Elevance Health Inc (ELV) 2022 Q2 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to Anthem's Second Quarter Earnings Conference Call. (Operator Instructions) As a reminder, today's conference is being recorded. I would now like to turn the conference over to the company's management. Please go ahead.

女士們，先生們，感謝你們的支持，歡迎參加 Anthem 的第二季度收益電話會議。 （操作員說明）提醒一下，今天的會議正在錄製中。我現在想把會議交給公司管理層。請繼續。

Good morning, and welcome to Elevance Health Second Quarter 2022 Earnings Call. This is Steve Tanal, Vice President of Investor Relations. And with us this morning on the earnings call are Gail Boudreaux, President and CEO; John Gallina, our CFO; Peter Haytaian, President of Carelon; Morgan Kendrick, President of our Commercial and Specialty Business Division; and Felicia Norwood, President of our Government Business division.

早上好，歡迎來到 Elevance Health 2022 年第二季度財報電話會議。我是投資者關係副總裁史蒂夫·塔納爾。今天早上與我們一起參加財報電話會議的還有總裁兼首席執行官 Gail Boudreaux；我們的首席財務官約翰·加利納； Carelon總裁Peter Haytaian；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 and recent progress against our strategic initiatives. John will then discuss our financial results and outlook in greater detail. After our prepared remarks, the team will be available for Q&A.

蓋爾將在電話會議開始時簡要討論本季度以及我們戰略舉措的最新進展。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, elevancehealth.com. 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 Elevance Health. 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.

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 elevancehealth.com 上找到。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，這些陳述受到某些風險和不確定性的影響，其中許多難以預測，並且通常超出 Elevance Health 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 Elevance Health delivered another strong quarter. In the second quarter, GAAP earnings per share was $6.79, and we grew adjusted earnings per share over 14% to $8.04. Based on our results in the first half of the year and the momentum in our business, we've increased our full year adjusted earnings guidance to greater than $28.70 per share, representing growth of at least 13.9% off of the adjusted baseline we provided at the beginning of the year.

謝謝，史蒂夫，大家早上好。今天，我們很高興地分享 Elevance Health 又一個強勁的季度。第二季度，GAAP 每股收益為 6.79 美元，調整後每股收益增長 14% 以上至 8.04 美元。根據我們上半年的業績和我們業務的發展勢頭，我們已將全年調整後收益指引提高至每股 28.70 美元以上，比我們提供的調整後基線增長至少 13.9%年初。

Before we discuss the quarter in more detail, I want to spend a moment on our recent name change and rebranding strategy. We officially changed our holding company name to Elevance Health on June 28, having secured shareholder approval in May and are now trading under the new ticker symbol, ELV. This marks the culmination of a multiyear journey in which we have transformed from a traditional health insurance company to a lifetime trusted health partner, addressing the physical, behavioral and social drivers that we know are critical to achieving optimal health.

在我們更詳細地討論本季度之前，我想花點時間了解一下我們最近的名稱更改和品牌重塑戰略。我們於 6 月 28 日正式將控股公司名稱更改為 Elevance Health，並於 5 月獲得股東批准，現在以新的股票代碼 ELV 進行交易。這標誌著我們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的多年旅程的高潮，解決了我們知道對實現最佳健康至關重要的身體、行為和社會驅動因素。

Elevance Health captures the fact that we are now much more than a health insurance company and reinforces our commitment to elevating the importance of whole health and advancing health beyond health care for our consumers, their families and communities.

Elevance Health 抓住了這樣一個事實，即我們現在不僅僅是一家健康保險公司，並強化了我們對提升整體健康重要性的承諾，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。

Last month, we also announced the launch of our new health care services brand, Carelon, and the health plan brand, Wellpoint, which joined the company's family of brands that include Anthem Blue Cross and Blue Shield. Our simplified brand architecture will streamline our brand portfolio, reduce complexities and reinforce our evolution as an organization delivering solutions beyond health insurance.

上個月，我們還宣布推出新的醫療保健服務品牌 Carelon 和健康計劃品牌 Wellpoint，該品牌加入了公司的品牌家族，包括 Anthem Blue Cross 和 Blue Shield。我們簡化的品牌架構將簡化我們的品牌組合，降低複雜性並加強我們作為提供健康保險以外解決方案的組織的發展。

Grounded in our mission and fueled by our bold and ambitious purpose to improve the health of humanity, Elevance Health reflects our position as a health leader.

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，反映了我們作為健康領導者的地位。

Strong growth in all of our businesses continued in the second quarter, demonstrating that our employer, consumer and state partners are universally looking for whole health solutions that address underlying drivers of cost while enhancing the consumer experience. Our strategies and investments in these areas are propelling strong organic membership growth, in addition to creating opportunities to scale our services division.

我們所有業務在第二季度繼續強勁增長，這表明我們的雇主、消費者和州合作夥伴正在普遍尋找整體健康解決方案，以解決潛在的成本驅動因素，同時增強消費者體驗。除了為擴大我們的服務部門創造機會外，我們在這些領域的戰略和投資正在推動強勁的有機會員增長。

Medical membership grew 6% year-over-year to 47.1 million members, maintaining Elevance Health's position as the largest insurer by U.S. medical membership. Over the past year, we've added more than 2.7 million net new members, including over 1.5 million net new government members and nearly 1.2 million net new commercial members.

醫療會員人數同比增長 6%，達到 4710 萬，保持了 Elevance Health 作為美國醫療會員最大保險公司的地位。過去一年，我們淨新增會員超過 270 萬，其中政府新增會員超過 150 萬，商業會員淨新增近 120 萬。

In Medicaid, the ongoing suspension of eligibility redeterminations and our industry-leading RFP win rate continues to drive organic growth, which we continue to supplement through programmatic health plan acquisitions consistent with our strategy.

在 Medicaid 中，資格重新確定的持續暫停和我們行業領先的 RFP 贏得率繼續推動有機增長，我們繼續通過符合我們戰略的計劃性健康計劃收購來補充這一點。

In the second quarter, we closed the acquisition of Integra Managed Care, a Medicaid plan in New York focused on patients in need of long-term support services to help them live in their homes and communities. We're excited to welcome the Integra team to the Elevance Health family. Their commitment to patients with complex and chronic needs is well aligned with our focus on serving the needs of the people who need us most.

在第二季度，我們完成了對 Integra Managed Care 的收購，這是紐約的一項醫療補助計劃，重點關注需要長期支持服務的患者，以幫助他們在家中和社區生活。我們很高興歡迎 Integra 團隊加入 Elevance Health 大家庭。他們對有復雜和長期需求的患者的承諾與我們專注於滿足最需要我們的人的需求是一致的。

In Medicare Advantage, personalized health solutions are resonating with seniors, notably dual eligible members with complex and chronic needs and our supplemental benefits, which emphasize social drivers of health, supporting members with in-home support, transportation needs, healthy groceries, assisted devices and more, continue to gain traction. We remain on track to produce double-digit organic growth in our individual MA business, led by growth in duals, and are excited about our plans for 2023.

在 Medicare Advantage 中，個性化的健康解決方案正在引起老年人的共鳴，特別是具有復雜和慢性需求的雙重合格會員以及我們的補充福利，這些福利強調健康的社會驅動因素，支持會員提供家庭支持、交通需求、健康食品、輔助設備和更多，繼續獲得牽引力。在雙重增長的帶動下，我們的個人 MA 業務仍有望實現兩位數的有機增長，並對我們 2023 年的計劃感到興奮。

In the employer market, our share gains are being driven by our leading cost-of-care position and innovative solutions focused on consumer experience and engagement. Employers have come to expect more, and we're investing to meet their needs.

在雇主市場，我們領先的醫療成本地位和專注於消費者體驗和參與的創新解決方案推動了我們的份額增長。雇主已經開始期待更多，我們正在投資以滿足他們的需求。

Today, we have strong traction in our total health connection's fleet of advocacy solutions that serves 3.9 million members, representing a 33% year-over-year increase. The programs guide members to the next step in care through a simple, intuitive and personalized experience. We leverage real-time data analytics to identify health risks so their advocates can personally connect with members to proactively facilitate preventive and, at times, responsive care.

今天，我們在為 390 萬會員提供服務的整體健康連接的宣傳解決方案中擁有強大的吸引力，同比增長 33%。這些計劃通過簡單、直觀和個性化的體驗引導會員進行下一步的護理。我們利用實時數據分析來識別健康風險，因此他們的倡導者可以親自與成員聯繫，以主動促進預防性和有時響應性的護理。

Our commitment to whole health solutions extends to our care providers, where we continue to advance value-based care and are increasingly looking to integrate health equity and social drivers of health measures into our contracts. The early indicators we are seeing in Commercial, Medicare and Medicaid businesses demonstrate that value-based care delivers higher quality care and greater affordability. In fact, our value-based providers are helping us achieve significantly higher quality scores for impacted plans, including an 8-point improvement in quality compliance measures for Commercial members and value-based arrangements.

我們對整體健康解決方案的承諾延伸到我們的護理提供者，我們繼續推進基於價值的護理，並越來越多地尋求將健康公平和健康措施的社會驅動因素納入我們的合同。我們在商業、醫療保險和醫療補助業務中看到的早期指標表明，基於價值的護理提供更高質量的護理和更高的可負擔性。事實上，我們以價值為基礎的提供商正在幫助我們為受影響的計劃獲得更高的質量分數，其中包括商業會員和基於價值的安排的質量合規措施提高了 8 分。

In addition, our value-based provider partners are conducting 12% more annual wellness visits with our members on average and delivering lower overall costs for our Commercial, Medicare Advantage and Medicaid members, with 19% lower emergency cases per 1,000 for members and value-based arrangements compared to those not and 50% lower inpatient admissions. With the highest local concentration of membership of any health insurer, we're taking a market-by-market approach to our provider strategy to accelerate value-based care.

此外，我們基於價值的提供商合作夥伴每年與我們的會員進行的健康訪問次數平均增加了 12%，並為我們的商業、醫療保險優勢和醫療補助會員提供了更低的總體成本，每 1,000 名會員的緊急情況減少了 19%，並且價值-與那些沒有的安排相比，住院病人的入院率降低了 50%。憑藉任何健康保險公司的最高本地會員集中度，我們正在對我們的供應商戰略採取逐個市場的方法來加速基於價值的護理。

Our local market density is unique and a valuable strategic advantage that provides optionality, allowing us to balance partnerships and investments in certain care models and geographies with select ownership through Carelon in markets where we see opportunity. We do not believe a single primary care model will prove superior for all populations and markets over time, and we are committed through a thoughtful approach that considers the structure of care delivery in our local markets and our membership density across lines of business, notably with respect to complex and chronic members.

我們的本地市場密度是獨一無二的，並且是一項寶貴的戰略優勢，提供了選擇性，使我們能夠在我們看到機會的市場中通過 Carelon 來平衡對某些護理模式和地區的合作夥伴關係和投資以及選擇所有權。我們不相信單一的初級保健模式會隨著時間的推移證明對所有人群和市場都具有優越性，我們致力於通過一種深思熟慮的方法來考慮我們當地市場的護理提供結構和我們跨業務線的會員密度，特別是尊重複雜和長期的成員。

With our deep roots in our communities, we're continuing to leverage our proprietary Whole Health Index, a dynamic model tracking the health of our communities across local, social and clinical drivers. We're increasingly using the tool to measure our impact on the health of our communities and to identify and better address local, social and physical drivers of health with an emphasis on health equity and members who need us most.

憑藉我們在社區中的深厚根基，我們將繼續利用我們專有的整體健康指數，這是一個動態模型，在本地、社會和臨床驅動因素中跟踪我們社區的健康狀況。我們越來越多地使用該工具來衡量我們對社區健康的影響，並確定和更好地解決當地、社會和身體健康的驅動因素，重點是健康公平和最需要我們的成員。

We've leveraged the tool to identify at-risk or equity-challenged member populations across Medicare, dual special needs plans, Medicaid and our commercial exchange-based populations. And we're working with community-based partners to coordinate engagement, outreach and support, bridging physical, behavioral and social services.

我們利用該工具在醫療保險、雙重特殊需求計劃、醫療補助和我們基於商業交換的人群中識別處於風險或面臨公平挑戰的成員人群。我們正在與基於社區的合作夥伴合作，協調參與、外展和支持，在身體、行為和社會服務方面架起橋樑。

In practice, we're reimagining the ecosystem of care delivery for our most vulnerable members with plans to scale learnings for even greater member impact in care coordination over time. We're privileged to be in a position to positively impact our members' lives, especially in light of the challenges faced since the beginning of the pandemic. In addition to helping us achieve our purpose as an organization, to improve the health of humanity, we're confident that our efforts are being recognized through our industry-leading Medicaid RFP track record.

在實踐中，我們正在為我們最脆弱的成員重新構想提供護理的生態系統，併計劃擴大學習規模，以便隨著時間的推移在護理協調中產生更大的成員影響。我們很榮幸能夠對我們會員的生活產生積極影響，特別是考慮到自大流行開始以來所面臨的挑戰。除了幫助我們實現我們作為一個組織的目標、改善人類健康之外，我們相信我們的努力正在通過我們行業領先的 Medicaid RFP 跟踪記錄得到認可。

Core to our enterprise-wide focus on whole health, we also continue to accelerate our service and capabilities business through Carelon to connect people to accessible, affordable and integrated care with focus on those with complex needs. The top priority for Carelon today is to work in concert with our health plans to develop offerings that drive differentiated value for the 47 million medical members we serve, including more than 20 million fully insured members and the more than 118 million consumers we support across Elevance Health.

作為我們在整個企業範圍內對整體健康的關注的核心，我們還繼續通過 Carelon 加速我們的服務和能力業務，以將人們連接到可訪問、負擔得起的綜合護理，重點是那些有復雜需求的人。今天，Carelon 的首要任務是與我們的健康計劃合作，開發為我們服務的 4700 萬醫療會員（包括超過 2000 萬完全保險會員和我們在 Elevance 支持的超過 1.18 億消費者）帶來差異化價值的產品健康。

Partnering with owned and aligned providers, our near-term focus is driving greater affordability and quality outcomes by providing the right care in the right settings, such as enabling care in the home or more effectively managing specialty pharmacy.

與自有和一致的供應商合作，我們近期的重點是通過在正確的環境中提供正確的護理來提高可負擔性和質量結果，例如實現家庭護理或更有效地管理專業藥房。

As an example, MyNEXUS, with its deep experience in managing home-based care, recently launched a new post-acute care product serving our Medicare Health Plan in Indiana via a capitated risk-sharing arrangement. Enabling providers with better technology and tools, MyNEXUS will help optimize appropriate levels of care post inpatient discharge, delivering a much better patient and provider experience while having a positive impact on our health plans and driving growth for Carelon. Over the next 6 to 12 months, we expect to scale the post-acute care product to all of Elevance Health Medicare markets.

例如，MyNEXUS 憑藉其在管理家庭護理方面的豐富經驗，最近推出了一種新的急性後護理產品，通過按人頭計費的風險分擔安排服務於我們在印第安納州的 Medicare 健康計劃。 MyNEXUS 為提供者提供更好的技術和工具，將有助於優化住院出院後的適當護理水平，提供更好的患者和提供者體驗，同時對我們的健康計劃產生積極影響並推動 Carelon 的增長。在接下來的 6 到 12 個月內，我們預計會將急性後護理產品擴展到所有 Elevance Health Medicare 市場。

For more than 30 years, we've been recognized as a leader in behavioral health management, an area that is a major driver of health care cost today and a critical component of whole person health. We manage behavioral health benefits inside of Carelon for more than 40 million consumers. And our expertise in this space was reinforced recently when Beacon, a Carelon Company, was awarded a contract to participate in the operation of the new 988 National Suicide Prevention Lifeline. The launch of 988 is a game-changing shift in how mental health services are accessed in our country, and we're proud to be part of this historic milestone.

30 多年來，我們一直被公認為行為健康管理領域的領導者，該領域是當今醫療保健成本的主要驅動力，也是全人健康的重要組成部分。我們在 Carelon 內部為超過 4000 萬消費者管理行為健康福利。最近，當 Carelon 公司 Beacon 獲得一份參與新的 988 國家自殺預防生命線運營的合同時，我們在這一領域的專業知識得到了加強。 988 的推出是我們國家獲取心理健康服務方式的一個改變遊戲規則的轉變，我們很自豪能成為這一歷史性里程碑的一部分。

Guided by our enterprise strategy, we are fueled by a passion for making a positive difference in the world. In fact, environmental, social and governance frameworks are integral to our enterprise strategy. And we understand the connection to long-term business success. Accordingly, we continue to invest in key areas such as health equity, greenhouse gas mitigation and community health as part of our ESG practices.

在我們的企業戰略的指導下，我們充滿激情地為世界帶來積極的變化。事實上，環境、社會和治理框架是我們企業戰略不可或缺的一部分。我們了解與長期業務成功的關係。因此，作為我們 ESG 實踐的一部分，我們將繼續投資於健康公平、溫室氣體減排和社區健康等關鍵領域。

We're also proud to be an initial signatory to the health care sector climate pledge focused on achieving net-zero greenhouse gas emissions by 2050. We are confident in our organization's ability to adapt and to achieve our pledge, having met our goal of powering all of our operations with 100% renewable electricity earlier this year, 4 years ahead of schedule. We're proud that these efforts have been recognized externally.

我們也很自豪能成為衛生保健部門氣候承諾的初始簽署方，該承諾的重點是到 2050 年實現溫室氣體淨零排放。我們對我們組織適應和實現承諾的能力充滿信心，實現了我們的目標今年早些時候，我們所有的運營都使用 100% 可再生電力，比計劃提前了 4 年。我們很自豪這些努力得到了外界的認可。

Elevance Health was recently named to Points of Light 2022 List of the Civic 50, a national standard for corporate citizenship. Just 100 ranked our organization first among health care providers for just business behavior. And we are the highest rated managed health care company by ISS and Sustainalytics, including a perfect quality score from ISS.

Elevance Health 最近被評為 2022 年公民 50 強光點名單，這是企業公民的國家標準。只有 100 家將我們的組織評為僅商業行為的醫療保健提供者之首。我們是 ISS 和 Sustainalytics 評價最高的託管醫療保健公司，其中包括 ISS 的完美質量評分。

In closing, I'd like to thank our nearly 100,000 associates for the important work they do every day on behalf of the members we are privileged to serve. Our passion to improve lives and communities is unwavering, and we look forward to making a meaningful difference as Elevance Health.

最後，我要感謝我們近 100,000 名員工每天代表我們有幸服務的會員所做的重要工作。我們對改善生活和社區的熱情堅定不移，我們期待著作為 Elevance Health 做出有意義的改變。

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. Earlier this morning, we reported second quarter results, including GAAP earnings per share of $6.79 and adjusted earnings per share of $8.04, reflecting growth of more than 14% year-over-year. We were pleased to deliver another quarter of double-digit growth in revenue, operating income and adjusted earnings per share, driven by the disciplined execution of our strategy.

謝謝你，蓋爾，大家早上好。今天上午早些時候，我們公佈了第二季度業績，包括 6.79 美元的 GAAP 每股收益和 8.04 美元的調整後每股收益，反映同比增長超過 14%。在嚴格執行我們的戰略的推動下，我們很高興在收入、營業收入和調整後每股收益方面又實現了兩位數的增長。

Our results exceeded our expectations. And with momentum in all of our businesses and confidence in our growth trajectory, we have increased our full year earnings per share outlook. We ended the second quarter with 47.1 million members, up 2.7 million or 6.1% year-over-year, including growth of 276,000 members in the second quarter. We grew enrollment year-over-year in each of our benefit businesses with approximately 90% of our membership growth being organic, supplemented by the acquisitions of the Paramount and Integra Health Plans, which added 255,000 members and 43,000 Medicaid members in the first and second quarters of this year, and together strengthened our footprint in 2 attractive existing markets.

我們的結果超出了我們的預期。憑藉我們所有業務的發展勢頭以及對我們增長軌蹟的信心，我們提高了全年每股收益預期。我們在第二季度結束時擁有 4710 萬會員，同比增長 270 萬或 6.1%，其中第二季度增加了 276,000 名會員。我們在每個福利業務中的註冊人數逐年增加，大約 90% 的會員增長是有機增長的，此外還收購了 Paramount 和 Integra Health Plans，在第一和第二年增加了 255,000 名會員和 43,000 名 Medicaid 會員今年幾個季度，共同加強了我們在兩個有吸引力的現有市場的足跡。

Second quarter operating revenue of $38.5 billion increased $5.2 billion or approximately 16% over the prior year quarter with strong growth in each of our businesses. We earned higher premium revenue driven by membership growth in Medicaid, Medicare and Commercial; premium rate increases to cover overall cost trends; the acquisitions of Paramount and Integra; and the timing of the MMM acquisition, which closed at the end of the second quarter in the prior year. Our services businesses, Carelon and IngenioRx, produced very strong growth. IngenioRx revenue grew 14% year-over-year, while the other segment revenue, comprised primarily of Carelon, grew operating revenue 31%.

第二季度營業收入為 385 億美元，比去年同期增加 52 億美元或約 16%，我們的每項業務都實現了強勁增長。在 Medicaid、Medicare 和 Commercial 會員增長的推動下，我們獲得了更高的保費收入；提高保費率以涵蓋整體成本趨勢；收購派拉蒙和 Integra；以及 MMM 收購的時間，該收購於上一年第二季度末結束。我們的服務業務 Carelon 和 IngenioRx 實現了非常強勁的增長。 IngenioRx 收入同比增長 14%，而主要由 Carelon 組成的其他部門收入增長了 31%。

The strong performance in our services businesses is being driven by the disciplined execution of our strategy to work side-by-side with our health plans, the scale services that drive differentiated value for consumers, beginning with the more than 47 million medical members, which includes the more than 20 million that are fully insured, for whom we can more quickly roll out new capabilities.

我們服務業務的強勁表現得益於我們嚴格執行與我們的健康計劃並肩工作的戰略，為消費者帶來差異化價值的規模服務，從超過 4700 萬醫療會員開始，包括超過 2000 萬完全保險的人，我們可以更快地為他們推出新功能。

Beyond helping to improve our members' lives and reducing health care costs across the system, the growth of Carelon and IngenioRx are aiding diversification of Elevance Health's businesses and producing cash flow in noninsurance and therefore, nonregulated entities. Revenue eliminated in consolidation, a proxy for business between Carelon and IngenioRx and our own risk-based health plans grew 24% year-over-year in the second quarter and represented 21.8% of the consolidated benefit expense, up from 20.5% a year ago.

除了幫助改善我們會員的生活和降低整個系統的醫療保健成本外，Carelon 和 IngenioRx 的增長還有助於 Elevance Health 業務的多元化，並在非保險和非監管實體中產生現金流。合併中消除的收入，代表 Carelon 和 IngenioRx 之間的業務以及我們自己的基於風險的健康計劃在第二季度同比增長 24%，佔合併福利支出的 21.8%，高於一年前的 20.5% .

The consolidated benefit expense ratio for the second quarter was 87%, an increase of 20 basis points over the second quarter of 2021, driven primarily by the shift in mix of business towards government programs, which carry higher medical loss ratios relative to the Commercial business.

第二季度的綜合福利費用率為 87%，比 2021 年第二季度增加 20 個基點，主要是由於業務組合向政府計劃的轉變，與商業業務相比，政府計劃的醫療損失率更高.

The overall medical cost structure across our insurance businesses remained higher than what we consider to be a normalized level had the pandemic never happened, with Commercial furthest above, Medicare near normal cost levels and Medicaid still somewhat below. However, medical costs in the quarter were slightly favorable to our expectations. We expect the cost structure for health plans to remain somewhat elevated in the back half of the year, which is reflected in our guidance.

如果大流行從未發生過，我們保險業務的整體醫療成本結構仍高於我們認為的正常水平，其中商業成本最高，醫療保險接近正常成本水平，醫療補助仍略低於正常成本水平。然而，本季度的醫療費用略好於我們的預期。我們預計醫療計劃的成本結構將在今年下半年保持較高水平，這反映在我們的指導中。

Elevance Health's SG&A ratio in the second quarter was 11.1% on a GAAP basis, a decrease of 40 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. Second quarter operating cash flow was $2.5 billion or 1.5x net income, which includes the impact of higher working capital in relation to certain provider pass-through payments in one of our Medicaid states that we anticipate will be paid in the third quarter of this year.

Elevance Health 第二季度的 SG&A 比率按公認會計原則計算為 11.1%，比去年同期下降 40 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的投資增加所抵消。第二季度運營現金流為 25 億美元或淨收入的 1.5 倍，其中包括與我們預計將在今年第三季度支付的醫療補助州之一的某些供應商轉帳付款相關的較高營運資金的影響.

As a reminder, we also continue to expect to pay $500 million, which is our share of the Blue Cross Blue Shield Association's litigation settlement.

提醒一下，我們還預計將繼續支付 5 億美元，這是我們在藍十字藍盾協會訴訟和解中的份額。

Turning to our balance sheet. We ended the second quarter with a debt-to-capital ratio of 39.7%, in line with our expectations and consistent with our target range. During the quarter, we repurchased approximately 1.3 million shares of common stock for $624 million. Year-to-date, we've been opportunistic with respect to share repurchases during periods of volatility in our stock and have already repurchased 2.5 million shares for $1.2 billion.

轉向我們的資產負債表。我們以 39.7% 的債務資本比率結束了第二季度，符合我們的預期並符合我們的目標範圍。本季度，我們以 6.24 億美元回購了約 130 萬股普通股。年初至今，我們在股票波動期間對股票回購持機會主義態度，並且已經以 12 億美元的價格回購了 250 萬股股票。

Our full year outlook of $1.5 billion is, however, still an appropriate figure for full year modeling purposes. We continue to maintain a prudent posture with respect to reserves. Days and claims payable stood at 47.8 days at the end of the second quarter, an increase of 0.9 days sequentially and a decrease of 0.3 days year-over-year. DCPs would have been 46 days, excluding the timing of certain provider pass-through payments that we will anticipate in the third quarter of this year.

然而，我們對 15 億美元的全年展望仍然是用於全年建模目的的合適數字。我們在儲備方面繼續保持審慎的姿態。二季度末天數及應付理賠天數為47.8天，環比增加0.9天，同比減少0.3天。 DCP 應該是 46 天，不包括我們預計在今年第三季度的某些供應商轉帳付款的時間。

As a reminder, DCPs were elevated by 1.6 days in the second quarter last year due to the timing of acquisitions. Normalizing for timing-related impacts, DCPs are very consistent on a year-over-year basis. Given stronger-than-expected performance year-to-date and the continued momentum in each of our businesses, we are increasing our full year earnings outlook.

提醒一下，由於收購的時機，去年第二季度 DCP 增加了 1.6 天。對於與時間相關的影響進行標準化，DCPs 在逐年的基礎上非常一致。鑑於年初至今強於預期的業績以及我們每項業務的持續發展勢頭，我們正在上調全年盈利前景。

We now expect adjusted earnings per share to be greater than $28.70, implying growth of approximately 14% off of the adjusted baseline of $25.20 provided at the beginning of the year.

我們現在預計調整後的每股收益將超過 28.70 美元，這意味著比年初提供的調整後基線 25.20 美元增長約 14%。

In closing, we are pleased to have delivered another strong quarter, our first reported as Elevance Health. In my 28 years with the company, this is easily the most prepared and well balanced our enterprise has been as we look into the future. Strong underlying fundamentals, coupled with our balanced and diverse set of businesses, gives me confidence in our ability to deliver another strong year of growth in 2022, regardless of how the macroeconomic environment evolves. The diversification of our enterprise and the resilience that provides is an extremely valuable asset.

最後，我們很高興實現了又一個強勁的季度，我們第一次報告為 Elevance Health。在我為公司工作的 28 年裡，這很容易成為我們企業在展望未來時準備得最充分、最平衡的一次。強勁的基本面，加上我們平衡和多樣化的業務，讓我對我們有能力在 2022 年實現又一個強勁增長的一年充滿信心，無論宏觀經濟環境如何演變。我們企業的多元化和提供的彈性是一項極其寶貴的資產。

Consider that in 2021, operating revenue of our Commercial and Specialty businesses represented just 25% of our total gross operating revenue, down from nearly 70% in 2008. And for the first time last year, operating earnings in our government business exceeded operating earnings in our commercial business. It is no coincidence that we have produced strong growth for our enterprise in both good and bad times for the broader economy in recent years.

考慮到 2021 年，我們的商業和專業業務的營業收入僅占我們總營業收入的 25%，低於 2008 年的近 70%。去年，我們政府業務的營業收入首次超過營業收入我們的商業業務。近年來，無論是在整體經濟的好壞時期，我們都為我們的企業帶來了強勁的增長，這絕非巧合。

Simply put, we are well prepared to meet the needs of our clients should they evolve in response to a more challenged business environment. Today, the momentum in each of our businesses, driven by the disciplined execution of our strategy, coupled with the diversity of our businesses, positions us uniquely well.

簡而言之，我們已準備好滿足客戶的需求，以應對更具挑戰性的商業環境。今天，我們每項業務的發展勢頭，在我們嚴格執行戰略的推動下，加上我們業務的多樣性，使我們處於獨特的有利地位。

With that, operator, please open the line for questions.

有了這個，接線員，請打開問題線。

(Operator Instructions) For our first question, we'll go to the line of A.J. Rice from Credit Suisse.

（操作員說明）對於我們的第一個問題，我們將轉到 A.J.瑞士信貸大米。

Just maybe drill down a little more on the comments around the commercial business. I know the commercial operating margin dipped year-to-year to 7.6%. And I wondered, it sounds like you're seeing elevated utilization there. Is that something that you just think is temporary? Will that correct itself? And are you moving toward making pricing adjustments for '23 on that? Or is this sort of the run rate to go forward with?

只是可能進一步深入了解有關商業業務的評論。我知道商業運營利潤率同比下降至 7.6%。我想知道，聽起來你在那裡看到了更高的利用率。你認為那是暫時的嗎？這會自我糾正嗎？您是否正在朝著 23 年的價格調整方向邁進？還是這種運行速度可以繼續前進？

Thanks for the question, A.J. I think as you think about our commercial business, there's a couple -- like I want to parse out a little bit of what you're seeing in that business, because I think it's important to first look at the entire business. One, we've had strong and consistent growth and feel pretty good -- very good about our business in the last few years. And there's 2 elements. One is obviously the risk-based business and the other fee-based business. I'm going to start with the fee based, and I'll address your question directly on risk base.

謝謝你的問題，A.J.我認為當您考慮我們的商業業務時，有幾個 - 就像我想解析您在該業務中看到的一些內容，因為我認為首先查看整個業務很重要。第一，我們擁有強勁且持續的增長，感覺非常好——過去幾年我們的業務非常好。並且有2個元素。一個顯然是基於風險的業務，另一個是基於費用的業務。我將從基於費用開始，我將直接基於風險解決您的問題。

In terms of the fee-based business, we're making really good progress on the strategy around margin improvement, and as we've laid out on the 5:1 to 3:1 strategy, and we continue to grow our fee-based business, I think, at an industry-leading rate. And just a couple of, I think, proof points that help show that even inside of the totality of the business, our fee revenue grew 7.9% year-over-year, and then if you just look at it sequentially, 7.3% for the 6 months ending June 30, which shows that acceleration of growth that we've been talking about. And you compare that to our membership, which grew about 3.4% year-over-year. So clearly, there is really good improvement. And I think we're very much on the progression that we described at our Investor Day to improve our revenue for fee-based members.

在收費業務方面，我們在提高利潤率的戰略上取得了非常好的進展，正如我們制定的 5:1 到 3:1 戰略一樣，我們繼續發展我們的收費業務我認為，以行業領先的速度開展業務。我認為，只有幾個證明點有助於表明，即使在整個業務範圍內，我們的費用收入也同比增長了 7.9%，然後如果您按順序查看，則為 7.3%截至 6 月 30 日的 6 個月，這表明我們一直在談論的增長加速。您將其與我們的會員資格進行比較，會員人數同比增長約 3.4%。很明顯，確實有很好的改進。而且我認為我們非常符合我們在投資者日所描述的進步，以提高收費會員的收入。

Turning to the operating margin, more in our risk-based business. As I've shared before, that does remain challenged by COVID, and that really is what we believe to be the most significant issue, and we do think it's transitory. We do expect our margins to recover to the pre-pandemic levels and are taking actions to do that. You saw an improvement overall from first to second quarter. But again, this has to pace through as we do renewals.

談到營業利潤率，更多的是我們基於風險的業務。正如我之前分享的那樣，這確實仍然受到 COVID 的挑戰，這確實是我們認為最重要的問題，而且我們確實認為它是暫時的。我們確實希望我們的利潤率能夠恢復到大流行前的水平，並正在採取行動來做到這一點。從第一季度到第二季度，您看到了總體上的改善。但同樣，這必須在我們進行更新時進行。

The last thing I would say is we also know we've been in this pandemic now for several years. COVID is not going to 0. Ultimately, as we think about our pricing in the commercial market, we're not changing anything about the approach or philosophy that we've used historically. We're always pricing to our forward view of costs.

我要說的最後一件事是，我們也知道我們已經經歷了這種大流行好幾年了。 COVID 不會歸零。最終，當我們考慮在商業市場中的定價時，我們不會改變我們過去使用的方法或理念。我們總是根據我們對成本的前瞻性看法來定價。

If you look at this year, COVID hit at a time high in January and February. So as we look to forward pricing, we're looking around all of our costs and now, I think, have a much better perspective on projection of what those costs should be. And so you'll see ratable improvement over the course.

如果你看一下今年，COVID 在 1 月和 2 月創下歷史新高。因此，當我們展望遠期定價時，我們正在審視我們所有的成本，我認為現在對這些成本應該是多少有了更好的預測。因此，您將在課程中看到可評價的改進。

And maybe I'll ask John to just talk about your question on utilization a little bit. John?

也許我會請約翰談談你關於利用率的問題。約翰？

Yes. Thank you, A.J. And associated with utilization, in our first quarter call, I think we were very clear that the Omicron surge in January was most significant to the commercial market. And so that obviously has a direct impact on the Commercial margins. And even as we go through the full 6 months and project out for the rest of 2022, we do believe that Commercial will have a cost structure, when you add COVID and non-COVID combined, to be in excess of baseline -- above baseline actually each quarter for the year. Medicare is going to be close to baseline. And Medicaid, we expect to be a bit below baseline. Overall, the entire company above baseline for the rest of the year. So clearly, those cost structures being directed more towards the commercial marketplace have a direct impact on the commercial margins that you're seeing. And as Gail said, we do believe that they're transitory, and that we will price the forward trend for the future.

是的。謝謝你，A.J.與利用率相關的是，在我們的第一季度電話會議中，我認為我們非常清楚 1 月份 Omicron 的飆升對商業市場來說是最重要的。因此，這顯然對商業利潤有直接影響。即使我們經歷了整整 6 個月併計劃到 2022 年剩餘時間，我們確實相信，當您將 COVID 和非 COVID 結合起來時，商業的成本結構將超過基線 - 高於基線實際上是一年中的每個季度。醫療保險將接近基線。而醫療補助，我們預計會略低於基線。總體而言，整個公司在今年剩餘時間裡都高於基線。很明顯，那些更多地面向商業市場的成本結構對您所看到的商業利潤有直接影響。正如蓋爾所說，我們確實相信它們是暫時的，我們將為未來的前進趨勢定價。

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。

If I could just follow up on A.J.'s question first. You have a 2025 margin target, I think, in the Commercial business of 11% out there. Let's say, you do close to 8% this year, do you still take 11% a reasonable target for 2025? And if so, how do you think the pace of kind of getting there is over the next 3 years?

如果我能先跟進 A.J. 的問題。我認為，商業業務的 2025 年利潤率目標是 11%。比方說，你今年接近 8%，你仍然認為 11% 是 2025 年的合理目標嗎？如果是這樣，您認為未來 3 年實現這一目標的速度如何？

And then my question would just be, can you give us an update on the City of New York contract? Looks like you pulled out of that. Can you give us some background on how that affects numbers?

然後我的問題是，你能告訴我們紐約市合同的最新情況嗎？看起來你已經退出了。你能給我們一些關於這如何影響數字的背景嗎？

Sure. Well, thanks for the question, Justin. Let me address your first question. We have not changed our 2025 perspective in the short run, different impacts that we didn't obviously have at the time we gave that, but we haven't changed anything about our 2025 overall margin perspective across the businesses that we shared. So I just want to be really clear about that.

當然。好吧，謝謝你的問題，賈斯汀。讓我回答你的第一個問題。在短期內，我們沒有改變我們對 2025 年的看法，我們當時顯然沒有改變不同的影響，但我們沒有改變我們共享的業務中對 2025 年整體利潤率的看法。所以我只想說清楚這一點。

In terms of your second question, the City of New York contract, a couple of things on that. One, when we originally bid on this contract, it was set to go live in January 1 of this year. But as you know, and we've shared on this call, due to litigation, that go-live date has been delayed several times now. Based on the fact that we've been on in the active litigation, we had asked the City for some certainty around exactly what the benefits would be. And also, quite frankly, Medicare Advantage contracts take a lot of work to put up, and we want to make sure that the members were best served. We've served these members for a long time, and we needed greater certainty.

關於你的第二個問題，紐約市的合同，還有幾件事。一，我們最初對這份合同進行投標時，它定於今年 1 月 1 日上線。但正如你所知，我們在這次電話會議上分享了，由於訴訟，上線日期現在已經推遲了好幾次。基於我們一直在進行積極訴訟的事實，我們已經要求紐約市確定具體的好處是什麼。而且，坦率地說，Medicare Advantage 合同需要大量工作才能完成，我們希望確保為會員提供最好的服務。我們已經為這些成員服務了很長時間，我們需要更大的確定性。

So we did not feel, based on the inability of what's going on with the litigation as well as being prepared, that we could go forward with the contract. And then notably, the city remains one of our very important customers, and we continue to serve those clients on a fee-based business. So that's where we stand on the city in New York. Thanks very much for the question, though.

因此，由於無法進行訴訟以及做好準備，我們不認為我們可以推進合同。然後值得注意的是，這座城市仍然是我們非常重要的客戶之一，我們繼續通過收費業務為這些客戶提供服務。這就是我們在紐約市的立場。不過，非常感謝這個問題。

Next, we'll go to the line of Lance Wilkes from Bernstein.

接下來，我們將轉到伯恩斯坦的 Lance Wilkes 路線。

Yes. Could you talk a little bit about the Carelon business. And in particular, I'm interested in as you look at penetration in the fully insured and the self-insured business, what is the current status of kind of product penetration there? And what are the biggest opportunities for you as you drive that forward?

是的。你能談談 Carelon 的業務嗎？特別是，當您看到全保和自保業務的滲透率時，我很感興趣，那裡的產品滲透率現狀如何？在你推動這一進程的過程中，對你來說最大的機會是什麼？

Thanks for the question, Lance. I'm going to have Pete Haytaian, who leads Carelon, please address that. Pete?

謝謝你的問題，蘭斯。我將請領導 Carelon 的 Pete Haytaian 解決這個問題。皮特？

Thanks, Lance. Appreciate the question. First of all, we're really pleased with our progress and performance in Carelon so far from a growth and operating perspective as we build up the services business. Overall, Q2 is in line with the improvements we expected. I'm really pleased with the performance improvements across all the verticals. As we've discussed before, Lance, one of our main focal points is really driving more capitation and risk through Carelon. So as it relates to progress, we're really executing on that strategy with strength. So from a cross-selling perspective, we've played that through in Beacon, in AIM and with MyNEXUS. As we talked about with AIM, we just finalized capitating a lot of the services this year starting last year.

謝謝，蘭斯。欣賞這個問題。首先，在我們建立服務業務的過程中，從增長和運營的角度來看，我們對 Carelon 的進展和表現感到非常滿意。總體而言，第二季度符合我們預期的改善。我對所有垂直領域的性能改進感到非常滿意。正如我們之前討論過的，蘭斯，我們的主要焦點之一是通過 Carelon 真正推動更多的人頭和風險。因此，由於它與進步有關，我們確實在大力執行該戰略。因此，從交叉銷售的角度來看，我們已經在 Beacon、AIM 和 MyNEXUS 中實現了這一點。正如我們與 AIM 討論的那樣，我們剛剛確定了從去年開始的今年很多服務的資本化。

We're also executing on our strategy associated with growth, and I'm really excited about the innovation that's occurring. Gail mentioned in her remarks, a really great example is the rollout of a post-acute care offering being MyNEXUS. This is a great example of penetrating our business to a greater degree.

我們也在執行與增長相關的戰略，我對正在發生的創新感到非常興奮。蓋爾在她的講話中提到，一個非常好的例子是推出急性後護理產品 MyNEXUS。這是在更大程度上滲透我們業務的一個很好的例子。

I think you've heard me talk about this before, but one of the things we're trying to do is naturally extend our offerings and penetrate our business to a greater degree. And that's exactly what the post-acute care offering is. We're taking the tools, technology and capabilities of MyNEXUS, and we're utilizing that with a new offering to penetrate the Medicare business in a much more broad way. So I'm really thrilled with the progress. You'll continue to see that. I think the opportunities are vast in terms of further penetration.

我想你以前聽過我談論這個，但我們正在嘗試做的事情之一是自然地擴展我們的產品並在更大程度上滲透我們的業務。這正是急性後護理產品的特點。我們正在利用 MyNEXUS 的工具、技術和功能，並通過新產品利用它以更廣泛的方式滲透醫療保險業務。所以我對進展感到非常興奮。你會繼續看到這一點。我認為進一步滲透的機會是巨大的。

Yes. Thanks, Pete, and thanks for the question, Lance. And I think, as Pete shared, we're excited about this business. It's an important strategic lever for us. But importantly, it's really early innings. And the examples that I shared in my early -- earlier comments to show that we can begin to implement this in certain markets, get experience on it on a risk basis and then roll it out to the rest of our 20 million-plus risk-based members and 47 million total. So lot of opportunity for us, but we also want to make sure we execute this with precision and benefit both our health plans as well as Carelon.

是的。謝謝皮特，謝謝蘭斯的提問。我認為，正如皮特所分享的，我們對這項業務感到興奮。這對我們來說是一個重要的戰略槓桿。但重要的是，這真的是早期的一局。我在早期分享的例子——早些時候的評論表明我們可以開始在某些市場實施這一點，在風險基礎上獲得經驗，然後將其推廣到我們超過 2000 萬風險的其餘部分——基礎成員和總數為 4700 萬。對我們來說有很多機會，但我們也希望確保我們精確地執行此操作，並使我們的健康計劃和 Carelon 都受益。

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。

This is Cal Sternick on for Lisa. A quick question on the Medicaid redeterminations. So what are you assuming for timing on when those will resume? And I know you've previously talked about retaining about 1/3 of the members you added during the public health emergency period. Does that still seem like the right target in your view?

這是麗莎的卡爾斯特尼克。關於醫療補助重新確定的快速問題。那麼，您對何時恢復這些時間有何假設？而且我知道您之前曾談到保留您在突發公共衛生事件期間添加的大約 1/3 的成員。在您看來，這仍然是正確的目標嗎？

I'm going to ask Felicia, who leads our government business, to please address that. Felicia?

我要請領導我們政府事務的費利西亞解決這個問題。費利西亞？

And thank you for the question. As you know, the PHE was recently extended to October 13. So it follows that we are going to have Medicaid attrition related to redetermination that could begin as early as November. However, I would say, given back-to-school, it's also possible that COVID prevalence could rise around the September, October time frame or that the population might need boosters or other vaccines. So at this point, it's really simply too early to predict, but it's certainly possible that we could have a PHE extension into January of 2023.

謝謝你的問題。如您所知，PHE 最近被延長至 10 月 13 日。因此，我們將最早在 11 月開始與重新確定相關的 Medicaid 減員。但是，我想說，鑑於返校，COVID 流行率也有可能在 9 月、10 月的時間範圍內上升，或者人們可能需要加強劑或其他疫苗。所以在這一點上，現在預測還為時過早，但我們肯定有可能將 PHE 延期到 2023 年 1 月。

If there is another extension into January of 2023, that could lead to Medicaid attrition starting right around the February time frame. So redeterminations would then commence over what would be 14 months, given guidance from CMS that ask states to have up to 14 months to redetermine members and not redetermine more than one night of that membership in a single month.

如果再延長到 2023 年 1 月，這可能會導致 Medicaid 的減員從 2 月的時間框架左右開始。因此，根據 CMS 的指導，重新確定將在 14 個月內開始，該指導要求各州有長達 14 個月的時間重新確定成員，並且在一個月內重新確定該成員的時間不超過一晚。

As we think about where we are, you should keep in mind that we operate obviously in 14 Blue states. And our Medicaid membership -- our total Medicaid membership, I'll say, has grown significantly across that platform. So as we think about where we are today, we are going to continue to work very closely with our commercial colleagues to make sure that we have in place a process for looking very thoughtfully market by market and having a view of the competitive dynamics in those markets and capture as much as we can inside of the Anthem 14 Blue states, where we will be offering ACA plans in nearly every county in 2023.

當我們考慮我們所處的位置時，您應該記住，我們顯然在 14 個藍色州開展業務。我們的 Medicaid 會員資格——我會說，我們的 Medicaid 會員總數在該平台上顯著增長。因此，當我們思考我們今天所處的位置時，我們將繼續與我們的商業同事密切合作，以確保我們制定了一個流程，可以非常周到地逐個市場尋找並了解這些市場的競爭動態市場並在 Anthem 14 Blue 州內盡可能多地捕獲，我們將在 2023 年在幾乎每個縣提供 ACA 計劃。

So as we sit here today, we gave that early numbers, certainly with respect to 35% of that membership staying within Medicaid, another 45% or so going into Commercial plans, about 15% on the exchanges and 5% in uninsured, but the macro environment certainly has changed tremendously.

因此，當我們今天坐在這裡時，我們給出了早期的數字，當然是關於 35% 的會員留在醫療補助計劃中，另外 45% 左右進入商業計劃，大約 15% 在交易所，5% 沒有保險，但是宏觀環境當然發生了翻天覆地的變化。

What we'll say is that we are positioned very well to navigate through the end of this PHE and the return of redeterminations when that happens based on a very balanced portfolio here at Anthem, Elevance Health, I should say. And certainly, we'll continue to work closely with our Commercial colleagues to make sure that our members have access to care, continuity of coverage and can really navigate this landscape when redeterminations begin.

我們要說的是，我應該說，基於 Anthem 的非常平衡的投資組合，我們處於很好的位置，可以通過這個 PHE 的結束和重新確定的回歸。當然，我們將繼續與我們的商業同事密切合作，以確保我們的成員能夠獲得護理、覆蓋的連續性，並能夠在重新裁決開始時真正駕馭這一局面。

Thank you, Felicia. I just want to reiterate one point, I think, that's really important that Felicia made, which she and John have said many times, which is the balanced portfolio that we have across Elevance Health. And one of the statistics that I think really brings at home is there's been more than 6 million Medicaid entrants as part of not doing redeterminations in our 14 Blue states. And we have significantly, regardless of the percentage you look at in our commercial business, have coverage now in nearly every county on our individual exchanges.

謝謝你，費利西亞。我只想重申一點，我認為，Felicia 所做的非常重要，她和 John 已經多次說過，這是我們在 Elevance Health 中擁有的平衡投資組合。我認為真正帶回家的統計數據之一是，在我們的 14 個藍州沒有重新確定的情況下，有超過 600 萬的 Medicaid 進入者。而且，無論您在我們的商業業務中查看的百分比如何，我們現在已經在我們個人交易所的幾乎每個縣都有覆蓋。

So we've been planning for this. We're preparing for it across our businesses and feel very well prepared to manage that. And again, obviously, CMS has given the guidance to take up to 14 months and not determine more than one night at a month. So again, thank you very much for the question. But overall, we feel that we've got very good coverage.

所以我們一直在為此做計劃。我們正在為我們的業務做準備，並為管理它做好了充分的準備。再一次，顯然，CMS 已經給出了長達 14 個月的指導，並且每個月不超過一個晚上。再次感謝您的提問。但總的來說，我們覺得我們的覆蓋面非常好。

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

接下來，我們將轉到 BMO 的 Matt Borsch 產品線。

I just wanted to ask about, as you pull these pieces together or have pulled them together for Carelon, how are you thinking about home health? And I mentioned that in the context that, of course, an acquisition of a home health company by one of your largest competitors and also the issues in the home health area with the shortage of nurses and so forth, and how you're grappling with that, frankly, in the current environment?

我只是想問一下，當您將這些碎片拼湊在一起或為 Carelon 拼湊在一起時，您如何看待家庭健康？我提到的背景是，當然，您最大的競爭對手之一收購了一家家庭保健公司，以及家庭保健領域的護士短缺等問題，以及您如何應對坦率地說，在當前環境下？

Sure, Pete, would you like to address that, please?

當然，Pete，你想解決這個問題嗎？

Yes. No, I appreciate the question, Matt. Home Care is a space we're really interested in. Our focus with Carelon, as we've talked about, is on complex patients. We've talked about being on the right side of health care, giving patients access to services in the most appropriate setting. And certainly, home is a critical component in that regard.

是的。不，我很欣賞這個問題，馬特。家庭護理是我們真正感興趣的領域。正如我們已經談到的，我們與 Carelon 的重點是複雜的患者。我們已經談到站在醫療保健的正確一邊，讓患者在最合適的環境中獲得服務。當然，在這方面，家是一個關鍵組成部分。

I think when you look at our acquisition of MyNEXUS, which closed last year, and its focused on the home through utilization management tools and capabilities and partnering with a very vast network of providers, we have 9 of the top 10 nationally to drive the most appropriate level of services in the home is a good example.

我認為，當您查看我們對去年關閉的 MyNEXUS 的收購時，它通過利用管理工具和功能以及與非常龐大的供應商網絡合作專注於家庭，我們在全國前 10 名中擁有 9 個推動最大家庭中適當的服務水平就是一個很好的例子。

Another example in terms of how we're penetrating the home today is through Aspire. It's a national leading company in the delivery of palliative care services. So I'd say strategically, in the short term, I mentioned this before, we've been looking actively for natural extension opportunities with regard to the assets we have. And again, a great example of that is the post-acute care launch that we just mentioned.

關於我們今天如何滲透家庭的另一個例子是通過 Aspire。它是提供姑息治療服務的全國領先公司。所以我會從戰略上說，在短期內，我之前提到過，我們一直在積極尋找我們擁有的資產的自然擴展機會。再一次，一個很好的例子就是我們剛剛提到的急性後護理啟動。

We also launched most recently, as it relates to the home, the delivery of social determinants of health and star services via those capabilities.

我們最近還推出了與家庭相關的服務，通過這些功能提供健康的社會決定因素和明星服務。

On a longer-term basis, in terms of your question, we really -- we do continue to evaluate further opportunities in terms of direct care that can be provided in the home and delivering that value to all our Elevance Health plans and ensuring patients get the right level of care. And we are very sensitive to your last point about the labor issues. It's been interesting, but a lot of the companies that we've been partnering with have been able to effectively navigate some of the labor issues as it relates to home in terms of our members getting critical care. So that's a good thing right now in the short term.

從長遠來看，就您的問題而言，我們確實 - 我們確實會繼續評估可以在家中提供的直接護理方面的進一步機會，並為我們所有的 Elevance Health 計劃提供價值，並確保患者得到適當的護理水平。我們對你關於勞工問題的最後一點非常敏感。這很有趣，但我們一直在與之合作的許多公司都能夠有效地解決一些與家庭有關的勞工問題，因為我們的會員可以得到重症監護。所以這在短期內是一件好事。

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。

I wanted to ask on the commercial selling season for '23, you're obviously coming off a very strong national account selling season for '22. Could you talk about maybe how those conversations have progressed for the upcoming year? And have there been any changes in the nature of those conversations just given the macro backdrop? And has that changed the opportunity to sell in services like pharmacy or stop loss or others?

我想問一下 23 年的商業銷售旺季，你顯然正在結束 22 年一個非常強勁的全國客戶銷售旺季。您能否談談這些對話在來年的進展情況？在宏觀背景下，這些對話的性質是否有任何變化？這是否改變了出售藥房或止損等服務的機會？

Well, thanks for the question. I'll have Morgan Kendrick, who leads our Commercial and Specialty Business to address that. Morgan?

嗯，謝謝你的問題。我將請領導我們的商業和專業業務的 Morgan Kendrick 來解決這個問題。摩根？

Nathan, thank you for the question. Yes, it's -- the business is cyclical. Typically, these cases renew on a 36- or 60-month cycle. So you think about the very large year we had for the 2022 cycle, 2023 is down from that, and that's expected. There were a number of jumbos last year.

內森，謝謝你的問題。是的，它是——業務是周期性的。通常，這些案例每 36 或 60 個月更新一次。因此，您考慮一下我們在 2022 年周期中擁有的非常大的一年，2023 年低於此，這是意料之中的。去年有很多巨型。

What we're seeing notably, which is consistent with last year, is a number of cases going out for single vendor opportunities. That hasn't changed and what we've seen this year, albeit we have seen the dampening in the large jumbo cases in our geographies. But the conversations are consistent. You can certainly imagine, you alluded to the fact that we've got a talent challenge. And employers have shifted this concept to more of a human capital strategy and how they actually think about their benefits differently in attracting, retaining talent. So that's been a big piece of it.

我們看到的值得注意的是，與去年一致的是，許多案例都在尋求單一供應商的機會。這並沒有改變，我們今年也看到了這種情況，儘管我們已經看到我們所在地區的大型巨型案件有所減少。但對話是一致的。您當然可以想像，您提到了我們面臨人才挑戰的事實。雇主已經將這一概念轉變為更多的人力資本戰略，以及他們在吸引和留住人才方面如何真正考慮自己的利益。所以這是其中很大一部分。

At the end of the day, the conversations are generally focused around 2 things: number one, economics; number two, experience. When we think about the assets that we deliver from a network perspective, nationally, we score very well. Also, when you think about how we think about the experience component, Gail mentioned earlier our total Health Connection suite of services up 33%, with nearly 4 million of our commercial members. That's almost half of our commercial business is using that service. We think that's going to crescendo.

在一天結束時，談話通常集中在兩件事上：第一，經濟；第二，經驗。當我們從網絡的角度考慮我們在全國范圍內交付的資產時，我們的得分非常好。此外，當您考慮我們如何看待體驗組件時，Gail 早些時候提到我們的整體 Health Connection 服務套件增長了 33%，擁有近 400 萬的商業會員。這幾乎是我們商業業務的一半正在使用該服務。我們認為這將逐漸增強。

So we feel confident in it. Certainly, it's a smaller sales cycle. We're seeing that across the country. It's not notable to any geography, but we are seeing wins where we're seeing consolidation, and we're having -- we're starting to get the answers for the [1:1s], they're affirmative, and we feel really good. Thanks again for the question.

所以我們對此充滿信心。當然，這是一個較小的銷售週期。我們在全國范圍內都看到了這一點。這在任何地區都不引人注目，但我們看到了我們看到整合的勝利，我們正在擁有 - 我們開始得到 [1:1s] 的答案，他們是肯定的，我們覺得真的很好。再次感謝您的提問。

I'm going to have Pete address your pharmacy penetration question. Pete?

我要讓皮特解決你的藥房滲透問題。皮特？

Yes. No, thanks for that. And working very closely with Morgan, this is a critical issue for us as we've talked about in terms of penetrating the Elevance book of business and our ASO business. And we continue to get really strong feedback from the distribution community regarding a lot of our solutions. Our pricing is coming in line. Many of our offerings, like our specialty cost relief program, our enhanced specialty condition management programs are really gaining legs as well as the way we're bundling offerings.

是的。不，謝謝。與摩根密切合作，這對我們來說是一個關鍵問題，正如我們在滲透 Elevance 業務手冊和我們的 ASO 業務方面所討論的那樣。對於我們的許多解決方案，我們繼續從分銷社區獲得非常強烈的反饋。我們的定價是一致的。我們的許多產品，例如我們的專業成本減免計劃、我們增強的專業狀況管理計劃以及我們捆綁產品的方式，確實正在獲得支持。

How this is playing out in the market is a really good results and improvement year-over-year. We've experienced a 300% improvement year-over-year, year-to-date in terms of the total numbers sold. And importantly, I want to emphasize at this point, we're seeing a lot of growth in the middle market and down market, less than 10,000 members. It's a really nice sweet spot for us. It's where Morgan and the commercial business do very, very well. And our margin profile is very strong as well as it really plays through on the integrated value proposition, and that is a big contributor to the 5:1 to 3:1 that we've talked about historically.

這在市場上的表現是一個非常好的結果，並且逐年改善。就售出的總數而言，今年以來，我們經歷了 300% 的同比增長。重要的是，我想在這一點上強調，我們在中端市場和低端市場看到了很多增長，不到 10,000 名會員。這對我們來說是一個非常好的甜蜜點。這是摩根和商業業務做得非常非常好的地方。而且我們的利潤率狀況非常強大，並且它確實在綜合價值主張上發揮了作用，這是我們歷史上談到的 5:1 到 3:1 的重要貢獻者。

Yes. Thanks, Pete. I think what you heard from both Morgan and Pete is really, we're very pleased that we're winning in the most sophisticated and discerning segment of the market, and that really plays across all of our customers. So thanks very much for the question.

是的。謝謝，皮特。我認為你從 Morgan 和 Pete 那裡聽到的是真的，我們很高興我們在最複雜和最挑剔的市場領域中獲勝，這確實影響了我們所有的客戶。所以非常感謝這個問題。

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。

Can you hear me now?

你能聽到我嗎？

Yes, we can hear you, Gary.

是的，我們可以聽到你的聲音，加里。

Okay. Great. Sorry. I just want to come back to Commercial operating income a little bit. obviously, you had growth -- modest growth this quarter. COVID's still impacting it. I think earlier in the year, you had talked about some of the extreme quarterly seasonality in Commercial OI easing a bit this year, which would imply that Commercial OI growth in the second half will continue to look better. Just want to make sure that's still your expectation. And particularly with -- just in the early months of July, we are seeing COVID hospitalizations picking up again. Is it still your expectation that, that Commercial OI growth can improve from what we've seen in the first half?

好的。偉大的。對不起。我只想稍微回到商業營業收入。顯然，你有增長——本季度適度增長。 COVID仍在影響它。我認為今年早些時候，您曾談到今年商業 OI 的一些極端季度季節性有所放緩，這意味著下半年商業 OI 的增長將繼續看起來更好。只是想確保這仍然是您的期望。尤其是在 7 月初，我們看到 COVID 住院人數再次增加。您是否仍然期望商業 OI 的增長可以比我們在上半年看到的有所改善？

Thank you for the question, Gary. Associated with the seasonality, I'll just clarify for everyone on the line of what we talked about during the first quarter, was that there are many of the services that Carelon offers are being sold to Commercial on a capitated rate basis. And so the seasonality that historically would have been in Commercial associated with those services is now going to be in our Carelon segment. And commercial will have less seasonality.

謝謝你的問題，加里。與季節性相關，我將向大家澄清我們在第一季度所討論的內容，即 Carelon 提供的許多服務正在按人頭費率出售給 Commercial。因此，歷史上與這些服務相關的商業季節性現在將出現在我們的 Carelon 部分。商業廣告的季節性會更小。

So yes, that is still playing out exactly as we talked about 90 days ago, and that will continue to be part of the quarterly cadence for both of those entities over time. And then associated with the overall cost structure. As I had said, I think in A.J.'s question, we are expecting the commercial cost structure for COVID and non-COVID combined to be above baseline again in the third quarter and again in the fourth quarter, which obviously puts pressure on the overall margins. Thank you.

所以，是的，這仍然像我們 90 天前所說的那樣，隨著時間的推移，這將繼續成為這兩個實體的季度節奏的一部分。然後與整體成本結構相關聯。正如我所說，我認為在 A.J. 的問題中，我們預計 COVID 和非 COVID 的商業成本結構將在第三季度和第四季度再次高於基線，這顯然會給整體帶來壓力邊距。謝謝你。

Thank you. And that, again, as John said, very consistent with the expectations that we've always had.

謝謝你。而且，正如約翰所說，這與我們一直以來的期望非常一致。

Next, we'll go to the line of Scott Fidel from Stephens.

接下來，我們將轉到斯蒂芬斯的斯科特菲德爾線。

I wanted to ask about just for an update on the marketplace business. And if you can talk about how marketplace margins have been performing year-to-date relative to plan. Then also just some initial insights on how you're thinking about the pricing environment for the exchanges in 2023. Obviously, a lot of different moving pieces to pricing as there always seems to be in this business, but does seem that at least some of the most, let's call it, aggressive actors in the market have started to file for some firming rate increases. So just interested in your perspectives on how pricing is looking for the exchanges next year.

我想詢問有關市場業務的最新信息。如果你能談談今年迄今為止市場利潤率相對於計劃的表現如何。然後，還有一些關於您如何考慮 2023 年交易所定價環境的初步見解。顯然，在這個行業中似乎總是有很多不同的定價因素，但似乎至少有一些最多，讓我們稱之為，市場上激進的參與者已經開始申請一些堅定的利率上調。所以只是對你對明年交易所定價的看法感興趣。

Sure. Let me ask Morgan Kendrick to comment on that. Please, Morgan?

當然。讓我請摩根肯德里克對此發表評論。請問，摩根？

Yes, Scott. Thanks for the question. Generally, your question is around how we think about the '23 pricing, again, we've noted we really like this business. There's a great opportunity. Our margins are performing as expected, quite honestly, for '22. We're just now pricing '23. We're in the middle of that cycle. Your point is spot on, that there's always an actor that's looking to take aggressive share in aggressive pricing points in each geography. We are seeing some firming, but there's always a new actor that wants to come into the mix, so to speak. It is a competitive market, but we continue to look at this as an expanding opportunity.

是的，斯科特。謝謝你的問題。一般來說，您的問題是關於我們如何看待 '23 定價，我們再次注意到我們真的很喜歡這項業務。有一個很好的機會。老實說，我們的利潤率在 22 年的表現符合預期。我們現在才定價 '23。我們正處於那個週期的中間。你的觀點是正確的，總是有一個演員希望在每個地區的激進定價點中佔據積極的份額。我們看到了一些堅定，但總有一個新演員想要加入，可以這麼說。這是一個競爭激烈的市場，但我們繼續將其視為一個不斷擴大的機會。

As Gail alluded to and Felicia alluded to, when we think about the Medicaid redetermination, we are now in north of 95% of the counties in the geographies that we serve. So we feel strongly about it. We're taking prudent normal pricing actions. Nothing's changed in our pricing strategy. We're pricing to the forward view of trend with all of -- in modifying for all of the challenges that are currently facing in the business or in the economies. That said, we expect it to be expanding. We've been notified some expansions in some of our largest geographies. We know that we look good in those geographies. So over the next 60 days through -- 60 to 90 days, we will firm up the position. But right now, we feel quite good about it.

正如蓋爾和費利西亞所暗示的那樣，當我們考慮重新確定醫療補助計劃時，我們現在位於我們所服務地區 95% 的縣的北部。所以我們對此有強烈的感覺。我們正在採取謹慎的正常定價行動。我們的定價策略沒有任何變化。我們正在為所有趨勢的前瞻性定價 - 修改當前在業務或經濟中面臨的所有挑戰。也就是說，我們預計它會擴大。我們已獲悉在一些最大的地區進行了一些擴展。我們知道我們在這些地區看起來不錯。因此，在接下來的 60 天內，通過 - 60 到 90 天，我們將鞏固立場。但現在，我們對此感覺很好。

Yes. And thanks, Morgan. I think sort of summarizing that, we feel good about this business. We've had a pretty consistent strategy. We haven't looked for outsized growth. We want to be in markets where we can be for the long term. And that's why you've seen us year-over-year expand the counties we're in as we continue to see the stability of that marketplace. So again, that business is performing along our expectations, and we expect to be in more counties. We see some opportunities, obviously, as redeterminations come in as a real catchers met for some of that. So thanks for the question.

是的。謝謝，摩根。我想總結一下，我們對這項業務感覺良好。我們有一個相當一致的策略。我們沒有尋求過大的增長。我們希望進入可以長期存在的市場。這就是為什麼您看到我們逐年擴大我們所在的縣，因為我們繼續看到該市場的穩定性。再說一次，該業務的表現符合我們的預期，我們希望在更多的縣開展業務。顯然，我們看到了一些機會，因為重新確定是因為真正的捕手遇到了一些機會。所以謝謝你的問題。

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。

I guess mine is really just more of a confirmatory question around some of the comments on the elevated commercial medical cost trends. I think in one part of the Q&A, you mentioned the elevated costs relate to maybe more to the exchange individual membership within Commercial. So I just want to confirm, yes or no, is that the bigger part of what's happening? And I guess just for further clarification, yes or no, is the group risk-based commercial book of business, in particular, seeing elevated medical cost trends above the pre-COVID baseline? Just a little more color around the 2 subsegments within commercial risk.

我想我的問題實際上只是圍繞一些關於商業醫療成本上升趨勢的評論的確認性問題。我認為在問答的一部分中，您提到成本上升可能更多地與商業內的交換個人會員資格有關。所以我只想確認，是或否，這是正在發生的事情的主要部分嗎？而且我想只是為了進一步澄清，是或否，基於集團風險的商業商業賬簿，特別是看到高於 COVID 之前基線的醫療成本趨勢？在商業風險中的 2 個子段周圍再增加一點顏色。

Thank you, Steve, for the question. So just for clarity, we have not provided any commentary associated with the difference between ACA and group. We've talked about commercial in total. So I'm not exactly sure what comment that you were referring to, but it's not anything that was part of this call. And just to reiterate what I've said, we have seen overall cost structures in commercial to be elevated in excess of what a normalized baseline would have been had COVID had never occurred. You can certainly look at the amount of membership that we have in fully insured risk versus ACA. And obviously, risk is the lion's share of the membership -- the group risk. I'm sorry, is the lion's share of the fully insured membership. So obviously, that is the primary driver.

謝謝你，史蒂夫，這個問題。因此，為了清楚起見，我們沒有提供任何與 ACA 和組之間的差異相關的評論。我們已經全面討論了商業。所以我不確定你指的是什麼評論，但這不是本次電話會議的一部分。重申一下我所說的，我們已經看到商業的總體成本結構超過了在沒有發生 COVID 的情況下的正常化基線。您當然可以查看我們在完全保險風險與 ACA 中的會員數量。顯然，風險是成員中最大的份額——團體風險。對不起，是完全保險會員的最大份額。很明顯，這是主要驅動力。

But overall, we do believe that the COVID costs are transitory. They're not going to go to 0, as Gail had said. We are going to proactively price for forward trend. But the impact that we have on our margins currently is a transitory piece of that equation. And so we feel very good about our long-term aspects. Thank you.

但總的來說，我們確實認為 COVID 成本是暫時的。正如蓋爾所說，他們不會歸零。我們將主動為未來趨勢定價。但是，我們目前對利潤的影響只是該等式的一小部分。所以我們對我們的長期方面感覺很好。謝謝你。

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

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

I wanted to ask a question on Medicare Advantage. I think you're targeting double-digit growth this year, rolling your way to that. Wondering if that can be -- if that can continue next year, what you're thinking about for the open enrollment and competitive landscape there and with the necessarily healthy rate for 2023. So just views on Medicare Advantage.

我想問一個關於 Medicare Advantage 的問題。我認為您今年的目標是實現兩位數的增長，並朝著這個目標前進。想知道這是否可以——如果明年可以繼續下去，你對那裡的公開招生和競爭格局以及 2023 年必然健康的比率有何想法。所以只是對 Medicare Advantage 的看法。

Sure. Felicia, would you like to address that?

當然。 Felicia，你想解決這個問題嗎？

Thank you, David. First and foremost, let me start by saying, we are pleased with how we are performing this year. We started with a very strong AEP, and that certainly has kept us on track to deliver double-digit growth in our individual MA business. You might also want to recall that most of our business continues to come in throughout the course of the year, because we have a very balanced portfolio when we look at our duals growth, and that membership comes in year round.

謝謝你，大衛。首先，讓我先說，我們對今年的表現感到滿意。我們從一個非常強大的 AEP 開始，這無疑使我們能夠在我們的個人 MA 業務中實現兩位數的增長。您可能還想回想一下，我們的大部分業務在整個一年中都在繼續，因為當我們查看我們的雙業務增長時，我們有一個非常平衡的投資組合，而且會員資格是全年都有的。

It's too early to talk about '23 and anything associated with double-digit growth. I will say, we expect to continue to have strong growth. We have what we believe will be very competitive products in the marketplace. Our benefit designs, which are really led with our supplemental benefit offerings as we think about whole health, continue to resonate with consumers. And we continue to be very focused on going deeper in our markets, particularly in our Blue states.

現在談論 23 年以及與兩位數增長相關的任何事情還為時過早。我會說，我們預計將繼續強勁增長。我們擁有我們認為在市場上極具競爭力的產品。當我們考慮整體健康時，我們的福利設計實際上以我們的補充福利產品為主導，繼續引起消費者的共鳴。我們繼續非常專注於深入我們的市場，特別是在我們的藍色州。

So when we think about how we are positioned today, with very nice competitive benefits, strategically, we've continued on that course as we head into 2023. And I think we're positioned to continue to deliver strong growth.

因此，當我們從戰略上考慮我們今天的定位以及非常好的競爭優勢時，我們在進入 2023 年時繼續沿著這條路線前進。我認為我們的定位是繼續實現強勁增長。

Long term, our focus and our -- certainly, our perspective on Medicare Advantage remains unchanged. This is a very attractive segment for us, strategically important with us and our Carelon services as well. and we're committed to continuing to deliver strong growth in our business.

從長遠來看，我們的重點和我們——當然，我們對醫療保險優勢的看法保持不變。這對我們來說是一個非常有吸引力的細分市場，對我們和我們的 Carelon 服務具有戰略意義。我們致力於繼續實現業務的強勁增長。

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。

So one clarifying question. You talked clearly about COVID plus noncore utilization being about above a baseline for the year and second half. What are you seeing for non-COVID utilization on the Commercial business? Is it in line with pre-COVID or below?

所以一個澄清的問題。您清楚地談到了 COVID 加上非核心利用率大約高於今年和下半年的基線。您對商業業務的非 COVID 使用有何看法？它是否符合 COVID 之前或更低？

And then secondly, can you comment on the sensitivity of commercial membership to potential changes in unemployment? One of your competitors talked about 50 basis points for every 100 basis point change nonemployment. So just kind of like wanted to see if you have any context to give us there? And what are you hearing from your clients about their plans to manage their workforce?

其次，您能否評論一下商業會員對潛在失業變化的敏感性？您的一位競爭對手談到每 100 個基點的變化非就業 50 個基點。所以只是想看看你是否有任何背景可以給我們？您從客戶那裡聽到了哪些關於他們管理員工計劃的信息？

Thank you, Ricky, for that multipart question. Let me try to answer the first part of it, and then ask one of my partners here to reply to the other part of your question in terms of cost structure. So we have been really disclosing COVID and non-COVID combined as our total cost and not really specifying or trying to parse out the -- at least publicly, the amount that's COVID and the amount that's non-COVID. And I can tell you that non-COVID, all by itself, is a bit below baseline even in Commercial. And then when you add COVID on top, the total of the 2 exceeds baseline. We have seen still ER utilization being down from pre-pandemic levels. Inpatient is actually down a bit here this year. Outpatient is actually up a little bit compared to pre-COVID levels or pre-pandemic levels. But all in, the cost structure is the cost structure, we have to cover it all, and we certainly will. So hopefully, that gives you the clarity you need.

謝謝你，瑞奇，這個多部分的問題。讓我試著回答它的第一部分，然後請我這裡的一位合作夥伴從成本結構方面回答您的問題的另一部分。因此，我們一直在真正披露 COVID 和非 COVID 的總成本，而不是真正指定或試圖解析出——至少公開地，是 COVID 的金額和非 COVID 的金額。我可以告訴你，即使在商業領域，非 COVID 本身也略低於基線。然後，當您在頂部添加 COVID 時，兩者的總和超過了基線。我們看到 ER 利用率仍然低於大流行前的水平。今年住院人數實際上有所下降。與 COVID 之前的水平或大流行前的水平相比，門診病人實際上略有上升。但總而言之，成本結構就是成本結構，我們必須涵蓋所有內容，而且我們肯定會這樣做。因此，希望這可以為您提供所需的清晰度。

Yes. And to the second part of your question, I think I caught most of it, Ricky. But I think there's a few things, one, to your how are employees thinking about their workforce. As I think we shared a little bit earlier in the call Morgan did. We're really seeing kind of employers still expanding their workforce and looking for more benefits and to maintain the strength of their workforce. So we haven't seen any pullback yet in terms of our employer populations across any of the sized segments that we serve. That's not to say that, that couldn't happen. But at this stage, it's -- as you think about the challenges in the economy, they're more inflation-based than employment-based at this stage. And employers are still looking for strong solutions.

是的。對於你問題的第二部分，我想我明白了大部分內容，Ricky。但我認為有幾件事，一是你的員工如何看待他們的勞動力。正如我認為我們在摩根所做的電話中早些時候分享的那樣。我們確實看到一些雇主仍在擴大他們的勞動力並尋求更多福利並保持勞動力的實力。因此，就我們所服務的任何規模的細分市場的雇主人數而言，我們還沒有看到任何回落。這並不是說，那不可能發生。但是在這個階段，當你考慮經濟中的挑戰時，在這個階段它們更多是基於通脹而不是基於就業。雇主仍在尋找強有力的解決方案。

One of the things that we're offering, obviously, is affordable products. We've been continuing to enhance our product portfolio. We have a very strong cost position. Again, one of the reasons we win is we go in with a very strong medical cost position across all those segments. So I think from that perspective, we have not seen any noticeable difference.

顯然，我們提供的其中一件事是價格實惠的產品。我們一直在繼續增強我們的產品組合。我們擁有非常強大的成本優勢。同樣，我們獲勝的原因之一是我們在所有這些領域都擁有非常強大的醫療成本地位。所以我認為從這個角度來看，我們沒有看到任何明顯的差異。

In terms of our own book of business, if you look at our history, we've got actually -- I really can't comment on the others who've given you some numbers around what they think would happen. But our book of business has been quite resilient. As you remember, we have a very deep -- we support school districts, public service -- public services, et cetera. And so we have a very, I think, different profile across our businesses, and our history has shown that those have had greater stickiness during both up and downtimes in the economy. So overall, I think at this stage, we're still seeing strong interest and strong growth from the commercial sector.

就我們自己的業務而言，如果你看看我們的歷史，我們實際上 - 我真的無法評論其他人給你一些關於他們認為會發生的事情的數字。但我們的商業賬簿一直很有彈性。正如你所記得的，我們有一個非常深的——我們支持學區、公共服務——公共服務等等。因此，我認為，我們在我們的業務中有著非常不同的形象，我們的歷史表明，這些業務在經濟上行和下行期間都具有更大的粘性。所以總的來說，我認為在這個階段，我們仍然看到商業領域的強烈興趣和強勁增長。

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

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

Just wanted to follow up on Medicaid. Given that now utilization within the Medicaid business has been running below baseline or below expectations for the past several quarters, is there any risk to states coming back to you and doing rate adjustments given the lower-than-expected utilization?

只是想跟進醫療補助計劃。鑑於過去幾個季度 Medicaid 業務的利用率一直低於基線或低於預期，鑑於利用率低於預期，各州是否有風險回复您並進行費率調整？

Yes. Thanks, Rob. Very good question. I would say, first and foremost, we are always working with our state partners to ensure that we have actuarially justified rates, rates that really mirror the acuity of the population.

是的。謝謝，羅伯。非常好的問題。我想說，首先，我們一直在與我們的州合作夥伴合作，以確保我們有精算合理的費率，真正反映人口敏銳度的費率。

There is one really significant item just to make sure that we're all aware of, and that's we're in an MLR collar or MLR rebate position in many of our Medicaid states currently. So we will be refunding back to the states amounts of the premium that we've been paid here this past year or so. And as we look at what future rate actions or rate filings could do, the first thing that they will do is they will reduce the amount of the MLR rebates before we end up with our final REIT. But at the end of the day, we feel very good about our ability to negotiate actuarially justified rates with our state partners. Thank you.

有一個非常重要的項目只是為了確保我們都知道，那就是我們目前在我們的許多 Medicaid 州都處於 MLR 領或 MLR 回扣位置。因此，我們將把過去一年左右在這裡支付的保費退還給各州。當我們研究未來的利率行動或利率申報可以做什麼時，他們要做的第一件事就是在我們最終獲得最終的 REIT 之前減少 MLR 回扣的金額。但歸根結底，我們對與州合作夥伴協商精算合理費率的能力感到非常滿意。謝謝你。

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 just wanted to ask about the assumptions you're making on utilization in the back half of the year and what we should think about through the MLR cadence there. So appreciating that you're running above what you view as the baseline, but it does seem like other parts of the system view that they're below baseline, are expecting a ramp of utilization throughout the year. I guess how much of that is in your thinking for the guidance.

我只是想問一下你在下半年對利用率所做的假設，以及我們應該通過那裡的 MLR 節奏來思考什麼。因此，很高興您的運行速度高於您認為的基線，但係統視圖的其他部分似乎低於基線，預計全年利用率會有所提高。我猜你的指導思想中有多少。

Steve, I'm not positive I can comment on what other parts of the system you're referring to without a little bit more specificity on that. But I'll just say that we track utilization very closely. We certainly understand the seasonality factors associated with utilization. I think Felicia even mentioned going back to school and things that, that might cause, and we're trying to factor all those variables in. And we actually feel very, very good about the analytics and the informatics we have associated with this information. So we have certainly put our best thinking forward in terms of our -- in terms of the cost trends, the pricing and the guidance that we've provided. So thank you for the question.

史蒂夫，我不肯定我可以評論你所指的系統的其他部分，而不需要更具體一點。但我只想說我們非常密切地跟踪利用率。我們當然了解與利用率相關的季節性因素。我認為 Felicia 甚至提到了回到學校和可能導致的事情，我們正在嘗試將所有這些變量考慮在內。實際上，我們對與這些信息相關的分析和信息學感覺非常非常好。因此，在我們提供的成本趨勢、定價和指導方面，我們當然已經提出了我們最好的想法。所以謝謝你的問題。

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

接下來，我們將轉到 SVB Leerink 的 Whit Mayo 產品線。

I just wanted to go back to MyNEXUS for a second. Can you share like what percent of your MA membership is in states that you have delegated some services to MyNEXUS today? I'm just trying to think of the opportunity as you scale the partnership. And when you delegate risk, if that's what we want to call it to MyNEXUS, what are they doing with network strategies? Are you tiering, narrowing the network when you optimize the level of care? Is that just reducing the allowable visits? I'm just trying to properly understand exactly what you're doing.

我只是想回到 MyNEXUS 一會兒。您能否分享一下您今天已將某些服務委託給 MyNEXUS 的州的 MA 會員比例是多少？我只是想在您擴大合作夥伴關係時考慮機會。當您將風險委託給 MyNEXUS 時，如果我們想將其稱為 MyNEXUS，那麼他們對網絡策略做了什麼？當您優化護理水平時，您是否在分層、縮小網絡？那隻是減少允許的訪問量嗎？我只是想正確理解你在做什麼。

Sure. Pete, would you like to respond?

當然。皮特，你願意回應嗎？

Yes. Let me start with what you asked about exactly what we're doing on the post-acute care launch because it's something that we're really excited about in terms of the natural extension of the capabilities we have.

是的。讓我先從你問的關於我們在急性期後護理啟動中所做的確切事情開始，因為就我們擁有的能力的自然擴展而言，這是我們非常興奮的事情。

Today, when you think about what MyNEXUS does, we have industry-leading tools and capabilities that really allow us to efficiently manage on the UM side. And as we've talked about, partner with our network providers and then effectively manage the level and appropriateness of services in the core product, it's in the home. So when you think about the post-acute care product, just to give you specificity on what we're doing, we're really -- we're leveraging these tools for post-acute care management upon discharge of the patient out of the inpatient setting.

今天，當您想到 MyNEXUS 所做的事情時，我們擁有行業領先的工具和功能，真正讓我們能夠在 UM 方面進行有效管理。正如我們已經談到的，與我們的網絡提供商合作，然後有效地管理核心產品中服務的水平和適當性，它就在家裡。因此，當您考慮急性後護理產品時，只是為了讓您具體了解我們正在做什麼，我們真的 - 我們正在利用這些工具在患者出院後進行急性後護理管理住院環境。

And then through our leading portal, again, the tools and technologies that really differentiate us, post-acute care providers are easily able to make requests for services. It creates a much more effective and efficient experience for the provider. And this enables us to be very clear upfront in terms of the most appropriate levels of post-acute care. So when you think about that in that setting, you think about long-term acute care facilities, you think about rehabilitation facilities, you think about skilled nursing facilities. And we're managing the appropriate level of services, and then we're eventually facilitating a discharge hopefully to the home.

然後再次通過我們領先的門戶網站，真正讓我們與眾不同的工具和技術，急性期後護理提供者能夠輕鬆地提出服務請求。它為提供商創造了更加有效和高效的體驗。這使我們能夠非常清楚地了解最合適的急性期後護理水平。因此，當您在那種環境中考慮這一點時，您會想到長期急症護理設施，您會想到康復設施，您會想到專業護理設施。我們正在管理適當的服務水平，然後我們最終會幫助患者出院回家。

And as we've talked about, what Carelon does, as we manage that entire episode of care on a capitated basis, this builds in predictable cost of care for our partners and the health plans in this case, for Felicia, in the Medicare business. And if we're effective at managing that, we are driving an incremental margin for Carelon and then incremental benefit for Elevance.

正如我們所討論的，Carelon 所做的，當我們按人頭管理整個護理過程時，這為我們的合作夥伴和醫療保險業務中的 Felicia 的健康計劃建立了可預測的護理成本.如果我們能夠有效地管理這一點，我們將為 Carelon 帶來增量利潤，然後為 Elevance 帶來增量收益。

Yes. Thanks, Pete. I think that there's 2 points that I wanted to highlight from Pete's subscription. One, a core part of our strategy that we shared about Carelon is moving from a fee basis to a risk basis. And so when we acquired MyNEXUS, we did have a large participation with them and knew them quite well in our Medicare business, but on a fee basis. So this is the next iteration across all of our Carelon services, where we now have, I think, much better insight and can move this to a risk basis. So that was just the beginning and why I see early innings there.

是的。謝謝，皮特。我認為我想從 Pete 的訂閱中強調兩點。第一，我們分享的關於 Carelon 的戰略的核心部分是從收費基礎轉向風險基礎。因此，當我們收購 MyNEXUS 時，我們確實與他們有大量的參與，並且非常了解他們在我們的醫療保險業務中，但是以收費為基礎的。所以這是我們所有 Carelon 服務的下一次迭代，我認為我們現在擁有更好的洞察力，並且可以將其轉移到風險基礎上。所以這只是一個開始，也是我在那裡看到早局的原因。

And then the second thing is we see this as a huge opportunity, as you talk about network strategy, pull this through our value-based contracts and our partnerships and relationships. And again, another core part of our strategy where we see this as very synergistic. So thanks for the question.

然後第二件事是我們認為這是一個巨大的機會，當你談論網絡戰略時，通過我們基於價值的合同以及我們的伙伴關係和關係來實現這一點。同樣，我們認為這是非常協同的戰略的另一個核心部分。所以謝謝你的問題。

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。

This is Adam Ron on for Kevin. Going back to the comments about Medicaid, how should we think about maybe the impacts to margins from redeterminations? I could see 2 potential sources of margin compression that are pretty clear, like one is obviously just negative fixed cost leverage from losing membership. But more importantly, and I guess, complicated is the potential that healthy people are more likely to lose coverage first. So there are a risk that there would be a rate mismatch from the state for an extended period of time, it may take time to reevaluate the acuity.

這是凱文的亞當羅恩。回到關於 Medicaid 的評論，我們應該如何考慮重新確定對利潤率的影響？我可以看到兩個非常明顯的潛在利潤壓縮來源，比如一個顯然只是失去會員資格的負固定成本槓桿。但更重要的是，我想，複雜的是健康人更有可能首先失去保險。因此，有可能在很長一段時間內與該州的利率不匹配，重新評估敏銳度可能需要時間。

Yes. Thank you, Kevin, for the question. And certainly, some of the questions you asked were may be consistent with some of the things we saw in 2019. So let me just maybe reference a little bit what's different now versus then.

是的。謝謝你，凱文，你的問題。當然，你提出的一些問題可能與我們在 2019 年看到的一些事情是一致的。所以讓我來參考一下現在與當時的不同之處。

So in 2019, we went through a redetermination process. It worked through very quickly. And then the overall acuity of the population was a little bit higher than what the rates that had been set, well, justified. And just FYI, there were retroactive rate increases ultimately, but there was clearly a disconnect for a few quarters there in 2019, where now we have a very well thought-out process that's going to take up to 14 months that won't even begin until after the PHE expires.

因此，在 2019 年，我們經歷了重新確定過程。它很快就完成了。然後人口的整體敏銳度比設定的比率高一點，嗯，是合理的。僅供參考，最終有追溯性加息，但在 2019 年的幾個季度顯然存在脫節，現在我們有一個經過深思熟慮的過程，這將需要長達 14 個月甚至不會開始直到 PHE 到期後。

The other thing is, as I had mentioned in a different question, we're in an MLR collar position in virtually every Medicaid market. And so the immediate impact to any of the rates will first be to reduce the MLR collar position that we're in. In 2019, we were -- had very, very few MLR collars. But I think the most important element of all this is now part of how the pricing is done, that the -- thanks to some of the great work our teams have done, that the standard rating input now, as part of the Medicaid pricing, includes an acuity change factor. And that was not the case in 2019. That was a one-off conversation, and now it's part of the standard input into the rates for 2022.

另一件事是，正如我在另一個問題中提到的那樣，我們幾乎在每個醫療補助市場中都處於 MLR 領地。因此，對任何費率的直接影響將首先是降低我們所處的 MLR 項圈位置。在 2019 年，我們擁有非常非常少的 MLR 項圈。但我認為現在所有這一切中最重要的因素是定價方式的一部分，由於我們團隊所做的一些出色工作，現在標準評級輸入，作為醫療補助定價的一部分，包括一個敏銳度變化因素。 2019 年的情況並非如此。那是一次性的對話，現在它已成為 2022 年費率標準輸入的一部分。

So all in, we think we're in a significantly better position today than we were then. 2019 might be informative but it's certainly not a precedent. So we actually feel very good about our future state prospects. Thank you for the question.

所以總而言之，我們認為我們今天的處境比那時要好得多。 2019 年可能會提供豐富的信息，但肯定不是先例。所以我們實際上對我們未來的狀態前景感覺非常好。感謝你的提問。

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。

I just wanted to do a quick follow-up to Dave's question about the competitive backdrop for MA and duals. Clearly, supplemental benefits is a key area of competition as we go forward and this Medicare Advantage becomes more competitive. Just wanted to see if you could go into a little bit more detail about how you're differentiating your supplemental benefits and products for those members. And I think you had mentioned on the first quarter call, everyday extras. And just if you could go into more detail on that and how that's differentiating your offering?

我只是想快速跟進 Dave 關於 MA 和雙打的競爭背景的問題。顯然，隨著我們向前發展，補充福利是一個關鍵的競爭領域，而且這種醫療保險優勢變得更具競爭力。只是想看看您是否可以更詳細地了解您如何為這些會員區分您的補充福利和產品。我想你在第一季度的電話會議上提到過，每天的臨時演員。如果您可以更詳細地了解這一點以及這如何使您的產品與眾不同？

Sure. Felicia?

當然。費利西亞？

Yes. Ben, thank you for the question. I will say that we were really early leaders in the supplemental benefit areas because of our focus on whole person health. And what everyday extras or what we call essential extras allow us to do is to allow members to really personalize the benefit that best meets their needs.

是的。本，謝謝你的問題。我會說我們是補充福利領域的早期領導者，因為我們專注於全人健康。日常附加服務或我們所說的基本附加服務允許我們做的是讓會員真正個性化最能滿足他們需求的福利。

All of our members are different. And at the end of the day, we think it's important that they are able to have a range of benefit offerings that either allow them to provide transportation, grocery benefits, whatever that need is from an overall whole health perspective. So I think the differentiation for us lies really in the personalization.

我們所有的成員都是不同的。歸根結底，我們認為重要的是，他們能夠提供一系列福利，讓他們能夠提供交通、食品雜貨福利，從整體健康的角度來看，無論需要什麼。所以我認為我們的差異化真正在於個性化。

So we've developed a range of offerings that allow members to really improve their overall health outcomes, and that gives them the flexibility to be able to decide what works best for them. So ultimately, I think that's the differentiating factor for us from a Medicare Advantage perspective. We've tried to make sure we continue with that stability as we head into 2023 and certainly give members the opportunity to make those personalized decisions that works best for them.

因此，我們開發了一系列產品，讓會員能夠真正改善他們的整體健康結果，並讓他們能夠靈活地決定什麼對他們最有效。所以最終，我認為從醫療保險優勢的角度來看，這是我們的差異化因素。我們已努力確保在進入 2023 年時繼續保持這種穩定性，並肯定讓會員有機會做出最適合他們的個性化決定。

Thank you, Felicia, and now we'll take our last question.

謝謝你，Felicia，現在我們將回答最後一個問題。

For our final question will go to the line of Josh Raskin from Nephron Research.

對於我們的最後一個問題，我們將向 Nephron Research 的 Josh Raskin 提問。

So with the rebranding complete, and it's been a little while since the 2021 Investor Day, could you just remind us the overall strategy at Carelon? And I'd be most interested in any areas of interest that have changed over the last 1.5 years or so and why.

因此，隨著品牌重塑的完成，距離 2021 年投資者日已經過去了一段時間，您能否提醒我們 Carelon 的整體戰略？我最感興趣的是在過去 1.5 年左右發生變化的任何感興趣的領域以及原因。

Thank you. And I'll have Pete address the Carelon strategy. But I think what you saw certainly in our overall rebranding with Elevance Health is our business has changed. We've been on a journey from just traditional health benefits, which are still important to us and continue to grow. And as John shared and just how our revenue has changed even over the last 5 years, a pretty significant shift. Carelon's a really important part of our move in the services strategy around the complex and chronic but more importantly, that serving our captive membership already of 47 million members. So just maybe, Pete, you can talk a little bit more about how you see Carelon strategy evolving.

謝謝你。我會讓Pete 討論Carelon 策略。但我認為你在我們對 Elevance Health 的整體品牌重塑中肯定看到的是我們的業務發生了變化。我們一直在從傳統的健康益處開始前進，這對我們仍然很重要，並且還在繼續增長。正如約翰所分享的，我們的收入在過去 5 年中發生了怎樣的變化，這是一個非常重大的轉變。 Carelon 是我們圍繞複雜和長期的服務戰略採取行動的一個非常重要的部分，但更重要的是，它為我們已經擁有 4700 萬會員的專屬會員提供服務。所以也許，Pete，你可以多談談你如何看待 Carelon 戰略的演變。

Thanks, Gail. And Gail just hit it at a high level in terms of our high-level strategies, advancing whole health and connecting people to accessible, affordable and integrated care. And as she said, our focus now is on the Elevance Health plans, 20 million (inaudible) 47 million folks in total. And just to double-click on that, we're really focused on those complex populations. When you think about the spend in those complex populations on a per member per year basis, significantly higher at $12,500, for example, versus a standard average commercial number of $4,500 per member per year. And again, this creates a real wonderful springboard for us to sell externally and penetrate clients externally, especially the Blues.

謝謝，蓋爾。就我們的高層次戰略而言，蓋爾剛剛達到了高水平，促進了整體健康並將人們與可獲得的、負擔得起的和綜合的護理聯繫起來。正如她所說，我們現在的重點是 Elevance Health 計劃，總共有 2000 萬（聽不清）4700 萬人。只需雙擊它，我們就真正專注於那些複雜的人群。例如，當您考慮這些複雜人群中每位成員每年的支出時，12,500 美元明顯高於每位成員每年 4,500 美元的標準平均商業費用。再一次，這為我們在外部銷售和外部滲透客戶創造了一個真正美妙的跳板，尤其是藍調。

In addition, we talk a lot about being on the right side of health care, which, again, means providing services in the most affordable, highest-quality setting. So that's something that we're very focused on and ensuring that those are connected to the growing profit pools outside of traditional insurance. So none of that has really changed. As you know, Josh, in terms of what we talked about historically, the verticals that we're focused on are care delivery, behavioral health, advanced analytics and services and then pharmacy.

此外，我們經常談論站在醫療保健的正確一邊，這再次意味著在最實惠、最高質量的環境中提供服務。所以這是我們非常關注的事情，並確保這些與傳統保險之外不斷增長的利潤池相關聯。所以這一切都沒有真正改變。如你所知，喬希，就我們歷史上所說的而言，我們關注的垂直領域是護理服務、行為健康、高級分析和服務，然後是藥房。

I'd say what we're very interested moving forward, I wouldn't say it's a change, but that we're very interested is a deeper interest in the home, as we've talked about, certainly, specialty pharmacy, where we're seeing trends accelerate. And we believe the opportunity is really vast to penetrate the Elevance book.

我想說的是我們對前進非常感興趣，我不會說這是一個變化，但我們非常感興趣的是對家庭的更深層次的興趣，正如我們已經談到的，當然，專業藥房，在哪裡我們看到趨勢在加速。我們相信，滲透 Elevance 書籍的機會真的很大。

And then finally, I'll close on something that we're very, very focused on and we believe could be a differentiator is how we connect with our digital organization and build a digital platform for health that really connects all these services in a cohesive and coherent way, ultimately for the patient. And that's something that we're actively working on.

最後，我將結束一些我們非常非常關注的事情，我們認為可能成為差異化因素的是我們如何與我們的數字組織建立聯繫並建立一個健康的數字平台，真正將所有這些服務連接到一個有凝聚力的連貫的方式，最終為患者服務。這是我們正在積極努力的事情。

Thank you, Pete, and thank you to everyone for joining us and for your questions this morning. In closing, we're really pleased with the ongoing momentum in our business in 2022 to date. And we're confident that the ongoing execution of our strategy positions us to continuing to deliver against the financial targets that we shared with you at our investor conference last year. We'll keep executing with excellence and discipline to bring increasing value to all of our stakeholders.

謝謝你，皮特，感謝大家今天早上加入我們並提出問題。最後，我們對 2022 年迄今為止我們業務的持續發展勢頭感到非常滿意。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。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 Elevance Health, and have a great rest of the week.

感謝您對 Elevance Health 的關注，祝您本週休息愉快。

Ladies and gentlemen, a recording of this conference will be available for replay after 11 a.m. today through August 20, 2022. You may access the replay system at any time by dialing 866-430-8797 and international participants can dial (203) 369-0943. This concludes our conference for today. Thank you for your participation and for using Verizon conferencing. You may now disconnect.

女士們，先生們，本次會議的錄音將在今天上午 11 點之後至 2022 年 8 月 20 日期間提供回放。您可以隨時撥打 866-430-8797 訪問回放系統，國際與會者可以撥打 (203) 369- 0943.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。