Elevance Health Inc (ELV) 2022 Q1 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to Anthem's First Quarter Earnings Conference Call. (Operator Instructions) As a reminder, today's conference is being recorded.

女士們，先生們，感謝您的支持，歡迎參加 Anthem 的第一季度收益電話會議。 （操作員說明）提醒一下，今天的會議正在錄製中。

I would now like to turn the conference over to the company's management. Please go ahead.

我現在想把會議交給公司管理層。請繼續。

Good morning, and welcome to Anthem's First Quarter 2022 Earnings Call. This is Steve Tanal, Vice President of Investor Relations.

早上好，歡迎參加 Anthem 2022 年第一季度財報電話會議。我是投資者關係副總裁史蒂夫·塔納爾。

And with us this morning on the earnings call are Gail Boudreaux, our President and CEO; John Gallina, our CFO; Peter Haytaian, President of our Diversified Business Group and IngenioRx; Morgan Kendrick, President of our Commercial and Specialty Business Division; and Felicia Norwood, President of our Government Business Division.

今天早上與我們一起參加財報電話會議的還有我們的總裁兼首席執行官 Gail Boudreaux；我們的首席財務官約翰·加利納； Peter Haytaian，我們多元化業務集團和 IngenioRx 的總裁；我們的商業和專業業務部總裁 Morgan Kendrick；和我們政府業務部總裁 Felicia Norwood。

Gail will begin the call with a brief discussion of the quarter, recent progress against our strategic initiatives and close on Anthem's proposal to change our holding company name to Elevance Health. John will then discuss our financial results and outlook in greater detail. After our prepared remarks, the team will be available for Q&A.

Gail 將在電話會議開始時簡要討論本季度、我們戰略舉措的最新進展，並結束 Anthem 將我們的控股公司名稱更改為 Elevance Health 的提議。約翰隨後將更詳細地討論我們的財務業績和前景。在我們準備好發言後，該團隊將進行問答。

During the call, we will reference certain non-GAAP measures. Reconciliations of these non-GAAP measures to the most directly comparable GAAP measures are available on our website, antheminc.com.

在電話會議期間，我們將參考某些非公認會計原則措施。這些非公認會計原則措施與最直接可比的公認會計原則措施的對賬可在我們的網站 antheminc.com 上找到。

We will also be making some forward-looking statements on this call. Listeners are cautioned that these statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond the control of Anthem. These risks and uncertainties can cause actual results to differ materially from our current expectations. We advise listeners to carefully review the risk factors discussed in today's press release and in our quarterly filings with the SEC.

我們還將就此次電話會議發表一些前瞻性陳述。聽眾請注意，這些陳述存在一定的風險和不確定性，其中許多難以預測並且通常超出 Anthem 的控制範圍。這些風險和不確定性可能導致實際結果與我們目前的預期大相徑庭。我們建議聽眾仔細審查今天的新聞稿和我們向美國證券交易委員會提交的季度文件中討論的風險因素。

I will now turn the call over to Gail.

我現在將把電話轉給蓋爾。

Thanks, Steve, and good morning, everyone. Today, we're pleased to share that Anthem is off to a strong start in 2022. In the first quarter, we delivered GAAP earnings per share of $7.39 and grew adjusted earnings per share by 18% to $8.25, exceeding our expectations.

謝謝，史蒂夫，大家早上好。今天，我們很高興地分享 Anthem 在 2022 年的強勁開局。第一季度，我們實現了 7.39 美元的 GAAP 每股收益，調整後的每股收益增長了 18% 至 8.25 美元，超出了我們的預期。

Based on the strong start to the year and the momentum in our business, we have increased confidence in our ability to deliver another year of growth in line with our long-term 12% to 15% annual adjusted earnings per share growth target.

基於今年的強勁開局和我們業務的發展勢頭，我們對實現又一年增長的能力增強了信心，這符合我們 12% 至 15% 的年度調整後每股收益增長目標。

As a result, we've increased our full year outlook to greater than $28.40 per share, representing growth of at least 12.7% off the adjusted baseline we provided last quarter. It's the ongoing momentum in every one of our businesses, driven by the disciplined execution of the strategy we shared with you at last year's investor conference, coupled with the balance and resilience of our core benefits business, that is allowing us to produce this level of growth.

因此，我們將全年展望上調至每股 28.40 美元以上，比我們上季度提供的調整後基線增長至少 12.7%。在去年投資者大會上與您分享的戰略的嚴格執行以及我們核心福利業務的平衡和彈性的推動下，我們每一項業務都保持著持續的勢頭，這使我們能夠生產出這種水平的生長。

We ended the first quarter with medical membership of 7.5% year-over-year to 46.8 million members, widening Anthem's lead as the largest insurer by U.S. medical membership.

我們在第一季度結束時，醫療會員人數同比增長 7.5%，達到 4680 萬，擴大了 Anthem 作為美國醫療會員最大保險公司的領先地位。

In recent years, Anthem has been on a journey to transform from a traditional health insurance company to a lifetime trusted health partner, by focusing on whole health, addressing the physical, behavioral and social drivers that we know are critical to achieving optimal health.

近年來，Anthem 一直在從傳統的健康保險公司轉變為終生值得信賴的健康合作夥伴，專注於整體健康，解決我們所知道的對實現最佳健康至關重要的身體、行為和社會驅動因素。

Our results demonstrate that our employer, consumer and state partners are universally looking for solutions that address underlying drivers of cost, while enhancing and simplifying the consumer experience. We are delivering in these areas and it's propelling strong organic membership growth in each of our benefits businesses, in addition to creating opportunities to scale our service divisions.

我們的結果表明，我們的雇主、消費者和州合作夥伴普遍在尋找解決潛在成本驅動因素的解決方案，同時增強和簡化消費者體驗。我們正在這些領域提供服務，除了創造擴大我們服務部門的機會外，它還推動了我們每個福利業務的強大的有機會員增長。

Last quarter, we shared that Anthem produced its strongest national account selling season in the history of the company. Today, you can see in our results that Commercial group fee-based enrollment grew by over 750,000 members in the first quarter alone, with a meaningful proportion of that growth driven by existing large employer clients consolidating their business with Anthem after working with us on a piece of their business in the past.

上個季度，我們分享了 Anthem 創造了公司歷史上最強勁的全國客戶銷售旺季。今天，您可以在我們的結果中看到，僅在第一季度，商業團體的收費註冊會員就增加了超過 750,000 名，其中很大一部分是由現有的大型雇主客戶在與 Anthem 合作後與 Anthem 進行業務整合所推動的。他們過去的業務。

Cost of care is paramount for self-funded groups, and the success we're seeing underscores our confidence in our leading cost-of-care position. Employers have come to expect more, notably in the way of enhanced experiences, and we continue to innovate to meet their needs.

對於自籌資金的團體來說，護理成本至關重要，我們所看到的成功突顯了我們對我們領先的護理成本地位的信心。雇主已經開始期待更多，特別是在增強體驗方面，我們繼續創新以滿足他們的需求。

In the first quarter, we expanded virtual primary care capabilities to reach 5 million Commercial members and expect to reach 10 million members by year-end. We're excited about the potential to expand access to care, especially in underserved and rural areas, while offering convenient, personalized solutions.

在第一季度，我們將虛擬初級保健功能擴展到 500 萬商業會員，預計到年底將達到 1000 萬會員。我們對擴大獲得護理的潛力感到興奮，特別是在服務不足和農村地區，同時提供方便、個性化的解決方案。

We also continue to advance client advocacy solutions and elevate our consumer engagement platform, Sydney Health, which has been core to our success in the employer market. Last year, we launched Sydney Preferred, a version of our Sydney Health app that allows employers to customize our engagement platform for their unique benefits and needs.

我們還繼續推進客戶宣傳解決方案並提升我們的消費者參與平台 Sydney Health，這是我們在雇主市場取得成功的核心。去年，我們推出了 Sydney Preferred，這是我們的 Sydney Health 應用程序的一個版本，允許雇主根據他們的獨特福利和需求定制我們的參與平台。

Today, nearly 1.2 million members are on Sydney Preferred, and we closed the first quarter with more than 12 million registered users on Sydney, up approximately 40% year-over-year.

如今，Sydney Preferred 有近 120 萬會員，我們在第一季度結束時在悉尼擁有超過 1200 萬註冊用戶，同比增長約 40%。

Our commitment to whole health is also driving growth in our Government Business, where we are focused on health equity and meeting the needs of vulnerable members. Last quarter, we shared how our whole health index helps us better understand and address local, social and physical drivers of health. We're leveraging the tool to identify members with diabetes who may benefit from one-on-one virtual coaching, supplies and preemptive notifications to help better manage their health.

我們對整體健康的承諾也推動了我們政府業務的增長，我們專注於健康公平和滿足弱勢成員的需求。上個季度，我們分享了我們的整個健康指數如何幫助我們更好地理解和解決當地、社會和身體健康的驅動因素。我們正在利用該工具來識別可能受益於一對一虛擬指導、用品和先發製人通知的糖尿病患者，以幫助更好地管理他們的健康。

In our Diversified Business Group, new behavioral health programs, launched by Beacon, address family therapy, suicide prevention and offer a concierge model for members with comorbid conditions. All of these efforts support our focus on community health.

在我們的多元化業務集團中，Beacon 推出了新的行為健康計劃，旨在解決家庭治療、自殺預防，並為患有合併症的會員提供禮賓服務模式。所有這些努力都支持我們對社區健康的關注。

Through our whole health index, we've been measuring Anthem's impact on health outcomes and are seeing encouraging, albeit early trends. Our health equity and community health initiatives that targeted vaccine outreach, community health worker readiness, housing stability and diabetes management during COVID-19, programs made possible by our deep roots in our communities were recognized recently by the Institute of Medicaid Innovation. All of this work keeps Anthem uniquely well-positioned to serve the needs of our state partners and directly ties to our 100% Medicaid RFP win rate that we extended into 2022 with renewal awards in Indiana and Louisiana.

通過我們的整個健康指數，我們一直在衡量 Anthem 對健康結果的影響，並且看到了令人鼓舞的趨勢，儘管是早期趨勢。我們在 COVID-19 期間針對疫苗推廣、社區衛生工作者準備、住房穩定性和糖尿病管理的健康公平和社區衛生倡議，由於我們在社區中的深厚根基而成為可能，最近得到了醫療補助創新研究所的認可。所有這些工作使 Anthem 處於獨特的有利位置，可以滿足我們州合作夥伴的需求，並與我們的 100% 醫療補助 RFP 贏率直接相關，我們在印第安納州和路易斯安那州通過續約獎延長到 2022 年。

Personalized whole health solutions are also resonating with seniors, notably dual eligible members with complex and chronic needs, and driving strong growth for Anthem and Medicare Advantage. For example, supplemental health plan benefits, like those offered by Simply Healthcare, address food insecurity issues by delivering food shipments directly to our most vulnerable members. Benefit packages like our Everyday Extras, provides members the flexibility to choose which supplemental benefits matter most to them from menu of options.

個性化的整體健康解決方案也引起了老年人的共鳴，尤其是具有復雜和長期需求的雙重合格會員，並推動了 Anthem 和 Medicare Advantage 的強勁增長。例如，Simply Healthcare 提供的補充健康計劃福利通過直接向我們最脆弱的成員運送食品來解決食品不安全問題。福利套餐，如我們的 Everyday Extras，讓會員可以靈活地從選項菜單中選擇對他們最重要的補充福利。

We remain on track to produce double-digit organic growth in our individual MA business, led by growth in duals. We also remain opportunistic in terms of driving inorganic growth through acquisitions. MMM has performed well since we acquired them last year, and we look forward to adding Integra, a high-performing plan serving high-needs Medicaid members in New York, to our portfolio when we close our purchase later this year.

在對偶業務增長的帶動下，我們的個人 MA 業務仍有望實現兩位數的有機增長。我們還在通過收購推動無機增長方面保持機會主義。 MMM 自去年收購以來表現良好，我們期待在今年晚些時候完成購買時將 Integra（為紐約高需求醫療補助成員提供服務的高性能計劃）添加到我們的投資組合中。

Across our organization, we're committed to accelerating value-based care, both in context of benefit expense for our health plans and growth of our diversified services businesses. We know that value-based care leads to higher quality outcomes, better patient and provider satisfaction, more predictable costs for our health plans and by extension, more stability in our benefit packages. All of these factors can lead to higher star ratings in Medicare Advantage, which is a key strategic priority for Anthem.

在我們的整個組織中，我們致力於加速基於價值的護理，無論是在我們的健康計劃的福利費用方面，還是在我們多元化服務業務的增長方面。我們知道，基於價值的護理可以帶來更高質量的結果、更好的患者和提供者滿意度、更可預測的健康計劃成本，進而使我們的福利方案更加穩定。所有這些因素都可以提高 Medicare Advantage 的星級評分，這是 Anthem 的關鍵戰略重點。

Over the last year, we significantly advanced our care provider strategy with investments and risk-bearing primary care providers and aggregators. This drive toward value-based care is one of the most important strategic imperatives inside of our organization.

在過去的一年裡，我們通過投資和承擔風險的初級保健提供者和聚合器顯著推進了我們的保健提供者戰略。這種對基於價值的護理的推動是我們組織內部最重要的戰略要務之一。

In 2021, more than 60% of our consolidated medical expenses were paid under value-based care arrangements, with roughly 1/5 of that or a low double-digit percentage of total spend in arrangements with downside risk. In the coming years, our primary focus will be to increase the penetration of downside risk sharing, including via global capitation. We expect to make significant strides in the coming years, targeting more than 1/3 of overall spend arrangements with downside risk in 2025, with significant increases in penetration in Medicaid, Commercial and Medicare.

2021 年，我們 60% 以上的綜合醫療費用是在基於價值的護理安排下支付的，其中大約 1/5 或占總支出的低兩位數百分比是在有下行風險的安排下支付的。未來幾年，我們的主要重點將是提高下行風險分擔的滲透率，包括通過全球人頭法。我們預計未來幾年將取得重大進展，目標是到 2025 年將超過 1/3 的總體支出安排具有下行風險，醫療補助、商業和醫療保險的滲透率將顯著提高。

In addition to the benefits our health plans derive from value-based care, we see significant pull-through opportunities for our Diversified Business Group in the areas of provider enablement and carve-outs of specialized care management, including behavioral and home health. Beacon and MyNEXUS are leaders in these areas, with the proven ability to generate high-quality outcomes and solid profitability in risk-based arrangements.

除了我們的健康計劃從基於價值的護理中獲得的好處外，我們還看到我們的多元化業務集團在提供者支持和專業護理管理（包括行為和家庭健康）的分拆領域有重大的推動機會。 Beacon 和 MyNEXUS 是這些領域的領導者，已證明有能力在基於風險的安排中產生高質量的結果和穩固的盈利能力。

Notably, 100% of myNEXUS' affiliated revenue earned from Anthem's health plans and 99% of Beacons will flow through risk-based contracts in 2022. Guided by our enterprise strategy, we are making significant investments in our digital capabilities and platforms. We see 3 distinct benefits: elevating consumer and provider experiences; improving the cost and quality of care; and improving administrative efficiency by automating manual processes.

值得注意的是，到 2022 年，myNEXUS 的 100% 的關聯收入來自 Anthem 的健康計劃，99% 的 Beacons 將通過基於風險的合同流轉。在我們的企業戰略的指導下，我們正在對我們的數字能力和平台進行重大投資。我們看到了 3 個明顯的好處：提升消費者和供應商的體驗；提高護理成本和質量；通過自動化手動流程來提高管理效率。

Adoption of our digital tools, combined with strong and rising customer satisfaction surveys, suggests that our consumers and care providers are finding value in our digital channels. Less than 2 years ago, we implemented live chat and AI messaging capabilities for our consumers and care providers to provide more choice and convenience.

採用我們的數字工具，結合強大且不斷上升的客戶滿意度調查，表明我們的消費者和護理提供者正在我們的數字渠道中發現價值。不到 2 年前，我們為消費者和護理提供者實施了實時聊天和 AI 消息傳遞功能，以提供更多選擇和便利。

Today, chat is our best-performing channel for issue resolution and consumer experience metrics. Consumer chat usage grew by nearly 40% year-over-year in the first quarter, and now represents 24% of the contact mix. For care provider chat, usage grew by nearly 50% year-over-year and now represents 20% of our provider contacts.

今天，聊天是我們在問題解決和消費者體驗指標方面表現最好的渠道。第一季度，消費者聊天使用量同比增長近 40%，現在佔聯繫人組合的 24%。對於護理提供者聊天，使用量同比增長近 50%，現在占我們提供者聯繫人的 20%。

Meanwhile, Anthem is benefiting from improved efficiency, having reduced an estimated 1.2 million calls from members and another 1 million from care providers in the first quarter alone. Year-to-date, we've also made significant progress advancing our Health OS digital platform, which is now utilizing clinical data from providers and health systems for more than 20 million members.

與此同時，Anthem 受益於效率的提高，僅在第一季度就減少了來自會員的 120 萬個電話和另外 100 萬個來自護理提供者的電話。年初至今，我們還在推進我們的 Health OS 數字平台方面取得了重大進展，該平台現在正在為超過 2000 萬會員利用來自供應商和衛生系統的臨床數據。

We use this data to advance clinical quality and elevate experiences by sharing more comprehensive data and insights with care providers and value-based care arrangements in order to facilitate better care management and personalize member interventions. We're also leveraging the platform to advance our cost-of-care analytics and streamline data collection for risk adjustment, all while automating processes that reduce administrative burden for our associates and providers. We're rolling this tool out rapidly with a goal of covering another 4.5 million members by the end of this year.

我們使用這些數據通過與護理提供者和基於價值的護理安排分享更全面的數據和見解來提高臨床質量和提升體驗，以促進更好的護理管理和個性化的會員干預。我們還利用該平台推進我們的護理成本分析並簡化數據收集以進行風險調整，同時自動化流程以減輕我們的員工和供應商的管理負擔。我們正在迅速推出此工具，目標是到今年年底再覆蓋 450 萬會員。

In conclusion, we're continuing on our journey to transform from a traditional health benefits organization to become a lifetime trusted health partner and our proposed name change to Elevance Health marks an important milestone.

總之，我們正在繼續從傳統的健康福利組織轉變為終生值得信賴的健康合作夥伴的旅程，我們提議的更名為 Elevance Health 標誌著一個重要的里程碑。

Bringing together the ideas of elevate and advance, Elevance Health will reflect our position as a health leader, committed to elevating the importance of whole health and advancing health beyond health care for our consumers, their families and communities.

Elevance Health 將提升和進步的理念結合在一起，將體現我們作為健康領導者的地位，致力於提升整體健康的重要性，並為我們的消費者、他們的家人和社區推進健康以外的健康。

Grounded in our mission and fueled by our bold and ambitious purpose to improve the health of humanity, Elevance Health represents the company that we are today and will continue to be in the future.

Elevance Health 以我們的使命為基礎，並以我們改善人類健康的大膽而雄心勃勃的目標為動力，代表了我們今天和未來將繼續存在的公司。

I would like to thank our nearly 100,000 associates for the important work they do every day on behalf of the members who we are privileged to serve. Our passion to improve lives and communities is inspiring, and it extends to our own associates.

我要感謝我們近 100,000 名員工每天代表我們有幸服務的成員所做的重要工作。我們對改善生活和社區的熱情鼓舞人心，並延伸到我們自己的員工身上。

We were pleased to once again be recognized as 1 of Fortune's 100 Best Companies to Work For, with a ranking of 57, up from 71 last year, on this year's list of America's leading employers and workplaces.

我們很高興再次被評為財富 100 家最適合工作的公司之一，在今年的美國領先雇主和工作場所名單中，排名從去年的 71 位上升到 57 位。

Now I'd like to turn the call over to John for more on our operating results. John?

現在我想把電話轉給約翰，以了解更多關於我們的經營業績的信息。約翰？

Thank you, Gail, and good morning to everyone on the line. As Gail mentioned, we delivered strong first quarter results, including GAAP earnings per share of $7.39 and adjusted earnings per share of $8.25, reflecting growth of approximately 18% year-over-year. Our first quarter results demonstrate continued momentum across all of our businesses, driven by the execution of our enterprise strategy, the benefits of investments in key capabilities and the balance and resilience of our core benefits business.

謝謝你，蓋爾，大家早上好。正如蓋爾所說，我們實現了強勁的第一季度業績，包括 GAAP 每股收益 7.39 美元和調整後每股收益 8.25 美元，同比增長約 18%。我們的第一季度業績表明，在我們企業戰略的執行、關鍵能力投資的好處以及我們核心利益業務的平衡和彈性的推動下，我們所有業務的持續發展勢頭。

We ended the first quarter with 46.8 million members, up 3.3 million or 7.5% year-over-year, with nearly 3/4 of the growth being organic. In fact, we generated organic growth in each of our Medicaid, Medicare, Commercial risk and Commercial fee-based businesses. Membership grew by 1.4 million lives in the quarter alone, driven by the strongest national account selling season in Anthem's history and aided by the acquisition of Ohio Medicaid members from Paramount Advantage.

我們在第一季度結束時擁有 4680 萬會員，同比增長 330 萬或 7.5%，其中近 3/4 的增長是有機的。事實上，我們的醫療補助、醫療保險、商業風險和商業收費業務均實現了有機增長。在 Anthem 歷史上最強勁的國民賬戶銷售旺季的推動下，以及從 Paramount Advantage 收購俄亥俄州醫療補助計劃成員的幫助下，僅本季度的會員人數就增加了 140 萬。

Commercial membership is off to an especially strong start this year as Anthem's integrated solutions, which focus on whole health, the customer experience and total cost of care, continue to resonate in the employer market. Our brand value and unique product offering, leveraging our deep local roots and value-based provider partnerships, also continued to gain traction with consumers.

隨著 Anthem 專注於整體健康、客戶體驗和總護理成本的綜合解決方案在雇主市場上繼續引起共鳴，商業會員今年的開局特別強勁。我們的品牌價值和獨特的產品，利用我們深厚的本地根基和基於價值的供應商合作夥伴關係，也繼續受到消費者的青睞。

For example, in the ACA exchange market, we delivered individual membership growth of 8% in the quarter or 12% year-over-year. The Medicare open enrollment period was also consistent with our expectations as we remain on track to produce double-digit organic enrollment growth in our individual Medicare Advantage business. This includes strong growth in our dual special needs plans, where our strategic investments targeting specific benefit categories continue to attract consumers with complex and chronic health needs.

例如，在 ACA 交易所市場，我們實現了本季度個人會員增長 8% 或同比增長 12%。 Medicare 開放註冊期也符合我們的預期，因為我們仍有望在我們的個人 Medicare Advantage 業務中實現兩位數的有機註冊增長。這包括我們雙重特殊需求計劃的強勁增長，我們針對特定福利類別的戰略投資繼續吸引具有復雜和慢性健康需求的消費者。

In Medicaid, we overcame a significant membership headwind to start the year as additional carriers entered 2 of our existing markets and we still ended the quarter up 319,000 net new members.

在醫療補助計劃中，隨著更多運營商進入我們現有的兩個市場，我們在年初克服了重大的會員阻力，並且在本季度末我們仍然增加了 319,000 名淨新會員。

In addition to continued organic membership growth, the acquisition of Paramount Advantage’s Ohio Medicaid members in February added 256,000 members in the quarter. We are very excited about this strategic acquisition, which provides Anthem scale in Ohio's Medicaid program ahead of the future launch of the new contract we were awarded last year.

除了持續的有機會員增長外，2 月份收購 Paramount Advantage 的俄亥俄州醫療補助會員在本季度增加了 256,000 名會員。我們對這次戰略收購感到非常興奮，它在我們去年獲得的新合同的未來推出之前為俄亥俄州的醫療補助計劃提供了 Anthem 規模。

First quarter operating revenue of $37.9 billion increased $5.8 billion or 18% over the prior year quarter, with strong growth in each and every one of our businesses. We earned higher premium revenue due to the growth in Medicaid membership, the acquisition of MMM and Paramount, and the individual Medicare Advantage and Commercial risk-based enrollment growth, in addition to premium rate increases to cover overall cost trends.

第一季度營業收入為 379 億美元，比去年同期增加 58 億美元或 18%，我們的每一項業務都實現了強勁增長。由於 Medicaid 會員的增長、對 MMM 和 Paramount 的收購，以及基於個人 Medicare Advantage 和商業風險的註冊人數增長，以及保費率增加以覆蓋整體成本趨勢，我們獲得了更高的保費收入。

We also produced strong double-digit organic growth in our IngenioRx and Diversified Business Group businesses. Our services businesses are off to a strong start this year as IngenioRx's value proposition is gaining traction in the market. The Diversified Business Group continues to execute on the strategy we articulated at our Investor Day in March of 2021, growing both affiliated and unaffiliated operating earnings across its portfolio of best-in-class assets.

我們還在 IngenioRx 和多元化業務集團業務中實現了強勁的兩位數有機增長。隨著 IngenioRx 的價值主張在市場上獲得牽引力，我們的服務業務今年開局強勁。多元化業務集團繼續執行我們在 2021 年 3 月投資者日闡明的戰略，在其一流資產組合中增加附屬和非附屬營業收入。

In the first quarter, DBG continued to grow its risk-based arrangements with our commercial health plans, consistent with our strategy. With the risk transfer between businesses, we expect more seasonality in DBG's earnings, with a larger proportion of full year earnings in the first quarter relative to prior years and a decrease in the seasonality inherent in the Commercial business. It is important to note that this affects seasonality only. Our annual segment target margins for the Commercial and Specialty business division are unchanged.

在第一季度，DBG 繼續通過我們的商業健康計劃增加其基於風險的安排，這與我們的戰略一致。隨著業務之間的風險轉移，我們預計 DBG 收益的季節性更強，第一季度全年收益的比例相對於往年而言更大，商業業務固有的季節性會下降。需要注意的是，這僅影響季節性。我們商業和專業業務部門的年度分部目標利潤率保持不變。

Revenue eliminated in consolidation, representing intersegment business, grew 23% year-over-year and represented 21.4% of benefit expense in the first quarter, up from 20.7% in the same period a year ago.

合併中扣除的收入（代表跨部門業務）同比增長 23%，佔第一季度福利支出的 21.4%，高於去年同期的 20.7%。

Anthem's consolidated benefit expense ratio for the first quarter was 86.1%, an increase of 50 basis points over the first quarter of 2021, primarily driven by the continued shift in mix of business towards government, which has a higher medical loss ratio.

Anthem 第一季度的綜合福利費用率為 86.1%，比 2021 年第一季度增加了 50 個基點，主要是由於業務組合持續向醫療損失率較高的政府轉移。

Relative to our expectations as of mid-January, when the Omicron surge was still peaking and the terms of the at-home COVID testing coverage rule had just been released, our medical cost structure developed meaningfully better than our original guidance ranges, driven by a lower net impact from COVID.

相對於我們截至 1 月中旬的預期，當 Omicron 的激增仍在達到頂峰並且家庭 COVID 測試覆蓋規則的條款剛剛發佈時，我們的醫療成本結構的發展明顯好於我們最初的指導範圍，這是由降低 COVID 的淨影響。

Specifically, the Omicron surge dissipated faster than we had expected in February, while producing lower acuity COVID cases relative to prior surges. This, combined with the absence of any material stockpiling or abuse of free at-home COVID test, helped drive favorability in the first quarter benefit expense ratio relative to our initial guidance.

具體來說，Omicron 激增的消散速度比我們在 2 月份的預期要快，同時相對於之前的激增產生了較低敏銳度的 COVID 病例。再加上沒有任何材料儲存或濫用免費的家庭 COVID 測試，有助於推動第一季度福利費用比率相對於我們最初的指導。

Even with these positives, the overall cost of care in the quarter was still above what we would consider to be a normalized level. Anthem's SG&A expense ratio in the first quarter was 11.5% on a GAAP basis, a decrease of 70 basis points over the prior year quarter. The decrease was driven by expense leverage associated with strong growth in operating revenue, partially offset by higher investments to support our growth and digital transformation. First quarter operating cash flow was $2.5 billion or 1.4x net income.

即使有這些積極因素，本季度的總體護理成本仍高於我們認為的正常水平。按公認會計原則計算，Anthem 第一季度的 SG&A 費用率為 11.5%，比去年同期下降 70 個基點。下降的原因是與營業收入強勁增長相關的費用槓桿，部分被支持我們增長和數字化轉型的投資增加所抵消。第一季度經營現金流為 25 億美元或 1.4 倍淨收入。

Please note that we continue to expect to pay our share of the BCBSA litigation settlement of approximately $500 million later in 2022, which was included in the guidance we provided for full year operating cash flow of greater than $6.9 billion as we discussed on our fourth quarter 2021 earnings call.

請注意，我們繼續預計在 2022 年晚些時候支付我們在 BCBSA 訴訟和解中的份額約 5 億美元，正如我們在第四季度討論的那樣，這已包含在我們為全年運營現金流量超過 69 億美元提供的指導中2021 年財報電話會議。

As of the end of the first quarter, Anthem's debt-to-cap ratio was 39.2%, in line with our expectations and well within our targeted range. Consistent with our approach throughout the pandemic, we maintained a prudent posture with respect to reserves. Days and claims payable stood at 46.9 days at the end of the first quarter, an increase of 1.7 days from year-end and in line with the first quarter of 2021. Medical claims payable once again grew faster than premium revenue in the first quarter relative to the prior year.

截至一季度末，Anthem 的債務資本比率為 39.2%，符合我們的預期，並在我們的目標範圍內。與我們在整個大流行期間的做法一致，我們在儲備方面保持了審慎的姿態。一季度末應付天數和理賠天數為46.9天，比年底增加1.7天，與2021年一季度持平。一季度醫療賠付增速再次快於保費收入到上一年。

With respect to our outlook, we are pleased to have delivered a stronger-than-anticipated start to the year. Outperformance in the first quarter has increased our confidence in our ability to grow adjusted earnings per share 12% to 15% in 2022 off the adjusted baseline of $25.20, in line with our long-term target.

關於我們的前景，我們很高興今年的開局好於預期。第一季度的出色表現增強了我們對 2022 年調整後每股收益從 25.20 美元的調整後基線增長 12% 至 15% 的能力的信心，這符合我們的長期目標。

We now expect benefit expense ratio for the full year to be at the midpoint or in the lower half of our initial full year guidance range for this metric. Given the strong start to the year, we now expect to produce adjusted net income per share greater than $28.40, representing growth of at least 12.7% from our adjusted baseline.

我們現在預計全年的福利費用比率將處於該指標初始全年指導範圍的中點或下半部分。鑑於今年開局強勁，我們現在預計調整後的每股淨收益將超過 28.40 美元，比我們調整後的基線增長至少 12.7%。

With the recent extension of the federal public health emergency, we also now expect Medicaid redeterminations will begin later than we had previously assumed. While the extension will enable us to maintain our Medicaid membership longer, please note that we will also incur increased cost associated with the PHE and our Medicare and Commercial risk-based businesses for an additional 3 months.

隨著最近聯邦公共衛生緊急事件的延長，我們現在還預計 Medicaid 重新確定將比我們之前假設的更晚開始。雖然延期將使我們能夠更長時間地維持我們的 Medicaid 會員資格，但請注意，我們還將在額外 3 個月內增加與 PHE 以及我們的醫療保險和商業風險業務相關的成本。

Importantly, Anthem is uniquely well-positioned to navigate the end of the public health emergency and to support continuity of care for Medicaid members who lose access to Medicaid by providing a robust set of commercial offerings. The momentum we have in each of our businesses, coupled with the balance and resilience of our core benefits business, should allow us to maintain healthy levels of membership, while continuing to scale our diversified services operations.

重要的是，Anthem 具有獨特的優勢，可以通過提供一套強大的商業產品來應對公共衛生緊急情況的結束，並支持為失去 Medicaid 服務的 Medicaid 成員提供連續性護理。我們每項業務的發展勢頭，加上我們核心福利業務的平衡性和彈性，應該使我們能夠保持健康的會員水平，同時繼續擴大我們的多元化服務業務。

Consistent with this strategy, we are well-positioned to continue delivering against the financial targets we shared at our March 2021 investor conference.

根據這一戰略，我們有能力繼續實現我們在 2021 年 3 月投資者會議上分享的財務目標。

In that context, I want to point out that while we are excited by strong growth in our Commercial business, and the expansion of our risk-based arrangements with our Diversified Business Group, the operating margin of the Commercial & Specialty division remains challenged by the net impacts of COVID. However, while the year-over-year margin performance in our reportable segments table includes the impact of the seasonality shift I mentioned earlier, the underlying performance of the business is better than the optics.

在這種情況下，我想指出，雖然我們對商業業務的強勁增長以及我們與多元化業務集團基於風險的安排的擴展感到興奮，但商業和專業部門的營業利潤率仍然受到挑戰COVID的淨影響。然而，雖然我們的可報告分部表中的同比利潤率表現包括我之前提到的季節性變化的影響，但該業務的基本表現優於光學。

Relatedly, we would caution against annualizing first quarter operating profit of the Other segment, which includes the Diversified Business Group, and the impact of the seasonality shift in that business. Importantly, the expanded risk-sharing arrangements with DBG have no impact on our full year margin expectations for the Commercial & Specialty business. We expect Commercial margins to recover as the effects of the pandemic subside. We also anticipate strong earnings growth in our Medicare business.

相關地，我們會警告不要將包括多元化業務集團在內的其他部門的第一季度營業利潤年化，以及該業務的季節性變化的影響。重要的是，與 DBG 擴大風險分擔安排不會影響我們對商業和特種業務的全年利潤率預期。隨著大流行的影響消退，我們預計商業利潤率將恢復。我們還預計我們的醫療保險業務將實現強勁的盈利增長。

These opportunities, coupled with the expectation of continued strong double-digit growth in our services businesses, Anthem's programmatic approach to M&A and our opportunistic focus on share repurchases, leave Anthem uniquely well-positioned for growth in the coming years.

這些機會，再加上我們的服務業務持續強勁兩位數增長的預期、Anthem 的併購程序化方法以及我們對股票回購的機會主義關注，使 Anthem 在未來幾年的增長中處於獨特的有利位置。

With that, operator, we will now open up the line for questions.

有了這個，接線員，我們現在將打開問題線。

(Operator Instructions) For our first question, we'll go to the line of Scott Fidel from Stephens.

（操作員說明）對於我們的第一個問題，我們將轉到 Stephens 的 Scott Fidel 線路。

Interested if you could give us your perspective on the final 2023 Medicare Advantage rates. Certainly looked quite solid from my opinion. And just interested in how you're thinking about some of the game theory at this point just around competitive psychology out there, just given what seems to be a pretty strong tailwind that we're seeing around the 2023 MA rates.

如果您能告訴我們您對最終 2023 年醫療保險優惠費率的看法，有興趣。從我看來，當然看起來很可靠。並且只是對你在這一點上如何思考一些博弈論感興趣，只是考慮到我們在 2023 年 MA 利率附近看到的似乎相當強勁的順風。

Thanks, Scott. I'm going to have Felicia Norwood, who leads our Government Business, to address your question.

謝謝，斯科特。我將請領導我們政府業務的 Felicia Norwood 來回答你的問題。

Good morning, Scott, and thank you for the question. With respect to the CMS final notice, the expected rate increase, excluding CMS' estimate of coding trend, was 4.88%, which was certainly better than we expected. We're also very pleased with the progress that we've made in STARs last October, which will have approximately 73% of our members in plans that are 4 stars or higher in the payment year for 2023, which is up from 58% in payment year 2022.

早上好，斯科特，謝謝你的提問。關於 CMS 的最終通知，不包括 CMS 對編碼趨勢的估計，預期增長率為 4.88%，這肯定好於我們的預期。我們也對去年 10 月在 STARs 中取得的進展感到非常滿意，在 2023 年的付款年度，我們將有大約 73% 的會員參加 4 星或更高的計劃，高於 58% 2022 年付款。

So coupled with the positive proposed rate increase from CMS, we think that 2023 is shaping up well. Our plans have stayed competitive as we focus on supplemental benefits to address whole person health and believe we will continue to remain competitive.

因此，再加上 CMS 提議的積極加息，我們認為 2023 年的情況良好。我們的計劃一直保持競爭力，因為我們專注於補充福利以解決整個人的健康問題，並相信我們將繼續保持競爭力。

So all things considered, we would expect our Medicare margins to be inside of our target range. And we would expect another predictably competitive year with respect to Medicare Advantage.

因此，考慮到所有因素，我們希望我們的醫療保險利潤率在我們的目標範圍內。我們預計在 Medicare Advantage 方面又是一個競爭激烈的年份。

Thanks, Felicia, and thanks, Scott. And as you heard, I think we feel really good about our Medicare Advantage, especially the start to this year and going into next.

謝謝，費利西亞，謝謝，斯科特。正如你所聽到的，我認為我們對我們的 Medicare Advantage 感覺非常好，尤其是從今年開始到明年。

Next, we'll go to the line of Justin Lake from Wolfe Research.

接下來，我們將前往 Wolfe Research 的 Justin Lake 線路。

Question on the cost trends and can you give us a little bit of color of where you see COVID versus non-COVID across the 3 businesses in the quarter?

關於成本趨勢的問題，您能否給我們一點顏色，說明您在本季度的 3 家企業中看到的 COVID 與非 COVID 的對比？

And, John, you also talked about Commercial and some investments you're making there running a little bit below. Where do you think Commercial margins could shake out over the next 2 or 3 years once you get passed through the 5:1 to 3:1 and get -- and commercial trend normalizes?

而且，約翰，您還談到了商業和您在下面進行的一些投資。一旦您通過 5:1 到 3:1 並獲得 - 並且商業趨勢正常化，您認為商業利潤率在未來 2 或 3 年內會在哪裡發生變化？

Yes. Thanks, Justin. So in terms of COVID and non-COVID combined, as you know, that there was a significant spike of COVID in January and then it came down even at a faster rate in February and March than we had seen a decline at any point in time during the entire pandemic.

是的。謝謝，賈斯汀。因此，如您所知，就 COVID 和非 COVID 的總和而言，1 月份 COVID 出現了顯著的高峰，然後在 2 月和 3 月以更快的速度下降，甚至比我們在任何時間點看到的下降速度都要快在整個大流行期間。

Having said that, Commercial had the highest COVID cost in the quarter on a comparative basis. So Commercial COVID and non-COVID combined were clearly above baseline for the quarter. Medicare was next. And if you take Medicare COVID and Medicare non-COVID combined, it was still above baseline, but performed actually much better than Commercial.

話雖如此，相比之下，商業在本季度的 COVID 成本最高。因此，商業 COVID 和非 COVID 的總和明顯高於本季度的基線。接下來是醫療保險。如果您將 Medicare COVID 和 Medicare 非 COVID 結合起來，它仍然高於基線，但實際上比 Commercial 表現要好得多。

And then Medicaid continues to actually be the line of business that's performing the absolute best during the entire pandemic from a COVID and non-COVID combined perspective, and the total of those 2 are relatively close to baseline. So all-in, the company was above baseline, even though it was better than our overall expectations.

然後，從 COVID 和非 COVID 的綜合角度來看，醫療補助實際上仍然是在整個大流行期間表現絕對最佳的業務線，並且這兩者的總數相對接近基線。綜上所述，該公司高於基線，儘管它好於我們的整體預期。

Associated with Commercial margins, we do feel good about the targets that we laid out in Investor Day back in 2021. As you know, we talked about getting to a 10.5% to 11.5% range by 2025. We've got a lot of things going on with COVID. It's certainly the single biggest factor that is causing Commercial margins to be a little bit challenged this year versus prior years. And we also have some seasonality issues with our risk deals with our Diversified Business Group. And that's not going to impact the annual margins at all, but it will impact certainly the quarterly margins.

與商業利潤率相關，我們確實對我們在 2021 年投資者日制定的目標感到滿意。如您所知，我們談到了到 2025 年達到 10.5% 至 11.5% 的範圍。我們有很多事情要做繼續 COVID。與往年相比，這無疑是導致今年商業利潤率受到挑戰的最大因素。我們與多元化業務集團的風險交易也存在一些季節性問題。這根本不會影響年度利潤率，但肯定會影響季度利潤率。

And Diversified Business Group, as I said in my prepared comments, I would not annualize that because of the fact of the shifting seasonality. And then Commercial, I wouldn't annualize that either because of that same aspect. So we feel very good about the Commercial growth and where we're heading as a company and the value proposition it has and feel very good about our 2025 targets. We're just challenged this year given -- or this quarter, given the high COVID in January. But thanks for the questions, Justin.

正如我在準備好的評論中所說，多元化業務集團，由於季節性變化的事實，我不會將其年度化。然後是商業，由於同樣的方面，我也不會將其年度化。因此，我們對商業增長以及我們作為一家公司的發展方向以及它所擁有的價值主張感到非常滿意，並且對我們的 2025 年目標感覺非常好。鑑於 1 月份的高 COVID，我們今年或本季度剛剛面臨挑戰。但謝謝你的問題，賈斯汀。

Next, we'll go to the line of A.J. Rice from Credit Suisse.

接下來，我們將前往 A.J.瑞士信貸大米。

I wondered, if I could just get updated thoughts on how you're thinking about the reverifications on the Medicaid side. I know it's delayed. Does that change your thinking about how much of a roll off there might be? What opportunities there might be for you to recapture your own in other areas like the exchanges or in the commercial book?

我想知道，如果我能得到關於你如何看待醫療補助方面的重新驗證的最新想法。我知道它延遲了。這是否會改變您對可能會有多少滾降的想法？您可能有什麼機會在交易所或商業書籍等其他領域重新獲得自己的機會？

And then also just in that aspect, the enhanced subsidies, which are slated to expire this year on the public exchanges, how important is it that those get extended and you're thinking about recapturing some people that might come off on the reverifications?

然後也只是在這方面，計劃於今年在公共交易所到期的增強補貼，延長這些補貼有多重要，你正在考慮重新獲得一些可能會因重新驗證而失敗的人？

Well, thanks for the multipart question, A.J. We'll try to address it because there's a number of pieces in that, one about our -- how we're thinking about reverifications in Medicaid, which right now, as you think about, we've said, with the extension, we're really looking for those to begin sometime towards the late part of the summer. We also believe that they're going to be paced over time. So I think it's important to remember that the states now have up to 14 months to do the reverifications. And as a result of that, each state will have a very different cadence of that. So we do think that will be more phased in.

好吧，謝謝你的多部分問題，A.J.我們將嘗試解決它，因為其中有很多部分，其中一個是關於我們的 - 我們如何考慮重新驗證醫療補助計劃，現在，正如你所想的那樣，我們已經說過，隨著擴展，我們'真的在尋找那些在夏末的某個時候開始的人。我們也相信它們會隨著時間的推移而變化。所以我認為重要的是要記住，各州現在有長達 14 個月的時間進行重新驗證。因此，每個州都會有非常不同的節奏。所以我們確實認為這將更加分階段進行。

In terms of your second part of your question, I'm going to ask Morgan Kendrick to address that in terms of how we're thinking about capturing that. We've done quite a bit of work on that, and I know we've shared some of the statistics about where we see that business going. But I think Morgan can offer a lot more color on that business. So Morgan?

關於你問題的第二部分，我將請 Morgan Kendrick 就我們如何考慮捕捉它來解決這個問題。我們在這方面做了很多工作，我知道我們已經分享了一些關於我們看到該業務發展方向的統計數據。但我認為摩根可以為該業務提供更多色彩。那麼摩根？

Yes. Thanks, Gail, and A.J., good morning. We have done a lot of work. And if you think about the fact that the Commercial business, the Medicare business, well, the Government Business in entirety as well as our marketing organization and our governmental affairs partners have worked to build out a plan for when reverification begins. And presently, we're expecting roughly 35% of the present Medicaid membership to stay with the Government division. And then 45% of that will move into commercial group insurance, with another 20 moving into the individual ACA exchanges.

是的。謝謝，蓋爾和 A.J.，早上好。我們做了很多工作。如果您考慮商業業務、醫療保險業務，以及整個政府業務以及我們的營銷組織和我們的政府事務合作夥伴已經努力製定重新驗證何時開始的計劃。目前，我們預計現有 Medicaid 成員中約有 35% 將留在政府部門。然後其中 45% 將進入商業團體保險，另外 20% 進入個人 ACA 交易所。

Certainly, the commercial group insurance will be one that the employers will pick it back up as they begin reverification. But on the exchanges, I think one thing that's notably important is we talked last quarter about a renewed focus on our individual ACA business. And looking at that business differently and more competitively, we've expanded the product offering. We've expanded the network opportunities. We've expanded the counties in which we serve our customers from 71% to 83% of the counties in our 14 geographies this year.

當然，商業團體保險將是雇主在開始重新驗證時將其取回的一種。但在交易所，我認為特別重要的一件事是我們在上個季度談到了重新關注我們的個人 ACA 業務。並且以不同的方式和更具競爭力的方式看待該業務，我們已經擴展了產品供應。我們擴大了網絡機會。今年，我們將服務客戶的縣從 14 個地區的 71% 擴大到了 83%。

So we feel we're poised quite well to pick up when verification begins. And as Gail noted, that most certainly will slide over a period of time given the 14 months that the states have to continue to work. But thanks again for the question.

因此，當驗證開始時，我們覺得我們已經做好了準備。正如蓋爾指出的那樣，鑑於各州必須繼續工作 14 個月，這肯定會在一段時間內下滑。但再次感謝您的提問。

Yes. And just a bit of a clarification, 35% really relates to the lives that were added during the suspension of redeterminations. So as you know, some of our growth is also the result of winning new RFPs and new entrants into markets. But overall, we feel good about the plan. We've obviously had this in place for a number of years. And in addition to capturing some of our own Medicaid lives in Commercial, we think we have an opportunity to capture others' Medicaid lives that will be coming off the books.

是的。稍微澄清一下，35% 確實與在暫停重新裁決期間增加的生命有關。如您所知，我們的一些增長也是贏得新 RFP 和新進入市場的結果。但總的來說，我們對該計劃感覺良好。顯然，我們已經實施了很多年。除了在商業中捕捉我們自己的一些 Medicaid 生活外，我們認為我們還有機會捕捉其他人的 Medicaid 生活，這些生活將脫離書本。

So again, been planning for it. We hope to see a very organized transition of this, and that's what we're working for. So thanks very much for the question.

所以再一次，一直在計劃它。我們希望看到一個非常有組織的過渡，這就是我們正在努力的目標。所以非常感謝這個問題。

Next, we'll go to the line of Matt Borsch from BMO Capital Markets.

接下來，我們將介紹來自 BMO Capital Markets 的 Matt Borsch。

Yes. Could I just ask about your Commercial enrollment -- or your enrollment outlook for the rest of the year, but particularly on the Commercial side? Because you did have such a strong result in the first quarter. You're already well above, as I can see it anyway, the high end of your guidance ranges on both insured and self-insured enrollment.

是的。我可以問一下您的商業註冊 - 或者您今年剩餘時間的註冊前景，特別是在商業方面嗎？因為您在第一季度確實取得瞭如此強勁的成績。你已經遠遠超過了，無論如何我可以看到，你的保險和自保註冊指導範圍的高端。

I'm wondering how you see it progressing from here.

我想知道你如何看待它從這裡開始的進展。

I'm going to ask Morgan to address the question on Commercial. Thank you.

我要請摩根回答關於商業的問題。謝謝你。

So Matt, thanks again for the question. So yes, we've had a fantastic start to the year. We do expect that to continue. Certainly, north of 50% of our business, especially on the upper end, all of -- just about all of the national business is January focused. So we've kind of gone through that.

所以，馬特，再次感謝這個問題。所以，是的，我們今年的開局非常棒。我們確實希望這種情況繼續下去。當然，我們 50% 的業務以北，尤其是高端業務，幾乎所有的全國業務都集中在 1 月份。所以我們已經經歷了那個。

The balance of the business will be the continued local market business. And we've seen a big uptick in our fee-based business, which is terrific. We see the next big tranche coming on in July. I wouldn't expect it to be materially larger than what we've seen in typical years, but we're growing that business nicely month-over-month.

業務的餘額將是持續的本地市場業務。我們已經看到我們的收費業務大幅增長，這非常棒。我們看到下一個大的部分將在 7 月到來。我不認為它會比我們在典型年份看到的要大得多，但我們正在逐月增長該業務。

To me, the assets are resonating in the market, when I look at how the business is performing. And also the opportunity, back to the comment earlier, on, expanding in account value, the 5:1/3:1 strategy is proceeding nicely, just given the actual opportunity with the fee-based business around stop-loss. Presently, our penetration, we've got opportunities there as well as our specialty products, pharmacy as well. So feel really good about it.

對我來說，當我查看企業的表現時，這些資產正在市場上引起共鳴。還有機會，回到前面的評論，關於擴大賬戶價值，5:1/3:1 策略進展順利，只是在止損附近提供了基於費用的業務的實際機會。目前，我們的滲透，我們在那里以及我們的特色產品，藥房都有機會。所以感覺真的很好。

I wouldn't expect it to be -- right now, we've said that we would be somewhere around 1 million members, Commercial business full year. And we have some attrition that certainly bleeds off through the year of the national business, but feel good about our position now and for the balance of the year as how it's setting up. So thank you for your question.

我不希望它是——現在，我們已經說過我們將有大約 100 萬會員，全年商業業務。而且我們有一些減員肯定會在全國業務的這一年中消失，但對我們現在的位置以及今年剩餘時間的情況感到滿意。所以謝謝你的問題。

Yes. Thanks for the question. Overall, strong growth, and we really feel that we had a really strong selling season. And as Morgan said, feel good about our positioning, so thanks again.

是的。謝謝你的問題。總體而言，強勁的增長，我們真的覺得我們有一個非常強勁的銷售季節。正如摩根所說，對我們的定位感覺良好，所以再次感謝。

Next, we'll go to the line of Nathan Rich from Goldman Sachs.

接下來，我們將轉到高盛的 Nathan Rich 的路線。

John, I just wanted to follow up on the updated expectations for MCR for the year. I guess given the significant beat in the first quarter, I guess looking at the updated guidance, it doesn't seem like your expectations have changed significantly for cost trend over the balance of the year. I guess, is that fair? And are you still expecting, I guess, second quarter cost trend to be above baseline levels?

約翰，我只是想跟進今年 MCR 的最新預期。我想鑑於第一季度的顯著節拍，我想看看更新的指導，您對今年餘下時間成本趨勢的預期似乎沒有顯著變化。我想，這公平嗎？我猜，您是否仍然期望第二季度的成本趨勢高於基線水平？

And related to that, I'd just be curious if you're seeing any signs of a recovery in surgical procedures that some other medtech companies have talked about in April? Just be curious on your updated second quarter outlook.

與此相關，我很好奇你是否看到其他一些醫療技術公司在 4 月份談到的外科手術恢復的跡象？只是對您更新的第二季度展望感到好奇。

Yes. Thanks, Nathan. I appreciate the question. We did end the quarter better than anticipated, but still above baseline. Certainly, very pleased with our start for the year. However, there is still uncertainty, boosters, vaccination, potential spikes in COVID. But we feel very good about where we are right now. And with those unknowns, we still believe that we want to take a prudent posture to our guidance.

是的。謝謝，內森。我很欣賞這個問題。我們確實在本季度結束時好於預期，但仍高於基線。當然，對我們今年的開局非常滿意。然而，仍然存在不確定性、助推器、疫苗接種、COVID 的潛在高峰。但我們對我們現在所處的位置感覺非常好。有了這些未知數，我們仍然相信我們希望對我們的指導採取謹慎的態度。

With that, though, right now, we have a bias that our medical loss ratio is going to be closer to the midpoint to the lower half of the range. So it is an improved outlook from what we talked about 90 days ago. but still very prudent given the overall circumstances. Thank you for the question.

但是，現在，我們有一個偏見，即我們的醫療損失率將更接近該範圍的下半部分的中點。因此，與我們 90 天前討論的內容相比，前景有所改善。但考慮到整體情況，仍然非常謹慎。感謝你的提問。

Next, we'll go to the line of Stephen Baxter from Wells Fargo.

接下來，我們將前往富國銀行的斯蒂芬·巴克斯特（Stephen Baxter）。

I wanted to ask about the significantly higher interest rate backdrop we find ourselves in. I was hoping you could talk a bit about how you think this will impact your investment portfolio over the next couple of years as your investments mature and reinvested.

我想問一下我們所處的利率顯著升高的背景。我希望你能談談你認為隨著你的投資成熟和再投資在未來幾年這將如何影響你的投資組合。

And also, I guess, how should we think about this as impacting the EPS growth rate you're targeting over the next few years? Wondering if it's going to be used, potentially invest further in the business or potentially this could help fuel you towards the higher end or maybe even slightly above the outlook you've laid out.

而且，我想，我們應該如何看待這會影響您未來幾年的目標每股收益增長率？想知道它是否會被使用，可能會進一步投資於業務，或者這可能有助於推動您走向高端，甚至可能略高於您制定的前景。

Sure. Thanks for the question. I'll take that one as well. On the interest rates and its impact, you look at our investment portfolio, we have about $35 billion in fixed maturities at this point in time and about 30% of that $35 billion is in variable rate. So there is an immediate benefit that, that portion of the portfolio gets from the rising interest rates.

當然。謝謝你的問題。我也會拿那個。關於利率及其影響，你看看我們的投資組合，我們目前有大約 350 億美元的固定期限，其中 350 億美元中有大約 30% 是浮動利率。因此，有一個直接的好處是，這部分投資組合從利率上升中獲得。

And then you look at the other half of the balance sheet. And as you know, we try to target close to a 40% debt-to-cap ratio. We're at 39.2% at the end of the quarter. So very much in line with our targets. And that, right now, is about $23 billion of the debt, and only less than 10% of that is variable rate, which obviously will go up. So we're actually winning the arbitrage game from that perspective. And so the rising interest rates were actually a net good guy to us.

然後你看看資產負債表的另一半。如您所知，我們試圖將目標鎖定在接近 40% 的債務與上限比率。我們在本季度末為 39.2%。非常符合我們的目標。而目前，這大約是 230 億美元的債務，其中只有不到 10% 是浮動利率，這顯然會上升。所以從這個角度來看，我們實際上是在贏得套利遊戲。因此，不斷上升的利率實際上對我們來說是個好人。

In terms of long-term earnings expectations, we're still very comfortable reaffirming the 12% to 15% growth rate in EPS that we've been talking about here since our last Investor Day. And I think what these interest rates do is give us a lot more flexibility in terms of decisions that we can make and be more strategic with those decisions here in the future. Thank you for the question.

就長期收益預期而言，我們仍然很樂意重申自上次投資者日以來我們一直在這裡談論的 12% 至 15% 的每股收益增長率。而且我認為這些利率的作用是在我們可以做出的決策方面給我們更多的靈活性，並且在未來對這些決策更具戰略性。感謝你的提問。

Next, we'll go to the line of Whit Mayo from SVB Securities.

接下來，我們將轉到 SVB 證券的 Whit Mayo 線。

Gail, can you elaborate more on the carve-out opportunity with Beacon and myNEXUS? Maybe just more specifically myNEXUS and just elaborate like what you're doing differently? It sounds like something's new here. I've kind of thought about this more as a utilization management play, but I hear you talking more about risk. So just anything that strategically changed would be helpful.

Gail，您能否詳細說明與 Beacon 和 myNEXUS 的分拆機會？也許只是更具體地說 myNEXUS 並詳細說明您正在做的不同？聽起來這裡有什麼新鮮事。我認為這更像是一種利用率管理遊戲，但我聽到你更多地談論風險。因此，任何戰略性改變都會有所幫助。

Great. Well, thanks very much for the question. And I think myNEXUS is a great example as our AIM and Beacon and some of the other assets that we have inside of the Diversified Business Group. When we brought myNEXUS into the family, the opportunity, obviously, to transition patients from the hospital to the home, we had strong expertise with them already in our Medicare Advantage business.

偉大的。嗯，非常感謝這個問題。我認為 myNEXUS 是一個很好的例子，作為我們的 AIM 和 Beacon 以及我們在多元化業務集團內部擁有的一些其他資產。當我們將 myNEXUS 帶入家庭時，很明顯，這是將患者從醫院轉移到家中的機會，我們已經在 Medicare Advantage 業務中與他們擁有了強大的專業知識。

But part of our goal is to do 2 things: one, to take our assets and embed them in our value-based payment arrangements. So as I mentioned, we have a number of those arrangements already that we're working on, both with primary care assets that we've invested in, plus also those that we're moving to value-based care. We see that as a downstream opportunity, but we also have an opportunity to capitate that business inside of Anthem's health plans, and there's a huge runway for us there.

但我們的部分目標是做兩件事：第一，獲取我們的資產並將其嵌入我們基於價值的支付安排中。正如我所提到的，我們已經有一些我們正在努力的安排，包括我們投資的初級保健資產，以及我們正在轉向基於價值的護理的那些。我們認為這是一個下游機會，但我們也有機會在 Anthem 的健康計劃中利用該業務，那裡有一條巨大的跑道。

And so generally, we've started in our Diversified Business Group first with a fee-for-service arrangement. And then, as we get confidence in our ability to execute and do well with that, we're moving that along the risk continuum to cap, and that's a good example of that.

因此，一般而言，我們首先在多元化業務組中採用按服務收費的安排。然後，當我們對自己的執行能力充滿信心並在這方面做得很好時，我們正在將其沿著風險連續體移動到上限，這就是一個很好的例子。

It might be a good opportunity for Pete to share a little bit about how he sees what's happening in our Diversified Business Group, and may even talk a little bit more about myNEXUS capabilities. Pete?

這可能是 Pete 分享一下他如何看待我們多元化業務組中正在發生的事情的好機會，甚至可能會更多地談論 myNEXUS 的功能。皮特？

Yes, I would -- appreciate that, Gail. And I think Gail answered it really well comprehensively. I would say though, what you've sort of referenced a change in strategy, let me just reiterate what our strategy is.

是的，我會 - 很感激，蓋爾。我認為蓋爾回答得非常全面。不過，我想說的是，你提到的戰略變化，讓我重申一下我們的戰略是什麼。

We're really focused on managing the complex and chronic patients and managing the complexities in health care more generally. And as Gail said, our primary client is Anthem. The opportunity is very vast. When you think about the complex and the chronic members and the spend associated with that population, you're talking about around $12,500 per member per year. Compared to an average commercial member, that's about $4,500 per member per year. So you can see there's a lot of spend there, a lot of opportunity there.

我們真正專注於管理複雜和慢性患者，以及更廣泛地管理醫療保健中的複雜性。正如蓋爾所說，我們的主要客戶是 Anthem。機會非常廣闊。當您考慮複雜和長期會員以及與該人群相關的支出時，您所說的是每位會員每年約 12,500 美元。與普通商業會員相比，每位會員每年約 4,500 美元。所以你可以看到那裡有很多支出，那裡有很多機會。

And as Gail said, as we get more mature in the development of our assets, when you think about things like myNEXUS, we think there's a lot of opportunity to actually grow the portfolio. Yes, it is known for its UM capabilities and its access-to-care capabilities in terms of managing home care, but we see a lot of natural extension opportunities.

正如蓋爾所說，隨著我們在資產開發方面變得更加成熟，當你想到像 myNEXUS 這樣的東西時，我們認為實際上有很多機會來擴大投資組合。是的，它以其 UM 功能和在管理家庭護理方面的獲得護理功能而聞名，但我們看到了很多自然的擴展機會。

So for example, we're very focused on post-acute care. We're very focused on DME as an opportunity. We're focused on social determinants of health. These are all areas in that complex and chronic category, where we can ultimately take risk and drive more value for our health plan businesses, creating predictable and stable cost of care, but then importantly, generating value in the DBG and incremental value for Anthem overall.

例如，我們非常關注急性期後護理。我們非常關注 DME 作為一個機會。我們專注於健康的社會決定因素。這些都是複雜和慢性類別中的所有領域，我們最終可以承擔風險並為我們的健康計劃業務創造更多價值，創造可預測和穩定的護理成本，但重要的是，在 DBG 中產生價值並為 Anthem 整體增加價值.

Thanks, Pete.

謝謝，皮特。

Next, we'll go to the line of Rob Cottrell from Cleveland Research.

接下來，我們將轉到 Cleveland Research 的 Rob Cottrell 的路線。

I guess I'll ask about the upcoming national account selling season given the strength that you all saw for this year. Any early commentary you can provide, given the kind of increased expectations for switching into 2023?

鑑於你們今年看到的實力，我想我會問一下即將到來的全國客戶銷售季節。鑑於對轉換到 2023 年的期望越來越高，您可以提供任何早期評論嗎？

Sure. Morgan, why don't you address that?

當然。摩根，你為什麼不解決這個問題？

Yes, Rob, thanks for the question. This season was spectacular. As John said, it was the best we've ever had in the company. So I'll tell you, the business doesn't all -- the cycle isn't always the same. These very, very large cases, usually bid on a 36-month cycle. So certainly, we're not seeing the volume.

是的，Rob，謝謝你的提問。這個季節很壯觀。正如約翰所說，這是我們公司有史以來最好的一次。所以我會告訴你，業務並非全部——週期並不總是相同的。這些非常非常大的案例通常以 36 個月的周期出價。所以當然，我們沒有看到數量。

It's interesting, we've seen some very early, very large 2024 prospects already that we're bidding on. But I expect the assets to continue to resonate and our win rate to be consistent with what we've seen in the past. We continue to build upon what we've done. And our digital assets are resonating quite nicely, our clinical assets as well.

有趣的是，我們已經看到了一些非常早、非常大的 2024 年前景，我們正在競標。但我預計資產將繼續引起共鳴，我們的贏率將與我們過去看到的一致。我們將繼續在我們所做的基礎上再接再厲。我們的數字資產產生了很好的共鳴，我們的臨床資產也是如此。

So it's a bit early of -- we do have some wins already in the books for January '23. But nonetheless, the size of the cases and the volume differ by year, and that's not inconsistent. So it's not unexpected. Thanks again for your question.

所以現在有點早了——我們確實已經在 23 年 1 月的書中取得了一些勝利。但儘管如此，案件的大小和數量每年都有所不同，這並沒有矛盾。所以這並不意外。再次感謝您的提問。

Yes. Thanks, Morgan. I think, to add to that, he mentioned a couple of areas that have been really important for us. One is consumer experience, our investment in digital platforms. I mentioned Sydney Preferred has been very popular, along with our consumer advocacy model. And then the last area is our high-performance networks.

是的。謝謝，摩根。我認為，除此之外，他還提到了幾個對我們來說非常重要的領域。一是消費者體驗，我們對數字平台的投資。我提到 Sydney Preferred 和我們的消費者倡導模式一樣非常受歡迎。最後一個領域是我們的高性能網絡。

Across all of the Blue system, I think we've done really well, and that's been a really strong validation of our unique cost of care position for the system. So thanks very much for the question. Again, really strong selling season and very encouraged by what we're seeing.

在整個 Blue 系統中，我認為我們做得非常好，這是對我們在系統中獨特的護理成本位置的有力驗證。所以非常感謝這個問題。再次，銷售旺季非常強勁，我們所看到的非常鼓舞人心。

Next, we'll go to the line of Dave Windley from Jefferies.

接下來，我們將轉到 Jefferies 的 Dave Windley 的路線。

John, your DCP was up close to 2 days sequentially in the first quarter on what has already been a fairly conservative posture through the pandemic period. Could you talk about the drivers of that? Were there any kind of payment timing issues that might have influenced that? Or was that all just growth in IBNR?

約翰，您的 DCP 在第一季度連續上升了近 2 天，這在大流行期間已經相當保守。你能談談它的驅動因素嗎？是否有任何類型的付款時間問題可能會影響到這一點？或者這只是 IBNR 的增長？

Thank you, Dave, and I appreciate the fact that you recognized that we've already had a conservative stance associated with our reserves. But our approach to reserves has been both prudent and consistent, and we obviously need to ensure that we follow actuarial standards and comply with generally accepted accounting principles.

謝謝你，戴夫，我很感激你認識到我們已經對我們的儲備採取了保守的立場。但我們的準備金方法既謹慎又一致，我們顯然需要確保我們遵循精算標準並遵守公認的會計原則。

Associated with the first quarter, there is a natural seasonality aspect to the days and claims payable metric. And the first quarter has typically been a little bit higher than the fourth quarter on a sequential basis. And you can see that the last several years and that happened again this year. A lot of it has to do with a lot of new clients coming on, and we did have such a significant new sales activity.

與第一季度相關的是，天數和應付索賠指標具有自然的季節性因素。第一季度通常比第四季度略高。你可以看到過去幾年和今年再次發生這種情況。這在很大程度上與許多新客戶的到來有關，我們確實有如此重要的新銷售活動。

And as you know, we have 1.4 million new lives in the first quarter alone. And it usually takes a little bit of time for those folks to really get through to the doctors and get them manning and get all those claims paid. So it's very natural to have a small increase in the first quarter.

如您所知，僅在第一季度，我們就有 140 萬新生命。這些人通常需要一點時間才能真正與醫生聯繫並讓他們配備人員並支付所有這些索賠。所以一季度有小幅增長是很自然的。

I would say that we feel very confident with the strength of our balance sheet and that the reserves that we booked as of March 31, they're very consistent with the reserves that were booked on December 31. So thank you for the question.

我想說，我們對我們的資產負債表的實力非常有信心，而且我們截至 3 月 31 日登記的準備金與 12 月 31 日登記的準備金非常一致。所以謝謝你的問題。

Next, we'll go to the line of Lisa Gill from JPMorgan.

接下來，我們將轉到摩根大通的 Lisa Gill 的路線。

I just wanted to ask about IngenioRx. And one, how it came out in the quarter versus your internal expectations?

我只是想問一下 IngenioRx。第一，與您的內部預期相比，本季度的結果如何？

And then secondly, you talked about the strong growth in the commercial market. Can you maybe talk about the cross-sell opportunity, the penetration that you have? And did you see that pull-through come through here in 2022? Or is there a longer selling season once you bring the commercial member on?

其次，您談到了商業市場的強勁增長。你能談談交叉銷售的機會，你的滲透率嗎？您是否看到 2022 年實現了這一突破？或者，一旦您將商業會員帶入，銷售季節會更長嗎？

Thanks, Lisa. I'm going to have Pete address that.

謝謝，麗莎。我要讓皮特解決這個問題。

Yes. Thanks a lot for the question, Lisa. First of all, we're really pleased with our progress and growth occurring in the pharmacy business. We're encouraged by what we're seeing and we saw through Q1 '22 in terms of the receptivity in the marketplace around IngenioRx, around our integrated offering as we penetrate Anthem's ASO Commercial business.

是的。非常感謝你的問題，麗莎。首先，我們對藥房業務的進步和增長感到非常滿意。我們對我們所看到的感到鼓舞，我們在 22 年第一季度看到了 IngenioRx 周圍市場的接受度，圍繞我們的綜合產品，我們滲透到 Anthem 的 ASO 商業業務。

In fact, we saw about a 300% year-over-year improvement in the members sold when you compare Q1 of '21 to Q1 of '22. And I do want to point out where we're seeing really good traction, that's in the middle market and down market, where I think Anthem has a lot of strength. And we create a lot of value. So a really good place for us to be.

事實上，當您將 21 年第一季度與 22 年第一季度進行比較時，我們發現售出的會員數量同比增長了 300%。我確實想指出我們在哪裡看到了非常好的牽引力，那就是在中端市場和低端市場，我認為 Anthem 有很大的優勢。我們創造了很多價值。所以對我們來說是一個非常好的地方。

As it relates to our operating gain performance and the differences there, Q1 '21 over Q1 '22, it's really completely explained by a onetime positive reconciliation item that we mentioned previously in '21. Without that, we're completely on track. We remain confident in achieving our '22 operating gain expectations and our growth expectations.

由於它與我們的經營收益表現和那裡的差異有關，21 年第一季度與 22 年第一季度的差異，這完全可以通過我們之前在 21 年提到的一次性積極調節項目來解釋。沒有它，我們就完全走上了正軌。我們仍然有信心實現我們的 '22 經營收益預期和增長預期。

Thank you.

謝謝你。

Next, we'll go to the line of Ricky Goldwasser from Morgan Stanley.

接下來，我們將轉到摩根士丹利的 Ricky Goldwasser。

Can you give us an update on the New York Group MA contract? There's some news that it's been delayed from April 1. So when do you expect to onboard it? And how should we think about the impact on guidance for the rest of the year considering that I think it was supposed to be dilutive for 2022?

您能給我們介紹一下紐約集團 MA 合同的最新情況嗎？有消息稱它已從 4 月 1 日開始推遲。那麼您預計什麼時候可以上線呢？考慮到我認為它應該對 2022 年造成稀釋，我們應該如何考慮對今年剩餘時間的指導的影響？

Yes, thanks. Thanks for the question, Ricky. First and foremost, I want to say that we are looking forward to serving the retirees of the city of New York and extremely -- remain extremely pleased about have been awarded this contract -- have been awarded this contract. We've had a long relationship with the city, and we do continue to administer those benefits for the employees in our fee-based business today, just as a bit of background.

對了謝謝。謝謝你的問題，瑞奇。首先，我想說的是，我們期待著為紐約市的退休人員提供服務，並且非常 - 仍然非常高興獲得這份合同 - 已經獲得了這份合同。我們與這座城市有著長期的合作關係，我們今天確實繼續為我們收費業務中的員工管理這些福利，就像一點背景一樣。

As you mentioned, based on a legal challenge, the city did not move forward as planned on April 1, and the city has appealed the decision. However, at this stage, given that process, we'll share more definitive information when it becomes available.

正如你所提到的，基於法律挑戰，該市在 4 月 1 日沒有按計劃推進，該市已對該決定提出上訴。但是，在這個階段，鑑於該過程，我們將在可用時分享更明確的信息。

As you think about how you should think about the financial impact, it's not dissimilar from what we said on our last call when we had a 3-month delay at hand, which was directionally slightly positive as we're still incurring, as you know, run rate costs from being ready to go on 1/1, and that still remains the case today. So thank you for the question, and we look forward to serving the city.

當您考慮應該如何考慮財務影響時，這與我們在上次電話會議上所說的沒有什麼不同，當時我們手頭有 3 個月的延遲，正如您所知，這在方向上略顯積極，因為我們仍在發生，從準備好運行 1/1 開始的運行率成本，今天仍然如此。感謝您的提問，我們期待為這座城市服務。

Next, we'll go to the line of Ben Hendrix from RBC Capital Markets.

接下來，我們將介紹 RBC Capital Markets 的 Ben Hendrix。

Just a quick question on your capitated strategy and increasing your downside risk sharing. I was wondering if you could kind of give us an opportunity -- or an idea of what the margin opportunity is there versus typical MA margins? And kind of where that could go? What you're targeting? And how that is progressing with the capitation membership that you've achieved so far?

只是一個關於你的資本化策略和增加你的下行風險分擔的快速問題。我想知道您是否可以給我們一個機會 - 或者了解保證金機會與典型 MA 保證金的區別？那可以去哪裡？你的目標是什麼？到目前為止，隨著您獲得的人頭會員資格，這進展如何？

Yes. Thanks very much for the question, and thanks for bringing it up. I'll just sort of start really at a broader perspective. Our care provider strategy is really a core component of our enterprise strategy, which is the integration of our whole health focus.

是的。非常感謝您提出這個問題，並感謝您提出這個問題。我將真正從更廣泛的角度開始。我們的護理提供者戰略實際上是我們企業戰略的核心組成部分，它是我們整個健康焦點的整合。

And we've set a couple of key things: one, better outcomes we see by capitating and moving to more upside-downside risk; certainly, higher satisfaction; better and predictable outcomes from our health plans; higher star ratings, which we think, because of the alignment drives and greater stability for our benefits business, MA, our Medicare Advantage business, but also our Commercial and Medicaid businesses are a really important part of the strategy.

我們已經設定了幾件關鍵的事情：第一，通過資本化和轉向更多的上行風險，我們看到了更好的結果；當然，更高的滿意度；從我們的健康計劃中獲得更好和可預測的結果；更高的星級評級，我們認為，因為我們的福利業務、MA、我們的醫療保險優勢業務以及我們的商業和醫療補助業務的一致性驅動和更大的穩定性，是該戰略的一個非常重要的部分。

Over the past year, we've made some very significant advancements in that strategy, particularly with our investments in risk-bearing primary care providers and aggregators, but we've also been advancing those that we haven't invested in around our VBC process. And that ties very much to our high-performing networks, and we're seeing growth there, as I mentioned a few moments ago.

在過去的一年裡，我們在該戰略方面取得了一些非常重要的進展，特別是我們對承擔風險的初級保健提供者和聚合器的投資，但我們也一直在推進我們尚未圍繞 VBC 流程投資的那些.這與我們的高性能網絡密切相關，正如我剛才提到的，我們在那裡看到了增長。

So as I think about those and your direct question, these are at kind of an early stage. We do see pull-through opportunities. So there's more than just your question about how does it affect MA. We see pull-through opportunities in our Diversified Business Group, and they're resonating things like combining Aspire with those groups and their palliative care offering. We just talked about myNEXUS a little bit. And again, those are opportunities for us again to advance our overall performance at Anthem generally.

因此，當我考慮這些和您的直接問題時，這些還處於早期階段。我們確實看到了拉動機會。所以不僅僅是你關於它如何影響 MA 的問題。我們在多元化業務集團中看到了突破性的機會，他們正在引起共鳴，比如將 Aspire 與這些集團及其姑息治療產品相結合。我們剛剛談到了 myNEXUS。再一次，這些是我們再次提升我們在 Anthem 整體表現的機會。

As we move, we're moving, very specifically to your question, to move to more capitation risk within the Anthem health plans. This year, we started some of the services like AIM. But our strategy, again, isn't relying on a single model. So I want to, again, reiterate that. I've shared that in the past. As we see our value-based care mature, we think that there's a number of models in that.

隨著我們的移動，我們正在移動，非常具體地針對您的問題，在 Anthem 健康計劃中移動到更多的人頭風險。今年，我們啟動了一些服務，比如 AIM。但是，我們的策略再次不是依賴於單一模型。所以我想再次重申這一點。我過去曾分享過。當我們看到我們基於價值的護理成熟時，我們認為其中有許多模型。

Specifically, about 60% of our consolidated medical expense, as I mentioned, is paid under VBC. That number is interesting, but I don't think it's the most important. The number that we're really targeting is moving upside and downside risk. We have global capitation, and as I mentioned, today, we're about low double-digit range across our enterprise, with about 40% in Medicare in capitated arrangements, to put some perspective on that. Our target is that about 1/3 of our overall spend in value-based care by 2025 will have downside risk. So again, a pretty significant move. And again, that's across Medicaid, Commercial and Medicare so you get a sense of the breadth of the strategy that we're deploying.

具體來說，正如我所提到的，我們大約 60% 的綜合醫療費用是根據 VBC 支付的。這個數字很有趣，但我認為這不是最重要的。我們真正瞄準的數字是上行和下行風險。我們有全球人頭，正如我所提到的，今天，我們整個企業的兩位數範圍都很低，醫療保險中約有 40% 的人頭安排，對此有一些看法。我們的目標是，到 2025 年，我們在基於價值的護理方面的總支出中約有 1/3 將存在下行風險。再說一次，這是一個非常重要的舉措。再說一次，這涉及醫療補助、商業和醫療保險，因此您可以了解我們正在部署的戰略的廣度。

So overall, feel good about the progress we're making. I think there are a number of value drivers across our business beyond just the simple question around Medicare Advantage. But clearly, that's an important one, both for top line and bottom line in our Medicare as well as our other businesses. So thanks very much for the question.

所以總的來說，對我們正在取得的進展感覺良好。我認為，除了圍繞醫療保險優勢的簡單問題之外，我們的業務還有許多價值驅動因素。但顯然，這對我們的醫療保險以及我們其他業務的頂線和底線都很重要。所以非常感謝這個問題。

Next, we'll go to the line of Josh Raskin from Nephron Research.

接下來，我們將介紹 Nephron Research 的 Josh Raskin。

I want to understand a little bit better the admin fee growth of 7% against that really strong membership growth, and this movement of 5:1 down to 3:1. And just sort of understanding where you are on that path. And maybe what's the pushback from employers that aren't signing up for those additional services?

我想更好地理解 7% 的管理費增長與真正強勁的會員增長，以及從 5:1 下降到 3:1 的趨勢。只是了解你在那條路上的位置。也許沒有註冊這些附加服務的雇主的反對是什麼？

And lastly, if you could just include stop-loss as one of those services in terms of trends you're seeing, that would be helpful.

最後，如果您可以根據您所看到的趨勢將止損作為其中一項服務，那將很有幫助。

Yes, Josh, thanks for the question. Certainly, we're very pleased with the growth. The admin fee growth is both a combination of the ASO fees on the fee-based membership along with the fee-for-service aspects of many of these add-on value proposition type services.

是的，喬希，謝謝你的問題。當然，我們對增長感到非常滿意。管理費的增長既是收費會員的 ASO 費用，也是許多這些附加價值主張類型服務的按服務收費方面的組合。

And then we -- as you know, on the 5:1 to 3:1, we're doing very well. We had about a year delay at the beginning of COVID, but we ended 2021 and began 2022 at about a 4:1, within that range. And we still feel very good about hitting 3:1 by 2024.

然後我們——如你所知，在 5:1 到 3:1 的比賽中，我們做得很好。我們在 COVID 開始時延遲了大約一年，但我們在 2021 年結束並在 2022 年開始時以大約 4:1 的比例在該範圍內。我們仍然對到 2024 年達到 3:1 感到非常滿意。

In terms of the overall growth, I mean, look at the membership. I mean the membership is just going awesome. Our best national account selling season ever, and that's obviously adding to the admin fee revenue growth.

就整體增長而言，我的意思是，看看成員。我的意思是會員資格真是太棒了。我們有史以來最好的全國客戶銷售季節，這顯然增加了管理費收入的增長。

And maybe, Morgan, to comment a little bit about what's happening in employer decision-making.

也許，摩根，對雇主決策中發生的事情發表一點評論。

Yes. And, Josh, thanks again for the question. When I think about the reasons for the win, it's basically 2 things: it's economics and experience. And when you look at the upmarket business, let's just focus there for a minute, it's -- one of the things that's consistent is buying various levels of advocacy services. So it's a heightened service model on the front end, which is probably north of 90% of our business. That's part of complementary to the just base admin fee that John described earlier.

是的。而且，喬希，再次感謝您的提問。當我想到獲勝的原因時，基本上是兩件事：經濟和經驗。當您查看高端業務時，讓我們專注於那裡一分鐘，其中一致的事情之一是購買各種級別的宣傳服務。因此，這是一種增強的前端服務模式，可能占我們業務的 90% 以上。這是對約翰之前描述的基本管理費的補充的一部分。

Also, we think about a clinical model that's unique and more elegant connecting back to a higher order front end. That's another model that we've seen great success for in the national market. In fact, we launched in 2018 with Total Health, Total You. Presently, we're sitting almost 7 million members across both the national business and the local markets that have accepted that product and are enjoying the product and what it's delivering.

此外，我們考慮了一種獨特且更優雅地連接回更高階前端的臨床模型。這是我們在全國市場上取得巨大成功的另一種模式。事實上，我們在 2018 年推出了 Total Health, Total You。目前，我們在全國企業和當地市場擁有近 700 萬會員，他們已經接受了該產品並正在享受該產品及其所提供的內容。

You think about where the market's kind of evolved, to your point around what people are looking to buy, I mean this -- the labor market is tight. Most employers look at their health benefits as a human capital strategy, and they're looking for these unique nuanced ways to have a better solution rather than just a health benefits product.

你想想市場在哪裡演變，圍繞人們想要購買的東西，我的意思是——勞動力市場緊張。大多數雇主將他們的健康福利視為一種人力資本戰略，他們正在尋找這些獨特而細緻入微的方法來獲得更好的解決方案，而不僅僅是一種健康福利產品。

Lastly, commenting on your comment around the -- or question regarding stop-loss, there's a big opportunity there for us. When you look at the penetrable market, upmarket, we have a very, very large percent of it. We've got roughly 60% of our business in the stop-loss business penetrated today. We expect that to continue and look for different opportunities to serve our employers through value-based arrangements where it's a pay for value. And we do find the sign-up or the employer uptake to be quite large when it's positioned that way when payment is received upon value delivered. So again, thank you for your question.

最後，評論您對 - 或關於止損的問題的評論，這對我們來說是一個很大的機會。當您查看可滲透的高端市場時，我們擁有非常非常大的百分比。今天，我們的止損業務已經滲透了大約 60% 的業務。我們希望這種情況繼續下去，並通過基於價值的安排尋找不同的機會為我們的雇主服務，這是一種按價值付費的方式。我們確實發現，當它以這種方式定位時，在交付價值後收到付款時，註冊或雇主的吸收量相當大。再次感謝您的提問。

And thanks, Morgan and John. Just to put a fine point on it, Josh, we think the strong growth that we've seen, particularly across the Commercial business, is a really nice runway for us to add additional services. And that's really been the trajectory of our business over the last several years, is continuing to consolidate employers and continuing to demonstrate our value first on the medical cost side but also on digital tools and other things that we're bringing to market. So we feel good about the trajectory and the opportunity that we have. And again, very strong growth, and we're really pleased to see it.

謝謝，摩根和約翰。喬希，為了說明這一點，我們認為我們所看到的強勁增長，特別是在商業業務中，是我們增加額外服務的一個非常好的跑道。這確實是我們過去幾年業務的發展軌跡，正在繼續整合雇主，並繼續首先在醫療成本方面展示我們的價值，同時也在數字工具和我們推向市場的其他東西上展示我們的價值。因此，我們對我們擁有的軌跡和機會感覺良好。再次，非常強勁的增長，我們真的很高興看到它。

Next, we'll go to the line of Kevin Fischbeck from Bank of America.

接下來，我們將轉到美國銀行的 Kevin Fischbeck 的線路。

I'm just wondering, if you could provide a little bit more color about what was driving the improvement in MLR, specifically, COVID, non-COVID? And if you'd go into a little more detail about the types of procedures that you don't expect, or that are coming in better than expected?

我只是想知道，您是否可以提供更多關於推動 MLR 改進的因素，特別是 COVID 和非 COVID？如果您更詳細地了解您不期望的程序類型，或者比預期的要好？

Thanks, Kevin. Specifically associated with the first quarter medical loss ratio, really you have to look at what the situation was when we first provided guidance. The Omicron variant was peaking at a higher point than at any time since the pandemic began and the home-testing rule adjustment issued, amongst other things. And so part of the guidance that we provided at that point in time was having those facts in front of us.

謝謝，凱文。具體與第一季度的醫療損失率相關，你真的要看看我們第一次提供指導時的情況。自大流行開始和發布家庭測試規則調整等以來，Omicron 變體的峰值比任何時候都高。因此，我們當時提供的部分指導就是將這些事實擺在我們面前。

Well, what happened was is that February and then March had even a much more significant drop in positivity rate than we had seen for any of the other prior surges that we've had since COVID started. And then we're also very pleased that there is no evidence of any abuse or stockpiling of the free home-testing kits that was part of our concern as well.

好吧，發生的事情是，2 月和 3 月的陽性率下降幅度甚至比自 COVID 開始以來我們之前看到的任何其他激增都要大得多。然後，我們也很高興沒有任何證據表明我們擔心的免費家庭檢測試劑盒遭到任何濫用或囤積。

And non-COVID obviously went back up as COVID went down as has occurred at every phase through the pandemic. But all in, the cost structure was better than our expectations. Still above baseline, but better than our expectations. And that really was the primary driver of the better performance in the quarter. Thank you.

當 COVID 下降時，非 COVID 明顯回升，就像在大流行的每個階段發生的那樣。但總而言之，成本結構好於我們的預期。仍高於基線，但好於我們的預期。這確實是本季度表現更好的主要驅動力。謝謝你。

Next, we'll go to the line of Steven Valiquette from Barclays.

接下來，我們將轉到巴克萊銀行的 Steven Valiquette。

Just a quick confirmation question, and then the real question. First, on the investment income, $360 million in 1Q, that puts you above the run rate for the full year guidance of $1.1 billion. I guess the question there is, was the $151 million of net loss on financial instruments in 1Q, was that part of the full year guide for non-investment income or is that separate?

只是一個快速確認問題，然後是真正的問題。首先，第一季度的投資收入為 3.6 億美元，高於全年指導的 11 億美元的運行率。我想問題是，第一季度金融工具的 1.51 億美元淨虧損是非投資收入全年指南的一部分，還是單獨的？

Then the real question was just quickly just to confirm, a lot of the discussion around the seasonality of MLR. But as far as the comment you made last quarter about 55% of income in the first half of the year, is that tossed out the window now? Or is that still valid as we kind of think about that comment that you made last quarter?

然後真正的問題只是快速確認，圍繞 MLR 的季節性進行了很多討論。但就你上個季度關於上半年收入的 55% 的評論而言，現在是否被拋到了窗外？或者當我們考慮一下你上個季度發表的評論時，這仍然有效嗎？

Thanks, Steve. I'll see if I can answer both those questions. On the investment income, do not run rate our first quarter performance. And first of all, no the loss on the write-down of the assets was not part of that. The outperformance really had to do with our alternative investment portfolio and some of the positives that has come through. We're very, very happy with that, but we do not believe it's run rate.

謝謝，史蒂夫。我看看能不能回答這兩個問題。關於投資收益，不要跑評我們一季度的業績。首先，資產減記的損失不是其中的一部分。出色的表現確實與我們的另類投資組合和一些積極因素有關。我們對此非常非常滿意，但我們不相信它的運行速度。

And then associated with the seasonality and the MLR, again, we're very pleased with the strong start for the year. And we did raise our full year guidance to $28.40. Simple math will tell you, $8.25 is about 29% of the full year.

然後與季節性和 MLR 相關聯，我們再次對今年的強勁開局感到非常滿意。我們確實將全年指導提高到 28.40 美元。簡單的數學會告訴你，8.25 美元大約是全年的 29%。

Essentially, for modeling purposes, I'd say the current consensus estimates for the second quarter right now are a reasonable approximation of second quarter expectations. So hopefully, that helps. Thank you.

從本質上講，出於建模目的，我認為目前對第二季度的共識估計是第二季度預期的合理近似值。所以希望，這會有所幫助。謝謝你。

Next, we'll go to the line of Gary Taylor from Cowen.

接下來，我們將從 Cowen 轉到 Gary Taylor 的路線。

I might just piggyback on that last thought, John, and just go a little bit further. If we look at the last 5 years or so, MLR almost always grew sequentially every quarter. This year, because of the COVID cost you're anticipating, you had a different cadence that fortunately didn't play out. So the questions are, are we just back to a typical sequential MLR build through the year? Is that reasonable?

我可能只是捎帶最後一個想法，約翰，然後走得更遠一點。如果我們回顧過去 5 年左右，MLR 幾乎總是每個季度都按順序增長。今年，由於您預期的 COVID 成本，您有不同的節奏，幸運的是沒有發揮出來。所以問題是，我們是否剛剛回到全年典型的順序 MLR 構建？這合理嗎？

And then same question for G&A. I think in the last 5 years, with the exception of 1Q of '21, G&A dollars generally just grew sequentially throughout the year. It looks like now they would have to drop for a while, otherwise, you might miss your full year guidance. But on MLR cadence, are we sort of back to normal? And then on G&A, do we -- how do we think about that over the next few quarters?

然後是 G&A 的相同問題。我認為在過去的 5 年中，除了 21 年第一季度之外，G&A 美元通常只是全年連續增長。看起來現在他們將不得不下降一段時間，否則，您可能會錯過全年的指導。但是在 MLR 節奏上，我們是否恢復了正常？然後在 G&A 上，我們是否 - 在接下來的幾個季度中如何看待這一點？

Yes. No, sure, Gary. Good questions. On the medical loss ratio, we're not completely back to normal. There are still certain things associated with the public health emergency, where various cost shares are waived. The free home-testing kits, even though there weren't abuse or stockpiling of those, there was a cost. They did cost. And we expect to continue to incur those throughout the entirety of the public health emergency. So we think the seasonality factors will differ a bit from historical patterns because we're just in a completely different situation.

是的。不，當然，加里。好問題。關於醫療損失率，我們還沒有完全恢復正常。仍然有一些與突發公共衛生事件相關的事情，其中各種費用分攤被免除。免費的家庭檢測試劑盒，即使沒有濫用或儲存這些試劑盒，也是有代價的。他們確實付出了代價。我們預計在整個突發公共衛生事件期間將繼續招致這些事件。因此，我們認為季節性因素會與歷史模式略有不同，因為我們處於完全不同的情況。

And then associated with the SG&A and the cost structure, some of it is also opportunistic spending of accelerating investments in our digital areas when we have the ability to accelerate. And our expectation is, is that with the really excellent top line growth that we've seen, clearly, top line growth does include some variable cost that will obviously be incurred above and beyond what had been assumed, but we feel very good about still hitting our guidance numbers for the full year.

然後與 SG&A 和成本結構相關聯，當我們有能力加速時，其中一些也是加速我們數字領域投資的機會主義支出。我們的預期是，隨著我們所看到的非常出色的收入增長，很明顯，收入增長確實包括一些可變成本，這些成本顯然會超出假設，但我們仍然感覺非常好達到我們全年的指導數字。

So unfortunately, I don't think our historical seasonality patterns are a great proxy given the situation that we're in this year. Thank you.

所以不幸的是，鑑於我們今年的情況，我不認為我們的歷史季節性模式是一個很好的代理。謝謝你。

I think we have time for one last question.

我想我們有時間回答最後一個問題。

Our final question comes from the line of George Hill from Deutsche Bank.

我們的最後一個問題來自德意志銀行的 George Hill。

John, mine is an MLR-related question. It has to do with medical cost inflation. And I guess could you talk about what you guys are seeing as it relates to cost inflation? I'm thinking about things like provider wages and medical supplies that could be inflation impacted versus what you guys are doing to offset that. And the question really is, are you guys seeing inflation yet?

約翰，我的是一個與 MLR 相關的問題。這與醫療成本膨脹有關。我想你能談談你們所看到的與成本通脹有關的情況嗎？我正在考慮可能會受到通貨膨脹影響的供應商工資和醫療用品之類的事情，而你們正在採取哪些措施來抵消它。真正的問題是，你們看到通貨膨脹了嗎？

And maybe if you can rank order the big buckets of what you can do to offset inflation? Clearly, virtual is one thing you can do to offset it. Capitation and risk sharing is another thing. Just trying to understand the big puts and takes as it relates to MLR cost drivers, focusing on inflation.

也許如果你能對你能做些什麼來抵消通貨膨脹進行排序？顯然，虛擬是您可以做的一件事來抵消它。人頭和風險分擔是另一回事。只是試圖了解與 MLR 成本驅動因素相關的大看跌期權，重點關注通貨膨脹。

Yes. Thanks for the question, George. I think, first, there's no question that the labor market is tight. So as you think about inflation, we hear it certainly from our provider partners, and we see it in certain parts of our own business.

是的。謝謝你的問題，喬治。我認為，首先，勞動力市場緊張是毫無疑問的。因此，當您考慮通貨膨脹時，我們肯定會從我們的供應商合作夥伴那裡聽到它，並且我們會在我們自己業務的某些部分看到它。

Now let me start with the biggest bucket, which is hospital pricing. As you know, the majority of our contracts are 3 years in duration. So we negotiate roughly 1/3 of those each year. And yes, there is more pressure on the system. But at this point, we're not seeing incremental rate pressure. And quite frankly, we believe our ultimate responsibility is -- that's paramount for our customers is affordability. So we have -- we're keeping costs contained to the lowest possible level and take that responsibility very seriously. It's really the core of kind of, frankly, what we do.

現在讓我從最大的部分開始，即醫院定價。如您所知，我們的大部分合同期限為 3 年。所以我們每年談判大約 1/3。是的，系統壓力更大。但在這一點上，我們沒有看到增量的利率壓力。坦率地說，我們相信我們的最終責任是——對我們的客戶來說最重要的是負擔能力。所以我們 - 我們將成本控制在盡可能低的水平，並非常認真地承擔這一責任。坦率地說，這確實是我們所做工作的核心。

We're also taking the opportunity though to change this conversation and make it less a transactional conversation and move to value-based care, which has been the core part of our strategy with all of our providers. So we believe that there is an opportunity to transition from just unit cost negotiation and volume-based discussions to value-based care. And our strategy is key in that context.

我們也藉此機會改變了這種對話，使其不再是交易性對話，並轉向基於價值的護理，這一直是我們與所有供應商的戰略的核心部分。因此，我們認為有機會從僅僅單位成本談判和基於數量的討論過渡到基於價值的護理。在這種情況下，我們的戰略是關鍵。

So we think that that's a core element of this, paying for outcomes and paying for value. We've been investing, as you heard through the discussion that we've had, in tools that help our providers make that transition to value-based care and also help safeguard and mitigate some of the uncertainty that they have. So that's a core part of we think what's important in managing that.

因此，我們認為這是其中的一個核心要素，即為結果付費並為價值付費。正如您從我們的討論中聽到的那樣，我們一直在投資工具，幫助我們的提供者過渡到基於價值的護理，並幫助保護和減輕他們所擁有的一些不確定性。所以這是我們認為管理它的重要部分的核心部分。

We're watching these dynamics closely. And we've been refining our high-performance, high value-based care model. So again, we think that's an acceleration opportunity in our own business. We're strongly committed to digitizing and looking for end-to-end improvements across our business. We've been on a multiyear journey around that. We look at a number of areas around our own -- how do we improve experiences. How do we tie things end to end better? How do we improve our own efficiencies? Looking at touchless claims, as an example, simplifying our pre-authorization processes, investments in better provider finders.

我們正在密切關注這些動態。我們一直在完善我們的高性能、高價值護理模式。再說一次，我們認為這是我們自己業務的加速機會。我們堅定地致力於數字化並在我們的業務中尋求端到端的改進。我們已經為此進行了多年的旅程。我們著眼於我們自己的許多領域——我們如何改善體驗。我們如何更好地將事情端到端地聯繫起來？我們如何提高自己的效率？以非接觸式索賠為例，簡化我們的預授權流程，投資於更好的供應商尋找者。

So a number of the things that we're investing in around our digital transformation helps us in terms of our own internal cost structure, but also improves the cost structure of our trading partners, care providers and our customers. And again, affordability, we think, is critical in this environment in the scenario that we believe is our role and responsibility and are very focused on it.

因此，我們圍繞數字化轉型進行的一些投資有助於我們改善自己的內部成本結構，同時也改善了我們的貿易夥伴、護理提供者和客戶的成本結構。再一次，我們認為，在我們認為是我們的角色和責任並且非常關注它的情況下，可負擔性在這種環境中至關重要。

So we have a number of tools, shared those, on the provider side, really focused on value-based care and then on our own side, around really changing workflows and digitization and moving much more aggressively into that space. So thank you very much for the question.

因此，我們有許多工具，共享這些工具，在提供者方面，真正專注於基於價值的護理，然後在我們自己方面，圍繞真正改變工作流程和數字化，並更積極地進入該領域。所以非常感謝你的問題。

I'd now like to close by saying thank you. We're pleased to have carried forward our momentum into 2022, and we're confident that the ongoing execution of our strategy positions us to continue to deliver against the financial targets we shared with you at our investor conference last year.

我現在想說聲謝謝。我們很高興將我們的勢頭延續到 2022 年，我們相信，我們戰略的持續執行使我們能夠繼續實現我們在去年投資者會議上與您分享的財務目標。

Across our organization, we're accelerating innovation to advance our digital capability and resources, simplifying our processes, improving our consumer experience and delivering products and services to champion a whole health approach and advanced health beyond health care for consumers at all stages of their lives.

在整個組織中，我們正在加速創新，以提升我們的數字能力和資源，簡化我們的流程，改善我們的消費者體驗並提供產品和服務，以倡導一種完整的健康方法，並在消費者生命的各個階段為消費者提供超越醫療保健的先進健康.

We're fueled by a passion for making a positive difference in the world and we're improving health by addressing consumer needs at a personal level, removing barriers to care and creating more meaningful connections across the lifetime of milestones and experiences.

對世界產生積極影響的熱情激發了我們的動力，我們正在通過滿足個人層面的消費者需求、消除護理障礙並在里程碑和體驗的整個生命週期中建立更有意義的聯繫來改善健康。

We'll keep executing with excellence and discipline to bring increasing value to all of our stakeholders.

我們將繼續以卓越和紀律執行，為我們所有的利益相關者帶來越來越多的價值。

Thank you for your interest in Anthem, and have a great rest of week.

感謝您對 Anthem 的關注，祝您週末愉快。

Ladies and gentlemen, a recording of this conference will be available for replay after 11:00 a.m. today through May 20, 2022. You may access the replay system at any time by dialing (800) 813-5525, and international participants can dial (203) 369-3346.

女士們，先生們，本次會議的錄音將在今天上午 11:00 後至 2022 年 5 月 20 日期間提供回放。您可以隨時撥打 (800) 813-5525 訪問回放系統，國際與會者可以撥打 ( 203) 369-3346。

This concludes our conference for today. Thank you for your participation and for using Verizon Conferencing. You may now disconnect.

我們今天的會議到此結束。感謝您的參與和使用 Verizon 會議。您現在可以斷開連接。