturers.

我們的工作對於制衡藥品製造商的壟斷傾向具有重要意義。

This is why PBMs are needed and why manufacturers fight so hard to limit our capabilities.

這就是為什麼需要 PBM 以及為什麼製造商如此努力地限制我們的能力。

Multiple well-known economists have estimated that PBMs generated net value for the US health care system of over $100 billion per year.

多位知名經濟學家估計，PBM 每年為美國醫療保健系統創造的淨價值超過 1,000 億美元。

No one has demonstrated more success than the PBMs that are driving down drug prices.

在降低藥品價格方面，沒有人比 PBM 取得更大的成功。

For example, is the prior administration's negotiated maximum fair price, MFP, for the first 10 drugs as part of the Inflation Reduction Act.

例如，前政府根據《通膨削減法案》為前 10 種藥品協商確定的最高公平價格 MFP。

Not only had PBMs kept the rate of drug inflation in Medicare Part D at 1.3% per annum in the last 18 years, CVS Caremark specifically negotiated rates that contributed to a $1 billion improvement better than MFP.

在過去 18 年中，PBM 不僅將 Medicare Part D 中的藥品通膨率控制在每年 1.3%，CVS Caremark 還特別協商了比 MFP 好 10 億美元的費率。

More importantly, if we don't continue to negotiate further discounts beyond MFP, the loss savings will go directly into the pockets of broad manufactures.

更重要的是，如果我們不繼續協商 MFP 以外的進一步折扣，那麼損失節省將直接進入廣大製造商的口袋。

So when you look at all the data, not cherry-pick data points like those specifically referenced in the SEC interim reports, the conclusion is clear, PBMs deliver savings to their clients.

因此，當您查看所有數據，而不是挑選數據點（例如美國證券交易委員會中期報告中特別提到的數據點）時，結論很明確，PBM 為其客戶節省了開支。

Caremark has been and continues to be a critical solution to help ensure Americans pay less for drugs.

Caremark 一直是並將繼續成為幫助確保美國人減少藥物費用的重要解決方案。

We will continue to play our unique role in the drug supply chain, bringing the full breadth of our capabilities and market expertise to reduce drug prices for all customers.

我們將繼續在藥品供應鏈中發揮獨特的作用，充分發揮我們的能力和市場專業知識，為所有客戶降低藥品價格。

Throughout our history, we've led our industry in innovating to solve the issues most important to our clients and customers, whether it's cost, transparency, access to care or experiences.

在我們的歷史上，我們一直引領業界創新，解決對我們的客戶和顧客最重要的問題，無論是成本、透明度、獲得照護的機會或經驗。

A recent example of how we're using our enterprise assets to solve important issues for our clients and help offset the rising health care costs is through actions we've taken in the biosimilar market.

我們最近在生物相似藥市場採取的行動就是利用企業資產為客戶解決重要問題並幫助抵消不斷上漲的醫療保健成本的一個例子。

In 2024, through the combination of Cordavis, Caremark and CVS Specialty, we converted more than 90% of eligible Humira patients to a biosimilar at a list price that was more than 80% below the price branded Humira.

2024 年，透過 Cordavis、Caremark 和 CVS Specialty 的結合，我們將 90% 以上符合資格的 Humira 患者轉換為生物相似藥，其標價比 Humira 品牌藥低 80% 以上。

This enabled us to offer a $0 out-of-pocket cost for individuals consumers and generated almost $1 billion of savings for our clients.

這使我們能夠為個人消費者提供 0 美元的自付費用，並為我們的客戶節省近 10 億美元。

We are the only company that meaningfully drove biosimilar adoption amongst our clients and will continue to do so with a growing pipeline of additional biosimilars.

我們是唯一一家積極推動客戶採用生物相似藥的公司，並將繼續透過不斷增加其他生物相似藥的管道來做到這一點。

In our Pharmacy businesses, we delivered exceptional experiences with record high levels of NPS in our retail business and PBM retention rates consistently in the high-90s.

在我們的藥房業務中，我們提供了卓越的體驗，零售業務中的 NPS 水平創歷史新高，PBM 保留率始終保持在 90% 的高位。

However, we also recognize that in order to continue improving our customers experiences, health care needs to be more transparent.

然而，我們也意識到，為了持續改善客戶體驗，醫療保健需要更加透明。

So in late 2023, we took a leadership role to create a pathway for increased transparency and simplicity across the pharmacy marketplace.

因此，在 2023 年底，我們發揮領導作用，為整個藥局市場提高透明度和簡化程度開闢了一條道路。

We addressed this with the introduction of two important transparent price models.

我們透過引入兩個重要的透明價格模型來解決這個問題。

The first is Caremark's TrueCost model.

第一個是Caremark的TrueCost模型。

As a reminder, today, we passed through 99% rebates to our clients.

提醒一下，今天我們向客戶提供了 99% 的折扣。

When fully implemented, TrueCost enables patients to see those lower cost at the pharmacy counter, including the full pass-through of the rebates we generated from our negotiations with the manufacturers.

全面實施後，TrueCost 可以讓患者在藥局櫃檯看到較低的費用，其中包括我們與製造商談判所獲得的全部回扣。

TrueCost continued to resonate in the commercial marketplace and now have more than 75% of Caremark's commercial members, with two or more elements of the model in their pharmacy benefit.

TrueCost 繼續在商業市場上引起反響，目前已擁有超過 75% 的 Caremark 商業會員，他們的藥房福利中包含兩個或更多該模型的元素。

The second is CVS Pharmacy's CostVantage.

第二個是CVS Pharmacy的CostVantage。

Effective January 1, all of our commercial scripts dispensed through CVS Pharmacy are contracted through our innovative and transparent CVS CostVantage model.

自 1 月 1 日起，我們透過 CVS 藥局分發的所有商業處方均透過我們創新且透明的 CVS CostVantage 模式簽訂合約。

Under this new framework, we have tied reimbursement to our acquisition cost and will deliver savings to our payer partners as we continue to relentlessly drive down prices.

在這個新的框架下，我們將報銷與收購成本掛鉤，並將在繼續不懈地降低價格的同時為我們的付款合作夥伴節省開支。

Our team is now working to deliver our cost-based solution for Medicare and Medicaid markets.

我們的團隊目前正致力於為醫療保險和醫療補助市場提供基於成本的解決方案。

These models remove the market basket approach and the unintended consequences that existed in the pharmacy reimbursement, ensuring that patients continue to have access to the most durable and frequent interaction in their health care journey.

這些模型消除了市場籃子方法和藥房報銷中存在的意外後果，確保患者在醫療保健過程中繼續能夠獲得最持久和最頻繁的互動。

We are also focused on expanding access to high-quality care to help address some of the provider shortages facing in the US with their health care delivery businesses, continuing to see full growth.

我們也致力於擴大高品質醫療服務的機會，以幫助解決美國醫療保健業務面臨的一些供應商短缺問題，並繼續實現全面成長。

Signify had a record volume year supported by growth in Aetna members, which nearly doubled to last year.

由於 Aetna 會員數量的增長，Signify 今年的銷量創下了歷史新高，與去年相比增長了近一倍。

We've also seen an accelerated patient growth at Oak Street, supported by enterprise connections.

在企業關係的支持下，我們也看到 Oak Street 的患者數量加速成長。

We continue to expand access to this leading care model and ratifying opportunities to utilize market-leading capabilities more broadly across the enterprise.

我們將繼續擴大此領先護理模式的覆蓋範圍，並批准在整個企業內更廣泛地利用市場領先能力的機會。

We are advancing technology to reduce frictions that partner the experience Americans have when they utilize their benefits and make it difficult to navigate the complex US health care system.

我們正在推動技術進步，以減少美國人在享受福利時遇到的摩擦，並使他們難以適應複雜的美國醫療保健體系。

Our updated CVS Health App makes it easier for consumers to manage their health by giving them seamless access to appointments, co-pay details and perception status.

我們更新的 CVS Health App 讓消費者可以無縫存取預約、共同支付詳情和感知狀態，從而更輕鬆地管理他們的健康狀況。

We're also leveraging AI to create a more intuitive workflow and faster turnaround time to reduce frustrations for our members and provider partners.

我們也利用人工智慧來創建更直觀的工作流程和更快的周轉時間，以減少我們的會員和提供者合作夥伴的挫折感。

While we are working to address the issues across the US health care system, we are also focused on addressing the performance challenges within our own business.

在我們努力解決美國醫療保健系統的問題的同時，我們也致力於解決我們自身業務內部的績效挑戰。

At Aetna, we drove meaningful progress improving and strengthening our operations.

在安泰，我們在改善和加強業務營運方面取得了有意義的進展。

We have significant opportunities to unlock embedded earnings that is most pronounced in our Medicare Advantage business.

我們有重大機會釋放內含收益，這在我們的醫療保險優勢業務中表現得最為明顯。

Our focus remains on delivering on our commitments to our Medicare Advantage members while creating a viable path to appropriate margins.

我們的重點仍然是履行對醫療保險優勢計劃會員的承諾，同時創造一條可行的適當利潤途徑。

In line with our commentary, we expect that we will shrink the Medicare Advantage membership by high single-digit percentage from year-end 2024.

根據我們的評論，我們預計從 2024 年底開始，醫療保險優勢計畫的會員數量將減少高個位數百分比。

Our deliberate approach to our 2025 Medicare Advantage business, combined with our improved star ratings, will improve margins this year and are part of our ongoing commitment to restore this business to target margins of 3% to 5%.

我們對 2025 年醫療保險優勢業務的謹慎態度，加上我們提高的星級評定，將提高今年的利潤率，這也是我們持續致力於將該業務恢復到 3% 至 5% 的目標利潤率的一部分。

Last month, CMS released the proposed 2026 Medicare Advantage Advance Rate Notice.

上個月，CMS 發布了擬議的 2026 年醫療保險優勢預付費率通知。

This update does not address the unprecedented utilization trend experienced across the industry over the past two years.

此次更新並未解決過去兩年來整個產業所經歷的前所未有的利用率趨勢。

Our team is advocating for a more appropriate rate update, including adjustments for the industry-wide cost trends seen in 2024.

我們的團隊正在倡導更合適的費率更新，包括針對 2024 年全行業成本趨勢的調整。

We are encouraged by the constructive dialogue with the new administration to help ensure that American seniors will not continue to see significant disruption to their benefits driven by drastic changes to the Medicare Advantage program.

我們很高興看到與新政府的建設性對話，這有助於確保美國老年人的福利不會繼續因醫療保險優勢計劃的重大變化而受到嚴重破壞。

Beyond Medicare, we are also encouraged by progress in our other Aetna lines of business.

除了醫療保險之外，安泰其他業務的進展也令我們感到鼓舞。

We are advancing our rate efficacy efforts in Medicaid, we've seen high retention and strong welcome season in our national accounts book and have made meaningful progress in the rightsizing of our individual exchange footprint.

我們正在推進醫療補助計劃的費率有效性工作，我們在國家帳戶帳簿中看到了高保留率和強勁的歡迎季節，並在個人交易足蹟的合理化調整方面取得了有意義的進展。

Every day, we work hard to improve the health of all the people we serve.

每天，我們都在努力改善我們服務的所有人的健康狀況。

This is always a top priority at CVS Health.

這始終是 CVS Health 的首要任務。

While we have made progress addressing some of the frictions that exist in the US health care system, including leading the industry and increasing transparency and simplicity, we know the health care system must be better.

雖然我們在解決美國醫療保健系統中存在的一些摩擦方面取得了進展，包括引領產業、提高透明度和簡單性，但我們知道醫療保健系統必須變得更好。

Our unique collection of assets and our deep connections with our consumers, members and patients position us to deliver a better and differentiated experience to everyone we serve.

我們獨特的資產集合以及與消費者、會員和患者的深厚聯繫使我們能夠為每個服務對象提供更優質、差異化的體驗。

We have strong momentum heading into 2025.

我們邁向 2025 年的勢頭強勁。

We have the right assets, the right leadership and the right strategy in place.

我們擁有合適的資產、合適的領導力和合適的策略。

Our dedicated employees put our members, patients and consumers at the center of everything we do.

我們敬業的員工將會員、患者和消費者放在我們所做的一切的中心。

We have worked hard to stabilize our Aetna business, and have made meaningful progress to address the issues that led to the underperformance in 2024.

我們努力穩定安泰業務，並在解決導致 2024 年業績不佳的問題上取得了重大進展。

We are well positioned to be the leader in driving change in the health care system.

我們有能力成為推動醫療保健系統變革的領導者。

As I hand the call over to Tom, I want to reiterate the importance of delivering on our commitments to our shareholders.

當我把電話交給湯姆時，我想重申履行對股東的承諾的重要性。

We are focused on building trust and establishing credibility as we work hard to deliver on our financial performances in 2025 and beyond.

我們致力於建立信任和樹立信譽，努力實現 2025 年及以後的財務表現。

Tom?

湯姆？

Thank you, David, and thanks to everyone for joining us this morning.

謝謝你，大衛，也謝謝大家今天早上加入我們。

I'll start with a few highlights on total company performance.

我將首先介紹公司整體業績的幾個亮點。

Fourth quarter revenues of nearly $98 billion increased more than 4% over the prior year quarter, primarily driven by growth in our Health Care Benefits and Pharmacy & Consumer Wellness segments.

第四季營收近 980 億美元，較去年同期成長超過 4%，主要得益於健康保健福利以及藥品和消費者健康部門的成長。

We delivered adjusted operating income of over $2.7 billion and adjusted EPS of $1.19, as we saw strong performance across multiple lines of business and favorable prior period reserve development in our Aetna business.

我們實現了超過 27 億美元的調整後營業收入和 1.19 美元的調整後每股收益，這得益於我們的多個業務線表現強勁以及 Aetna 業務前期準備金發展良好。

Full year cash flow from operations was approximately $9.1 billion, benefiting from early receipt of cash, particularly in our Pharmacy Services business.

全年經營現金流約 91 億美元，受益於早期收到的現金，尤其是我們的藥局服務業務。

Turning to our segments.

轉向我們的細分領域。

In Health Care Benefits, we grew revenues to approximately $33 billion, an increase of over 23% over the prior year quarter, reflecting growth in all lines of business.

在醫療保健福利方面，我們的收入成長至約 330 億美元，比去年同期成長超過 23%，反映了所有業務線的成長。

Medical membership of approximately 27.1 million was roughly flat sequentially, as membership in our Individual Exchange business started to modestly decline in advance of the 2025 rate increases we took in that book.

醫療會員人數約為 2,710 萬，與上一季基本持平，因為我們的個人交易所業務的會員人數在我們記帳的 2025 年費率上調之前開始小幅下降。

During the quarter, the segment generated an adjusted operating loss of $439 million.

本季度，該部門調整後經營虧損為 4.39 億美元。

This result was lower than the prior year quarter, primarily driven by a higher medical benefit ratio, partially offset by the release of the premium deficiency reserve we recorded in the third quarter, higher levels of favorable prior period reserve development and increased net investment income.

該結果低於去年同期，主要原因是醫療福利比率提高，但部分被我們在第三季度記錄的保費缺口準備金釋放、前期準備金發展水平較高以及淨投資收益增加所抵消。

Our medical benefit ratio of 94.8% increased 630 basis points from the prior year quarter.

我們的醫療福利率為 94.8%，比去年同期增加了 630 個基點。

This increase was primarily driven by higher utilization, the premium impact of lower Star ratings for payment year 2024 and higher acuity in Medicaid, partially offset by a 220 basis point impact from the already mentioned premium deficiency reserves recorded in the third quarter, as well as higher levels of favorable prior period reserve development.

這一增長主要歸因於利用率提高、2024 年付款年度星級評定降低對保費的影響以及醫療補助計劃 (Medicaid) 敏銳度提高，但被第三季度記錄的已經提到的保費不足準備金產生的 220 個基點的影響以及前期準備金發展水平提高所部分抵消。

While medical trends remain elevated, the experience we observed to date was less severe than the trends we assumed in the downside scenario we discussed last quarter.

儘管醫療趨勢仍然高漲，但我們迄今為止觀察到的經驗並不像上個季度討論的下行情景中假設的趨勢那麼嚴重。

Importantly, during the quarter, we experienced positive prior period reserve development across all lines of business, primarily related to second and third quarter days of service.

重要的是，在本季度，我們所有業務線都經歷了積極的前期儲備發展，主要與第二季和第三季的服務天數有關。

In our Medicare book, continued elevated trend levels were attributable to the same categories we discussed last quarter, including inpatient, outpatient, supplemental benefits and pharmacy.

在我們的醫療保險書中，持續上升的趨勢水平可歸因於我們上個季度討論的相同類別，包括住院、門診、補充福利和藥房。

Relative to our downside scenario discussed on the third quarter call, we did see some moderation of inpatient trends, while supplemental benefit costs remains steadily high.

相對於我們在第三季電話會議上討論的下行情景，我們確實看到住院趨勢有所緩和，而補充福利成本仍然保持高位。

We are cautiously optimistic that our benefit design changes in 2025 will help alleviate some of the supplemental benefit structure.

我們謹慎樂觀地認為，2025 年的福利設計變化將有助於緩解一些補充福利結構。

In our Medicaid business, acuity remained consistent with the latter part of the third quarter as redeterminations have largely concluded across our state footprint.

在我們的醫療補助業務中，敏銳度與第三季後半段保持一致，因為我們所在州的重新確定工作已基本結束。

We continue to work closely with our partners to align rates with the changes in acuity.

我們將繼續與合作夥伴密切合作，以使費率與敏銳度的變化保持一致。

During the quarter, we made additional progress on rate updates, and with over 40% of our book having repriced in early January 2025, we have a line of sight to a mid-4 percentage point rate increase.

在本季度，我們在利率更新方面取得了進一步的進展，其中超過 40% 的帳簿已於 2025 年 1 月初重新定價，我們預計將實現 4% 左右的利率上調。

Our overall rate advocacy efforts are currently on track.

我們的整體利率倡議工作目前進展順利。

In our group commercial risk book, fourth quarter trends remained elevated.

在我們的集團商業風險書中，第四季的趨勢仍然高漲。

And similar to others in the industry, we experienced some pressure on our stop-loss business, which represents less than 3% of our 2024 premiums.

與業內其他公司類似，我們的停損業務也面臨一些壓力，這部分業務占我們 2024 年保費的不到 3%。

We continue to take a cautious outlook on medical cost trends in this block and combined with lower membership, we expect lower contributions from this business in '25.

我們繼續對該區塊的醫療成本趨勢持謹慎態度，加上會員人數減少，我們預計'25年該業務的貢獻將會減少。

Finally, in our Individual Exchange book of business, we saw continued acceleration of medical cost trends, driven by the specialist, inpatient and ambulatory categories.

最後，在我們的個人交易業務中，我們看到醫療成本趨勢持續加速，這主要受到專科、住院和門診類別的推動。

As we discussed on prior calls, we made meaningful price adjustments at our offerings for this product in 2025, which will lead to a significant rationalization of membership, while also shifting mix towards bronze plans.

正如我們在之前的電話會議上所討論的那樣，我們對 2025 年該產品的報價進行了有意義的價格調整，這將導致會員資格的顯著合理化，同時也將組合轉向青銅計劃。

Taken together, these actions should improve results in our Individual Exchange offerings in 2025.

綜合起來，這些措施應該會改善我們 2025 年個人交易所產品的表現。

Days claims payable at the end of the quarter was 44 days, down 0.6 days sequentially, primarily reflective of seasonality.

本季末索賠應付天數為 44 天，比上一季減少 0.6 天，主要反映季節性因素。

DCP was down 1.9 days from the prior year quarter, primarily driven by growth in our Medicare business and the impact of increased pharmacy trends.

DCP 較去年同期減少了 1.9 天，主要受醫療保險業務成長和藥局趨勢增加的影響。

We remain confident in the adequacy of our reserves.

我們對我們的儲備充足仍然充滿信心。

Our Health Services segment generated revenues of approximately $47 billion during the quarter, a decrease of approximately 4% year-over-year and primarily driven by the previously announced loss of a large client and continued pharmacy client price improvements.

我們的健康服務部門本季創造了約 470 億美元的收入，較去年同期下降約 4%，主要原因是先前宣布失去一個大客戶，以及藥房客戶價格持續改善。

These decreases were partly offset by pharmacy drug mix, increased contributions from our health care delivery assets and growth in Specialty Pharmacy.

這些下降部分被藥房藥物組合、醫療保健資產貢獻的增加以及專科藥房的成長所抵消。

Fourth quarter adjusted operating income of nearly $1.8 billion drove a full year result of $7.24 billion, just shy of the high end of the previous guidance range we reiterated for investors last quarter.

第四季調整後營業收入近 18 億美元，推動全年業績達到 72.4 億美元，略低於我們上個季度向投資者重申的預期範圍高端。

On a year-over-year basis, adjusted operating income increased 5% from the prior year quarter, primarily driven by continued pharmacy client price improvements, the previously announced loss of a large client and the impact of higher health care costs in our health care delivery assets that are tied to Medicare, including CVS Accountable Care and Oak Street Health.

與去年同期相比，調整後的營業收入較上年同期增長了 5%，主要原因是藥房客戶價格持續改善、先前宣布的失去一位大客戶以及與醫療保險掛鉤的醫療保健服務資產（包括 CVS Accountable Care 和 Oak Street Health）的醫療保健成本上漲的影響。

The decrease were largely offset by improved purchasing economics and increased volume at Signify.

這一下降在很大程度上被 Signify 的採購經濟狀況改善和銷售成長所抵消。

Total pharmacy claims processed in the quarter were nearly $500 million and total pharmacy services membership as of the end of the quarter was approximately $90 million.

本季處理的藥房索賠總額接近 5 億美元，截至本季末的藥房服務會員總額約為 9,000 萬美元。

We ended the year with another strong quarter of growth in our health care delivery business.

我們醫療保健服務業務在今年最後一個季度又實現了強勁成長。

As David mentioned, Signify achieved a record volume year completing over 3 million in home health evaluations.

正如 David 所提到的，Signify 今年的業務量創下了歷史新高，完成了超過 300 萬份家庭健康評估。

This performance contributed to revenue growth in the quarter of approximately 32% as compared to the prior year.

這一業績推動本季營收較上年同期成長約 32%。

We continue to experience strong top line growth at Oak Street, supported by our enterprise connections.

由於企業關係的支持，Oak Street 的營收持續保持強勁成長。

During the quarter, Oak Street revenue increased approximately 39% over the prior year, driven by patient growth.

本季度，由於患者數量的增長，Oak Street 的收入較上年同期增長了約 39%。

Total at-risk members increased approximately 35% compared to the same quarter last year.

與去年同期相比，高風險會員總數增加了約 35%。

While the Medicare Advantage industry experienced elevated utilization throughout 2024, Oak Street's care model achieved a trend lower than the broader industry.

儘管醫療保險優勢產業的使用率在 2024 年全年都有所提升，但 Oak Street 的照護模式卻呈現低於整個產業的趨勢。

Our Pharmacy & Consumer Wellness segment delivered another strong quarter.

我們的藥品和消費者保健部門又取得了強勁的季度業績。

We generated revenues of over $33 billion, an increase of approximately 7% versus the prior year quarter and over 10% on a same-store basis.

我們創造了超過 330 億美元的收入，比去年同期成長約 7%，同店銷售額成長超過 10%。

Adjusted operating income of nearly $1.8 billion declined approximately 13% from the prior year quarter, primarily driven by continued pharmacy reimbursement pressure and lower front store volumes, partially offset by improved drug purchase.

調整後營業收入近 18 億美元，較去年同期下降約 13%，主要原因是藥房報銷壓力持續存在以及前店銷量下降，但藥品採購量的增加部分抵消了這一影響。

Results in the fourth quarter were also lower due to pull forward of immunizations into the third quarter.

由於免疫接種提前至第三季度，第四季的業績也較低。

Same-store pharmacy sales in the quarter increased 13% versus the prior year and same-store prescription volumes increased nearly 6%.

本季同店藥局銷售額較上年同期成長 13%，同店處方量成長近 6%。

Same-store front store sales were down approximately 1% versus the same quarter last year.

同店銷售額與去年同期相比下降約 1%。

We successfully completed our three-year store closure plan and are progressing further footprint optimization in 2025.

我們成功完成了為期三年的門市關閉計劃，並將在 2025 年進一步優化門市佈局。

Despite the reduction in our store count, we continue to maintain a retail pharmacy script share position of over 27%.

儘管我們的門市數量有所減少，但我們仍然保持著 27% 以上的零售藥局處方份額。

This highlights our strong execution, robust omnichannel capabilities and our ability to deliver superior customer experiences, while maintaining a deep community presence, with 85% of Americans within 10 miles of a CVS location.

這凸顯了我們強大的執行力、強大的全通路能力以及提供卓越客戶體驗的能力，同時保持著深度的社區影響力，85% 的美國人居住在距離 CVS 地點 10 英里以內的範圍內。

Shifting now to cash flow and the balance sheet.

現在轉向現金流和資產負債表。

We generated cash flows from operations of approximately $9.1 billion for the full year.

我們全年經營產生的現金流約為 91 億美元。

This result was higher than our expectations due to early payment for Pharmacy Services business will correspondingly lower our expected cash flows in 2025.

該結果高於我們的預期，因為藥房服務業務的提前付款將相應降低我們對 2025 年的預期現金流。

During the quarter, we returned $838 million to our shareholders through our quarterly dividend, bringing total shareholder dividend payments in 2024 to over $3.3 billion.

本季度，我們透過季度股息向股東返還了 8.38 億美元，使 2024 年股東股息總額超過 33 億美元。

We ended the quarter with approximately $3.8 billion of cash at the parent and unrestricted subsidiaries.

截至本季末，母公司和不受限制的子公司的現金餘額約為 38 億美元。

Our leverage ratio at the end of the quarter was approximately 4.7 times, which remains above our long-term target.

我們本季末的槓桿率約為4.7倍，仍高於我們的長期目標。

During the quarter, we executed a liability management transaction that included the issuance of $3 billion of subordinated debt securities and the retirement of approximately $2.6 billion of outstanding debt principal.

本季度，我們執行了一項負債管理交易，其中包括發行 30 億美元的次級債務證券和償還約 26 億美元的未償還債務本金。

The net result of these transactions modestly reduced our leverage ratio.

這些交易的淨結果略微降低了我們的槓桿率。

We are committed to prudent financial policies, including maintenance of our current dividend, as we look to maintain and improve our investment-grade rating and expect our leverage to return to more normalized levels as we continue to execute on margin recovery in the Aetna business.

我們致力於採取審慎的財務政策，包括維持當前的股息，因為我們希望維持和提高我們的投資級評級，並預計隨著我們繼續執行安泰業務的利潤率恢復，我們的槓桿率將回到更正常的水平。

Shifting now to outlook for 2025.

現在轉向2025年的展望。

As David mentioned, we are establishing our initial full year 2025 guidance for adjusted EPS in the range of $5.75 to $6.00. Consistent with past practice, this range does not assume the recurrence of prior year reserve development, which contributed approximately $0.18 to our 2024 GPS results.

正如 David 所提到的，我們制定了 2025 年全年初始調整後每股收益指引值，範圍在 5.75 美元至 6.00 美元之間。與過去的做法一致，該範圍不假設前一年儲備開發的重複，這為我們 2024 年的 GPS 結果貢獻了約 0.18 美元。

After excluding the favorable impact of prior year reserve development, our initial 2025 adjusted EPS guidance represents year-over-year growth of approximately 10% at the low end of the range.

在排除上一年儲備發展的有利影響後，我們初步預測的 2025 年調整後每股盈餘將年增約 10%。

We believe this represents an appropriately achievable baseline with opportunities for outperformance.

我們相信，這代表了一個適當可實現的基線，並具有超越的機會。

Incorporated across our guidance elements is the initial down payment on our multi-year $2 billion cost efficiency ever.

我們的指導要素中包括了我們多年來 20 億美元成本效益的首期付款。

Based on our work to date, we were successful in identifying actions that, at a minimum, will offset the return of certain variable expenses in 2025, as we work to drive further efficiencies across the enterprise over the coming years.

根據我們迄今為止的工作，我們成功地確定了至少可以抵消 2025 年某些變動費用回報的行動，因為我們致力於在未來幾年內提​​高整個企業的效率。

Now let's turn to some of the segment details.

現在讓我們來看看部分片段細節。

I'll start with our Health Care Benefits segment.

我將從醫療保健福利部分開始。

We expect aggregate membership to decline by over 1 million members, primarily driven by reductions in our Individual Exchange and Medicare products.

我們預計總會員人數將減少100多萬，主要原因是個人交易所和醫療保險產品的減少。

We estimate that membership in our Individual Exchange block could contract by over 800,000 lives, and we'll have greater visibility when all effectuated members have paved their premiums by end of March.

我們估計，個人交易所的會員人數可能會減少 80 萬多人，當所有受影響的會員在 3 月底前支付完保費後，我們將有更大的可見性。

We also expect our Medicare Advantage membership to end the year down a high single-digit percentage from year-end 2024.

我們也預計，今年年底我們的醫療保險優勢計畫會員數量將比 2024 年底下降一個高個位數的百分比。

This is consistent with the guidance we have said investors since last summer and have strong execution by our team as they lead the difficult choices necessary to improve Medicare Advantage profitability in 2025.

這與我們自去年夏天以來對投資者的指導方針一致，並且我們的團隊執行力很強，因為他們做出了在 2025 年提高醫療保險優勢計劃盈利能力所必需的艱難選擇。

These membership declines are going to be partially offset by growth in our Commercial self-insured business.

會員人數的下降將被我們的商業自保業務的成長部分抵消。

We expect to generate Health Care Benefits revenue of approximately $132 billion as membership declines in Medicare Advantage and Individual Exchange are offset by Medicare program changes and growth in other products.

由於醫療保險優勢計劃和個人交易所會員人數的下降被醫療保險計劃的變化和其他產品的增長所抵消，我們預計將產生約 1,320 億美元的醫療保險福利收入。

At the low end of our Health Care Benefits adjusted operating income guidance range, we project our medical benefit ratio will improve by 100 basis points over 2024, yielding an MBR of approximately 91.5%.

在我們的健康照護福利調整後營業收入指引範圍的低端，我們預計我們的醫療福利比率將在 2024 年提高 100 個基點，使 MBR 達到約 91.5%。

Our performance on this ratio is one of the largest potential factors that could drive us higher in our adjusted EPS guidance range.

我們在這個比率上的表現是可能推動我們調整後每股盈餘指引範圍走高的最大潛在因素之一。

The largest driver of the reduction in our medical benefit ratio is projected an improvement in our government businesses, particularly in Medicare Advantage.

醫療福利比率降低的最大驅動力是政府業務預計改善，尤其是醫療保險優勢計劃。

We also project year-over-year improvement in our combined commercial lines business, driven by margin recovery in Individual Exchange, offset by pressures in group Commercial from membership declines and elevated levels of medical cost.

我們也預計，綜合商業險種業務將較去年同期有所改善，這主要得益於個人交易所業務利潤率的回升，但抵消了會員數下降和醫療成本上升給團體商業險種帶來的壓力。

We also expect that the contribution from net investment income will decline.

我們也預期投資淨收益的貢獻將會下降。

Overall, we expect Health Care Benefits to deliver adjusted operating income of at least $1.5 billion.

總體而言，我們預計健康保健福利業務將帶來至少 15 億美元的調整後營業收入。

This projection reflects a respectful view of trends in light of the continued elevated medical cost trends that we experienced in the fourth quarter.

鑑於我們在第四季度經歷的醫療成本持續上升的趨勢，這一預測反映了對趨勢的尊重看法。

As a reminder, every point of trend is worth approximately $800 million of Health Care Benefits adjusted operating income results.

提醒一下，每個趨勢點都價值約 8 億美元的健康保健福利調整後營業收入結果。

Shifting now to our Health Services segment.

現在轉向我們的健康服務部門。

We expect revenue of approximately $185 billion, primarily driven by growth at Caremark as we continue to deliver value to our clients.

我們預計營收約為 1850 億美元，主要得益於 Caremark 的成長以及我們將繼續為客戶提供價值。

Adjusted operating income for this segment is expected to grow approximately 4% on to $7.54 billion.

該部門調整後營業收入預計將成長約 4%，達到 75.4 億美元。

While our 2025 guidance reflects continued core Pharmacy Services Group, the overall Health Services segment growth rate is diluted by headwinds in our Health Care Delivery business.

雖然我們的 2025 年指引反映了核心藥局服務集團的持續發展，但整體健康服務部門的成長率卻受到醫療保健交付業務阻力的削弱。

As you know, results in our Health Care Delivery business are highly correlated to Medicare Advantage medical cost trends and regulations.

如您所知，我們的醫療保健服務業務的結果與醫療保險優勢計劃的醫療成本趨勢和法規高度相關。

And at this stage, we have taken a prudent outlook on how these will develop throughout 2025.

目前，我們對 2025 年的發展進行了審慎的展望。

This initial guidance is consistent with the preview we presented last quarter where we noted that our initial outlook for this segment to be below our long-term growth framework, but would prudently reflect opportunities for upside over the course of the year.

這項初步指引與我們上個季度提出的預測一致，我們指出，我們對這一部門的初步展望低於我們的長期成長框架，但將審慎地反映全年的上行機會。

We expect health care delivery performance to improve starting in 2026 as the current medical cost trends experienced across the industry are more appropriately reflected in rates and planned bids and our continued investments in this business mature.

我們預計，從 2026 年開始，醫療保健服務的績效將會改善，因為整個行業當前的醫療成本趨勢將更恰當地反映在費率和計劃投標中，並且我們對這項業務的持續投資也將成熟。

Now for our Pharmacy & Consumer Wellness segment.

現在我們來談談藥局和消費者健康部分。

We project script growth of approximately 3.5% and revenue of approximately $134 billion.

我們預計劇本成長率約為 3.5%，營收約為 1,340 億美元。

We expect adjusted operating income to decline approximately 5%, in line with our long-term guidance framework to $5.48 billion.

我們預計調整後的營業收入將下降約 5%，與我們的長期指導框架一致，達到 54.8 億美元。

As we have discussed previously, 2025 is a transition year for CVS CostVantage, and we believe the implementation of this model positions the trajectory of the PCW business over time.

正如我們之前所討論的，2025 年是 CVS CostVantage 的過渡年，我們相信該模型的實施將決定 PCW 業務的未來發展軌跡。

We expect interest expense to increase approximately $300 million as we annualize the expense associated with our debt offerings in May and December of 2024.

我們預計，隨著我們將 2024 年 5 月和 12 月的債務發行相關費用年化，利息支出將增加約 3 億美元。

We project our tax rate to be approximately 25.5%.

我們預計稅率約為25.5%。

We also expect our share count to increase modestly to approximately 1.271 billion shares, and we are not contemplating any share repurchases in 2025.

我們也預計我們的股票數量將小幅增加至約 12.71 億股，我們不考慮在 2025 年進行任何股票回購。

Finally, we expect cash flow from operations to be approximately $6.5 billion.

最後，我們預計經營現金流約 65 億美元。

The operating cash flow declined versus 2024 is primarily driven by late year timing items that were pulled forward into 2024 cash flow, as well as the impact of lower risk membership on health care cost payable reserves and risk-adjusted revenue accruals, partially offset by improved operating performance in our Health Care Benefits business.

與 2024 年相比，經營現金流下降主要是由於年底的時間安排項目被提前到 2024 年現金流中，以及低風險會員資格對醫療保健成本應付準備金和風險調整後收入應計項目的影響，但部分被我們醫療保健福利業務經營業績的改善所抵消。

Over the '24 and 2025 calendar years, we expect that our business generated operating cash flows of $15.6 billion, which, when combined with improving operating performance, will help put us back on the path to our target leverage levels.

在 2024 年至 2025 年期間，我們預計我們的業務將產生 156 億美元的營運現金流，再加上不斷改善的營運業績，這將有助於我們重回目標槓桿率水準的道路。

As you think about the cadence of earnings in 2025, we expect earnings to be more weighted to the first half than the second half, likely a 55-45 split.

當您考慮 2025 年的獲利節奏時，我們預期獲利在上半年的比重將大於下半年，可能為 55-45 的比例。

Seasonal patterns in most of our segments should remain largely unchanged compared to 2024, with the notable exception of our Health Care Benefits segment, where the Part D changes due to the inflation Reduction Act, the timing of premium deficiency reserves recorded in 2024 will significantly change the progression of earnings.

與 2024 年相比，我們大多數部門的季節性模式應基本保持不變，但我們的醫療保健福利部門除外，該部門的 D 部分因《通貨膨脹削減法案》而發生變化，2024 年記錄的保費缺口準備金的時間將顯著改變收益的進展。

You can find additional details on the components of our 2025 guidance on our Investor Relations website.

您可以在我們的投資者關係網站上找到有關我們 2025 年指引組成部分的更多詳細資訊。

We are encouraged by our opportunities in 2025 and are excited to demonstrate the enormous potential that we see across CVS Health to unlock embedded earnings.

我們對 2025 年的機會感到鼓舞，並很高興展示我們在 CVS Health 中看到的巨大釋放內含收益的潛力。

We are working tirelessly to restore Aetna to target margins, which, over time, should represent meaningful upside above the high end of our 2025 guidance range.

我們正在不懈努力地將安泰的利潤率恢復到目標水平，隨著時間的推移，該目標利潤率將顯著高於我們 2025 年指導範圍的高端。

With that, we will now open the call to your questions.

現在，我們將開始回答你們的問題。

Operator?

操作員？

Thank you, Tom.

謝謝你，湯姆。

We will now begin the question-and-answer session.

我們現在開始問答環節。

(Operator Instructions)

（操作員指令）

Lisa Gill, JPMorgan.

摩根大通的麗莎吉爾 (Lisa Gill)。

Thanks very much, and good morning.

非常感謝，早安。

David, I wanted to start with -- you made some comments around your observations in the first 100 days.

大衛，首先我想問一下——你針對前 100 天的觀察發表了一些評論。

What are some of the things that you think you can really bring to CVS as the new CEO?

作為新任首席執行官，您認為您能為 CVS 帶來什麼？

And anything else that you'd want to share from an investor perspective, David, as you think of the first 100 days?

大衛，從投資人的角度看，您還有什麼想分享的嗎？

And then if I can also just maybe better understand the guidance, which is better than I had anticipated, the guidance being a good starting point.

然後，如果我也能更好地理解指導，這比我預期的要好，那麼指導就是一個很好的起點。

Tom made the comment of an opportunity for outperformance.

湯姆評論說這是一個超越對手的機會。

Last year, you gave a better-than number.

去年，你給的數字比較好。

This year, your range is $5.75 to $6.00. Can you maybe just talk about the confidence in that number and the potential outperformance around the guidance for 2025?

今年，您的範圍是 5.75 美元到 6.00 美元。您能否談談對該數字的信心以及 2025 年指引的潛在優異表現？

Thanks very much.

非常感謝。

Yeah, thank you, Lisa, and I appreciate the question.

是的，謝謝你，麗莎，我很感謝你的提問。

Let me give you a bit of perspective on the first 100 days and the things I believe that we're focusing on and can deliver into '25.

讓我介紹一下第一個100天的情況，以及我認為我們要關注並能在2025年實現的事情。

So as I mentioned in the first quarter or the very first earnings call, I needed to focus on the most pressing and urgent issues of the company, which, at this point, I'm happy to report, we spent a lot of time poking on Aetna and we've actually delivered material progress in terms of stabilizing Aetna's operation and also bringing the financial discipline back to the organization.

因此，正如我在第一季或第一次財報電話會議上提到的那樣，我需要關注公司最緊迫和最緊急的問題，此時此刻，我很高興地報告，我們花了很多時間研究安泰，並且在穩定安泰的運營和為組織帶來財務紀律方面實際上取得了實質性進展。

So I think as you look towards the open enrollment as well as the progress made, I'm very confident, very bullish on the continued recovery of that business.

因此，我認為，當你看到開放註冊以及所取得的進展時，我對該業務的持續復甦非常有信心，非常樂觀。

I think the second piece, and this speaks to where I've spent the last two years, it's critically important that we continue on this pharmacy transformation journey.

我認為第二點，這也反映了我過去兩年所經歷的事情，繼續進行藥局轉型之旅至關重要。

We recognize that there are kind of headlines around the role that PBMs and pharmacies play.

我們認識到，關於 PBM 和藥房所發揮的作用有很多報導。

And the fact that we've made significant progress in both changing the pricing models, whether it be on CVS Pharmacy's CostVantage, which we had 100% adoption in the commercial space, or within Caremark's TrueCost model, which we now have more than 70% of our clients adopting more than two of the features or attributes of that model.

事實上，我們在改變定價模型方面都取得了重大進展，無論是 CVS Pharmacy 的 CostVantage（在商業領域已 100% 採用）還是 Caremark 的 TrueCost 模型（現在我們有超過 70% 的客戶採用了該模型的兩個以上功能或屬性）。

These are really important elements, I believe, that continue to drive change and or transformation in the market.

我相信，這些都是非常重要的因素，它們將繼續推動市場的變化和轉型。

And the last thing I'll say is that the success that we had in the biosimilar launch with Cordavis was unprecedented.

我最後要說的是，我們在 Cordavis 生物相似藥發布中取得的成功是前所未有的。

We created what I believe is a durable biosimilar market.

我認為，我們創造了一個持久的生物相似藥市場。

We led the market in terms of the volume and the conversion change, leading this with both technology and an opportunity to lower cost for our customers.

我們在產量和轉換變化方面引領市場，憑藉技術和為客戶降低成本的機會引領市場。

So those are the two big headlines on the business front.

以上就是商業領域的兩大頭條新聞。

And I think as I look at the role that I'm playing, it's making sure that I'm surrounded with the right leadership.

我認為，當我審視自己所扮演的角色時，我要確保身邊有正確的領導力。

So this right leadership team -- I mentioned Steve Nelson coming in from the outside.

所以這個合適的領導團隊——我提到了從外部加入的史蒂夫·尼爾森。

He's been on the job now 90 days leading Aetna, both stabilizing that leadership team and the operations and the financial organization.

他已任職 90 天，領導安泰，穩定領導團隊以及營運和財務組織。

And then we've also announced Prem Shah in a new Group President role during the last quarterly earnings.

我們在上一季的財報中也宣布 Prem Shah 出任新集團總裁一職。

And that's allowed for us to both promote and elevate talent within the organization.

這使我們能夠在組織內提拔和提升人才。

So we have Len Shankman now running CVS Pharmacy, which is a 20-year-plus veteran of the business.

現在我們有 Len Shankman 來管理 CVS 藥房，他在這個行業有 20 多年的經驗。

We had Dr. Sree now running our Health Care Delivery assets, which again is a long tenured leader here in our business.

現在，Sree 博士負責管理我們的醫療保健服務資產，他也是我們業務中任職多年的領導者。

And then Ed DeVaney running CVS Caremark, which is another 20-year veteran of the business.

然後是 Ed DeVaney 執掌 CVS Caremark，他也是該行業另一位擁有 20 年經驗的老將。

So I think it shows the strength of the leadership team and the bench that we've built in the organization, which is going to continue to allow us, I believe, to lead from the

因此，我認為這表明了我們領導團隊的實力以及我們在組織中建立的後備力量，我相信這將繼續使我們能夠從

[front].

[正面]。

So as I look at specifically your question about the role that I'm playing, I believe we have the right assets.

因此，當我具體看待你關於我所扮演的角色的問題時，我相信我們擁有正確的資產。

I think we've established the right priorities for the business and the right strategy.

我認為我們已經為業務確定了正確的優先事項和正確的策略。

And hopefully, at this point, we're going to continue to at least in the listening tour, be able to earn the right to become America's leading and most trusted health care company.

希望此時此刻，我們能夠繼續至少在傾聽之旅中贏得成為美國領先和最值得信賴的醫療保健公司的權利。

So with that, I'd say my first 100 days was a leadership transition and now the focus will be a leadership transition becoming a transition to leadership.

因此，我想說，我的上任後的前 100 天是領導階層的過渡，而現在的重點將是領導階層的過渡，進而轉向領導階層的過渡。

So let me spend a second talking about the second question on guidance.

因此，讓我花一點時間談談有關指導的第二個問題。

It is, without question, important for me to establish both trust and credibility in terms of being able to deliver on the promises and commitments that we've made.

毫無疑問，對我來說，建立信任和信譽對於兌現我們所做的承諾非常重要。

So while we're going to talk about the overperformance and some of the drivers there, I also want to make sure that we that I'm in a position to make sure that we're delivering on the commitments and promises that we're making to the investment community.

因此，當我們談論超額表現及其中的一些驅動因素時，我也想確保我們能夠履行對投資界所做的承諾和承諾。

So with that, Tom, if you can share a couple of thoughts on the '25 year.

那麼，湯姆，你能和我們分享一下關於 25 年的一些想法嗎？

Absolutely.

絕對地。

So Lisa, thanks for the question.

所以麗莎，謝謝你的提問。

And thanks, David.

謝謝你，大衛。

We set this out to be an achievable target with opportunities for upside.

我們將其設定為一個可實現的目標，並且具有上升機會。

I think and hope that there are opportunities across all of our businesses, but the one that I think investors are rightfully most focused on is Health Care Benefits.

我認為並且希望我們所有的業務都有機會，但我認為投資者最關注的是醫療保健福利。

And as you think about that, you think about what I said in the prepared remarks, every point of trend is an $800 million swing on that business.

當你想到這一點時，請想想我在準備好的發言中所說的話，趨勢的每一個點都會對該業務造成 8 億美元的影響。

And we have taken a very prudent outlook on what our medical cost trends are in our preferred guidance, specifically because of how 2024 developed.

我們對優先指導中的醫療成本趨勢採取了非常謹慎的展望，特別是考慮到 2024 年的發展。

And we have respectfully looked at those trends and our guidance assumes that they persist into 2025.

我們認真審視了這些趨勢，我們的指導假設這些趨勢將持續到 2025 年。

So whether that's in our Medicare business, or our group commercial block, as we exited the year in 2024, those trends are consistent with what is in our guidance for 2025.

因此，無論是在我們的醫療保險業務中，還是在我們的集團商業區塊中，當我們在 2024 年退出時，這些趨勢與我們對 2025 年的指導是一致的。

And so I think that would be the place where you could see the most potential upside would be inside that Health Care Benefits business.

所以我認為，最有潛力上漲的地方就是醫療保健福利業務。

And this isn't necessarily a 2025 opportunity, we think a little bit longer term.

而且這不一定是 2025 年的機會，我們認為這是一個更長遠的機會。

The Health Care Benefits business, even at the top end of the guidance range, it's 1.5 points of margin compared to 2023, which was over 5%; and 2022, which was 7%.

醫療保健福利業務的利潤率即使處於指導範圍的最高端，也僅為 1.5 個百分點，而 2023 年則超過 5%；到 2022 年，這一數字將達到 7%。

And you look at some of our underlying businesses, government has improved, driven by Medicare in particular, but it's still projected to be a negative margin.

看看我們的一些基礎業務，政府業務有所改善，特別是在醫療保險的推動下，但預計利潤率仍為負。

Group commercial is a profitable business, seeing signs of pressure.

集團商業是一項獲利業務，但也出現壓力跡象。

IFP, our Individual Exchange product is expected to still lose money in our current outlook.

在我們目前的展望中，我們的個人交易所產品 IFP 預計仍會虧損。

And so if you do the math and you say, with the current share count and revenue base, each point of margin improvement is $0.75 of adjusted EPS.

因此，如果你算一下，你會發現，以目前的股票數量和收入基數，利潤率的每個改善點都會帶來 0.75 美元的調整後每股盈餘。

And so that implies we could have another $3, $4 more dollars of embedded adjusted EPS if we can get our Aetna business back to its target margins, and that's what we needed to doing over time.

因此，這意味著如果我們能夠使 Aetna 業務恢復到其目標利潤率，我們可以再獲得 3 到 4 美元的嵌入式調整後每股收益，而這正是我們隨著時間的推移所需要做的事情。

Thank you.

謝謝。

Justin Lake, Wolf Research.

賈斯汀·萊克（Justin Lake），沃爾夫研究公司。

Thanks, good morning, I want to follow up on some of your comments there, Tom.

謝謝，早安，我想跟進一下你的一些評論，湯姆。

First, on your Medicare Advantage trend.

首先，關於您的醫療保險優勢趨勢。

Maybe you can give us a little bit more detail there in terms of what did the trend look like coming out of the year for 2024?

也許您可以向我們提供一些更詳細的信息，例如 2024 年的趨勢是什麼樣的？

And specifically, what are you assuming for trend in 2025?

具體來說，您對 2025 年的趨勢有何假設？

I know you said it's kind of you're assuming it to keep that pace.

我知道您說過您假設它會保持這種速度。

So what the '24 trend and the '25 assumption?

那麼 24 年的趨勢和 25 年的假設又是什麼呢？

And maybe any detail you could share with us on kind of the costs you've taken out of the business just via the bids, for instance, and how you're seeing your membership mix kind of play out for 2025?

您是否可以與我們分享一些細節，例如您透過競標從業務中扣除的成本，以及您如何看待 2025 年的會員組合發展？

Thanks Justin.

謝謝賈斯汀。

Let me answer what I can for you on that.

讓我盡我所能為您解答這個問題。

So I noted this in the prepared remarks.

所以我在準備好的發言中提到了這一點。

So medical trends remained elevated, although what we experienced in the fourth quarter was less severe than what we assumed in our downside scenario.

因此，醫療趨勢仍然保持高位，儘管我們在第四季度經歷的情況沒有我們在下行情境中假設的那麼嚴重。

I'd also note, during the quarter, we experienced positive prior period reserve development across all of our lines of business, and that was primarily related to the second and third quarter dates of service.

我還要指出的是，在本季度，我們所有業務線的前期儲備均取得了積極的發展，這主要與第二季和第三季的服務日期有關。

So that was also a nice positive tailwind there.

所以這也是一個很好的積極順風。

But as you look at the major businesses, starting with government, I'd say -- and maybe specifically Medicare, we saw some modest improvement.

但當你看看主要企業時，我想說，從政府開始——也許特別是醫療保險，我們看到了一些適度的改善。

It was mostly driven by our group Medicare and our dual lines of business.

這主要得益於我們的集團醫療保險和雙重業務線。

And specifically, we saw some relief on inpatient earlier in the quarter.

具體來說，我們在本季早些時候看到住院費用有所減輕。

Our general enrollment population continue to see elevated trends, but a lot of where that pressure was, was actually in the specialist lines, and we think that, that might be more consistent with what we talked about as a rush to care as people looked at some of the changing benefit patterns in their supplemental benefits for 2025.

我們的整體投保人口持續呈現上升趨勢，但這種壓力很大程度上實際上來自於專科方面，我們認為，這可能與我們所說的急於求成的情況更加一致，因為人們看到 2025 年補充福利中的一些福利模式發生了變化，因此出現了急於求成的現象。

I mean so we're waiting to see how that's going to play out on those change benefits in early 2025.

我的意思是，我們正在等待，看看這將如何在 2025 年初發揮這些變革效益。

On Medicaid, we did start to see some favorability in that book.

關於醫療補助，我們確實開始在書中看到一些有利因素。

Our redeterminations came to a close in our state footprint.

我們的重新確定在我們的國家足跡中已經結束。

And that was the primary driver of the year-to-date trend was those redeterminations.

這些重新確定是年初至今趨勢的主要動力。

So as that started to stabilize, we also saw a little bit of improvement there and some modest rate improvements versus what we had forecast.

因此，隨著情況開始穩定，我們也看到了一些改善，與我們的預測相比，利率有一些適度的改善。

So generally, a good end to the year on the Medicaid business relative to the trends of the first three quarters.

總體而言，與前三個季度的趨勢相比，今年醫療補助業務的收尾不錯。

In the commercial block, trends in commercial remained elevated, and we saw some modest underlying improvement, but that was offset by stop-loss.

在商業領域，商業趨勢仍然保持高位，我們看到了一些適度的潛在改善，但這被停損所抵消。

And as you look at the stop-loss, it's very similar to what others in this industry have seen.

當您看到停損時，您會發現它與業內其他人所見的非常相似。

It's about the more specific attachment points than the aggregate detachment points.

它涉及比聚合分離點更具體的附著點。

And also within our commercial block then, on IFP, we really continue to see trends accelerate into the fourth quarter, and a lot of that was actually driven inpatient claims.

並且在我們的商業區塊中，在 IFP 上，我們確實繼續看到趨勢在第四季度加速，其中許多實際上是由住院索賠推動的。

We also took a little bit of an enhancement on our risk-adjusted revenue accruals after we got the most recent weekly data, although that was a little bit less than what we had previously talked about in that downside scenario.

在獲得最新的每週數據後，我們還對風險調整後的收入應計項目進行了少許增強，儘管這比我們之前在下行情景中談到的要少一些。

I'd say, as you think about that book, in particular, the most important factor there in '25 is going to be the significant pricing changes we took.

我想說，當你想到那本書時，特別是'25 年最重要的因素將是我們採取的重大定價變化。

And we're in the process of understanding how that mix change -- because that book could easily shrink in half, how that's going to yield the performance this year.

我們正在了解這種組合將如何變化——因為這本書的數量很容易就會減少一半，這將如何影響今年的業績。

And so we've taken a cautious outlook relative to that book overall.

因此，我們總體上對這本書持謹慎態度。

With respect to '25, it's a little too early to confidence with any -- excuse me, is a little too early to comment with any confidence, particularly given how much our membership mix has changed.

對於 25 而言，現在做出有信心的評論還為時過早 — — 對不起，現在做出有信心的評論還為時過早，特別是考慮到我們的會員結構發生了多大的變化。

I'd say, overall, our outlook remains respectful with respect to trends.

我想說，總的來說，我們對趨勢的展望仍然保持尊重。

Because they were so high, almost all of last year, things like the impact of the two midnight rule are now incorporated into the baseline, which should help to normalize some of our trends this year.

由於去年幾乎全年都處於高位，因此諸如兩次午夜規則的影響等因素現已被納入基線，這應該有助於使我們今年的一些趨勢正常化。

I guess I could also say we feel good about how our reserves as of 12-31 developing at this stage, but it's really early.

我想我也可以說，我們對截至 12 月 31 日的儲備狀況感到滿意，但現在還為時過早。

And so we'd like to have a better understanding of how that baseline is going to perform in '25 before we get too far ahead of ourselves.

因此，在我們走得太遠之前，我們希望更好地了解這個基線在 25 年的表現如何。

Stephen Baxter, Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

Yeah, hi, thank you.

是的，你好，謝謝你。

I was hoping you could update us on where the Medicare Advantage margins ended the full year 2024 and what's assumed in the guidance for 2025.

我希望您能向我們介紹一下 2024 年全年醫療保險優勢計劃的利潤率以及 2025 年指引中的假設。

Basically, the pacing of this obviously is going to be a huge area of focus for the investment community.

基本上，這項進程顯然將成為投資界關注的重點。

Any kind of general comments you can talk about progression of MA recovery over the next couple of years beyond 2025 would also be appreciated.

如果您能就 2025 年以後未來幾年 MA 復甦的進展發表任何一般性評論，我們將不勝感激。

Thank you.

謝謝。

Yes, Steve, maybe I'll start, and then I'll turn it over to Steve, because I think it would be good for you to hear from him about how he's been thinking about this business and how he's been moving the business along, the Aetna business.

是的，史蒂夫，也許我先開始，然後我會把時間交給史蒂夫，因為我認為聽聽他是如何看待這項業務的，以及他是如何推動這項業務，即安泰業務的，這對你會有好處。

The business itself ended the year with margins consistent with what we last said.

這項業務本身在年底的利潤率與我們上次所說的一致。

They were in the negative 4.5% to 5% range.

其範圍在-4.5%至-5%之間。

We're improving that in the current outlook.

我們正在根據當前情況改善這一點。

It's not getting back to breakeven, so it will be loss-making.

它並沒有恢復到收支平衡，所以它將會虧損。

And I think that's one of the biggest swing factors as performance of that business this year between the high and the low end.

我認為這是今年該業務表現在高端與低端之間的最大波動因素之一。

A lot of that, I think, is going to be driven by how Medicare performs over the remainder of the year, how some of those changes and benefits that we made and the changing membership mix and how those new members perform.

我認為，這在很大程度上將取決於醫療保險在今年剩餘時間內的表現、我們所做的一些改變和福利、會員結構的變化以及新會員的表現。

And so I think there's still a lot of opportunity there over time to get that back to the 3% to 5% target margins we've talked about.

因此我認為隨著時間的推移，仍然有很多機會將利潤率恢復到我們之前談到的 3% 到 5% 的目標水準。

Well thanks Tom.

好吧，謝謝湯姆。

Tom.

湯姆。

Good one.

很好。

Actually happy to make a few comments, just kind of perspective generally about it, and then I'll go into the Medicare Advantage business.

實際上我很高興發表一些評論，只是對此發表一些一般性的看法，然後我將談論醫療保險優勢業務。

But first of all, thrilled to be put a CVS Health leadership team and honored to lead.

但首先，我很高興加入 CVS Health 領導團隊，並很榮幸能夠領導。

I've competed against Aetna for many years and found it to be a really strong brand, and really known for its innovation in both product and clinical.

我與安泰競爭多年，發現它是一個非常強大的品牌，並且因其在產品和臨床方面的創新而聞名。

And so my early read is there's a lot to build on.

因此，我早期的理解是，有很多內容可以藉鏡。

And I add my commitment, my personal commitment to David's, Mark's and Tom's and the entire CVS Health leadership team and the Aetna team, to return to its target margins over a multi-year period.

此外，我還向大衛、馬克、湯姆以及整個 CVS 健康領導團隊和安泰團隊做出我個人的承諾，即在多年內恢復其目標利潤率。

Encouraged in the early days and confident that we can do that.

早期我們受到鼓舞並有信心我們能夠做到這一點。

I think we've made some really quick progress in a lot of areas.

我認為我們在很多領域都取得了非常快的進展。

I would just highlight a few.

我只想強調幾點。

Our capabilities around forecasting and all the levers and capabilities around managing total cost of care, really encouraged by the early progress and really meaningful progress there.

我們在預測方面的能力以及管理整體護理成本方面的所有槓桿和能力確實受到了早期進展和真正有意義的進展的鼓舞。

Also, as you think about our pricing discipline.

另外，您可以考慮我們的定價原則。

That's been a topic a lot here, and I'm very encouraged about what we've done there and that specifically relates to Medicare Advantage, our Individual Exchange business and honestly, our Commercial business as well.

這是一個經常討論的話題，我對我們在那裡所做的事情感到非常鼓舞，這特別涉及醫療保險優勢計劃、我們的個人交易所業務，老實說，也包括我們的商業業務。

And then we've been leaning into a member experience with our cutting-edge technology and really happy with some of the progress there.

然後，我們一直致力於利用我們的尖端技術來提升會員體驗，並對其中取得的一些進展感到非常高興。

We've stabilized our operations and strengthened them, which has led to and evidenced by a really well-executed welcome season in January.

我們已經穩定並加強了業務運營，這使得一月份的迎客季取得了圓滿成功。

And we've also welcomed one of the largest accounts ever sold in Aetna in the state of North Carolina, and that implementation has gone really, really well.

我們也迎來了安泰在北卡羅來納州簽訂的史上最大帳戶之一，而且這項實施進展非常順利。

Specifically in Medicare Advantage, the combination of the Stars, tailwind, best-in-industry performance there, the discipline that we use when we put together 2025 benefit plan and then the really well-executed AEP, I think all points to a really strong future for our Medicare Advantage business.

具體來說，在醫療保險優勢計劃中，星級、順風、業內最佳表現的結合，以及我們在製定 2025 年福利計劃時遵循的紀律，以及真正執行良好的 AEP，我認為所有這些都預示著我們的醫療保險優勢計劃業務將擁有非常強勁的未來。

It's positioned well, the momentum we've talked about.

它的定位很好，就是我們討論過的勢頭。

And specifically, this was a day-to-day, almost hour by hour, kind of decisions that we made, this execution, where we looked at our product mix.

具體來說，這是我們每天、幾乎每小時都要做出的決策，我們會執行，並檢視我們的產品組合。

And there were several products that we did see a path to the target margin, and we exited those products and transition our members into new products, and that's gone better than expected.

我們確實看到了幾種產品實現目標利潤的途徑，我們退出了這些產品並讓我們的會員轉向新產品，而且結果比預期的要好。

And so that's just kind of one piece of evidence about how we're executing and how we're thinking about the business.

這只是關於我們如何執行以及如何思考業務的一種證據。

Super committed to being an excellent performer and a leader in Medicare Advantage.

Super 致力於成為醫療保險優勢領域的優秀表現者和領導者。

So I could go on, but I'll just say, my early days here, my first three months, very encouraged and very confident in our path forward.

所以我可以繼續說下去，但我只想說，我在這裡的最初幾天，也就是前三個月，我對我們的前進道路感到非常鼓舞和充滿信心。

Thanks, Steve.

謝謝，史蒂夫。

Maybe just one other comment.

也許只是另一則評論。

As I look at the last 90 days with Steve's onboarding, the Aetna team has been incredibly resilient.

回顧史蒂夫加入後的過去 90 天，我發現安泰團隊表現得異常堅韌。

There's obviously been a lot of pressure in a lot of us on the turnaround efforts.

顯然，我們很多人都面臨著扭轉局勢的巨大壓力。

And I think Steve's ability to manage and lead and deliver a better and improved culture around that organization has allowed us, I think, to perform and execute.

我認為史蒂夫的管理和領導能力以及為該組織提供更好和改進的文化的能力使我們能夠表現和執行。

Which is really the theme of the day, which is making sure that we deliver and execute against the commitments that we've made.

這實際上是今天的主題，即確保我們兌現並履行我們所做的承諾。

And so we started with the open enrollment, which was a lot of fine-tuning and making sure we had the right mix.

因此，我們從開放招生開始，經過大量的微調，確保我們有正確的組合。

And then we couldn't lose sight of the largest account that we onboarded with the state of North Carolina, which was done and the team did just an exceptional job of staying focused and delivering on the service levels for our customers.

然後，我們不能忽視與北卡羅來納州簽訂的最大合同，這項合同已經完成，我們的團隊出色地完成了工作，保持專注並為客戶提供服務水平。

Thank you.

謝謝。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

Hi, good morning.

嗨，早安。

We spent a lot of time talking about Medicare margins, but you also took aggressive actions on the individual ACA business.

我們花了很多時間討論醫療保險利潤，但您也對個人 ACA 業務採取了積極行動。

So I was hoping you could elaborate on those actions, including any changes to provider networks and expected impact on margins embedded in guidance?

所以我希望您能詳細說明這些行動，包括對提供者網路的任何變化以及對指導中嵌入的利潤率的預期影響？

Thanks.

謝謝。

Sure, Andrew, Happy to take a shot at that.

當然，安德魯，我很樂意嘗試。

As you think about that business, so it ended the year about 1.85 million members.

正如您所想的那樣，到年底，該業務的會員數量約為 185 萬。

And it's going to probably be sub-1 million members this year, and that's consistent with the actions that we took.

今年的會員數可能會不到 100 萬，這與我們採取的行動一致。

We this is a business that had about $10 billion of premiums last year and lost nearly $1 billion and that's just not acceptable performance.

我們這家公司去年的保費收入約為 100 億美元，但卻虧損了近 10 億美元，這樣的表現實在令人無法接受。

So part of that performance last year was, as we've talked about, that we had a risk adjusted true-up out of 2023.

因此，正如我們所討論的那樣，去年表現的部分原因是我們在 2023 年進行了風險調整。

And I think we've spent a lot of time with the team, with the new CFO there, on thinking about how it is that we want to accrue, how we want to understand what that -- what the weekly data is telling us and what the potential risk associated with that data are.

我想我們和團隊、新任財務長一起花了很多時間思考我們想要如何積累，我們想要如何理解每週數據告訴我們什麼，以及與這些數據相關的潛在風險是什麼。

I feel good about where it is that we are booked at the end of this year that should hopefully not be a problem that comes back to bite us in 2025.

我對我們今年年底的預定情況感到很滿意，希望這不會成為 2025 年困擾我們的問題。

So then the question becomes what is the value of the actions that we took and with a membership mix that has churned so substantially, we think that we will make progress.

那麼問題就變成了我們所採取的行動有什麼價值，而且在會員結構發生如此大幅度變化的情況下，我們認為我們會取得進展。

But we really need to understand a little bit more about who even some of those members are, because they have until the end of March to pay their first month premium and be retroactive.

但我們確實需要更多地了解這些會員的身份，因為他們必須在 3 月底之前繳納第一個月的保費，並進行追溯。

But we feel good that we will make margin improvement in that business.

但我們對該業務的利潤率將會提高感到樂觀。

That's embedded in the guidance.

這已包含在指南中。

It will not get back to breakeven this year.

今年它還無法恢復收支平衡。

And it's something that we continue to watch very closely, particularly given the high levels of trend that we experienced -- an accelerating levels of trend we experienced in that book into the tail end of 2024.

我們會繼續密切關注這一點，特別是考慮到我們所經歷的高水準趨勢——在這本書中，我們經歷了到 2024 年底的加速趨勢。

Steve, I don't know, anything you want to add on that?

史蒂夫，我不知道，你還有什麼要補充嗎？

Yeah, sure, I'll just add a couple of points.

是的，當然，我只想補充幾點。

Similarly to the Medicare Advantage, AEP execution, I would point to the OEP execution for this business where we made really positive changes in the geographic and product mix in addition to the pricing discipline.

與 Medicare Advantage、AEP 執行類似，我想指出該業務的 OEP 執行情況，除了定價原則之外，我們還在地理和產品組合方面做出了真正積極的改變。

So I think that takes us business into 2025 with improved momentum.

所以我認為這將使我們的業務在 2025 年擁有更好的發展勢頭。

And -- but you referenced network and I -- and we are definitely taking a look at all components of what it takes to be successful in this business and -- not just network contracts, but network design, how we think about our capabilities around risk adjustment, managing the total cost of care in this population is different than other populations.

而且——但是你提到了網絡和我——我們肯定會考慮在這個行業取得成功所需的所有要素——不僅僅是網絡合同，還有網絡設計，我們如何看待我們在風險調整方面的能力，管理這個人群的護理總成本與其他人群不同。

And so improving our capability and capacity and just, overall, I would just say, sort of confidence in this business has been a priority and really like the position that we have now going into 2025.

因此，提高我們的能力和產能，總的來說，我只想說，對這項業務的信心一直是我們的首要任務，我真的很喜歡我們現在邁向 2025 年的地位。

But look, the business needs to perform at target margin, and we're committed to getting it back to that.

但是，業務需要達到目標利潤率，我們致力於回到這個目標。

It plays a really important role for individual consumers and it does play a role in our portfolio, but it needs to perform at the target margin.

它對個人消費者來說發揮著非常重要的作用，並且在我們的產品組合中也發揮作用，但它需要達到目標利潤率。

So I think we're taking good steps, more work to do, but we're committed to getting -- returning to target margins.

所以我認為我們正在採取良好的措施，還有更多的工作要做，但我們致力於恢復到目標利潤率。

Off to a good start.

開始很好。

Thank you.

謝謝。

Erin Wright, Morgan Stanley.

摩根士丹利的艾琳·賴特。

Great, thanks for taking my question.

太好了，感謝您回答我的問題。

How should we think about the quarterly progression for MLR?

我們應該如何看待 MLR 的季度進展？

And you gave us some of the detail on your overall assumptions from a utilization perspective for 2025, but any nuances particularly as we model out for the year, for instance, how IRA should flow through throughout the year?

您從利用率的角度為我們提供了有關 2025 年總體假設的一些細節，但在我們為這一年制定模型時，是否存在任何細微差別，例如，IRA 應如何在全年流通？

And any surprises on that front or elements to think about as we think about that quarterly?

當我們考慮該季度時，在這方面有什麼意外或需要考慮的因素嗎？

Thanks.

謝謝。

Thanks, Erin.

謝謝，艾琳。

So yes, I did have some comments about seasonality in the prepared remarks.

是的，我在準備好的評論中確實對季節性提出了一些評論。

We think it's going to be more of a 55-45 first half, second half split this year.

我們認為，今年上半年和下半年的比例將分別為 55:45。

And the primary driver of the seasonality change is Health Care Benefits and it's really the IRI impact, but also don't forget the PDR kind of messes a little bit with the cadence of earnings in 2024.

季節性變化的主要驅動因素是醫療保健福利，這確實是 IRI 的影響，但也不要忘記 PDR 會對 2024 年的獲利節奏造成一些影響。

Hopefully something we won't have to deal with again.

希望我們不必再遇到這樣的事情。

But as you think about the inflation reduction impacts to the Part D premium, we now get that premium upfront and monthly and we no longer have the same level of reinsurance protection, particularly at the back part of the year.

但是，當您考慮通貨膨脹降低對 D 部分保費的影響時，我們現在是每月預先獲得該保費，並且我們不再享有相同水平的再保險保護，尤其是在年底。

So your MBRs for the Aetna business, they're going to be lowest in the fourth first quarter and they're going to be higher in the fourth.

因此，安泰業務的 MBR 在第四季度第一季會達到最低，而在第四季會上升。

And you could see 8 points of swing between the first and the fourth quarter as you think about the progression of earnings and the progression of MBRs there.

當您考慮收益和 MBR 的進展時，您會發現第一季和第四季之間有 8 個點的波動。

And so -- and that's on the total of Aetna.

這就是 Aetna 的總額。

And the second and the third quarters will probably be more to close other, but there'll be a little bit more pressure in the third quarter than the second.

第二季和第三季可能還有更多的比賽要打，但第三季的壓力會比第二季稍微大一些。

But as you think about that changing cadence of earnings, just I would highlight just that's a good proxy for how to think about sloping it, given the PDP impacts on our book in particular.

但是，當您考慮獲利變化的節奏時，我只想強調，這是一個很好的指標，可以衡量如何考慮傾斜，尤其是考慮到 PDP 對我們帳簿的影響。

Thank you.

謝謝。

Ann Hynes, Mizuho Securities.

瑞穗證券的安‧海因斯 (Ann Hynes)。

Great, thank you.

太好了，謝謝。

Can you remind us with CostVantage, what is the headwind to growth the first year of the implementation?

您能否提醒我們 CostVantage 在實施的第一年面臨的成長阻力是什麼？

And when would you expect that to turn positive for you?

您預計什麼時候這會對您產生正面的影響？

And also, I know CostVantage is only focused on commercial contracts right now.

而且，我知道 CostVantage 目前只專注於商業合約。

Do you eventually believe it will impact Medicare contracts?

您最終是否相信它會影響醫療保險合約？

And if so, what's the timing on that?

如果是的話，時間是什麼時候？

Thanks.

謝謝。

All right.

好的。

Can I just make -- I'll make a couple of comments about cost vantage and true cost, and I'll let Prem speak specifically to how we're thinking about it flowing through for other product lines.

我可以就成本優勢和真實成本發表一些評論，然後讓 Prem 具體談談我們如何考慮將其應用於其他產品線。

This is a really important initiative for this enterprise.

對該企業來說，這是一個非常重要的措施。

We -- this has been something we announced in late '23.

這是我們在 23 年末宣布的事情。

We felt like we needed to take a leadership position in terms of changing the marketplace from a market basket to individual-priced products.

我們覺得我們需要在將市場從市場籃子轉變為個人定價產品方面發揮領導作用。

We thought this is important for adding simplicity and transparency and was a major push an initiative within the organization.

我們認為這對於增加簡單性和透明度非常重要，並且是組織內部的一項重大推動措施。

I'm proud to say that we've been able to move the market, because we've done this collectively as an enterprise, both leveraging the work that we've done in CVS Pharmacy as well as the TrueCost product portfolio that we have within Caremark.

我很自豪地說我們已經能夠推動市場，因為我們作為一個企業共同做到了這一點，既利用了我們在 CVS Pharmacy 所做的工作，也利用了我們在 Caremark 內的 TrueCost 產品組合。

So Prem, maybe I can have you speak to the -- how we're thinking about cost manage from a margin standpoint.

所以 Prem，也許我可以讓你談談——我們如何從利潤的角度考慮成本管理。

Yeah, thanks, David.

是的，謝謝，大衛。

And Ann, thanks for the question.

安，謝謝你的提問。

So if you think about cost management, we reiterated at the end of '23, and we walked through this last year, there's really three things that cost management was addressing.

因此，如果你考慮成本管理，我們在 23 年底重申過，而我們去年也討論過這個問題，成本管理實際上要解決三個問題。

First and foremost, it was really a shift of our pharmacy reimbursement model to more closely aligned to or the underlying cost of our business and the value that we create as a local community pharmacy for the tens of millions of patients that we serve.

首先，這實際上是我們藥房報銷模式的轉變，使其更緊密地與我們業務的潛在成本以及我們作為當地社區藥房為我們服務的數千萬患者創造的價值保持一致。

Secondly, when you think about pharmacy reimbursement, there was a lot of cross subsidization across brands and generics, and this allows us to ensure more stable pharmacy margins and a more durable kind of process as you think about what we do inside of the pharmacy supply chain, which is essentially serving the patients at the counter, for a more predictable margin for every script that we dispense.

其次，當你考慮藥房報銷時，品牌藥和仿製藥之間存在大量的交叉補貼，這使我們能夠確保更穩定的藥房利潤和更持久的流程，正如你在藥房供應鏈中所做的事情一樣，這本質上是在櫃檯為患者提供服務，以便為我們配發的每一張處方獲得更可預測的利潤。

And lastly, it creates the path for transparency for PBMs to provide that transparency in their drug pricing as well.

最後，它為 PBM 創造了透明度的道路，使其藥品定價也具有透明度。

And in our conversations with payers, I'm excited to say that we got this across the finish line, 100% of our commercial market.

在與付款人的對話中，我很高興地說，我們已經跨越了終點線，涵蓋了 100％ 的商業市場。

Your question as it relates to Medicare and Medicaid, we're actively working for 1126 to move the rest of our book into a CostVantage-like model.

您的問題與醫療保險和醫療補助有關，我們正在積極努力使 1126 書的其餘部分轉向類似 CostVantage 的模型。

Our initial results is -- from CostVantage and the industry-leading cost of goods that we have, PBMs and payers will benefit from this.

我們的初步結果是 - 從 CostVantage 和我們擁有的行業領先的商品成本來看，PBM 和付款人將從中受益。

And we're trending toward delivering more than $100 million of annualized purchasing improvement across all of our generics to the PBM and payer customers under CVS CostVantage contracts.

我們計劃根據 CVS CostVantage 合同，為 PBM 和付款人客戶提供所有仿製藥超過 1 億美元的年度採購改進。

And as we continue to improve cost of goods, we pass that through CostVantage to our customers.

隨著我們不斷改善商品成本，我們透過 CostVantage 將其轉嫁給我們的客戶。

And as we continue to move forward, we're excited about building this with our payers to create more calls and clinical solutions at the counter, where we can leverage the 30,000-plus pharmacists we have services day in and day out.

隨著我們不斷前進，我們很高興與我們的付款人一起建立這個體系，在櫃檯創造更多的呼叫和臨床解決方案，我們可以利用每天為我們服務的 30,000 多名藥劑師。

Thank you.

謝謝。

Elizabeth Anderson, Evercore.

伊麗莎白·安德森，Evercore。

Hi guys, good morning.

大家好，早安。

Thanks so much for the question.

非常感謝您提問。

Based on the color on the 2025 outlook in particular, I know you said you were looking at 4 points of Medicaid improvement year-over-year in terms of the pricing.

特別是根據 2025 年展望的顏色，我知道您說您正在考慮醫療補助在定價方面比去年同期提高 4 個百分點。

Can you -- and you said that you had 40% of it was sort of caught up.

你能嗎 — — 你說你已經追上了 40％ 。

Can you talk about how that catches up over the course of 2025?

您能談談到 2025 年將如何迎頭趕上嗎？

Should we think of that as like broadly ratable or are there any other kind of considerations to think about for that?

我們是否應該將其視為廣泛可評估的，或者是否還有其他需要考慮的因素？

Yeah, go ahead, Steve.

是的，繼續吧，史蒂夫。

Sure.

當然。

I'll start and then, Tom, I'm sure you'll have some thoughts to it.

我先開始了，然後，湯姆，我相信你會對此有一些想法。

Yes, so the team has worked really hard, the local Medicaid teams, all the different states, worked hard through the redeterminations and worked closely with state partners in combination with our great government affairs team.

是的，所以團隊確實非常努力，所有不同州的當地醫療補助團隊都透過重新確定而努力工作，並與我們優秀的政府事務團隊一起與州合作夥伴密切合作。

And yes, we are anticipating about a 4.5% year-over-year increase as we start 2025.

是的，我們預計到 2025 年，這一數字將年增約 4.5%。

But we have more work to do as we go through the course of the year.

但在這一年我們還有更多的工作要做。

And I think it's just going to play out as we continue to work on actuarial soundness with our state partners to make sure the program is adequately funded.

我認為，只要我們繼續與國家合作夥伴一起努力確保精算穩健，以確保該計劃獲得足夠的資金，這一切就會順利進行。

But really like the beginning position and the work that's been done.

但真的很喜歡開始的立場和已經完成的工作。

So work to do.

所以要做工作。

But Tom, any other comments?

但是湯姆，還有其他評論嗎？

No.

不。

Elizabeth, I'd say, the 4.5% on the first 40% of renewals in January is a great start.

伊莉莎白，我想說，一月份前 40% 的續約可享 4.5% 的折扣，這是一個很好的開始。

We're cautiously optimistic that there might be opportunity there on the backside.

我們謹慎樂觀地認為背後可能存在機會。

But our current outlook doesn't assume that get that same level of rate increase when we see the next bolus.

但我們目前的預測並不認為，在下一次升息時，利率會以同樣的幅度上漲。

I think we've got about another 40% that were renews around the third quarter.

我認為我們在第三季左右還有大約 40% 的訂單得到續約。

And so our presumption and our forward outlook is that the rate increases there will not be as robust.

因此，我們的推測和前瞻性展望是，那裡的利率成長不會那麼強勁。

But we are working, as Steve said, on the advocacy with all of our states, they understand the problem.

但正如史蒂夫所說，我們正在與所有州進行宣傳，他們了解這個問題。

But the rate timing of when they recognize actuarially sound rates is not always at the pace that we would like them to.

但他們確認精算合理利率的時間並不總是按照我們所希望的速度。

All right.

好的。

Thank you, Tom, and thank you, Elizabeth.

謝謝你，湯姆，謝謝你，伊莉莎白。

So this wraps up the call today.

今天的通話到此結束。

And before I close, I just want to especially thank our over 300,000 dedicated colleagues.

最後，我還要特別感謝我們30多萬位敬業的同事。

I'm grateful for you, for your commitment to the communities we serve and for your tireless dedication to improving health in America person by person.

我感謝你們，感謝你們對我們服務的社區的承諾，感謝你們為改善美國每個人的健康狀況所做的不懈奉獻。

So thank you for joining our call today and we look forward to providing updates on our progress throughout the year.

感謝您今天參加我們的電話會議，我們期待著提供全年進展的最新情況。

Thank you all for joining today's call with CVS Health.

感謝大家參加今天的 CVS Health 電話會議。

I can confirm today's call has now concluded.

我可以確認今天的電話會議已經結束。

Please enjoy the rest of your day, and you may now disconnect from the call.

請享受您剩餘的一天，現在您可以掛斷電話了。