Elevance Health Inc (ELV) 2022 Q3 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Elevance Health Third 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，感謝您的支持，歡迎參加 Elevance Health 第三季度收益電話會議。 （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's Third 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, our 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. 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.

早上好，歡迎參加 Elevance Health 的 2022 年第三季度財報電話會議。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； 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。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. I will now turn the call over to Gail.

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。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. This morning, we reported third quarter GAAP earnings per share of $6.68 and adjusted earnings per share of $7.53 ahead of expectations and reflecting strong revenue and earnings growth across our businesses. Based on our year-to-date results and confidence in our momentum, we are increasing our full year adjusted earnings guidance to greater than $28.95 per share representing growth of approximately 15% 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。今天上午，我們報告第三季度 GAAP 每股收益為 6.68 美元，調整後每股收益為 7.53 美元，超出預期，反映了我們業務的強勁收入和收益增長。基於我們年初至今的業績和對我們發展勢頭的信心，我們將全年調整後的收益指引提高到每股 28.95 美元以上，比我們在年初提供的調整後基線增長約 15%。

Before we discuss the quarter in more detail, I want to spend a moment on the recent hurricanes that have tragically impacted the lives of people in Florida and Puerto Rico, including some of our own health plan members and associates who live and work in the impacted areas. As an organization, deeply rooted in our communities, the impact of these disasters is personal. I'd like to thank our associates who are leading efforts to provide water, food, durable medical equipment, transportation and shelter, along with our clinical teams, social workers and behavioral health specialists for their extraordinary commitment to support those in need. It's in times such as these that our culture shines through, and I am proud of our associates for the work they are doing to support their colleagues and communities.

在我們更詳細地討論本季度之前，我想花一點時間來談談最近的颶風，這些颶風對佛羅里達和波多黎各人民的生活造成了悲慘的影響，包括我們自己的一些健康計劃成員和在受影響地區生活和工作的同事領域。作為一個深深植根於我們社區的組織，這些災難的影響是個人的。我要感謝我們帶頭努力提供水、食物、耐用醫療設備、交通和住所的同事，以及我們的臨床團隊、社會工作者和行為健康專家，感謝他們對支持有需要的人的非凡承諾。正是在這樣的時代，我們的文化閃耀著光芒，我為我們的員工為支持他們的同事和社區所做的工作而感到自豪。

Turning to our business performance. We are pleased to report ongoing broad-based momentum across Elevance Health, a testament to our integrated and personalized whole health approach to addressing the physical, behavioral and social needs of our members and communities. Our focused efforts and investments in these areas are resonating with employers and state partners driving strong organic membership growth in our commercial and government health benefits businesses as well as rapid growth for Carelon and IngenioRx. While our business trends remain strong, we are mindful of the inflationary pressure and general uncertainty in the economic environment and are focused on delivering affordability and value for customers and consumers in all of our businesses.

轉向我們的業務表現。我們很高興地報告 Elevance Health 持續的廣泛發展勢頭，這證明了我們採用綜合和個性化的整體健康方法來解決我們成員和社區的身體、行為和社會需求。我們在這些領域的集中努力和投資引起了雇主和州合作夥伴的共鳴，推動了我們的商業和政府健康福利業務的強勁有機會員增長，以及 Carelon 和 IngenioRx 的快速增長。儘管我們的業務趨勢依然強勁，但我們注意到經濟環境中的通脹壓力和普遍不確定性，並專注於為我們所有業務的客戶和消費者提供可負擔性和價值。

Medical membership grew 5% year-over-year to 47.3 million members. Over the past year, we've grown to serve 2.2 million more consumers with both our commercial and government businesses delivering robust growth that solidifies our position as the largest carrier by U.S.-based medical membership. In the employer market, we continue to gain market share on the strength of our leading cost of care position and innovative consumer products, such as our Total Health Connection suite of advocacy solutions. Total Health Connection is an example of where we're delivering an integrated whole health experience for consumers by guiding members to the next step in care through a simple, intuitive and personalized experience.

醫療會員人數同比增長 5%，達到 4730 萬。在過去的一年裡，我們的商業和政府業務實現了強勁的增長，為 220 萬更多消費者提供服務，鞏固了我們作為美國醫療會員最大運營商的地位。在雇主市場，我們憑藉領先的護理成本地位和創新的消費產品（例如我們的 Total Health Connection 倡導解決方案套件）繼續獲得市場份額。 Total Health Connection 就是一個例子，我們通過簡單、直觀和個性化的體驗引導會員進入下一步的護理，從而為消費者提供綜合的整體健康體驗。

Our clinical advocates help members navigate the health care system, leveraging real-time data analytics to identify health risks that enable our advocates to personally connect with members and help them proactively manage the medical, behavioral and social issues impacting their health. Health Connections has grown more than 60% over the past 2 years and will support more than 5 million of our members in 2023.

我們的臨床倡導者幫助會員瀏覽醫療保健系統，利用實時數據分析來識別健康風險，使我們的倡導者能夠親自與會員建立聯繫，並幫助他們主動管理影響他們健康的醫療、行為和社會問題。 Health Connections 在過去 2 年中增長了 60% 以上，到 2023 年將支持超過 500 萬會員。

In addition to advocacy solutions, our integrated digital offerings are also gaining momentum. Sydney Health, the digital front door for our members' health needs, continues to rapidly expand the number of registered users and is now hosting more than 6 million visits every month. We are also seeing strong member satisfaction with our virtual primary care offering, which is available through Sydney Health and integrated into our commercial products and is increasingly being used to support members with chronic conditions such as hypertension and type 2 diabetes. Our findings reflect that 62% of the top 10 diagnoses to date have resulted in the treatment of chronic conditions, demonstrating that virtual primary care can improve access to needed care with the potential to improve health outcomes and reduce overall costs.

除了宣傳解決方案外，我們的集成數字產品也獲得了發展勢頭。 Sydney Health 是我們會員健康需求的數字化前門，它的註冊用戶數量繼續迅速擴大，現在每月接待超過 600 萬次訪問。我們還看到會員對我們的虛擬初級保健產品非常滿意，該產品可通過 Sydney Health 獲得併集成到我們的商業產品中，並且越來越多地用於支持患有高血壓和 2 型糖尿病等慢性病的會員。我們的研究結果表明，迄今為止，前 10 名診斷中的 62% 已導致慢性病的治療，這表明虛擬初級保健可以改善獲得所需護理的機會，並有可能改善健康結果並降低總體成本。

Turning to our Medicare business. We're well-positioned to achieve another year of above-market growth in individual Medicare Advantage membership. For 2023, we expanded our Medicare Advantage offering to 145 new counties and added PPO plans in 210 counties, significantly increasing our reach into this important market as we continue to deliver differentiated value for seniors with strong core benefits and industry-leading supplemental offerings.

轉向我們的醫療保險業務。我們有能力在個人 Medicare Advantage 會員中實現又一年高於市場的增長。 2023 年，我們將 Medicare Advantage 產品擴展到 145 個新縣，並在 210 個縣增加了 PPO 計劃，顯著擴大了我們在這個重要市場的覆蓋面，因為我們繼續為老年人提供強大的核心福利和行業領先的補充產品的差異化價值。

With widespread pressure on the cost of daily living, affordability and value are more important for seniors than ever, and our health plans are positioned to meet their needs. Nearly 75% of our Medicare Advantage plans will have a $0 premium and no co-pays for primary care in 2023. Our supplemental benefits include popular over-the-counter offerings, transportation, dental and vision as well as in-home support and healthy groceries. Seniors on our plans will also now have a simplified way to access and keep track of their benefits with a single prepaid card that is customized with spending amounts for their unique benefits and can be used at thousands of participating retailers or on an online portal.

隨著日常生活成本的廣泛壓力，負擔能力和價值對老年人來說比以往任何時候都更加重要，我們的健康計劃旨在滿足他們的需求。到 2023 年，我們近 75% 的 Medicare Advantage 計劃將有 0 美元的保費，並且無需支付初級保健費用。我們的補充福利包括流行的非處方藥、交通、牙科和視力以及家庭支持和健康雜貨。我們計劃中的老年人現在還可以通過一張預付卡輕鬆訪問和跟踪他們的福利，該卡根據其獨特福利的消費金額進行定制，可在數千家參與的零售商或在線門戶網站上使用。

Medicare Star ratings remain a key focus area across Elevance Health. Many of our affiliated Medicare Advantage plans continue to earn high quality scores and we're particularly pleased with the performance of our HealthSun health plans in Florida, which received a 5-star rating for the sixth year in a row in the recently released 2023 Medicare Advantage star ratings, which will impact the 2024 payment year.

Medicare Star 評級仍然是 Elevance Health 的重點關注領域。我們的許多附屬 Medicare Advantage 計劃繼續獲得高質量分數，我們對佛羅里達州 HealthSun 健康計劃的表現特別滿意，該計劃在最近發布的 2023 Medicare 中連續第六年獲得 5 星評級優勢星級評級，這將影響 2024 年的付款年度。

In aggregate, we did see a modest drop in the percentage of our members in 4-star or higher-rated plans for the 2020 for payment year predominantly due to the end of COVID era relief. And while we will decline by less than the overall industry, we remain intensely focused on our long-term goal of achieving and maintaining star ratings at the high end of all Medicare Advantage plans in our markets. Carelon continues to accelerate its impact and drive differentiated value for Elevance health plan members. In the third quarter, we began implementing and rapidly scaling the myNEXUS post-acute care management product, which is now serving our Medicare Advantage members in 15 markets with plans to add more markets in the coming quarters.

總體而言，我們確實看到 2020 年付款年度 4 星或更高評級計劃的會員比例略有下降，這主要是由於 COVID 時代救濟的結束。雖然我們的下降幅度將小於整個行業，但我們仍然高度關注我們的長期目標，即在我們市場的所有 Medicare Advantage 計劃的高端實現和保持星級。 Carelon 繼續加速其影響力，並為 Elevance 健康計劃成員帶來差異化價值。在第三季度，我們開始實施並迅速擴展 myNEXUS 急性後護理管理產品，該產品現在為 15 個市場的 Medicare Advantage 成員提供服務，併計劃在未來幾個季度增加更多市場。

This new product offering represents a major service line expansion that helps optimize appropriate levels of care post inpatient discharge by working with acute and post-acute facilities to safely manage patient transitions and thereby reduce hospital readmissions and average length of stay. Carelon is also delivering distinctive cost and quality results for our commercial business at scale. As we discussed earlier this year, Carelon's AIM Specialty Health business expanded its risk-based contract with our commercial health plans to perform focused management of select clinical conditions, such as oncology, surgery and diagnostic imaging to cover our entire 14 state footprint at the beginning of this year. AIM has been performing well year-to-date, benefiting our commercial members while producing stable, predictable cost of care for complex conditions for our commercial health plans and driving growth for Carelon.

這種新產品代表了一項主要的服務線擴展，通過與急性和急性後設施合作，幫助優化住院後的適當護理水平，以安全地管理患者過渡，從而減少再入院和平均住院時間。 Carelon 還在大規模地為我們的商業業務提供獨特的成本和質量結果。正如我們今年早些時候所討論的，Carelon 的 AIM 專業健康業務擴展了其基於風險的合同與我們的商業健康計劃，以對選定的臨床狀況進行集中管理，例如腫瘤學、手術和診斷成像，以覆蓋我們整個 14 個州的足跡今年的。 AIM 今年迄今一直表現良好，使我們的商業會員受益，同時為我們的商業健康計劃的複雜條件提供穩定、可預測的護理成本，並推動 Carelon 的增長。

Our enterprise-wide focus on health equity remains central to our strategy and continues to guide our business decisions and targeted investments. We were pleased that our Simply Healthcare plan in Florida recently achieved Health Equity plus accreditation by the National Committee for Quality Assurance with an almost perfect score. Similarly, Anthem Blue Cross' individual exchange plan in California achieved NCQA distinction and multicultural health care. Awards like these show our commitment and progress to identify and address local, social and physical drivers of health with an emphasis on members who need us most.

我們在企業範圍內對健康公平的關注仍然是我們戰略的核心，並繼續指導我們的業務決策和有針對性的投資。我們很高興我們在佛羅里達州的簡單醫療保健計劃最近獲得了國家質量保證委員會的 Health Equity plus 認證，得分幾乎是滿分。同樣，Anthem Blue Cross 在加州的個人交流計劃獲得了 NCQA 的區別和多元文化的醫療保健。此類獎項顯示了我們在識別和解決當地、社會和身體健康驅動因素方面的承諾和進步，重點是最需要我們的會員。

These results would not be possible without the dedication of our more than 100,000 associates, and I would like to thank them for the important work they do and the impact they make every day. Their passion and commitment is reflected in our recent recognition as a Great Place to Work for the third consecutive year and also in our inclusion on the 2022 Fortune Best Places to Work for and People's Companies that Care lists. Our associates take pride in the work they do and the difference their contributions made to our company, our members and the community. We see this every day and, most recently, in the results of our associate engagement survey, which showed that 96% of associates understand and are inspired by our purpose to improve the health of humanity.

如果沒有我們 100,000 多名員工的奉獻精神，這些成果是不可能實現的，我要感謝他們所做的重要工作以及他們每天所產生的影響。他們的熱情和承諾體現在我們最近連續第三年被評為最佳工作場所，也體現在我們被列入 2022 年《財富》最佳工作場所和關心人們的公司名單中。我們的員工為他們所做的工作以及他們對我們公司、我們的成員和社區所做的不同貢獻感到自豪。我們每天都能看到這一點，最近，我們的員工敬業度調查結果顯示，96% 的員工理解並受到我們改善人類健康的目標的啟發。

These strong results and national recognitions reflect our commitment to leadership and represent our employees' experience defined by high levels of trust, respect, credibility, fairness and pride and help our efforts to recruit and retain top talent, a reflection of our culture. Our passion to improve lives and communities is unwavering, and we look forward to making a meaningful difference as Elevance Health. Now I'd like to turn the call over to John for more on our operating results. John?

這些強勁的成績和國家認可反映了我們對領導力的承諾，代表了我們員工的高度信任、尊重、信譽、公平和自豪感，有助於我們努力招聘和留住頂尖人才，這反映了我們的文化。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。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 earlier, we reported third quarter adjusted earnings per share of $7.53, an increase of approximately 11% year-over-year driven by broad-based momentum across our enterprise. We are pleased to have delivered another quarter of double-digit growth in revenue, operating income and adjusted earnings per share driven by the disciplined execution of our strategy and ongoing growth of health benefits and services businesses, progressing us further down our path of transforming from a health benefits company to a lifetime trusted partner in health.

謝謝你，蓋爾，大家早上好。正如蓋爾之前提到的，我們報告第三季度調整後每股收益為 7.53 美元，在我們企業的廣泛發展勢頭的推動下，同比增長約 11%。由於我們戰略的嚴格執行以及健康福利和服務業務的持續增長，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，進一步推動了我們從從健康福利公司到終生值得信賴的健康合作夥伴。

We ended the third quarter with 47.3 million members growing 2.2 million or nearly 5% year-over-year, including growth of 232,000 members in the third quarter. Our industry-leading organic enrollment growth, which constituted nearly 90% of our total enrollment growth year-over-year, was led by strong sales in our commercial fee-based membership growth in Medicaid driven in large part by the ongoing suspension of eligibility redeterminations and growth in excess of the overall market in our individual Medicare Advantage business primarily driven by dual eligible members.

我們在第三季度結束時有 4730 萬會員，同比增長 220 萬或近 5%，其中第三季度增加了 232,000 名會員。我們行業領先的有機註冊人數增長占我們總註冊人數同比增長的近 90%，這是由於我們在 Medicaid 的商業收費會員增長的強勁銷售，這在很大程度上是由於資格重新確定的持續暫停我們的個人 Medicare Advantage 業務的增長超過了整體市場，主要由雙重合格會員推動。

We supplemented strong organic growth with the acquisitions of the Paramount and Integra Medicaid health plans which together added approximately 300,000 Medicaid members earlier this year.

我們通過收購 Paramount 和 Integra Medicaid 健康計劃補充了強勁的有機增長，今年早些時候這些計劃總共增加了大約 300,000 名 Medicaid 成員。

Operating revenue in the third quarter was $39.6 billion, an increase of $4.1 billion or approximately 11% over the prior quarter with strong growth in each of our businesses. We earned higher premium revenue driven by membership growth in Medicaid, including the acquisitions of Integra and Paramount; Medicare; and commercial risk and fee-based membership growth and premium rate increases to cover overall cost trends in all of our health benefits lines.

第三季度營業收入為 396 億美元，比上一季度增加 41 億美元，增幅約為 11%，我們的各項業務均實現強勁增長。在 Medicaid 會員增長的推動下，我們獲得了更高的保費收入，包括收購 Integra 和 Paramount；醫療保險；商業風險和基於費用的會員增長和保費率增加，以涵蓋我們所有健康福利項目的總體成本趨勢。

Our services businesses, Carelon and IngenioRx produced a very strong growth as we continue to execute against our long-term growth strategy. IngenioRx grew revenue 11% year-over-year, while the other segment comprised primarily of Carelon, grew operating revenue of 26%. Carelon and IngenioRx are delivering significant value to our commercial and government health plans. And consistent with our strategy, we continue to increase the breadth and depth of services Carelon is providing.

隨著我們繼續執行我們的長期增長戰略，我們的服務業務 Carelon 和 IngenioRx 實現了非常強勁的增長。 IngenioRx 的收入同比增長 11%，而主要由 Carelon 組成的其他部門的營業收入增長了 26%。 Carelon 和 IngenioRx 正在為我們的商業和政府健康計劃帶來巨大價值。根據我們的戰略，我們將繼續增加 Carelon 提供的服務的廣度和深度。

Revenue eliminating consolidation, a proxy for affiliated business between our risk-based health plans and our services businesses, grew 17% year-over-year in the third quarter, representing approximately 21% of our consolidated benefit expense, up from approximately 20% a year ago.

收入消除合併，代表我們基於風險的健康計劃和我們的服務業務之間的關聯業務，第三季度同比增長 17%，占我們合併福利費用的約 21%，高於 20%一年前。

The consolidated benefit expense ratio for the third quarter was 87.2%, a decrease of 50 basis points over the third quarter of 2021. During the quarter, we realigned certain quality improvement expenses incurred since the beginning of this year, which had a favorable impact on our benefit expense ratio and an offsetting unfavorable impact on our SG&A expense ratio with no impact on operating earnings.

第三季度綜合福利費用率為 87.2%，比 2021 年第三季度下降 50 個基點。本季度，我們對年初以來發生的部分質量改進費用進行了調整，對我們的福利費用率和抵消對我們的 SG&A 費用率的不利影響，但對營業收入沒有影響。

Excluding the impact of the accounting realignment, our benefit expense ratio would have been approximately flat year-over-year and better than our expectations. We were pleased to deliver operating margin expansion in our commercial business driven in part by stronger medical underwriting performance in our commercial group risk business. The successful July 1 renewal process where we repriced approximately 25% of our large group risk business and the continued increases in penetration of services into our fee-based businesses contributed to the segment's performance.

排除會計調整的影響，我們的福利費用率將與去年同期基本持平，並且好於我們的預期。我們很高興在我們的商業集團風險業務中實現更強勁的醫療承保業績的推動下，我們的商業業務實現了營業利潤率的增長。 7 月 1 日成功的續訂過程中，我們重新定價了大約 25% 的大型集團風險業務，並且服務滲透到我們的收費業務中的持續增加為該部門的業績做出了貢獻。

We were pleased with the retention of our July 1 renewals and have even more confidence as we approach the January 1 renewal date. Elevance.

我們對保留 7 月 1 日的續訂感到高興，並且在我們接近 1 月 1 日的續訂日期時更有信心。高度。

Health's SG&A expense ratio in the third quarter was 11.4%, an increase of 30 basis points over the prior year quarter. The increase was primarily driven by spend to support growth and the realignment of certain quality improvement expenses as previously described. Excluding the realignment, our SG&A ratio would have improved by approximately 20 basis points year-over-year.

Health 第三季度的 SG&A 費用率為 11.4%，比去年同期增加 30 個基點。如前所述，這一增長主要是由支持增長的支出和某些質量改進費用的重新調整推動的。排除調整，我們的 SG&A 比率將同比提高約 20 個基點。

Third quarter operating cash flow was $4.9 billion or 3.1x net income driven primarily by the early receipt of certain fourth quarter premium revenue from CMS during the third quarter. We also paid our share of the Blue Cross Blue Shield Association's litigation settlement of approximately $500 million in the quarter. Excluding both of these items, operating cash flow would have been $3 billion or 1.9x net income, another indication of high-quality earnings.

第三季度經營現金流為 49 億美元或淨收入的 3.1 倍，主要是由於第三季度從 CMS 提前收到了第四季度的某些保費收入。我們還在本季度支付了我們在 Blue Cross Blue Shield Association 訴訟和解中的份額，金額約為 5 億美元。排除這兩個項目，運營現金流將達到 30 億美元或淨收入的 1.9 倍，這是高質量收益的另一個跡象。

Turning to our balance sheet. We ended the third 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 1.2 million shares of common stock for $579 million. Year-to-date, we've been opportunistic with respect to share repurchases during periods of volatility in our share price and have already repurchased 3.7 million shares for $1.7 billion, exceeding our initial outlook of repurchasing at least $1.5 billion in 2022.

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三季度，符合我們的預期和我們的目標範圍。本季度，我們以 5.79 億美元回購了約 120 萬股普通股。年初至今，我們在股價波動期間對股票回購持機會主義態度，並且已經以 17 億美元的價格回購了 370 萬股股票，超過了我們在 2022 年至少回購 15 億美元的初步預期。

We continue to maintain a prudent posture with respect to reserves. Days in claims payable stood at 47.7 days at the end of the third quarter, a decrease of 0.1 days sequentially but an increase of 0.9 days year-over-year. Given strong performance year-to-date, we are increasing our full year earnings outlook. We now expect adjusted earnings per share to be greater than $28.95, implying growth of approximately 15% of the adjusted baseline of $25.20 provided at the beginning of the year.

我們在儲備方面繼續保持審慎的姿態。三季度末應付理賠天數為47.7天，環比減少0.1天，同比增加0.9天。鑑於年初至今的強勁表現，我們正在提高全年盈利前景。我們現在預計調整後的每股收益將超過 28.95 美元，這意味著在年初提供的調整後基線 25.20 美元的基礎上增長約 15%。

Our businesses are continuing to perform well with strong momentum that we expect will carry into 2023. While we will not provide specific guidance for 2023 on this call, I would like to review some known tailwinds and headwinds worth considering as we continue planning for 2023. Starting with the tailwinds. The continued execution of our commercial margin recovery in 2023 through disciplined underwriting to cover our forward view of medical cost trends, enhanced operating efficiencies and ongoing strategies to improve the productivity and profitability of our commercial fee-based business.

我們的業務繼續表現良好，我們預計將延續到 2023 年。雖然我們不會在這次電話會議上提供 2023 年的具體指導，但我想回顧一些已知的順風和逆風，在我們繼續規劃 2023 年時值得考慮。從順風開始。通過嚴格的承保，我們在 2023 年繼續執行商業利潤率恢復，以涵蓋我們對醫療成本趨勢的前瞻性看法、提高的運營效率和持續的戰略，以提高我們的商業收費業務的生產力和盈利能力。

The growth we anticipate in our individual ACA and employer-sponsored membership as consumers transition coverage when Medicaid eligibility redeterminations resume. We expect strong earnings growth in Medicare Advantage driven by membership growth in excess of the broader market and operating margin expansion that we expect will be driven by 3 primary factors: number one, having 73% of our Medicare Advantage members in 4-star or higher-rated plans for the 2023 payment year, an increase of 15 percentage points year-over-year; number two, the continued recovery and risk adjustment as utilization has returned to more normalized levels; and number three, a relatively strong funding environment for the overall industry in 2023.

當 Medicaid 資格重新確定恢復時，隨著消費者過渡覆蓋範圍，我們預計個人 ACA 和雇主贊助的會員資格的增長。我們預計，Medicare Advantage 的盈利增長強勁，原因是會員增長超過了更廣泛的市場，並且我們預計營業利潤率的增長將受到 3 個主要因素的推動：第一，我們 73% 的 Medicare Advantage 會員為 4 星或更高2023繳費年度的評級計劃，同比提高15個百分點；第二，隨著利用率恢復到更加正常的水平，持續復甦和風險調整；第三，2023年整個行業的融資環境相對強勁。

Finally, we expect ongoing momentum in Carelon Services and IngenioRx, which will carry into next year. Our tailwinds will be weighed against one known headwind, and that is the membership attrition and related impacts on our Medicaid business is eligibility redeterminations are conducted over the course of the next year.

最後，我們預計 Carelon Services 和 IngenioRx 的勢頭將持續到明年。我們的順風將與一個已知的逆風相權衡，那就是會員流失和對我們的醫療補助業務的相關影響是在明年進行資格重新確定。

Although interest rates continue to rise rapidly, investment income is not expected to be a material tailwind or headwind. In 2022, we enjoyed significant outperformance in our alternative investments in the first half of the year. Rising interest rates are expected to benefit the second half, and we are anticipating a full year of benefit from higher rates in 2023. While performance in both years is expected to be strong overall, I would not call out investment income as a material tailwind or headwind for either 2023 or 2022 at this point. We're also mindful of the uncertain economic environment and the risk that business conditions could deteriorate.

儘管利率繼續快速上升，但預計投資收益不會是實質性的順風或逆風。 2022年上半年，我們的另類投資表現顯著。預計利率上升將使下半年受益，我們預計 2023 年全年將受益於更高的利率。雖然預計這兩年的整體表現都將強勁，但我不會將投資收入稱為重大順風或在這一點上，2023 年或 2022 年的逆風。我們還注意到不確定的經濟環境和商業狀況可能惡化的風險。

While the balance and resilience of our enterprise and the momentum we have across our businesses leaves us well-positioned for growth in the coming years, a more severe recession could create challenges. Our associates are prepared to adapt to any change in the business environment with detailed plans that ensure we will remain positioned to meet the unique needs of our clients and customers as they evolve with a commitment to affordability and value throughout.

雖然我們企業的平衡和彈性以及我們在整個業務中擁有的勢頭使我們為未來幾年的增長做好了準備，但更嚴重的衰退可能會帶來挑戰。我們的員工準備好通過詳細的計劃來適應商業環境的任何變化，以確保我們在客戶和客戶不斷發展的過程中，始終致力於滿足可負擔性和價值的獨特需求。

Accordingly, at this point in time, we expect to produce another year of growth in adjusted earnings per share in line with our long-term target compound annual growth rate in 2023, which is consistent with the current consensus estimate. We look forward to providing more specific guidance on our fourth quarter earnings call.

因此，在這個時間點，我們預計調整後的每股收益將再增長一年，這與我們在 2023 年的長期目標複合年增長率一致，這與當前的普遍預期一致。我們期待在第四季度財報電話會議上提供更具體的指導。

In closing, we continue to execute against the strategic priorities we mapped out at our 2021 Investor Conference and are pleased to have delivered another strong quarter while also continuing to reinvest in our business, better positioning us to deliver strong growth for years to come. With that, operator, please open the line for questions.

最後，我們將繼續執行我們在 2021 年投資者大會上製定的戰略重點，並很高興實現又一個強勁的季度，同時繼續對我們的業務進行再投資，更好地定位我們在未來幾年實現強勁增長。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 Justin Lake from Wolfe Research.

（操作員說明）對於我們的第一個問題，我們將前往 Wolfe Research 的 Justin Lake 線路。

This is Austin on for Justin here. On commercial margin, just focusing on that for a second. You guys showed some sequential improvement there, but it looks like you probably need around 300 basis points to kind of hit that 25 target range that you laid out there. Just curious on the pacing of that, how much are you expecting to come in '23 and '24? And then maybe a slight follow-up there. You mentioned retention, John. How did that track versus typical on those July 1 renewals?

這是賈斯汀在這裡的奧斯汀。在商業利潤上，只關註一秒鐘。你們在那裡展示了一些連續的改進，但看起來你可能需要大約 300 個基點才能達到你在那裡設定的 25 個目標範圍。只是對它的節奏感到好奇，你預計在 23 和 24 年會有多少？然後可能會在那裡進行輕微的跟進。你提到了保留，約翰。在 7 月 1 日的續訂中，該曲目與典型曲目相比如何？

Yes. No, thank you for the question, and maybe I'll start out and then turn it over to Morgan Kendrick to fine-tune some of the comments on retention. But in terms of the pacing, as I had stated 90 days ago, -- we expect that 300 basis points is a 2025 target, and it will be a little bit more heavily weighted to the beginning half of the timeframe. So as you know, we just repriced about 25% of our large group fully insured business here on July 1. We're going to reprice about 50% of that business on January 1. The other 25% goes throughout the year. Obviously, it's going to take a couple of years for that to get to the point where it needs to get to.

是的。不，謝謝你的問題，也許我會開始，然後把它交給摩根肯德里克來微調一些關於保留的評論。但就節奏而言，正如我在 90 天前所說的那樣，我們預計 300 個基點是 2025 年的目標，而且在時間框架的前半段，它的權重會更大一些。如您所知，我們剛剛在 7 月 1 日在這裡重新定價了大約 25% 的大型集團完全保險業務。我們將在 1 月 1 日重新定價該業務的約 50%。另外 25% 將全年進行。顯然，這需要幾年時間才能達到它需要達到的程度。

And then the -- really, the really nice trajectory and improvement we're having on upselling our fee-based businesses, our 5:1 to 3:1 strategy, it's going very much according to our expectations and the plans that we laid out, which actually do have us going through 2025. So I think the short answer to your question is a lot more of the improvements early on, but we will take until 2025 to get there. With that, Morgan?

然後 - 真的，我們在追加銷售我們的收費業務方面的非常好的軌跡和改進，我們的 5:1 到 3:1 戰略，它非常符合我們的期望和我們制定的計劃，這實際上確實讓我們經歷了 2025 年。所以我認為你的問題的簡短回答是早期的改進更多，但我們要到 2025 年才能到達那裡。有了這個，摩根？

Thanks, John, and thanks for the question, Justin. As John said, this is going to be -- it's going to take a bit to get it completely turned. July came in actually as expected. Certainly, there was some attrition in the large group risk business. To give you some concept there as it relate -- context here as it relates to January, John said about 50% of that business is up for renewal. We have just released those in market. So it's a bit early to tell, but our expectations are that there will be some attrition, which is -- would be natural when we're right pricing this business and we're unmoved by anything being different than expected as we move forward.

謝謝，約翰，謝謝賈斯汀的問題。正如約翰所說，這將是 - 需要一點時間才能完全扭轉局面。七月果然如期而至。當然，大型集團風險業務存在一些減員。為了給你一些相關的概念——這裡與一月份相關的背景，約翰說大約 50% 的業務需要更新。我們剛剛在市場上發布了這些。所以現在說還為時過早，但我們的預期是會有一些減員，這是 - 當我們正確定價這項業務時，這是很自然的，並且在我們前進的過程中，我們不會被任何與預期不同的事情所感動。

Thanks, Morgan, and thanks, Austin, for the question. And I think as you heard from both John and Morgan, we feel we're making really good progress in this business. And as I shared in my opening comments, we're seeing really strong uptake, particularly in our fee-based business, along with the disciplined process. And so overall, it met our expectations on attrition to be real specific. So overall, feel very good about the quarter and where we're heading on commercial.

謝謝摩根，謝謝奧斯汀的提問。我認為正如你從約翰和摩根那裡聽到的那樣，我們覺得我們在這項業務上取得了非常好的進展。正如我在開場評論中所分享的那樣，我們看到了非常強烈的吸收，特別是在我們的收費業務中，以及紀律嚴明的流程。總的來說，它符合我們對真正具體的減員的期望。因此，總體而言，對本季度以及我們在商業方面的發展方向感覺非常好。

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。

Maybe just get you to comment a little bit on the trends in the government business. I know you swung to a little bit of a decline in margin year-to-year in the government. Can you just parse out a little bit more what you're seeing there? And then any read on the landscape files and your expectations around MA growth next year? I know you said, John, I think, solid growth. I'm just wondering if there's any way to flesh that out further at this early date.

也許只是讓您對政府業務的趨勢發表一些評論。我知道您在政府中的利潤率逐年下降。你能再分析一下你在那裡看到的東西嗎？然後閱讀景觀文件以及您對明年 MA 增長的期望？我知道你說過，約翰，我認為，穩健增長。我只是想知道是否有任何方法可以在這麼早的時候進一步充實這一點。

Thank you for the question, A.J. So our Government Business division is actually performing very well. And for the year, we're certainly going to be posting some very strong results. Both Medicaid and Medicare have been growing nicely. And I think that's evidenced by the excellent top line growth we've seen of over 13% year-over-year.

謝謝你的問題，A.J.所以我們的政府業務部門實際上表現非常好。今年，我們肯定會發布一些非常強勁的結果。 Medicaid 和 Medicare 的發展勢頭良好。我認為這可以從我們所看到的超過 13% 的出色收入增長中得到證明。

Medicaid's performance is strong, but for Medicaid, and we've said this in the past, on a quarterly basis, results can be a bit more variable and susceptible to swings. And when viewed in isolation, any 1 quarter could be misleading. Medicare is continuing to perform consistent with our expectations and, as you know, has significant upside for 2023. If you think about Medicare and the improving star ratings that I talked about in my prepared comments, the more complete and accurate risk scoring that will allow us to enhance the revenue in those areas, we feel very well-positioned for the future of our Medicare Advantage book.

醫療補助的表現很強勁，但對於醫療補助，我們過去曾說過，每季度一次，結果可能會更加多變並且容易受到波動的影響。如果單獨來看，任何 1 個季度都可能具有誤導性。 Medicare 的表現繼續符合我們的預期，並且如您所知，2023 年有很大的上升空間。如果您考慮一下 Medicare 以及我在準備好的評論中談到的不斷提高的星級評級，那麼更完整和準確的風險評分將允許我們要增加這些領域的收入，我們對我們的醫療保險優勢書的未來感到非常有利。

And in terms of '23 growth, it is premature to provide specifics associated with 2023 growth. But our goal is to clearly grow faster than the industry. And we have done that on a percentage basis now for the last several years in a row and expect to do that for the next several years ongoing. So thank you for the question, A.J.

就 23 年的增長而言，現在提供與 2023 年增長相關的細節還為時過早。但我們的目標顯然是比行業增長得更快。在過去的幾年裡，我們已經按百分比完成了這項工作，並希望在接下來的幾年裡繼續這樣做。所以謝謝你的問題，A.J.

And thanks, AG. Maybe I'll ask Felicia Norwood, who leads our Government Business, to provide a little bit more color on our Medicare Advantage. It's early. We just started the AEP process. And as John said, we feel confident about above-market growth, but she can give you a little perspective on just how we're seeing the marketplace. Felicia?

謝謝，AG。也許我會請領導我們政府業務的 Felicia Norwood 為我們的 Medicare Advantage 提供更多色彩。現在還早。我們剛剛開始了 AEP 流程。正如約翰所說，我們對高於市場的增長充滿信心，但她可以讓您了解我們如何看待市場。費利西亞？

Yes. Thank you, Gail, and good morning, AJ. As Gail said, it was certainly very early in the Medicare Advantage annual election period. But we're pleased with what we've seen so far around our competitive positioning. When we think about our supplemental benefits, they really compare favorably with our competitors, and we really lead the industry in terms of our everyday extras, our over-the-counter offerings, transportation benefits and certainly those things that are focused on addressing the whole health needs of our members and those social drivers of health.

是的。謝謝你，蓋爾，早上好，AJ。正如蓋爾所說，這肯定是在 Medicare Advantage 年度選舉期間的早期。但我們對迄今為止圍繞我們的競爭定位所看到的情況感到滿意。當我們考慮我們的補充福利時，他們確實比我們的競爭對手更有優勢，而且我們在日常額外服務、非處方藥產品、運輸福利以及那些專注於解決整體問題的方面確實處於行業領先地位我們成員的健康需求和健康的那些社會驅動因素。

Additionally, as you know, we actually improved our footprint by expanding into 145 new counties on the HMO side and then 210 counties from a PPO perspective. So while we're early in this process based on the feedback we're getting from our distribution channel and others, we feel very good about how we are positioned as we head into AEP and look forward to continued growth in this business.

此外，如您所知，我們通過在 HMO 方面擴展到 145 個新縣，然後從 PPO 的角度擴展到 210 個縣，實際上改善了我們的足跡。因此，雖然根據我們從分銷渠道和其他渠道獲得的反饋，我們處於此過程的早期階段，但我們對進入 AEP 的定位感到非常滿意，並期待該業務的持續增長。

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。

Can you talk a little bit about IngenioRx? And what I'm interested in is both progress in cross sales for '23 that you're seeing thus far in the self-insured book. And then with the contract with CVS ending in '24, just wondering if you're entering into sort of a rebidding process or what the strategy is on a go-forward basis for that.

你能談談 IngenioRx 嗎？我感興趣的是迄今為止您在自我保險書中看到的 23 年交叉銷售方面的進展。然後與 CVS 的合同在 24 年結束，只是想知道您是否正在進入某種重新投標過程，或者在此基礎上的策略是什麼。

Yes. Thanks for the question, Lance. I'm going to have Pete Haytaian, who leads that business, give you a perspective on Ingenio. But overall, I'd just say we're really pleased seeing some really, really strong growth in Ingenio and more importantly, integrating it into our 5:1 to 3:1 strategy. So I think Pete can provide you a lot more granularity on kind of what we're seeing in the market. Pete?

是的。謝謝你的問題，蘭斯。我將請領導該業務的 Pete Haytaian 為您介紹 Ingenio。但總的來說，我只想說我們很高興看到 Ingenio 實現了非常非常強勁的增長，更重要的是，將其整合到我們的 5:1 到 3:1 戰略中。所以我認為皮特可以為你提供更多關於我們在市場上看到的東西的粒度。皮特？

Yes. Thanks a lot. I'll answer that question. We are very pleased with both the operating performance and the growth in Ingenio. Just to put a little bit more color on that, we are, as you know, trying to be a different PBM. We're talking about the integrated whole health value proposition. And that does continue to play through nicely in the marketplace.

是的。非常感謝。我會回答這個問題。我們對 Ingenio 的經營業績和增長感到非常滿意。只是為了增加一點色彩，如您所知，我們正在努力成為一個不同的 PBM。我們談論的是綜合的整體健康價值主張。這確實繼續在市場上很好地發揮作用。

This year, we're seeing, as it relates to your specific question on the ASO growth in the 5:1 to 3:1, about a 300% improvement year-over-year in terms of net new members that we're selling this year. We're seeing good RFP activity. I'd say really strong performance in the middle and down market, where we perform very, very well financially and where integration actually plays very well.

今年，我們看到，因為它與您關於 ASO 以 5:1 到 3:1 增長的具體問題有關，就我們銷售的淨新成員而言，同比增長了 300%今年。我們看到了良好的 RFP 活動。我想說的是中低端市場的表現非常強勁，我們在財務上的表現非常非常好，而且整合實際上表現得非常好。

Up market, as you would expect, there's a little bit more stickiness, especially in light of the economic situation we're in. But overall, we feel very good about our growth and prospects as we move forward. As we head into next year, we're already into the '23 selling season. It's well underway. We have good visibility on our growth. Again, we're seeing a lot of activity in the middle market and down market.

正如你所料，上行市場有更多的粘性，特別是考慮到我們所處的經濟形勢。但總的來說，隨著我們的前進，我們對我們的增長和前景感到非常好。當我們進入明年時，我們已經進入了 23 年的銷售季節。進展順利。我們對我們的成長有很好的了解。同樣，我們在中端市場和低端市場看到了很多活動。

The feedback we're getting right now from the brokers from a distribution perspective is our headline rates look really good. The other thing that we're very focused on as it relates to Ingenio is upselling additional products and services, so things like cost relief programs, specialty condition management programs and digital adherence program. So it's moving in the right direction.

從分銷角度來看，我們現在從經紀人那裡得到的反饋是，我們的整體利率看起來非常好。我們非常關注與 Ingenio 相關的另一件事是追加銷售額外的產品和服務，例如成本減免計劃、專業條件管理計劃和數字遵守計劃。所以它正朝著正確的方向發展。

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 was interested if you could just talk about the competitive environment and managed Medicaid a bit, particularly as we're in a pretty active RFP cycle right now and with a couple of other big states coming up. And with a couple of the competitors having shown some improved momentum in some of the recent RFP results. So interested just in the competitive the backdrop and then what Elevance is doing right now strategically or tactically to try to keep your competitive edge of Medicaid.

如果您能談談競爭環境並稍微管理一下醫療補助計劃，我很感興趣，特別是因為我們現在正處於一個非常活躍的 RFP 週期以及其他幾個大州即將到來的情況下。一些競爭對手在最近的一些 RFP 結果中顯示出一些改善的勢頭。只對競爭激烈的背景感興趣，然後 Elevance 現在在戰略或戰術上正在做什麼，以試圖保持您在 Medicaid 的競爭優勢。

Thank you. I'm going to ask Felicia Norwood to address your question.

謝謝你。我要請 Felicia Norwood 回答你的問題。

So good morning, Scott. In many respects, the Medicaid space has always been competitive. But you're right, it's certainly become hypercompetitive recently, and we continue to be, I think, well-positioned around our success. When I take a look at the RFP process, as you know, states really delayed part of the RFP process in the midst of COVID, but things have certainly wrapped up significantly over the past year or so.

早上好，斯科特。在許多方面，醫療補助領域一直具有競爭力。但你是對的，它最近肯定變得競爭激烈，而且我認為，我們繼續圍繞我們的成功處於有利地位。如您所知，當我查看 RFP 流程時，各州確實在 COVID 期間推遲了 RFP 流程的一部分，但在過去一年左右的時間裡，事情肯定已經大大結束。

When I take a look at where we are, our focus has really been around health equity, population health. You heard Gail reference earlier our NCQA distinction with respect to health equity. And our state partners are certainly looking at health plans who can help them improve outcomes and focus specifically on those health equity areas that we've been working on here at Elevance Health. So I feel strongly about our ability to kind of elevate in advance help for our members and address the needs of our state partners at a local level.

當我看看我們所處的位置時，我們的重點實際上是圍繞健康公平和人口健康。您之前聽到 Gail 提到了我們在健康公平方面的 NCQA 區別。我們的州合作夥伴當然正在研究可以幫助他們改善結果的健康計劃，並特別關注我們在 Elevance Health 一直在努力的那些健康公平領域。因此，我強烈感受到我們有能力提前為我們的會員提供幫助，並在地方一級解決我們州合作夥伴的需求。

When I look at the RFP opportunities we've been focused on, certainly, California was significant, a really big win for us. We won in every county, we were able to win in, and we actually picked up a county that was a new county for us. So a very strong performance there. We recently also reprocured our RFP in Puerto Rico coming in first, and that demonstrated to me continued strong momentum in terms of our ability to address the needs of our state partners. And most recently yesterday, having the DC City Council approve a new win for us in the district.

當我查看我們一直關注的 RFP 機會時，當然，加利福尼亞意義重大，對我們來說是一個非常大的勝利。我們在每個縣都贏了，我們能夠贏，而且我們實際上選擇了一個對我們來說是一個新縣的縣。所以那裡的表現非常強勁。我們最近還重新採購了我們在波多黎各的 RFP，排在首位，這向我展示了我們在滿足州合作夥伴需求的能力方面的持續強勁勢頭。最近的昨天，DC 市議會批准了我們在該地區的新勝利。

So I continue to see momentum around our value proposition, being able to respond to the needs of our state customers and meet our Medicaid members where they are. as we continue to focus on health equity, improved outcomes and advancing those issues that we know are very important to our state partners.

因此，我繼續看到圍繞我們的價值主張的勢頭，能夠響應我們州客戶的需求並滿足我們的 Medicaid 成員所在的位置。隨著我們繼續關注健康公平、改善結果和推進我們知道對我們的州合作夥伴非常重要的那些問題。

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 medical cost trend. I think the MCR was flat year-over-year excluding the accounting adjustment. Last quarter, John, I think you had talked about medical cost trend being elevated in the back half of the year, but it sounds like that might have come in a little bit better than your expectations. So what did you see play out by line of business? And as we think about your outlook for next year, how are you thinking utilization will trend into 2023? And if I could just add a quick clarification on the accounting adjustment. Could you provide more details on what costs moved out of benefit expense and, I guess, importantly, whether future periods will be impacted by this change?

我想問一下醫療費用的趨勢。我認為 MCR 與去年同期持平，不包括會計調整。上個季度，約翰，我認為您曾談到下半年醫療成本趨勢上升，但聽起來這可能比您的預期要好一些。那麼，您看到了哪些業務線？當我們考慮您對明年的展望時，您如何看待 2023 年的利用率趨勢？如果我可以快速澄清一下會計調整。您能否提供更多關於哪些成本從福利費用中移出的詳細信息，我想，重要的是，未來期間是否會受到這種變化的影響？

Thank you for the questions, Nathan. So let me do the easy one first, and that was the accounting adjustment. So during the third quarter, CMS provided clarifying guidance on the types of cost that can be included in the quality improvement cost and therefore, considered benefit expense versus those that need to be classified as SG&A.

謝謝你的問題，內森。所以讓我先做簡單的，那就是會計調整。因此，在第三季度，CMS 就可以包含在質量改進成本中的成本類型提供了明確的指導，因此，考慮了福利費用與需要歸類為 SG&A 的費用。

And our GAAP presentations have historically always mirrored the CMS definitions and requirements. So when CMS clarified those definitions, we realigned our reporting accordingly. And so just to be clear, the impact for the third quarter was to improve MLR by about 0.5%, which would then make the negative impact on SG&A about 0.5% with no impact on the bottom line, clearly a reclass. For the full year, it will be about a 20 basis point impact on each of those.

我們的 GAAP 演示文稿歷來反映了 CMS 的定義和要求。因此，當 CMS 澄清這些定義時，我們相應地重新調整了我們的報告。因此，需要明確的是，第三季度的影響是將 MLR 提高約 0.5%，這將對 SG&A 產生約 0.5% 的負面影響，而對底線沒有影響，顯然是重新分類。全年，這將對每一項產生約 20 個基點的影響。

And then in terms -- and we always, always try to be fully transparent. So we wanted to ensure everyone was aware of the nuances in this reporting and what we will see by the end of the year of about a 20 basis point benefit to MLR for this clarification that CMS provided that we aligned with. So hopefully, that helps from that perspective.

然後就條款而言——我們總是，總是盡量做到完全透明。因此，我們希望確保每個人都了解此報告中的細微差別，以及我們將在今年年底看到 MLR 為 MLR 提供約 20 個基點的好處，因為 CMS 提供了與我們保持一致的澄清。所以希望，從這個角度來看，這會有所幫助。

And then in terms of the trends in cost and utilization in general, as you stated, you pointed out, without the reclassification, our MLR would have been flat, which is actually a nice improvement because of a mix on a mix-adjusted basis. Since our government membership now is a higher percent of our fully insured membership than it was a year ago.

然後就成本和利用率的總體趨勢而言，正如您所說，您指出，如果沒有重新分類，我們的 MLR 將保持不變，這實際上是一個很好的改進，因為在混合調整的基礎上進行了混合。由於我們現在的政府會員在我們完全投保的會員中的百分比高於一年前。

So third quarter did come in better than expected, but the overall cost structure of the health system is still a bit higher than what it would have been had COVID never occurred. But I think the most important element of all this is that our trends continue to be in line with our expectations in each of our lines of businesses. So associated with lines of businesses, Medicaid is doing slightly better than historical levels. Medicare is very much in line. We're seeing outpatient a bit higher and inpatient a bit lower, helping offset to have a more normalized trend.

因此，第三季度的表現確實好於預期，但衛生系統的整體成本結構仍略高於未發生 COVID 的情況。但我認為所有這一切中最重要的因素是我們的趨勢繼續符合我們對每個業務線的期望。因此，與業務線相關聯，醫療補助的表現略好於歷史水平。醫療保險非常符合。我們看到門診病人有點高，住院病人有點低，有助於抵消一個更正常化的趨勢。

And then commercial, has been very consistent with our last several quarters, where outpatient continues to be higher but even more so than the benefit that we're seeing in inpatient. And so that's been all part of the process and all part of the guidance. So we're obviously not going to comment on 2023 at this point in time, but hopefully, that answers all your questions.

然後是商業，與我們過去幾個季度的情況非常一致，門診患者繼續增加，但甚至超過了我們在住院患者中看到的收益。這就是整個流程的一部分，也是指導的一部分。所以我們顯然不會在這個時間點對 2023 年發表評論，但希望這能回答你所有的問題。

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

接下來，我們將轉到巴克萊的 Stephen Valiquette 線。

So I guess just regarding the potential migration in '23 of the ineligible Medicaid members into commercial and exchange plans, I guess I'm curious whether or not there's been any evolution in your key states that might allow Elevance to more directly funnel your own ineligible Medicaid members into your own exchange plans. So could this be more of a controlled process for the industry now versus maybe where it stood a year ago? Would you still just describe the Medicaid market environment for '23 as really just kind of a big jump ball for all MCOs to try to grab the ineligible Medicaid members next year?

因此，我想只是關於 23 年不合格的 Medicaid 成員可能遷移到商業和交換計劃中，我想我很好奇您的關鍵州是否有任何演變可能使 Elevance 更直接地匯集您自己的不合格成員Medicaid 成員加入您自己的交換計劃。那麼，與一年前相比，這對行業來說是否更像是一個受控的過程？您是否仍將 23 年的 Medicaid 市場環境描述為所有 MCO 明年試圖抓住不合格的 Medicaid 成員的一個大跳球？

Well, Steve, thanks for your question. I think just a couple of, I'd say, clarifications. As we go through this process, we've been working very, very closely with our states and across our enterprise. And a few things that I think are important that we shared with you in the past. One, we've had a long time to plan for this and a long time to discuss this with each of our specific states. And, each state will have a bit of a different process, but where we can, we're sharing data that the states allow us to do that. We're also working with community organizations to make sure that, first and foremost, that everyone who's eligible for coverage retains eligibility for coverage. And I think that's probably where we started this whole process is ensure that those -- just because of administrative things, et cetera, that we ensure that they have the right eligibility for the right program.

好吧，史蒂夫，謝謝你的提問。我想只有幾個，我想說，澄清。當我們經歷這個過程時，我們一直在與我們的州和整個企業非常密切地合作。還有一些我認為很重要的事情，我們過去曾與你們分享過。第一，我們已經為此進行了很長時間的計劃，並與我們的每個特定州進行了很長時間的討論。而且，每個州都會有一些不同的過程，但在我們可以的情況下，我們正在共享州允許我們這樣做的數據。我們還與社區組織合作，首先確保有資格獲得保險的每個人都保留獲得保險的資格。我認為這可能是我們開始整個流程的地方，即確保那些——僅僅因為行政事務等等，我們確保他們有合適的資格參加合適的計劃。

For those that are not going to be eligible for Medicaid, again, we're working across our commercial business as well as our Medicaid business to provide, I think, the most education and seamless transition. If you start just a little bit of facts for our business, if you think about our 14 commercial states, Medicaid membership in those states grew roughly 7.5 million beneficiaries in those states. We, as part of our exchange footprint, now cover pretty much all of the counties in our footprint of 14 states and also have incredibly strong market share not only in the exchange but also in our commercial benefits business.

對於那些沒有資格獲得 Medicaid 的人，我們再次在我們的商業業務和 Medicaid 業務中開展工作，以提供我認為最多的教育和無縫過渡。如果您從我們業務的一些事實開始，如果您考慮一下我們的 14 個商業州，這些州的 Medicaid 會員資格在這些州增加了大約 750 萬受益人。作為我們交易所足蹟的一部分，我們現在覆蓋了我們 14 個州的幾乎所有縣，並且不僅在交易所而且在我們的商業利益業務中也擁有令人難以置信的強大市場份額。

So we think there's an opportunity, obviously, with our brand recognition, our dedication to this membership, our community involvement and the work we're doing, again, with community partners, educating our commercial business, to be quite frankly, well-positioned and don't see it as a jump ball. We think we're actually quite well-positioned in those states.

因此，我們認為，顯然，憑藉我們的品牌知名度、我們對會員的奉獻精神、我們的社區參與以及我們正在做的工作，再次與社區合作夥伴一起教育我們的商業業務，坦率地說，我們處於有利地位不要把它看作是一個跳球。我們認為我們實際上在這些州處於有利地位。

And in terms of our own Medicaid membership, approximately 2.7 million members -- million of those members came in as a result of the PAG. And obviously, we know those members well. They know us well. They recognize our brand. And so again, based on the state rules and regulations, we'll be working very closely to help that transition. So I feel like given the time we've had to plan, the guidance from the administration, our work with the states that actually this is going to be a much more organized process, then I would call it just to jump all with the real opportunity for those who lead in the market to have an opportunity to move those members and keep coverage, which again is our primary goal here. So again, thanks for the question, and we look forward to continuing to update everyone on our progress there. Thank you.

就我們自己的 Medicaid 會員而言，大約有 270 萬會員——其中數百萬會員是 PAG 的結果。顯然，我們很了解這些成員。他們很了解我們。他們認可我們的品牌。同樣，根據州法規，我們將密切合作以幫助實現過渡。所以我覺得考慮到我們必須計劃的時間，政府的指導，我們與各州的合作，實際上這將是一個更有組織的過程，然後我會稱之為只是跳出真正的讓那些在市場上處於領先地位的人有機會移動這些成員並保持覆蓋範圍，這也是我們在這裡的主要目標。再次感謝您的提問，我們期待繼續向大家介紹我們在該領域取得的進展。謝謝你。

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 just wanted to ask about negotiated environment with health systems. There's been some conversation in the market about financial pressures across health systems leading to increased value-based care adoption. Are you seeing that play out across your negotiations and your contracting team? And do you expect that to ultimately have a positive impact for you all over the next year or 2?

我想我只是想問一下與衛生系統協商的環境。市場上有一些關於整個衛生系統的財務壓力導致增加基於價值的護理採用的對話。您是否在談判和承包團隊中看到了這種情況？您是否預計這最終會對您在未來一兩年內產生積極影響？

Yes. Thanks for the question, Rob. A couple of things. One, I think it's been well documented that our contracts are on a 3-year in duration. So we negotiate again, about 1/3 of them each year. So that just gives you a little context to the sort of discussions. Clearly, there is more cost pressure in the system. But overall, I would say our deals are coming in within normal range, and we continually or proactively managing that contract and our products, obviously, to offer affordability, continue to look at our clinical strategies and ensure we can maintain our long-term trends. We'll, also, as we shared with you, maintain our underwriting discipline to price to our forward view of those costs.

是的。謝謝你的問題，羅布。有幾件事。第一，我認為我們的合同期限為 3 年，這是有據可查的。所以我們再次談判，每年大約 1/3。因此，這只是為您提供了有關此類討論的一些背景信息。顯然，系統中存在更大的成本壓力。但總的來說，我想說我們的交易在正常範圍內，我們持續或主動管理該合同和我們的產品，顯然，為了提供可負擔性，繼續關注我們的臨床策略並確保我們能夠保持我們的長期趨勢.正如我們與您分享的那樣，我們還將保持我們的承保紀律，以根據我們對這些成本的前瞻性看法進行定價。

Now ultimately, it's affordability that's paramount for our customers, particularly in this economic environment. We take that very, very seriously. Specifically to your question about value-based contracts with our providers, we are having those discussions. And quite frankly, we've made a lot of progress on our value-based contracts. We've shared with you roughly 60% of our total contracts are in value-based. And our goal is to move a lot more of those, at least 1/3 by 2025 to downside risk.

現在，歸根結底，對我們的客戶來說，負擔能力是最重要的，尤其是在這種經濟環境下。我們非常非常重視這一點。特別是關於您與我們的供應商簽訂的基於價值的合同的問題，我們正在討論這些問題。坦率地說，我們在基於價值的合同方面取得了很大進展。我們與您分享了我們總合同中大約 60% 的合同是基於價值的。我們的目標是在 2025 年之前至少將 1/3 的風險轉移到下行風險中。

I'm really pleased to share that we've made really good progress even in this last year and in the last quarter. And now where we were in sort of low double digits now in high teens in downside risk. So making great progress against our goal to get to more downside risk in our contracts as well as value-based care.

我很高興與大家分享，即使在去年和最後一個季度，我們也取得了非常好的進展。現在我們處於低兩位數的位置，現在處於下行風險的青少年時期。因此，我們的目標是在我們的合同和基於價值的護理中獲得更多的下行風險，從而取得了巨大的進展。

So back to your question, we do think that there is an opportunity to continue to move more of these to value-based care. We are seeing progress, not just on the hospital side, but across the broader provider care continuum. And the other thing that I think is important in trying to be a good partner with our care providers is we're also looking at how to reduce the administrative burden that they face, so how do we accelerate the work we're doing on data sharing, reduce some of the, I'll call it, administrative care review processes that may not have the highest value.

所以回到你的問題，我們確實認為有機會繼續將更多這些轉移到基於價值的護理中。我們看到了進步，不僅在醫院方面，而且在更廣泛的提供者護理連續體中。我認為與我們的護理提供者成為良好合作夥伴的另一件事是，我們也在研究如何減輕他們面臨的行政負擔，那麼我們如何加快我們在數據方面所做的工作共享，減少一些（我稱之為）可能沒有最高價值的行政護理審查流程。

And I think those are big opportunities for us as well in addition to just trying to increase rates. So we've seen progress there, and we're committed to continuing to work with care providers so that -- obviously, that we have a good long-term partnership with them. But overall, we're not seeing anything outside of our normal ranges right now and have been very successful with these strategies. So thanks very much for the question.

我認為除了試圖提高利率之外，這些對我們來說也是很大的機會。因此，我們已經看到了那裡的進展，我們致力於繼續與護理提供者合作，以便 - 顯然，我們與他們建立了良好的長期合作夥伴關係。但總的來說，我們現在沒有看到任何超出我們正常範圍的東西，並且這些策略非常成功。所以非常感謝這個問題。

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。

Again, I want to go back to your earlier comment today around Sydney Health and virtual health care. So you talked about 6 million visits per month. You talked about improving outcomes and cost. But I'm really interested in when we think about '23, are you offering a product in the marketplace where you have a lower premium where your primary care doctor is virtual. So that would be my first question. And then secondly, is there a way to quantify when we think about the potential cost benefit of utilizing virtual primary care.

再次，我想回到你今天早些時候關於悉尼健康和虛擬醫療保健的評論。所以你談到每月有 600 萬次訪問。你談到了改善結果和成本。但是當我們考慮到 23 年時，我真的很感興趣，您是否在市場上提供一種產品，在您的初級保健醫生是虛擬的情況下，您的保費較低。所以這將是我的第一個問題。其次，當我們考慮使用虛擬初級保健的潛在成本效益時，有沒有辦法量化。

So thanks for the question, Lisa. I'm going to ask Morgan to add some commentary, but just an overview. Yes, we are -- so first, Sydney is our front door to health care. So we have really embedded all of our capabilities in Sydney. And what I shared with you are a couple of things: one, that virtual primary care is one of the elements of our care delivery strategy, and Morgan talked about the product offerings that we have there as well.

所以謝謝你的問題，麗莎。我將請摩根添加一些評論，但只是一個概述。是的，我們是——首先，悉尼是我們醫療保健的大門。因此，我們確實將我們所有的能力都嵌入了悉尼。我與您分享的是幾件事：第一，虛擬初級保健是我們提供護理戰略的要素之一，摩根也談到了我們在那裡提供的產品。

But we're also seeing it -- and you saw some of the early data around an opportunity to help us manage chronics in a much more efficient way. And so we're seeing a lot of uptake in that. And it's also embedded into what our customers are selecting. So we're adding a lot more capability inside of Sydney. So a couple of very important just quick facts, but let me turn it over to Morgan to share with you a little bit about the product strategy, which is an element of our affordability offering for the market.

但我們也看到了它——你看到了一些早期數據，圍繞著一個機會來幫助我們以更有效的方式管理慢性病。所以我們看到了很多人對此的接受。它也嵌入到我們客戶的選擇中。因此，我們在悉尼內部添加了更多功能。所以有幾個非常重要的簡單事實，但讓我把它交給摩根與你分享一點關於產品策略的信息，這是我們為市場提供的可負擔性產品的一個元素。

Right. And thanks, Gail, and thanks, Lisa, for the question. When you think about the Commercial group business, you've got generational cohorts, 4 of them with boomers X, Y and Z that are part of the actual -- the makeup. And of course, the way they engage certainly is indeed different. Various modalities are very important to us. And as such, we have products that we are launching that have a virtual first component where one can elect a primary care position that would be a digital connection as opposed to a physical connection, but it also allows the opportunity to move into the physical world within the value-based constructs that Gail described in our value-based network strategies to keep a tight closed-loop integration, so to speak, on how this works.

正確的。感謝 Gail，感謝 Lisa 的提問。當您考慮商業集團業務時，您有幾代人，其中 4 個人與嬰兒潮一代 X、Y 和 Z 是實際的一部分 - 化妝。當然，他們參與的方式確實是不同的。各種形式對我們來說非常重要。因此，我們推出的產品具有虛擬的第一個組件，人們可以在其中選擇一個初級保健職位，該職位將是一個數字連接而不是物理連接，但它也允許有機會進入物理世界在 Gail 在我們的基於價值的網絡策略中描述的基於價值的結構中，可以說，它是如何工作的，以保持緊密的閉環集成。

One, in particular, that we've already launched for January versus in our Nevada market, which is a combination of a partnership with a single entity but layered with a digital first front end. The economics of that arrangement are quite attractive in the market, and we're expecting nice pull-through as the enrollment period concludes. But this is the beginning of it. We've been adding the virtual components to all of our commercial self-funded business and risk business over the past 1.5 years. And as such, we'll continue to build products anchored around those assets. Thanks again for the question.

特別是，我們已經在 1 月份推出了與內華達市場相比，這是與單一實體的合作夥伴關係的組合，但與數字第一前端分層。這種安排的經濟性在市場上非常有吸引力，隨著入學期的結束，我們預計會有很好的突破。但這是它的開始。在過去的 1.5 年裡，我們一直在將虛擬組件添加到我們所有的商業自籌資金業務和風險業務中。因此，我們將繼續圍繞這些資產構建產品。再次感謝您的提問。

Yes. Thanks, Morgan. And Lisa, just sort of 2 important concepts that I want to reiterate. One, that we've embedded virtual capabilities for our customers across the board and we're also aligning those with our high-performance networks. So when we talk about best cost in the marketplace and what's really driving a lot of our growth, it's that affordability. And again, it's not just virtual for virtual by itself, but it's aligned to our high-performance network strategy.

是的。謝謝，摩根。還有麗莎，我想重申兩個重要的概念。一，我們已經為我們的客戶全面嵌入了虛擬功能，並且我們還將這些功能與我們的高性能網絡保持一致。因此，當我們談論市場上的最佳成本以及真正推動我們大量增長的因素時，就是這種負擔能力。再說一次，它不僅僅是虛擬的虛擬本身，而且它與我們的高性能網絡戰略保持一致。

And then second, as Morgan said, we're in, I would say early days, but we have been beginning to launch a number of virtual-only products. But again, they have tied to physical assets or high-performance networks. So again, really trying to drive best cost and quality and outcomes for our members.

其次，正如摩根所說，我們處於早期階段，但我們已經開始推出一些僅限虛擬的產品。但同樣，它們與物理資產或高性能網絡相關聯。再說一次，真正努力為我們的會員帶來最佳的成本、質量和成果。

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 guess I want to go back to a comment that John made in prepared comments about the impact of the recession. I guess the company [historically] have talked about the kind of the balanced business mix between commercial and Medicaid and how the 2 businesses kind of offset each other during a recession. So I wanted to -- I guess, first, you didn't mention a recession either as a tailwind -- I'm sorry, as a headwind. So I assume -- does that mean that you don't assume a recession in the guidance? Or do you see a modest one has no impact? And then what exactly do you mean that if it's a severe recession, how should we think about how that impacts the company like Elevance, given your business mix?

我想我想回到約翰在準備好的關於經濟衰退影響的評論中發表的評論。我猜該公司 [歷史上] 已經談到了商業和醫療補助之間的平衡業務組合，以及這兩種業務在經濟衰退期間如何相互抵消。所以我想——我想，首先，你也沒有提到經濟衰退是順風——對不起，是逆風。所以我假設 - 這是否意味著您不會在指導中假設經濟衰退？還是您認為適度的沒有影響？那麼，如果這是一場嚴重的經濟衰退，你的意思是什麼，考慮到你的業務組合，我們應該如何考慮它如何影響像 Elevance 這樣的公司？

Yes. Thanks for the question, Kevin. I'll address that. And I think that there's a few things. One, we are mindful of the economic environment under which -- and John and the headwinds and tailwinds, where we talked about one specific known. Medicaid, you also did reference the broader economic environment that we're planning for across a whole series of scenarios.

是的。謝謝你的問題，凱文。我會解決的。我認為有幾件事。一，我們注意到經濟環境——以及約翰和逆風和順風，我們談到了一個特定的已知環境。醫療補助計劃，您還確實提到了我們在一系列情景中計劃的更廣泛的經濟環境。

But I want to take you back in terms of our business because we are a much more diversified business than we have been at any other time in our company's history. And just putting some facts around that, today, that 25% of our premium roughly is in our commercial business, whereas that number was 70% in 2008.

但我想帶你回顧一下我們的業務，因為我們是一家比我們公司歷史上任何時候都更加多元化的業務。今天，我們的保費中大約有 25% 來自我們的商業業務，而 2008 年這個數字是 70%。

And so as you think about that, the diversity of our businesses and in strong -- we've been able to perform in both good and bad economic times. Certainly, in stronger economic times, the commercial business continues to grow, but we haven't seen any impact in terms of our commercial business today, and we're still seeing strong growth in adds inside of our fee-based business.

因此，當您考慮到這一點時，我們業務的多樣性和強大的實力——我們能夠在經濟形勢好壞的情況下表現出色。當然，在經濟強勁的時期，商業業務繼續增長，但我們今天的商業業務沒有受到任何影響，而且我們仍然看到收費業務的增長強勁。

But clearly, our focus is on, as you just heard in the last question, affordable products, driving a differentiated value for our consumers. We've been able to demonstrate that. Just a quick fact that we talk a lot about in our own business, our growth, as you've seen in the fee base with some of our most discerning customers. We have been consolidating business from multi-carrier to single carrier over the last several years. We added another 8 additional clients for January of this year that consolidate with us. So these are just a couple of proof points in terms of the -- I would say, the resiliency right now of our commercial business.

但顯然，正如您在上一個問題中聽到的那樣，我們的重點是價格實惠的產品，為我們的消費者帶來差異化的價值。我們已經能夠證明這一點。只是一個簡單的事實，我們在自己的業務中談論了很多，我們的增長，正如您在收費基礎上與我們一些最挑剔的客戶所看到的那樣。在過去的幾年裡，我們一直在將業務從多運營商整合到單運營商。今年 1 月，我們又增加了 8 個與我們合併的客戶。因此，這些只是就我們商業業務目前的彈性而言的幾個證明點。

And then obviously, in more difficult times, Medicaid businesses tend to grow well and take on some of that. We're also in a very different environment than we were in the last recession. In that recession, we didn't have the ACA and the opportunity for individuals to go in, in a subsidized manner. And as you heard from us, we also now have full coverage in our counties and ACA exchange business.

然後很明顯，在更困難的時期，醫療補助業務往往會增長良好並承擔一些責任。我們所處的環境也與上次經濟衰退時截然不同。在那次經濟衰退中，我們沒有 ACA 和個人以補貼方式進入的機會。正如您從我們那裡聽到的那樣，我們現在也全面覆蓋了我們的縣和 ACA 交換業務。

And then we think the Medicare business, where we have 0 premium plans, is also quite resilient. So across our book, certainly, we're mindful of an economic downturn. We're planning for it in our businesses. We've been investing heavily in digital and trying to ensure that we can maintain our own cost structure. So those are the kinds of things and playbooks that we have inside of our business. So it's not that we're not planning and thinking about that business, but we do feel we have a much more resilient business and a much more diversified business that one business line isn't dominating our company as it had in the past.

然後我們認為我們擁有 0 保費計劃的醫療保險業務也很有彈性。因此，在我們的書中，當然，我們注意到經濟衰退。我們正在計劃在我們的業務中使用它。我們一直在大力投資數字化，並努力確保我們能夠維持自己的成本結構。所以這些就是我們在業務中擁有的東西和劇本。因此，並不是說我們沒有計劃和考慮該業務，而是我們確實認為我們擁有更具彈性的業務和更加多元化的業務，一個業務線並沒有像過去那樣主導我們的公司。

So -- and also, I would -- I would add that Carelon in times obviously adds -- we have a big roadmap for Carelon to add additional opportunities to impact the affordability of our health plan business and take on more risk. Just a couple of the examples I shared this morning between AIM and myNEXUS. We've got, I think, a long runway there. And that, again, is all about driving affordability.

所以 - 而且，我會 - 我會添加 Carelon 顯然會添加 - 我們為 Carelon 制定了一個大路線圖，以增加更多機會來影響我們的健康計劃業務的可負擔性並承擔更多風險。只是我今天早上在 AIM 和 myNEXUS 之間分享的幾個例子。我認為，我們在那裡有一條很長的跑道。而且，這一切都是為了提高負擔能力。

So I guess, in short, yes, we're planning for it. Yes, we're being prudent and diligent. And second, we know that affordability and differentiated value is going to be critical in a market where customers are strained, and those are the kind of products that we're putting in the market. And we feel we've got a nice a nice breadth of those right now, much more so than we've ever had. So thanks very much for the question.

所以我想，簡而言之，是的，我們正在為此做計劃。是的，我們正在謹慎和勤奮。其次，我們知道，在客戶緊張的市場中，可負擔性和差異化價值至關重要，而這些正是我們投放市場的產品。而且我們覺得我們現在擁有一個不錯的廣度，比以往任何時候都多。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。

Had a quick clarification for John and then maybe a quick one for Felicia. John, just on the reclass of the quality improvement incentives to G&A. Just wondering if there's any rebate implications retroactively from that. And then for Felicia, as we look at the 2023 Medicare benefits offering, I mean, one of the key places where it really looks like Elevance stands out as in special supplemental benefits for chronically ill just in your individual MA offering, your funding level there really looks substantially higher than many of your competitors. I was just wondering why the focus on that benefit specifically. And what percent of your individual MA will avail themselves of that particular benefit?

對 John 進行了快速澄清，然後可能對 Felicia 進行了快速澄清。約翰，剛剛對 G&A 的質量改進激勵措施進行了重新分類。只是想知道是否有任何追溯性的回扣影響。然後對於 Felicia，當我們查看 2023 年的醫療保險福利時，我的意思是，Elevance 真正脫穎而出的關鍵地方之一是在您的個人 MA 產品中針對慢性病的特殊補充福利，您的資金水平在那裡看起來確實比您的許多競爭對手高得多。我只是想知道為什麼要特別關注這個好處。你的個人 MA 中有多少人會利用這種特殊的好處？

Thank you, Gary. I'll answer the first part of your question and turn it over to Felicia for your second question. But in terms of the impact on rebates, it was de minimis. The vast majority of the reclassification impacted the commercial line of business. And while we do have occasional MR rebates in commercial, they're not nearly as prevalent as they are in some of our -- in Medicaid at this point in time. So it was really de minimis. That's why I said there's virtually no bottom line impact. Felicia?

謝謝你，加里。我會回答你問題的第一部分，然後交給 Felicia 來回答你的第二個問題。但就對回扣的影響而言，這是微不足道的。絕大多數重新分類影響了商業業務。雖然我們在商業中確實偶爾會有 MR 回扣，但它們並不像在我們的一些——此時在 Medicaid 中那樣普遍。所以這真的是微不足道的。這就是為什麼我說幾乎沒有底線影響。費利西亞？

Sure. And good morning, Gary. When I think about our Medicare Advantage business, we've been always very focused on a portfolio that takes a look at individuals who are complex and chronic, and our dual special needs plans have always been an area where we look to grow. Today, I think we represent probably the third largest footprint with respect to dual eligible individuals. And within our footprint, we're second. We believe that we have the capabilities as we sit within our Medicaid -- Medicare business and, certainly, as you take a look at Carelon to be able to deliver a value proposition to these individuals that differentiate it.

當然。早上好，加里。當我想到我們的 Medicare Advantage 業務時，我們一直非常專注於關注複雜和慢性個人的投資組合，我們的雙重特殊需求計劃一直是我們希望發展的領域。今天，我認為我們可能代表了雙重合格個人的第三大足跡。在我們的足跡中，我們是第二名。我們相信，我們有能力參與我們的 Medicaid - Medicare 業務，當然，當您查看 Carelon 時，我們能夠為這些與眾不同的人提供價值主張。

So when we take a look at how we are appropriately priced and competitive in the marketplace, it's certainly based on our strategy around playing to those strengths and being able to partner and look to do those individuals -- or work with those individuals in a way that's differentiating. So I think our competitive cost structure and the way that we think about our duals product certainly gives us the ability to address their specific needs.

因此，當我們看看我們如何在市場上獲得適當的定價和競爭力時，這當然是基於我們圍繞發揮這些優勢並能夠與這些人合作並尋求做這些人的戰略——或者以某種方式與這些人合作這就是區別。因此，我認為我們具有競爭力的成本結構以及我們對雙重產品的思考方式無疑使我們能夠滿足他們的特定需求。

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。

I just wanted to go back to Carelon for a second. Any way to frame what percent of your post-acute spend for MA today is being delegated to myNEXUS or any of your other assets? And then kind of what are the targets for that business over time? Just any way to quantify and put some numbers around it. I think I may have underappreciated the tail around this.

我只是想回到卡隆一會兒。有什麼方法可以確定您今天在 MA 的急性後支出中有多少百分比被委派給 myNEXUS 或您的任何其他資產？那麼隨著時間的推移，該業務的目標是什麼？只是任何量化和放置一些數字的方法。我想我可能低估了這一點。

Yes. Thanks, Whit, for the question. In terms of percentages, specific numbers on that, we're not going to sort of get into that. But the goal here is for our post-acute offering via myNEXUS to cover all of our Medicare Advantage business from a post-acute care perspective. We started on this journey in the middle of this year, launching in July. We've seen really good success. We also had another integration in September. We will complete all the Medicare Advantage markets in early '23. And so you can assume more broadly that as it relates to post-acute care management. For the Medicare business, we will be covering the management of all of that population.

是的。謝謝，惠特，這個問題。就百分比和具體數字而言，我們不會深入探討。但這裡的目標是讓我們通過 myNEXUS 提供的急性後產品從急性後護理的角度涵蓋我們所有的 Medicare Advantage 業務。我們於今年年中開始了這一旅程，於 7 月啟動。我們已經看到了非常好的成功。我們還在 9 月份進行了另一次整合。我們將在 23 年初完成所有 Medicare Advantage 市場。因此，您可以更廣泛地假設它與急性後護理管理有關。對於醫療保險業務，我們將涵蓋所有人口的管理。

Yes. Thanks, Pete. And a number that we do share more broadly as a percentage of spend that Carelon manages for Elevance Health, and that has continued to increase, and it's around 21%. So just to give you a little bit of perspective, and it's obviously a number that we continue to have a bigger impact on.

是的。謝謝，皮特。我們確實更廣泛地分享了一個數字，即 Carelon 為 Elevance Health 管理的支出的百分比，並且這個數字還在繼續增加，約為 21%。所以只是給你一點觀點，這顯然是一個我們繼續產生更大影響的數字。

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。

I wanted to come back to the comments around commercial renewal. In John's prepared, you talked about being even more confident about Jan 1 and July 1, which was successful. I wondered if you could put a finer point on the factors that drive that confidence. And then to what extent do those same factors benefit growth beyond renewal and/or help your catcher's mitt for catching Medicaid for redetermination?

我想回到關於商業更新的評論。在約翰的準備中，您談到對 1 月 1 日和 7 月 1 日更加自信，這是成功的。我想知道您是否可以更詳細地說明推動這種信心的因素。然後這些相同的因素在多大程度上有益於更新之外的增長和/或幫助你的接球手抓住醫療補助以重新確定？

I may ask Morgan to address your question.

我可以請摩根回答你的問題。

Thanks, Dave. To express confidence, I think that July played out, as we indicated exactly as we expected. The renewals that we needed we obtained. And of course, there was some attrition in the book that was certainly planned. That same phenomenon we're seeing, and we're in the very beginnings of it for January 1. I think the confidence that was alluded to earlier is in the actual position in which we're pricing the business.

謝謝，戴夫。為了表達信心，我認為 7 月的表現完全符合我們的預期。我們獲得了我們需要的更新。當然，書中肯定有一些減員是計劃好的。我們看到了同樣的現象，我們在 1 月 1 日才剛剛開始。我認為前面提到的信心是在我們為業務定價的實際位置。

We've sort of gotten the spot last year pricing early for '21 or '22 and then things revealed differently in the fall. That's sort of shaping up as planned as we see right now. So the confidence in the numbers in the market are there. When we think about this concept of a catcher's mitt with Medicaid redetermination, there's business that stays on the Medicaid side. There's a business that's going to move to the commercial side, be it group or individual. Gail alluded to the fact that we've done a really nice job in expanding our footprint to cover roughly 95% of the population of the geographies we serve from a commercial individual ACA perspective. And then we have very strong penetration in the commercial risk and non-risk business would also be part of that catcher's mitt, so to speak, for the group side.

去年，我們已經獲得了 '21 或 '22 的早期定價，然後在秋季情況有所不同。正如我們現在看到的那樣，這有點像計劃中的那樣。因此，對市場數字的信心就在那裡。當我們考慮這個帶有醫療補助重新確定的捕手手套的概念時，有業務留在醫療補助方面。有一項業務將轉向商業方面，無論是團體還是個人。 Gail 提到了這樣一個事實，即從商業個人 ACA 的角度來看，我們在擴大我們的足跡以覆蓋我們所服務地區的大約 95% 的人口方面做得非常好。然後我們在商業風險方面有很強的滲透力，非風險業務也將成為捕手手套的一部分，可以這麼說，對於集團方面。

So all in, we're confident in, a, the results from July; b, how we're lining up for January; and then lastly, that the catcher's mitt based on proven performance and share is going to serve us well. Thank you for that question.

因此，我們對 7 月份的結果充滿信心； b，我們如何為一月份排隊；最後，基於經過驗證的表現和份額的捕手手套將很好地為我們服務。謝謝你的問題。

Thank you, Morgan. We have time for one more question.

謝謝你，摩根。我們有時間再問一個問題。

Our final question comes from Stephen Baxter from Wells Fargo.

我們的最後一個問題來自富國銀行的斯蒂芬巴克斯特。

Just wanted to ask one follow-up on the group risk business. I was hoping you could give us a sense of what the in-group membership trends were in the quarter? Are you starting to see those slow a little bit as maybe the economy gets a little bit more uncertain. And I guess, basically, what I'm trying to get a sense of is whether we can attribute all the sequential decline to the attrition on the 7/1 renewals or whether the impact was larger or smaller than that and may be masked by some of those in-group trends.

只是想問一個關於集團風險業務的後續行動。我希望你能讓我們了解本季度的組內成員趨勢是什麼？您是否開始看到這些放緩，因為經濟可能變得更加不確定。而且我想，基本上，我想了解的是，我們是否可以將所有連續下降歸因於 7/1 續約的減員，或者影響是更大還是更小，並且可能被某些人所掩蓋這些群體內的趨勢。

Yes. Thanks for the question. I think in total, I think I shared this in sort of the recession response. We really haven't seen a lot of change in group, and actually, it's been up a little bit. So I wouldn't necessarily call it a trend, but it's been running fairly stable. And I think as you think about where employers are, they're holding on to their employees. They've got a number of jobs still open. So we're not seeing any impact yet across any of our commercial business on the attrition side, and actually we're seeing some net adds. So thank you very much for the question, and thank you, operator.

是的。謝謝你的問題。我認為總的來說，我認為我在某種衰退反應中分享了這一點。我們真的沒有看到小組有很大的變化，實際上，它已經上升了一點。所以我不一定稱其為趨勢，但它一直在運行相當穩定。而且我認為，當您考慮雇主所在的位置時，他們會留住員工。他們還有許多職位空缺。因此，我們在減員方面還沒有看到對我們任何商業業務的任何影響，實際上我們看到了一些淨增加。所以非常感謝你的問題，也謝謝你，接線員。

In closing, we're pleased with the broad-based momentum across our businesses and are confident that our ongoing execution of our strategy positions us to continue delivering against the financial targets we shared with you at our Investor Conference last year. We'll keep executing with excellence and discipline to deliver and enhance value to all of our stakeholders. Thank you for your interest in Elevance Health, and have a great rest of week.

最後，我們對我們業務的廣泛發展勢頭感到滿意，並相信我們持續執行我們的戰略將使我們能夠繼續實現我們在去年投資者大會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提供和提升價值。感謝您對 Elevance Health 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 November 18, 2022. You may access the replay system at any time by dialing (800) 813-5525, and international participants can dial (203) 369-3346. 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 11:00 後至 2022 年 11 月 18 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。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。