Elevance Health Inc (ELV) 2023 Q1 法說會逐字稿

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

女士們，先生們，感謝你們的支持，歡迎來到 Elevance Health 第一季度收益電話會議。 （操作員說明）提醒一下，今天的會議正在錄製中。

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

我現在想把會議轉交給公司管理層。請繼續。

Good morning, and welcome to Elevance Health's First Quarter 2023 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; and John Gallina, our CFO; Peter Haytaian, President of Carelon; Morgan Kendrick, President of our Commercial and Specialty Health Benefits division; and Felicia Norwood, President of our Government Health Benefits division.

早上好，歡迎來到 Elevance Health 的 2023 年第一季度收益電話會議。我是投資者關係副總裁 Steve Tanal。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；和我們的首席財務官 John Gallina； Carelon總裁Peter Haytaian；我們的商業和專業健康福利部門總裁 Morgan Kendrick；以及政府健康福利部門總裁 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. 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.

蓋爾將首先簡要討論本季度和我們戰略計劃的最新進展。然後，約翰將更詳細地討論我們的財務業績和前景。在我們準備好的評論之後，團隊將可以進行問答。在電話會議期間，我們將參考某些非 GAAP 措施。我們的網站 elevancehealth.com 提供了這些非 GAAP 措施與最直接可比的 GAAP 措施的調節。

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.

我們還將就此次電話會議發表一些前瞻性聲明。聽眾請注意，這些陳述受到某些風險和不確定性的影響，其中許多風險和不確定性難以預測，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不相同。我們建議聽眾仔細閱讀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 is off to a strong start to 2023 as we continue to execute on the strategy we discussed at our investor conference last month to become a lifetime trusted health partner for the consumers we are privileged to serve by focusing on whole health. At our March investor conference, we provided a road map for how we plan to continue to compound adjusted earnings per share by 12% to 15% through 2027 by optimizing our mature businesses, investing in high-growth opportunities and accelerating the growth of our organization through Carelon.

謝謝，史蒂夫，大家早上好。今天，我們很高興地宣布，Elevance Health 在 2023 年開局良好，我們將繼續執行我們在上個月的投資者會議上討論的戰略，成為我們有幸服務的消費者終身信賴的健康合作夥伴通過關注整體健康。在我們 3 月份的投資者會議上，我們提供了一份路線圖，說明我們計劃如何通過優化成熟業務、投資高增長機會和加速我們組織的發展，在 2027 年之前繼續將調整後每股收益複合 12% 至 15%通過卡倫。

First quarter results demonstrate progress on all fronts. GAAP earnings per share came in at $8.30. Adjusted earnings per share of $9.46, grew approximately 15% year-over-year, and we ended the quarter with 48.1 million medical members, growth of nearly 600,000 in the first quarter spread across Commercial, Medicare and Medicaid. Carelon's momentum also continued with year-over-year revenue and operating gain up 18% and 21%, respectively.

第一季度的業績表明各方面都取得了進展。 GAAP 每股收益為 8.30 美元。調整後每股收益為 9.46 美元，同比增長約 15%，本季度末我們擁有 4810 萬醫療會員，第一季度增長近 600,000 人，分佈在商業、醫療保險和醫療補助計劃中。 Carelon 的勢頭也繼續保持，收入和營業收入同比分別增長 18% 和 21%。

Given the strong start to the year and the momentum in both of our primary businesses, we raised our outlook for adjusted earnings per share to be greater than $32.70 for 2023. Carelon Services continues to expand the scale and scope of services it provides to our own health plans and to external customers. The Carelon post-acute care management expansion with our health plans that we discussed at our investor conference is well underway and will contribute meaningfully to growth in 2023.

鑑於今年的強勁開局和我們兩項主要業務的發展勢頭，我們將 2023 年調整後每股收益的預期上調至 32.70 美元以上。Carelon Services 繼續擴大其為我們自己提供的服務的規模和範圍健康計劃和外部客戶。我們在投資者會議上討論的 Carelon 急症後護理管理擴展以及我們的健康計劃正在進行中，並將對 2023 年的增長做出有意義的貢獻。

We are now working to develop more seamless integration between transitions of care throughout all post-acute solutions, including home health and we'll be looking to extend the post-acute management solution beyond Medicare in the future. Carelon Behavioral Health recently extended its leadership position in crisis management. When it began serving as the 988 Suicide and Crisis Lifeline managing entity to the New Jersey Division of Mental Health and Addiction Services at the beginning of this month. The scope of this work includes coordinating across all 988 centers in New Jersey, dispatching mobile crisis teams that provide emergency support and serving as the central integration partner for the unified technology platform.

我們現在正致力於在所有急性期後解決方案（包括家庭健康）中開發更多的護理過渡之間的無縫集成，我們將尋求在未來將急性期後管理解決方案擴展到 Medicare 之外。 Carelon Behavioral Health 最近擴大了其在危機管理方面的領導地位。本月初，它開始擔任新澤西州心理健康和成癮服務部的 988 自殺和危機生命線管理實體。這項工作的範圍包括協調新澤西州所有 988 中心，派遣移動危機小組提供緊急支持，並作為統一技術平台的中央集成合作夥伴。

Beyond our work in support of 988, we are leveraging our expertise to improve health outcomes for members proactively. Our suicide prevention program uses a predictive analytics model to identify members at risk for suicidal event. And once those members are identified, we intervene through telephonic case management support crisis intervention or access to a peer support specialist. In a recent study, we observed a more than 20% reduction in adolescent and young adult suicidal events for commercial risk-based members engaged in the program relative to control groups, corresponding to a 30% reduction in per member per month behavioral health spending for engaged members post intervention. We have since expanded the program to cover even more of our members.

除了我們支持 988 的工作外，我們還利用我們的專業知識主動改善會員的健康狀況。我們的自殺預防計劃使用預測分析模型來識別有自殺事件風險的成員。一旦確定了這些成員，我們就會通過電話案例管理支持危機干預或聯繫同行支持專家進行干預。在最近的一項研究中，我們觀察到，與對照組相比，參與該計劃的基於商業風險的成員的青少年和年輕成人自殺事件減少了 20% 以上，相當於每個成員每月的行為健康支出減少了 30%參與成員干預後。從那以後，我們擴大了該計劃以涵蓋更多的會員。

CarelonRx remains focused on owning the strategic levers that create differentiation to advanced whole health. Since closing the acquisition of BioPlus in February, we have deepened our bench of specialty pharmacy talent and broken ground on the construction of the first of 3 new dispensing facilities. These investments will support the expansion of dispensing capacity ahead of the planned migration of CarelonRx's Specialty Prescription onto the BioPlus platform beginning in 2024.

CarelonRx 仍然專注於擁有為先進的整體健康創造差異化的戰略槓桿。自 2 月完成對 BioPlus 的收購以來，我們加深了專業藥學人才儲備，並破土動工建設了 3 個新配藥設施中的第一個。這些投資將支持在計劃於 2024 年開始將 CarelonRx 的專業處方遷移到 BioPlus 平台之前擴大配藥能力。

We have also added BioPlus as an in-network specialty pharmacy for all of our Medicaid and Commercial contracts. Later this year, we will be launching CarelonRx Pharmacy, a modern differentiated home delivery experience, that will be integrated into our Sydney Health app, improving quality, access and consumer experience while creating value for CarelonRx through additional dispensing margin.

我們還添加了 BioPlus 作為我們所有醫療補助和商業合同的網絡內專業藥房。今年晚些時候，我們將推出 CarelonRx Pharmacy，這是一種現代差異化的送貨上門體驗，它將集成到我們的 Sydney Health 應用程序中，以改善質量、訪問和消費者體驗，同時通過額外的配藥利潤為 CarelonRx 創造價值。

In our Health Benefits business, we're pleased to report progress on our key commitments. Commercial risk-based margins continue to recover from pandemic-era lows, and we grew membership once again as the distinctive value we provide to the market continues to resonate. As you heard at our investor conference, our momentum reflects our steadfast focus on 3 things customers value across all segments: affordability, experience and simplicity.

在我們的健康福利業務中，我們很高興地報告我們在關鍵承諾方面取得的進展。基於商業風險的利潤率繼續從大流行時期的低點回升，隨著我們為市場提供的獨特價值繼續引起共鳴，我們的會員人數再次增加。正如您在我們的投資者會議上所聽到的那樣，我們的發展勢頭反映了我們堅定不移地關注客戶在所有細分市場中看重的三件事：可負擔性、體驗和簡單性。

Nearly all of our key experience metrics are at their highest point in years, including Net Promoter Score, customer satisfaction, customer effort and inquiry resolution. Meanwhile, retention rates across our national accounts business have tracked to historic highs in the past 2 selling seasons, yet another indication that our product innovation, digital investments and overall value proposition are resonating.

我們幾乎所有的關鍵體驗指標都處於多年來的最高點，包括淨推薦值、客戶滿意度、客戶努力度和查詢解決率。與此同時，我們國民賬戶業務的保留率在過去兩個銷售季中創下歷史新高，這再次表明我們的產品創新、數字投資和整體價值主張正在產生共鳴。

In alignment with our strategic focus on delivering exceptional consumer experiences, we continue to lead the market in advocacy. Our next-generation advocacy solution, total health connection entered the market this year, serving over 600,000 consumers, building on the success of our Total Health, Total You personalized engagement and clinical advocacy solution, which continues to gain momentum. And in the first quarter, enjoyed a 12 percentage point improvement in its NPS score to 82%.

為了與我們提供卓越消費者體驗的戰略重點保持一致，我們繼續在宣傳方面引領市場。我們的下一代宣傳解決方案 Total Health Connection 今年進入市場，服務超過 600,000 名消費者，建立在我們 Total Health、Total You 個性化參與和臨床宣傳解決方案取得成功的基礎上，該解決方案繼續獲得發展勢頭。在第一季度，NPS 得分提高了 12 個百分點，達到 82%。

Between these 2 innovative and integrated offerings, we now serve nearly 5 million advocacy members. We're also pleased with the performance of our individual business, which is poised for another year of strong growth through geographic expansion and strategic product positioning. We've grown membership 19% year-to-date compared with 5% growth for the market across our geographic footprint. We are well positioned for additional growth when Medicaid beneficiaries begin to transition coverage later this year, whether members of our own Medicaid health plans or with coverage elsewhere.

在這 2 項創新和集成的產品中，我們現在為近 500 萬宣傳成員提供服務。我們也對我們個人業務的表現感到滿意，該業務有望通過地域擴張和戰略產品定位實現又一年的強勁增長。年初至今，我們的會員人數增長了 19%，而我們整個地理足蹟的市場增長率為 5%。當 Medicaid 受益人在今年晚些時候開始轉換覆蓋範圍時，無論是我們自己的 Medicaid 健康計劃的成員還是其他地方的覆蓋範圍，我們都做好了進一步增長的準備。

Medicaid membership growth continued in the first quarter as eligibility redeterminations remained on hold. In alignment with CMS requirements and state guidance on renewal processes, we have begun outreach to members to drive awareness about Medicaid redeterminations. We are taking an omnichannel approach to our work, supported by already set for new campaign, ground game educational activities as well as our innovative digital decision support tool.

由於資格重新確定仍被擱置，第一季度醫療補助會員人數繼續增長。根據 CMS 要求和國家更新流程指南，我們已經開始與會員進行外展，以提高對醫療補助重新確定的認識。我們正在對我們的工作採取全渠道方法，並得到已經為新活動、地面遊戲教育活動以及我們創新的數字決策支持工具設置的支持。

Through this mobile-friendly web-based platform, we provide personalized guidance for consumers regarding their coverage options and eligibility for additional state and federal benefits based on answers to just a few quick questions. The support tool goes beyond traditional health care to include access to healthy food, child care and housing credits, alongside guidance on how to enroll.

通過這個基於網絡的移動友好平台，我們根據對幾個快速問題的回答，為消費者提供有關他們的保險選項和獲得額外州和聯邦福利的資格的個性化指導。該支持工具超越了傳統的醫療保健，包括獲得健康食品、兒童保育和住房信貸，以及如何註冊的指導。

Most importantly, it will allow us to reach all affected consumers who are in need of assistance to maintain access to care, whether or not they are members of our health plans today. This approach positions Elevance Health distinctly in the market, and our deep local roots provides a strong understanding of the unique needs of our communities, alongside a diversified portfolio of solutions spanning Commercial, Medicaid and Medicare coverage, we are uniquely well positioned to ensure access to quality health care.

最重要的是，它將使我們能夠接觸到所有需要幫助以維持獲得醫療服務的受影響消費者，無論他們今天是否是我們健康計劃的成員。這種方法使 Elevance Health 在市場上獨樹一幟，我們深厚的本地根基提供了對我們社區獨特需求的深刻理解，以及涵蓋商業、醫療補助和醫療保險覆蓋範圍的多元化解決方案組合，我們在確保獲得優質的醫療保健。

Medicare posted strong growth in dual-eligible special needs plan and group members, which more than offset slower growth within individual Medicare Advantage. As we stated at our investor conference last month, Medicare Advantage is a strategically important market for Elevance Health over the long term. And we were pleased to see CMS move to phase in the risk model revision it had proposed in the 2024 advance notice.

Medicare 在雙重資格的特殊需求計劃和團體成員方面實現了強勁增長，這足以抵消個人 Medicare Advantage 的緩慢增長。正如我們在上個月的投資者會議上所說，從長遠來看，Medicare Advantage 對 Elevance Health 來說是一個具有戰略意義的重要市場。我們很高興看到 CMS 進入其在 2024 年提前通知中提出的風險模型修訂階段。

This will provide time to help the industry adapt to the changes. Across all of our businesses, the transition to value-based care is a critical imperative and we continue to make progress working closely with care providers in our network including by integrating directly into their workflow processes through their own EMRs. Today, we are actively working with multiple leading EMR providers, including Epic, to establish bidirectional data exchanges with care providers that enable seamless prior authorization processes initiated directly within Care providers EMR workflow.

這將為幫助行業適應變化提供時間。在我們所有的業務中，向基於價值的護理過渡是一項至關重要的任務，我們將繼續與我們網絡中的護理提供者密切合作取得進展，包括通過他們自己的 EMR 直接集成到他們的工作流程中。今天，我們正積極與包括 Epic 在內的多家領先 EMR 提供商合作，與護理提供商建立雙向數據交換，從而實現直接在護理提供商 EMR 工作流程中啟動的無縫事先授權流程。

With this connectivity, our clinical staff can also review patient records and find the information they need to authorize care. In addition to accelerating Care approval processes for consumers, this is resulting in substantially fewer requests for additional clinical information and significantly lower provider appeal rates. Recently, we published our first advancing health together progress report, which summarizes how we are promoting whole health by contracting for outcomes, collaborating for success and connecting for health.

通過這種連接，我們的臨床工作人員還可以查看患者記錄並找到他們授權護理所需的信息。除了加快消費者的護理審批流程外，這還導致對額外臨床信息的請求大大減少，並顯著降低了提供者的上訴率。最近，我們發布了我們的第一份共同推進健康進展報告，總結了我們如何通過為成果而簽約、為成功而合作和為健康而聯繫來促進整體健康。

The report outlines our approach to make meaningful, measurable progress towards that goal by partnering closely with care providers to make whole health a reality, one person at a time. We encourage you to view the report, and we expect to provide annual updates on our progress towards achieving our 2027 target of having at least 80% of our consolidated benefit expense in value-based care with at least 40% in downside risk.

該報告概述了我們通過與護理提供者密切合作，使整體健康成為現實，一次一個人，從而在實現這一目標方面取得有意義、可衡量的進展的方法。我們鼓勵您查看該報告，我們希望每年更新我們實現 2027 年目標的進展情況，即至少 80% 的綜合福利支出用於基於價值的護理，至少 40% 的下行風險。

While social factors like Whole Health and HealthEquity will remain core to our business, we are also committed to strong governance and sustainability practices, especially those that drive better health outcomes and results in long-term value creation. We continue to receive strong recognition for our efforts and are proud to maintain sector-leading ratings from 3 of the most prominent ESG and corporate governance research, ratings and analytics firms.

雖然 Whole Health 和 HealthEquity 等社會因素仍將是我們業務的核心，但我們也致力於強有力的治理和可持續性實踐，尤其是那些推動更好的健康結果和長期價值創造的實踐。我們的努力繼續獲得強烈認可，並為保持 3 家最著名的 ESG 和公司治理研究、評級和分析公司的行業領先評級而感到自豪。

To learn more about how our social and environmental impact work supports our enterprise strategy, we encourage you to reference our recently released impact report for 2022. Now I'd like to take a moment to thank our more than 100,000 associates for the important work they do every day on behalf of the members who we are privileged to serve. Our commitment to improving lives and communities is unwavering, and it extends to our own associates. And we were pleased to be recognized for the third consecutive year as one of Fortune's 100 best companies to work for in 2023 and to be chosen by Fortune as one of America's most innovative companies.

要詳細了解我們的社會和環境影響工作如何支持我們的企業戰略，我們鼓勵您參考我們最近發布的 2022 年影響報告。現在我想花點時間感謝我們的 100,000 多名員工所做的重要工作每天為我們有幸服務的會員做事。我們對改善生活和社區的承諾是堅定不移的，它延伸到我們自己的員工。我們很高興連續第三年被評為《財富》雜誌 2023 年最適合工作的 100 家公司之一，並被《財富》雜誌選為美國最具創新力的公司之一。

We will continue to prioritize culture and talent in pursuit of achieving our vision for Elevance Health. In conclusion, we are pleased to have delivered a strong start to the year, as John will discuss in more detail in a moment. The balance and resilience of our enterprise will be key in 2023. We are confident in our ability to meet our commitments and remain focused on being a lifetime trusted health partner for those we are privileged to serve.

我們將繼續優先考慮文化和人才，以實現我們對 Elevance Health 的願景。總之，我們很高興今年開局良好，John 稍後將詳細討論。我們企業的平衡和彈性將成為 2023 年的關鍵。我們相信我們有能力履行我們的承諾，並繼續專注於成為我們有幸服務的人們終生值得信賴的健康合作夥伴。

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，了解更多關於我們的經營業績。約翰？

Thank you, Gail, and good morning to everyone on the line. As Gail mentioned earlier, we reported strong first quarter results, including GAAP earnings per share of $8.30 and adjusted earnings per share of $9.46, representing growth of approximately 15% year-over-year. Our first quarter results reflect the continued execution of our enterprise strategy as we continue to optimize our mature businesses, invest in high-growth opportunities and accelerate the growth of our enterprise through Carelon, all in service of becoming a lifetime trusted health partner.

謝謝你，蓋爾，早上好在線的每個人。正如蓋爾之前提到的，我們報告了強勁的第一季度業績，包括 GAAP 每股收益 8.30 美元和調整後每股收益 9.46 美元，同比增長約 15%。我們的第一季度業績反映了我們企業戰略的持續執行，因為我們繼續優化我們的成熟業務，投資高增長機會並通過 Carelon 加速我們企業的增長，所有這些都是為了成為終生值得信賴的健康合作夥伴。

We ended the first quarter with medical membership of 48.1 million members, an increase of nearly 600,000 in the quarter and over 1.3 million year-over-year. Risk-based membership grew by approximately 1 million members year-over-year, driven by organic growth in Medicaid and Medicare Advantage, dual-eligible special need plan and group members.

第一季度結束時，我們的醫療會員人數為 4810 萬，本季度增加近 60 萬，同比增加超過 130 萬。在 Medicaid 和 Medicare Advantage、雙重資格的特殊需求計劃和團體成員的有機增長的推動下，基於風險的會員人數同比增長了約 100 萬。

In our Commercial business, our individual membership grew by 124,000 lives or 15% year-over-year and by 19% year-to-date, driven by geographic expansion and strategic product positioning that should enable additional growth when coverage shifts related to Medicaid redeterminations begin later this year. Membership momentum in these areas was partially offset by attrition in our Commercial group risk business, which we expected as a result of the pricing actions we took on January 1 renewals to better reflect our post-pandemic cost structure and optimize the business for sustainable economics long term.

在我們的商業業務中，我們的個人會員人數同比增長 124,000 人，同比增長 15%，今年迄今增長 19%，這得益於地域擴張和戰略產品定位，當與醫療補助重新確定相關的覆蓋範圍發生變化時，這應該能夠實現額外增長今年晚些時候開始。這些領域的會員增長勢頭被我們的商業集團風險業務的流失部分抵消了，我們預計這是由於我們在 1 月 1 日續約時採取的定價行動，以更好地反映我們大流行後的成本結構並優化業務以實現長期可持續經濟學期。

Our fee-based business grew by approximately 370,000 lives year-over-year on top of a record selling season in the first quarter of last year, driven by strong retention rates and another solid national account selling season and with growth in BlueCard members. Overall, these results reflect balanced growth and strong momentum in our diverse Health Benefits business, and we believe that our well-balanced portfolio of offerings will serve us well when Medicaid beneficiaries begin to transition coverage in the coming quarters.

在去年第一季度創紀錄的銷售季之後，我們的收費業務同比增長了約 370,000 人，這得益於強勁的保留率和另一個穩健的國民賬戶銷售季以及 BlueCard 會員的增長。總體而言，這些結果反映了我們多樣化的健康福利業務的平衡增長和強勁勢頭，我們相信，當醫療補助受益人在未來幾個季度開始轉變覆蓋範圍時，我們均衡的產品組合將為我們提供良好的服務。

As we discussed at our investor conference last month, growth in medical membership translates to growth for Carelon, which continues to grow both organically and inorganically through expanding the scale and scope of services it provides to our own and other health plans. Carelon's momentum continued in the first quarter, evident in its top line growth of nearly 18% and margin expansion that allowed operating gain to grow by nearly 21%.

正如我們在上個月的投資者會議上討論的那樣，醫療會員的增長轉化為 Carelon 的增長，它通過擴大其為我們自己的和其他健康計劃提供的服務的規模和範圍，繼續實現有機和無機增長。 Carelon 的勢頭在第一季度繼續保持，其收入增長近 18% 和利潤率擴張使營業收益增長近 21%。

Now before discussing our first quarter results in more detail, I'd like to spend a minute on our adoption of the new GAAP accounting requirements for how insurance companies account for long-term future policy benefit liabilities and deferred acquisition costs. For us, this new accounting requirement impacts our Medicare supplement plans. We adopted the new accounting guidelines for the long duration targeted improvements at the beginning of the year and embedded the new approach in our initial 2023 guidance.

現在，在更詳細地討論我們第一季度的業績之前，我想花一點時間談談我們採用新的 GAAP 會計要求，了解保險公司如何計算長期未來保單福利負債和遞延收購成本。對我們來說，這項新的會計要求會影響我們的 Medicare 補充計劃。我們在年初採用了針對長期目標改進的新會計準則，並將新方法納入了我們最初的 2023 年指南。

The change does not impact our previously reported cash flow, our current cash position or our business strategy and will not materially impact future operating results. However, the new accounting pronouncement required us to restate prior year results. In the GAAP reconciliation table at the end of our press release, we have shown the isolated impact of the new accounting policies on our first quarter 2022 earnings, which we consider to be immaterial.

這一變化不會影響我們之前報告的現金流量、我們目前的現金狀況或我們的業務戰略，也不會對未來的經營業績產生重大影響。然而，新的會計公告要求我們重述前一年的業績。在我們新聞稿末尾的 GAAP 調節表中，我們顯示了新會計政策對我們 2022 年第一季度收益的孤立影響，我們認為這些影響並不重要。

First quarter operating revenue of $41.9 billion, increased approximately 11% year-over-year. Growth was driven by higher premium revenue in Medicaid and Medicare, premium rate increases to cover overall cost trends and strong top line growth in CarelonRx and Carelon services. The medical loss ratio for the first quarter was 85.8%, an improvement of 30 basis points year-over-year, driven by premium rate adjustments in our Health Benefits business to more accurately reflect our post-pandemic cost structure.

第一季度營業收入為 419 億美元，同比增長約 11%。增長的推動因素包括 Medicaid 和 Medicare 的保費收入增加、保費率上漲以涵蓋總體成本趨勢以及 CarelonRx 和 Carelon 服務的強勁收入增長。第一季度的醫療損失率為 85.8%，同比提高 30 個基點，這是由於我們的健康福利業務進行了保費調整，以更準確地反映我們大流行後的成本結構。

Our first quarter operating expense ratio came in at 11.5%, flat relative to the first quarter of 2022. Operating gain for the enterprise grew approximately 16% year-over-year in the first quarter as Carelon grew over 20%. And the Health Benefits delivered strong growth in the mid-teens percentage range on double-digit revenue growth and margin recovery of pandemic-era lows as we had expected.

我們第一季度的運營費用率為 11.5%，與 2022 年第一季度持平。第一季度企業的運營收益同比增長約 16%，因為 Carelon 增長超過 20%。正如我們預期的那樣，健康福利在兩位數的收入增長和大流行時代低點的利潤率恢復方面實現了十幾歲中期的強勁增長。

Turning to our balance sheet. We ended the quarter with a debt-to-capital ratio of 40.5%, up from 39.9% at year-end 2022. The increase was due to debt raised during the quarter, a portion of which was used to fund our acquisition of BioPlus, which closed in February and refinanced a debt maturity. During the quarter, we repurchased 1.3 million shares of our common stock at a weighted average price of $476.66 for approximately $622 million.

轉向我們的資產負債表。本季度末，我們的債務資本比率為 40.5%，高於 2022 年底的 39.9%。這一增長是由於本季度籌集的債務，其中一部分用於資助我們收購 BioPlus，於 2 月關閉並為債務到期再融資。本季度，我們以 476.66 美元的加權平均價格以約 6.22 億美元的價格回購了 130 萬股普通股。

Days in Claims Payable ended the first quarter at 46 days, a decrease of 1.5 days sequentially and 0.9 days year-over-year. Declines in DCPs were primarily driven by mix. With the Omicron COVID surge in the first quarter of 2022 and COVID claims generally having a longer cycle time than our overall average, DCPs were elevated a year ago. Medical Claims Payable also included nearly $400 million more of provider pass-through payments related to Medicaid in the first quarter of last year compared to the first quarter of this year.

第一季度末，應付索賠天數為 46 天，環比減少 1.5 天，同比減少 0.9 天。 DCP 的下降主要是由混合驅動的。隨著 Omicron COVID 在 2022 年第一季度激增，並且 COVID 聲稱的周期時間通常比我們的總體平均水平更長，DCP 在一年前有所提高。與今年第一季度相比，去年第一季度應付醫療索賠還包括近 4 億美元的與醫療補助計劃相關的供應商轉嫁付款。

Excluding provider pass-through payments from both periods, our Medical Claims Payable would have grown by 10.1% year-over-year compared with 9.4% growth in premium revenue. As a reminder, we expect our Days in Claims Payable to be in the low 40% range long term. Operating cash flow in the first quarter was $6.5 billion, including the early receipt of a month of premium revenue from CMS. Excluding it, operating cash flow was $3.5 billion or 1.7x net income.

不包括兩個時期的提供商轉嫁付款，我們的應付醫療索賠將同比增長 10.1%，而保費收入增長 9.4%。提醒一下，我們預計我們的應付索賠天數長期處於 40% 的低範圍內。第一季度的運營現金流為 65 億美元，包括提前收到 CMS 的一個月保費收入。不包括它，運營現金流為 35 億美元或淨收入的 1.7 倍。

Overall, we are pleased with our first quarter performance and the strong start to the year. Momentum in our Health Benefits and Carelon businesses bolsters our confidence in delivering another year of growth in adjusted earnings per share, consistent with our long-term target compound annual growth rate of 12% to 15%. Given the strong start to the year, the balance and resilience of our enterprise and the momentum we have in each of our business segments, we have raised our full year outlook for adjusted earnings per share to greater than $32.70.

總體而言，我們對第一季度的業績和今年的強勁開局感到滿意。我們的 Health Benefits 和 Carelon 業務的發展勢頭增強了我們對實現調整後每股收益又一年增長的信心，這與我們 12% 至 15% 的長期目標複合年增長率一致。鑑於今年的強勁開局、我們企業的平衡和彈性以及我們在每個業務部門的發展勢頭，我們將調整後每股收益的全年預期上調至 32.70 美元以上。

As we look to the rest of 2023, our focus will remain on execution of our strategy and demonstrating that we have the best catchers met in the industry. We will continue to optimize our mature businesses, invest in high-growth opportunities and accelerate the growth of our organization through Carelon.

展望 2023 年剩餘時間，我們的重點仍將放在戰略的執行上，並證明我們擁有業內最優秀的捕手。我們將繼續優化我們的成熟業務，投資於高增長機會，並通過 Carelon 加速我們組織的發展。

And with that, operator, please open up the call to questions.

有了這個，接線員，請打開問題電話。

(Operator Instructions) Our first question comes from Justin Lake with Wolfe Research.

（操作員說明）我們的第一個問題來自 Wolfe Research 的 Justin Lake。

I'll use my question on the DCP discussion thing, given it's a pretty important topic going on across the industry right now. So John, you talked about seasonality impacts. You talked about type -- different types of claims driving a little bit lower DCP. And then you said low 40s is where we're going. Now over time, I think everyone in -- every managed care investor looks at DCP and thinks of it as quality of earnings metric, right? When it's going up, it's good and down, it's bad, right?

我將在 DCP 討論中使用我的問題，因為這是目前整個行業正在討論的一個非常重要的話題。所以約翰，你談到了季節性影響。你談到了類型——不同類型的索賠導致 DCP 略低。然後你說我們要去的地方是 40 多歲。現在隨著時間的推移，我認為每個人 - 每個管理式醫療投資者都會關注 DCP 並將其視為收益質量指標，對嗎？當它上升時，它是好的，而下降時，它是壞的，對吧？

And typically, you just think that there's more or less reserving going on. I know there's a lot more to it. So maybe you can tell us what's been driving your DCP lower recently beyond what you talked about already? And how are we going to get to the low 40s, meaning, is it going to be for lower reserving? Or is it going to be the kind of mechanical aspects? And over what time period should we expect that to kind of normalize?

通常情況下，您只是認為或多或少會有保留。我知道還有很多。那麼，也許您可以告訴我們，除了您已經談到的內容之外，最近是什麼導致您的 DCP 降低？我們將如何達到 40 多歲的低點，意思是，它會降低準備金嗎？或者它會是那種機械方面的？我們應該期望在什麼時間段內恢復正常？

Thank you, Justin. And I do appreciate you're taking your question or maybe I should say questions on DCP. But yes, our DCP is down by 1.5 days quarter-over-quarter and 0.9 days sequentially. And there's a lot of things that go into that calculation all the way from the number of days and the denominator can change on a quarter-over-quarter basis to various other aspects. I'll just state at the outset that our DCP will not get lower by reducing reserves. We have a very consistent and conservative methodology associated with our actuarial team.

謝謝你，賈斯汀。非常感謝您提出問題，或者我應該就 DCP 提出問題。但是，是的，我們的 DCP 環比下降了 1.5 天，環比下降了 0.9 天。從天數到分母可以按季度變化到其他各個方面，計算中有很多東西。我一開始就聲明，我們的 DCP 不會因為減少準備金而降低。我們的精算團隊採用非常一致且保守的方法。

And in terms of coming up with reserves, those reserves are consistent here at March 31 as they were at December 31 and that there is no benefit to the income statement associated with this drop in DCP. So having that behind maybe talk a little bit about some of the mechanics that you asked about. We have a mix in the type of claims is obviously very important. And you look at a year ago, we were in the midst of the Omicron surge with COVID. COVID claims had a longer cycle time than other claims do. That had been the case through the entirety of the pandemic.

就準備金而言，這些準備金在 3 月 31 日與 12 月 31 日保持一致，並且與 DCP 下降相關的損益表沒有任何好處。所以在後面可能會談談你問到的一些機制。我們在索賠類型中的組合顯然非常重要。你看看一年前，我們正處於 COVID 的 Omicron 浪潮之中。 COVID 索賠的周期時間比其他索賠長。在整個大流行期間都是如此。

And when you have a claim type that takes longer, both for the provider to bill us and for our adjudication process, the cycle time becomes longer, DCP just mathematically becomes a little bit inflated. And so with COVID being so much less in the first quarter of 2023 than it was in 2022 or 2021 for that matter, that cycle time is really very important, and so you see a drop.

當您的索賠類型需要更長的時間時，無論是提供商向我們收費還是我們的裁決過程，週期時間都會變長，DCP 在數學上會變得有點膨脹。因此，由於 2023 年第一季度的 COVID 比 2022 年或 2021 年要少得多，所以這個週期時間真的非常重要，所以你會看到下降。

On reserves, and I made this comment in the prepared statements, but I think it's really important. On the reserves, we have these retrospective provider pass-through payments that we get from our Medicaid partners, Medicaid states. And the amount of those reserves as of March of '23 are $400 million less than they were at the end of March of '22. And if we pulled out from the calculation from our reserves, these pass-through payments, which passed through by definition, have 0 impact on net income.

關於儲備金，我在準備好的聲明中發表了這個評論，但我認為這真的很重要。在儲備金中，我們從我們的醫療補助計劃合作夥伴那裡獲得了這些追溯提供者轉嫁款項。截至 2023 年 3 月，這些儲備金額比 22 年 3 月底時少了 4 億美元。如果我們從儲備金的計算中剔除，這些按定義傳遞的轉嫁支付對淨收入的影響為零。

Then you would be able to see that our Medical Claims Payable balances have grown 10.1% year-over-year compared to a 9.4% growth in premium, further showing that our reserving methodologies are conservative and our reserves are still very, very strong. So in terms of how long it's going to take to get to the low 40s, be another few years. And there's any number of constructs that could -- will occur. But we are starting to see payment cycles more consistent with pre-pandemic era payment cycles. And as those things are fully baked into the numbers, you should expect DCP to tweak down as a result. So thank you very much for the question and the opportunity to clarify all that.

然後你會看到我們的應付醫療索賠餘額同比增長 10.1%，而保費增長 9.4%，進一步表明我們的準備金方法是保守的，我們的準備金仍然非常非常強勁。因此，就達到 40 多歲的低點需要多長時間而言，再過幾年。並且有任何數量的構造可能會發生。但我們開始看到支付週期與大流行前時代的支付週期更加一致。由於這些因素已完全融入數字中，因此您應該期望 DCP 會有所調整。非常感謝你提出這個問題，也感謝你有機會澄清這一切。

Yes. Thanks, John, and thanks, Justin. And I just want to reiterate what John said because I think it is a really important question. We feel we had a really strong start to this year and that, again, reiterating that DCP [didn't] impact earnings. And as you think about all the factors John talked about really is the mix and the longer tail of COVID claims and entering a more reasonable payment cycle.

是的。謝謝，約翰，謝謝，賈斯汀。我只想重申 John 所說的話，因為我認為這是一個非常重要的問題。我們認為今年的開局非常強勁，再次重申 DCP [沒有] 影響收益。當你考慮約翰談到的所有因素時，實際上是 COVID 索賠的混合和長尾，以及進入更合理的付款週期。

So thanks very much for the question and the opportunity to provide a little more perspective there.

非常感謝你提出這個問題，也感謝有機會提供更多觀點。

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

接下來，我們將轉到 A.J.來自瑞士信貸的大米。

MLR was right in line with expectations on a consolidated basis, at least Street expectations, 30 basis points better year-to-year. Can you comment on any trends you're seeing underlying that with both respect to service categories, areas of care management that are pluses or minuses? And as you look at your MLR guidance for the full year, any changes in your thinking about the rest of the year there?

MLR 在綜合基礎上符合預期，至少符合華爾街的預期，同比提高 30 個基點。您能否評論一下您在服務類別、護理管理領域的優勢或劣勢方面所看到的潛在趨勢？當您查看全年的 MLR 指南時，您對今年剩餘時間的想法有何變化？

No, thank you for the question, A.J. We're certainly very comfortable with our MLR guidance and really pleased to report a first quarter medical loss ratio of 85.8%. And maybe reiterating what I stated at Investor Day, the overall cost structure and the overall trends are very much aligned with our expectations, consistent with our pricing methodologies and consistent with our thought process. Now those trends are slightly elevated from what cost trends were pre-pandemic level.

不，謝謝你的問題，A.J.我們當然對我們的 MLR 指南感到非常滿意，並且非常高興地報告第一季度的醫療損失率為 85.8%。也許重申我在投資者日所說的話，總體成本結構和總體趨勢非常符合我們的預期，符合我們的定價方法並符合我們的思維過程。現在，這些趨勢略高於大流行前的成本趨勢水平。

But as I said, they're exactly in line with our expectations and exactly aligned with our pricing methodology. So our MLR certainly has improved from the first quarter of '22. And I think you can see that coming through in the Health Benefits segment margins. But we're pretty comfortable with where trend sits right now compared to our expectations.

但正如我所說，它們完全符合我們的預期，並且完全符合我們的定價方法。因此，我們的 MLR 肯定比 22 年第一季度有所改善。我認為你可以在健康福利部門的利潤率中看到這一點。但與我們的預期相比，我們對目前的趨勢感到非常滿意。

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

接下來，我們將轉到 Bernstein 的 Lance Wilkes 系列。

Could you talk a little bit about cross-sales in the quarter, in particular, I was interested in PBM cross sales and into your self-insured block? And then just in general, what your product strategy is with respect to self-insured as you're looking at your bundling in of some of your services businesses there?

你能談談本季度的交叉銷售嗎，特別是，我對 PBM 交叉銷售和你的自保塊很感興趣？然後總的來說，當你正在考慮你在那裡捆綁一些服務業務時，你的產品策略是關於自我保險的？

Yes. Thanks for the question, Lance. I'm going to ask Morgan Kendrick first to talk a little bit about our fee-based business and then probably, Pete, to share what's happening in Carelon because I think you hit on a really important point. One, the improvement of services that we're selling through to Commercial, it's been a strategy for a number of years, and we've made some nice progress, as you've seen just in the percentage of premium going up and the profit per member.

是的。謝謝你的問題，蘭斯。我將首先請 Morgan Kendrick 談談我們的收費業務，然後可能，Pete，分享一下 Carelon 正在發生的事情，因為我認為你說到了一個非常重要的觀點。第一，改善我們向商業銷售的服務，這是多年來的一項戰略，我們取得了一些不錯的進展，正如您所看到的保費上升百分比和利潤每個成員。

And then obviously, Carelon is a big part of that, not just with the PBM, but Carelon Services. So Morgan, pleased to share.

然後很明顯，Carelon 是其中的重要組成部分，不僅僅是 PBM，還有 Carelon Services。摩根，很高興分享。

Lance, thanks for the question. When we think about the fee-based business, we've had a really, really strong run in the past several years. And I think that goes back and speaks to the health and the value that we're driving to the market, especially to the employers who are actually spending their own money. To your point, Carelon is a big, big piece of it. We had a really nice selling cycle this year, in fact, with the pharmacy business.

蘭斯，謝謝你的提問。當我們考慮收費業務時，我們在過去幾年中的表現非常非常強勁。而且我認為這可以追溯到我們正在推動市場的健康和價值，特別是對於實際上花自己錢的雇主。就您的觀點而言，Carelon 是其中很大一部分。事實上，今年我們的銷售週期非常好，尤其是藥房業務。

We didn't see very many jumbos in the medical side. So thus, that was sort of absent from the actual Rx percentage as well for us. But nonetheless, we're seeing more and more attraction to this idea of the whole integrated delivery model of pharmacy medical together and the value that it's delivering. Secondly, you think about the other products that are working with Carelon on, whether it's the Behavioral Health, whether these are sort of the incentive programs around payment integrity and bill review, things of that nature, they are really important to our self-funded customers, that continues to see very strong growth and attraction from the market.

我們在醫療方面沒有看到很多巨無霸。因此，對於我們來說，實際 Rx 百分比中也沒有這種情況。但是，儘管如此，我們看到越來越多的人對藥房醫療的整個集成交付模型及其所提供的價值的想法越來越有吸引力。其次，你想想與 Carelon 合作的其他產品，無論是行為健康，還是圍繞支付完整性和賬單審查的激勵計劃，這些性質的東西，它們對我們的自籌資金非常重要客戶，繼續看到非常強勁的增長和來自市場的吸引力。

That said, at the end of the day, Pete's team and my team are working together to build for purpose things that create value in the market. And again, I'll anchor back to the 3 things that Gail mentioned in the beginning in her opening remarks. The market is keenly focused on affordability, experience and simplicity. And the more that we can pull together, the better it's going to be for our markets. And I think the connection here between Carelon and the Commercial fee-based business is strategically critical to that, continuing to drive growth.

也就是說，歸根結底，Pete 的團隊和我的團隊正在共同努力，打造能夠在市場上創造價值的產品。再一次，我將回到蓋爾在開場白中提到的三件事。市場非常關注可負擔性、體驗和簡單性。我們能齊心協力的越多，對我們的市場就越有利。我認為 Carelon 與商業收費業務之間的聯繫對此具有戰略意義，將繼續推動增長。

Pete, I'll turn it to you.

皮特，我會把它交給你。

All right. Thanks, Morgan. And thanks for the question, Lance. I'll start with the pharmacy and then I'll go to the services side of things. But as Morgan said, the integrated offerings that we're selling is really resonating in the marketplace. I think our economics are perceived today as being very strong. And we continue to see momentum, and we talked about this in the 10,000 or below segment where Morgan and the business have a lot of strength on the Commercial side of the business.

好的。謝謝，摩根。謝謝蘭斯的提問。我將從藥房開始，然後我將轉到服務方面。但正如摩根所說，我們銷售的集成產品確實在市場上引起了共鳴。我認為我們的經濟今天被認為非常強大。我們繼續看到勢頭，我們在 10,000 或以下的細分市場中討論了這一點，摩根和公司在業務的商業方面擁有強大的實力。

We've seen RFP activity, quite frankly, be up in '23 year-over-year. And another thing that I'll say is that I'm pleased with is retention is improving overall. So that's a really good thing. We're working closely with Morgan right now on the '24 selling season that has begun. The pipe is building. I would say that we're very interested in niche opportunities, again, where our Commercial business has a lot of strength.

坦率地說，我們已經看到 RFP 活動在 23 年同比增長。我要說的另一件事是，我很高興保留率總體上有所提高。所以這是一件非常好的事情。在已經開始的 24 年銷售旺季，我們正在與摩根密切合作。管道正在建設中。我想說的是，我們對利基機會非常感興趣，我們的商業業務在這方面有很大的優勢。

So for example, on the labor side as well as with TPAs. So we see continued a lot of opportunity in sort of either niche opportunities or that 10,000 and below. As it relates to Services, as Morgan said, we're really building off of where we started. And Gail mentioned in her prepared remarks, things like the post-acute care offering, that's a great example of where we started in Medicare, and we're really expanding that now into Commercial and expanding it not only with for post-acute care services, but the things like durable medical equipment as well as social determinants of health.

因此，例如，在勞動力方面以及 TPA 方面。因此，我們看到繼續有很多機會，無論是利基機會還是 10,000 及以下的機會。正如 Morgan 所說，與服務相關，我們確實是在我們開始的地方建立起來的。蓋爾在她準備好的發言中提到，諸如急性後護理服務之類的事情，這是我們從 Medicare 開始的一個很好的例子，我們現在真的正在將其擴展到商業領域，並且不僅將其擴展到急性後護理服務，但諸如耐用醫療設備以及健康的社會決定因素之類的東西。

And then in our medical benefits management business, formerly known as AIM, we are in-sourcing a lot of critical services that we're deploying and cross-selling into Morgan's business, things like genetic testing, oncology. So there's a lot of areas that I think are very important to Morgan on the Commercial business that we're driving through over the next year. So I appreciate that question.

然後在我們的醫療福利管理業務（以前稱為 AIM）中，我們正在採購許多我們正在部署和交叉銷售到摩根業務中的關鍵服務，例如基因檢測、腫瘤學。因此，我認為有很多領域對摩根在明年我們將推動的商業業務中非常重要。所以我很欣賞這個問題。

Yes. Thank you for the question. I would just offer one additional proof point. We've shared this before, which is the customers who are single sourcing with us that we have many times shared multiple carriers, and we've done 23 of those over the last few years. And I think that's another good example of our ability, not only to consolidate medical but also to sell additional services, and it shows the value that we're bringing to the market. So again, just another quick proof point on ability to cross-sell.

是的。感謝你的提問。我只想提供一個額外的證明點。我們之前分享過這個，這是我們多次與我們共享多個承運人的單一採購客戶，在過去幾年中我們已經完成了其中的 23 次。我認為這是我們能力的另一個很好的例子，不僅要鞏固醫療，還要出售額外的服務，它顯示了我們為市場帶來的價值。再一次，這只是交叉銷售能力的另一個快速證明點。

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

接下來，我們將轉到 RBC Capital Markets 的 Ben Hendrix。

Having had a little bit more time to work through the 2024 and a rate update and the RADV rule, are there any incremental thoughts you can offer on the rate impact to Anthem's plans specifically and the extent to which the risk rebating and audit could impact physicians' willingness to take risk within the Carelon partnerships?

在有更多時間完成 2024 年以及費率更新和 RADV 規則之後，您是否可以就費率對 Anthem 計劃的具體影響以及風險回扣和審計對醫生的影響程度提供任何增量想法' 願意在 Carelon 合作夥伴關係中承擔風險嗎？

Thanks for the question, Ben. And I guess, first, I'll start and then ask Felicia Norwood to provide some perspective. First and foremost, we were pleased to see that CMS moved to phase in the risk model in the final notice. That will give us time all in the industry and with care providers to adjust. So as you know, we're in the midst of the ['24] bids. So we won't talk a lot about that, but I'll ask Felicia maybe to share a little bit more perspective on everything.

謝謝你的問題，本。我想，首先，我會開始，然後請 Felicia Norwood 提供一些觀點。首先，我們很高興看到 CMS 在最終通知中進入風險模型階段。這將使我們有時間在整個行業和護理提供者中進行調整。如您所知，我們正在進行 ['24] 投標。所以我們不會談論太多，但我會請 Felicia 分享更多關於一切的觀點。

Ben, and thank you for that question. As Gail said, we're certainly pleased with the phase-in of the risk model changes. This will give us the opportunity to smooth the impact to beneficiaries as well as the providers who serve them. Medicare Advantage for us strategically is a very important business long term, and we will continue to be very focused on trying to make sure that we have a Whole Health approach and HealthEquity around certainly individuals who participate in this program significantly who have low incomes and are certainly very much underrepresented.

本，謝謝你提出這個問題。正如蓋爾所說，我們當然對風險模型變更的逐步實施感到高興。這將使我們有機會緩和對受益人以及為他們服務的提供者的影響。從戰略上講，Medicare Advantage 對我們來說是一項非常重要的長期業務，我們將繼續非常專注於努力確保我們擁有 Whole Health 方法和 HealthEquity 圍繞那些顯著參與該計劃的低收入和當然，代表性不足。

As I've said before, the individuals in this program, over 40% have incomes less than $25,000. And when we take a look at our opportunity around drivers of health and supplemental benefits, it's important that we're able to balance all of these things as we take a look at our bids for '24 as well as what we need to do with our provider partners long term.

正如我之前所說，這個項目中超過 40% 的人的收入低於 25,000 美元。當我們審視我們圍繞健康驅動因素和補充福利的機會時，重要的是我們能夠平衡所有這些事情，因為我們會審視我們對 24 世紀的出價以及我們需要做的事情我們的提供商是長期合作夥伴。

With that said, we certainly don't believe that we are disproportionately disadvantaged by any of the changes here relative to our competitors. And as we think about our strategy for 2024, we will continue to be very focused on how we grow this very important business for us and equally important, how we continue to deliver value for those that we're privileged to serve.

話雖如此，我們當然不認為我們因這裡的任何變化相對於我們的競爭對手處於不成比例的不利地位。當我們考慮 2024 年的戰略時，我們將繼續非常關注如何發展這項對我們非常重要的業務，同樣重要的是，我們如何繼續為我們有幸服務的人創造價值。

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

接下來，我們將轉到來自摩根大通的 Lisa Gill 的台詞。

I really wanted to go back to your primary care strategy. Gail, when you made your initial comments around Carelon and Carelon Services, you didn't talk about that. I was just wondering if maybe you could give us an update on the relationship you have with (inaudible) or other areas that you're thinking about as you continue to build on value-based care and relationships with primary care doctors?

我真的很想回到你的初級保健策略。蓋爾，當你對 Carelon 和 Carelon Services 發表初步評論時，你並沒有談論那個。我只是想知道，在您繼續建立基於價值的護理和與初級保健醫生的關係時，您是否可以向我們介紹您與（聽不清）或您正在考慮的其他領域的關係的最新情況？

Yes. Thank you for the question, Lisa. I think understanding our overall care provider strategy, it's really important that it's, first and foremost, critical to how we think about our Health Benefits business. And again, you said it at the beginning of the comments, it's about driving greater value-based care and importantly, increasing the amount of downside risk that we're going to share with providers.

是的。謝謝你的問題，麗莎。我認為了解我們的整體護理提供者戰略非常重要，它首先對我們如何看待我們的健康福利業務至關重要。再一次，你在評論的開頭說過，這是關於推動更大的基於價值的護理，重要的是，增加我們將與供應商分擔的下行風險。

A couple of weeks ago, we shared with you, as you know, at the investor conference that our goal is to get to 80% of our consolidated health care reimbursement and value-based care by 27% and 40% downside. And again, we're sitting in the mid-60% right now and a little bit varied by business. But again, as you are thinking about our strategy, you mentioned -- and a few others, that's just one piece of it. It's important that we're trying to solve this for all lines of business and across multiple geographies.

幾週前，如您所知，我們在投資者會議上與您分享了我們的目標是將我們綜合醫療保健報銷的 80% 和基於價值的護理減少 27% 和 40%。再一次，我們現在處於 60% 的中間位置，並且因業務而異。但同樣，當您考慮我們的戰略時，您提到了 - 以及其他一些人，這只是其中的一部分。重要的是，我們要努力為所有業務線和跨多個地區解決這個問題。

And so for us, we want it for Commercial, Medicaid and Medicare. So one size model isn't going to fit all for us. With respect to Carelon, what we're building and investing in our new enablement capabilities and those are going to allow us to accelerate the management and take more whole person risk from a variety of structures, quite frankly, not just through primary care.

所以對我們來說，我們希望它用於商業、醫療補助和醫療保險。所以一種尺寸的模型不會適合我們。關於 Carelon，我們正在建設和投資於我們的新支持能力，這些能力將使我們能夠加速管理並從各種結構中承擔更多的全人風險，坦率地說，不僅僅是通過初級保健。

And again, I guess I would like to point out what's different about how we're thinking about scaling and leveraging what Carelon has and building across that continuum is that we really see a huge opportunity to enable and integrate specialty for the chronic and complex. That's an area you just heard Felicia talk about the dual population. It's a big population for us, specialized populations in Medicaid. And they're a huge part of benefit expense, and we think that's an area that has been under sourced quite frankly.

再一次，我想我想指出我們如何考慮擴展和利用 Carelon 擁有的東西以及在整個連續體中構建的不同之處在於我們確實看到了一個巨大的機會來實現和整合慢性和復雜的專業。這是您剛剛聽到 Felicia 談論雙重人口的領域。對我們來說，這是一個很大的人口，醫療補助計劃中的特殊人群。它們是福利支出的很大一部分，坦率地說，我們認為這是一個資源不足的領域。

So as we think about it, yes, we are in partnerships. As you mentioned, some of those, they're important. They're helping us grow. But it's only one piece of our broader strategy, which, again, is to drive value-based care in our markets. And so we do see this as a big opportunity to drive both more consistency in our Health Benefits business, but also importantly drive operating gain and earnings inside of Carelon as we increase our capabilities.

因此，正如我們所考慮的那樣，是的，我們處於合作夥伴關係中。正如您提到的，其中一些非常重要。他們正在幫助我們成長。但這只是我們更廣泛戰略的一部分，這再次是在我們的市場中推動基於價值的護理。因此，我們確實認為這是一個很好的機會，可以推動我們的健康福利業務更加一致，但也很重要地推動 Carelon 內部的運營收益和收益，因為我們提高了我們的能力。

So a little bit different than just primary care focused. I think much broader than that and how we're thinking about the overall strategy. Thanks very much for the question.

所以與只關注初級保健有點不同。我認為比這更廣泛，以及我們如何考慮整體戰略。非常感謝你的提問。

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

接下來，我們將轉到 Stephens 的 Scott Fidel 的台詞。

Was interested maybe if you could drill in a little bit more on the post-acute care expansion in terms of where exactly things stand in terms of the scaling of that across the platform after the first quarter and then the timing on how you see that rolling out across the client base across Medicare and Commercial? And to the extent maybe just share some of the latest outcomes around that in terms of the key deliverables that you're driving for your clients on that?

如果你能在第一季度後整個平台的擴展方面的確切情況以及你如何看待滾動的時間方面，也許你可以在急性後護理擴展方面進行更多的鑽探跨越醫療保險和商業的客戶群？在某種程度上，也許只是分享一些關於您正在為客戶推動的關鍵交付成果的最新成果？

Sure. Thanks, Scott, and I'll have Pete Haytaian address your questions. Thank you.

當然。謝謝，Scott，我會讓 Pete Haytaian 回答您的問題。謝謝。

Thanks, Scott. As we talked about, and Gail mentioned in the prepared remarks, we're really excited about this product offering. I talked about this at Investor Day, but we started on this journey a year, maybe 13, 14 months ago, we were able to fully implement this and finalize the implementation of this in the Medicare business in the first quarter. And that was with respect to the core post-acute care offering.

謝謝，斯科特。正如我們所說的那樣，蓋爾在準備好的評論中提到，我們對這款產品感到非常興奮。我在投資者日談到了這一點，但我們開始了這一旅程一年，也許是 13、14 個月前，我們能夠全面實施這一點，並在第一季度完成在醫療保險業務中的實施。那是關於核心的急性後護理產品。

And as we talked about, we are now expanding that with respect to durable medical equipment and social drivers of health. That will happen throughout this year. We are also expanding these services in terms of post-acute care into Medicare and Medicaid, and that will flow through this year and into next year. So there's a lot of runway still internally to drive these services.

正如我們所說，我們現在正在擴大耐用醫療設備和健康社會驅動因素方面的範圍。這將在今年全年發生。我們還將這些服務擴展到 Medicare 和 Medicaid 中的急性期後護理，這將貫穿今年和明年。因此，在內部仍有很多跑道可以驅動這些服務。

In terms of your question on key metrics and performance, that also is something that I'm very excited about. I mean, again, what we're trying to really do here is create a differentiated experience for post-acute care providers. So when they are in need of services or approval of services, they're dealing with technology in a portal that's differentiated, and it's a streamlined service so that they can get the approvals they need in the most appropriate fashion.

就您關於關鍵指標和績效的問題而言，這也是我非常興奮的事情。我的意思是，我們在這裡真正要做的是為急性後期護理提供者創造差異化的體驗。因此，當他們需要服務或服務審批時，他們會在差異化的門戶中處理技術，這是一種簡化的服務，以便他們能夠以最合適的方式獲得所需的審批。

And as we're looking at the different levels of post-acute care, we're seeing our performance play through and meet our original objectives. And that is that where appropriate, going to the appropriate levels of care and sites of care and then ultimately into the home, where cost and quality is most effective. And so we look across a series of metrics in that regard, and we're very pleased at the progress we're making.

當我們審視不同級別的急性後期護理時，我們看到我們的表現發揮作用並達到了我們最初的目標。那就是在適當的時候，去適當的護理水平和護理地點，然後最終進入成本和質量最有效的家庭。因此，我們在這方面查看了一系列指標，我們對我們正在取得的進展感到非常高興。

So in terms of the core product and the performance, very good in terms of the expansion opportunity into other lines of business, that will happen over the next year into '24.

因此，就核心產品和性能而言，就擴展到其他業務線的機會而言非常好，這將在明年進入 24 年。

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

接下來，我們將轉到 Barclays 的 Steven Valiquette 系列。

So just a quick question here on your overall Commercial membership. Aside from the impact from the repricing strategy that you've talked about for a while now on the risk book, I think it's also kind of noteworthy that U.S. unemployment hasn't really increased so far in '23. I guess when thinking about both the commercial risk and the fee-based [push], just wanted to get your thoughts on the just seeming lack of negative macroeconomic impact on the Commercial membership year-to-date at this stage? And whether that could create any sort of upside bias on the overall Commercial membership? I know redeterminations are a big factor at around this year, but just curious on the macro view from your perspective.

所以這裡只是一個關於您的整體商業會員資格的快速問題。除了您已經在風險手冊上談論了一段時間的重新定價策略的影響之外，我認為還有一點值得注意的是，美國失業率在 23 世紀至今並未真正上升。我想在考慮商業風險和基於費用的 [push] 時，只是想了解您對今年迄今為止對商業會員的負面宏觀經濟影響似乎缺乏的想法？這是否會對整體商業會員造成任何形式的上行偏見？我知道重新確定是今年左右的一個重要因素，但只是對您的宏觀觀點感到好奇。

Yes. Thanks for the question, Steve. I'll ask Morgan to provide a little more color. But I guess I would say, if you look at the history of our business, we've had a pretty resilient book of business, both matched a little bit heavily -- more heavily to Government business, but we, quite frankly, diversified that and see nice growth in the Individual, which you mentioned.

是的。謝謝你的問題，史蒂夫。我會要求 Morgan 提供更多顏色。但我想我會說，如果你看看我們的業務歷史，我們的業務非常有彈性，兩者都與政府業務匹配得更多——更重要的是，但坦率地說，我們將其多元化並看到你提到的個人的良好成長。

From the employer perspective, I would just point to 2 things. One, we continue, as Morgan said, around those 3 areas of experience and value, affordability to really drive, I think, a distinctive offering in the marketplace. So that served us well, certainly in the fee-based business, but also BlueCard. The Blue system overall, our BlueCard numbers are up, and that shows the distinctive value we add in our networks across the entire system.

從雇主的角度來看，我只想指出兩件事。一，正如摩根所說，我們繼續圍繞這三個經驗和價值領域，我認為真正推動市場上獨特產品的可負擔性。所以這對我們很有幫助，當然是在收費業務中，還有 BlueCard。整個 Blue 系統，我們的 BlueCard 號碼都在增加，這表明我們在整個系統的網絡中增加了獨特的價值。

So I think that's another -- in a recessionary, whatever kind of environment that you might think about, we actually, I think, managed quite well because of distinctive value, and we're continuing to innovate our products. But I'll ask Morgan maybe to trade a little bit more color on how we see in the marketplace.

所以我認為這是另一個 - 在經濟衰退期間，無論你想到什麼樣的環境，我認為我們實際上管理得很好，因為獨特的價值，我們正在繼續創新我們的產品。但我會請摩根就我們在市場上的看法進行更多交易。

Steven, one thing to sort of camp on to Gail's comments there. When you think about our business, we're -- as she indicated, we're certainly not very indexed, so to speak, in the hospitality industry, the tech industry. To Gail's point, it's more Government business and when you think about our downmarket business in particular. It's -- I don't like to use the word resilient, but it certainly is to a degree more so than others that have a different focus of the business.

史蒂文，有點贊成蓋爾在那裡的評論。當你考慮我們的業務時，我們 - 正如她所指出的那樣，我們當然沒有被索引，可以這麼說，在酒店業，科技行業。就蓋爾而言，這更多是政府業務，尤其是當您考慮我們的低端市場業務時。它是——我不喜歡使用彈性這個詞，但它肯定在某種程度上比其他具有不同業務重點的人更有彈性。

When you think about the recessionary times being negative, of course, it's interesting because the market tends to gravitate to certainty. And I think that's what we're seeing. When we're seeing employers consolidate benefit decisions into single vendor, when employers were having all-time high persistency rates, not only upmarket, but also down market, certainly experienced attrition in the risk-based business downmarket, which was purposeful as we written that book, but feel really good about the progress that we're making and feel really good about the way the assets are being seen and resonating in the market with our customers.

當你認為經濟衰退時期是負面的時，當然，這很有趣，因為市場傾向於確定性。我認為這就是我們所看到的。當我們看到雇主將福利決策整合到單一供應商時，當雇主擁有歷史最高的持續率時，不僅是高端市場，還有低端市場，當然在基於風險的業務低端市場經歷了人員流失，這是我們寫的目的那本書，但對我們正在取得的進展感覺非常好，對資產在市場上與客戶產生共鳴的方式感覺非常好。

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

接下來，我們將轉到 Goldman Sachs 的 Nathan Rich 的路線。

I wanted to follow up on A.J.'s question on utilization. Could you talk about how you expect cost trends to develop over the course of the year? And I guess we've seen some data points on increases in procedure volumes. And at the Analyst Day, you had talked about cost pressure from the new GLP-1 drugs. I guess, are you comfortable that if we continue to see higher utilization in areas like these that it would be captured within your MLR guidance for the year?

我想跟進 A.J. 關於利用率的問題。您能否談談您預計成本趨勢在這一年中將如何發展？我想我們已經看到了一些關於手術量增加的數據點。在分析師日，您談到了新 GLP-1 藥物帶來的成本壓力。我想，如果我們繼續在這些領域看到更高的利用率，那麼您是否感到滿意，這將被包含在您今年的 MLR 指南中？

Yes. Thank you, Nathan. Appreciate the question, and I'll start with the end of your question first. We are very confident that the utilization trends that we are seeing are captured on our MLR guidance for the year. So that is not an issue at all as we sit here today. In terms of some of the cost pressures, I said there are cost pressures and there are a lot of areas that are doing better than we had anticipated.

是的。謝謝你，內森。感謝這個問題，我會先從你的問題的結尾開始。我們非常有信心，我們看到的利用率趨勢已反映在我們今年的 MLR 指南中。所以這根本不是我們今天坐在這裡的問題。在一些成本壓力方面，我說有成本壓力，有很多地方做得比我們預期的要好。

On the GLP-1, that's been talked about quite a bit. We've got a lot of protocols in there. I do want to make sure people are clear that GLP-1 is both weight loss and diabetes. And for weight loss, we do not cover weight loss drugs with the exception of a few states where it's required by state law. So that's not really has ever been part of the conversation and was never part of any of the commentary. I just want to make sure everybody was clear on that.

在 GLP-1 上，已經討論了很多。我們那裡有很多協議。我確實想確保人們清楚 GLP-1 既是減肥又是糖尿病。對於減肥，我們不承保減肥藥，但州法律要求的少數州除外。所以這並不是真正的對話的一部分，也從來沒有出現在任何評論中。我只是想確保每個人都清楚這一點。

And then in terms of the diabetes drugs, certainly, we want to make sure that people who have diabetes that need access to those drugs are getting access to them, but to have the appropriate protocol so that they're not utilized for purposes that are other than medical necessity for diabetes-type folks. And on the other side of the equation, we're still seeing very good trends maybe in terms of ER is still below pandemic era or pre-pandemic era levels.

然後就糖尿病藥物而言，當然，我們希望確保需要獲得這些藥物的糖尿病患者能夠獲得這些藥物，但要有適當的協議，這樣它們就不會被用於某些目的除了糖尿病患者的醫療必需品。在等式的另一邊，我們仍然看到非常好的趨勢，也許就 ER 而言仍低於大流行時代或大流行前時代的水平。

We've got -- COVID is actually a bit less than we had estimated at this point in time. We had a more mild flu season. The timing of when we pay for the vaccine Serum in terms of the boosters has now been pushed out later in the year. There are many, many, many estimates that go into trend. Overall, we are very comfortable with where we sit today.

我們已經 - COVID 實際上比我們此時估計的要少一些。我們度過了一個較為溫和的流感季節。我們以助推器的形式支付疫苗血清的時間現已推遲到今年晚些時候。有很多很多估計進入趨勢。總的來說，我們對今天的坐姿感到非常滿意。

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

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

I wanted to go to redetermination with that upon us. You talked about working with the states very closely for several quarters now. At the Investor Day, we were involved in some discussions where there was a little bit more detail offered around states prospectively estimating changes in the risk pool from redetermination and factoring that into rates. And so that seems a little bit more supportive, I guess, of margin prospectively and something we would be -- need to be less concerned about as this evolves and the risk pool changes.

我想在我們身上重新做出決定。你談到現在幾個季度與各州非常密切地合作。在投資者日，我們參與了一些討論，其中圍繞各州提供了更多細節，前瞻性地估計重新確定帶來的風險池變化並將其計入利率。因此，我猜，這似乎更能支持利潤率的前瞻性，而隨著這種情況的發展和風險池的變化，我們需要減少對利潤的關注。

I wondered if you could add some color to that and perhaps talk about what the composite rate looks like, how much higher it is than normal as a result of that type of activity?

我想知道你是否可以為此添加一些顏色，也許可以談談綜合利率是什麼樣的，由於那種類型的活動，它比正常情況高多少？

Thank you, Dave. I'll start out with just addressing the acuity factor is what you were describing, which is now part of a standardized Medicaid rate renewal process associated with what the belief is the acuity of the population will be that is covered, which is different than what existed in 2019. And so we feel very good about that. The acuity shifts are now a standard input into the actuarial rating models.

謝謝你，戴夫。我將從僅解決敏銳度因素開始存在於 2019 年。因此我們對此感覺非常好。敏銳度變化現在是精算評級模型的標準輸入。

And as I said, that was not the case in 2019. We -- this has started here already in 2023 in January. We work very closely with our state partners to ensure that we have actuarially justified rates. And since the acuity factors part of that actuarial assessment, we feel very, very good about it. In terms of the exact percentage, that's not something that we're going to talk about here publicly. Each state is different. Each state has its actuaries. We have our actuaries.

正如我所說，2019 年情況並非如此。我們 - 這已經在 2023 年 1 月份開始了。我們與我們的州合作夥伴密切合作，以確保我們擁有精算合理的費率。由於敏銳度因素是精算評估的一部分，我們對此感覺非常非常好。就確切的百分比而言，這不是我們要在這裡公開談論的事情。每個州都不一樣。每個州都有自己的精算師。我們有精算師。

We have had very, very good success at having the meeting of the minds with the vast majority of our states in terms of actuarially equivalent rates. So we feel very good about it. But nothing really has changed in terms of our ability to hit our numbers for the rest of the year and where we think really are great catchers met that we have positions us well for Medicaid redeterminations regardless where the members end up going to seek health insurance coverage.

就精算等價率而言，我們在與絕大多數州達成共識方面取得了非常非常好的成功。所以我們對此感覺很好。但是，就我們在今年剩餘時間里達到我們的數字的能力而言，並沒有真正改變，我們認為真正偉大的捕手遇到了我們，無論成員最終去哪裡尋求醫療保險，我們都為重新確定醫療補助計劃做好了準備.

Thanks, John. And maybe I'll ask Felicia just to give a little bit of perspective on what's happening with redetermination because the process has started, but it's fairly early in the process. So Felicia?

謝謝，約翰。也許我會請 Felicia 就重新確定的情況給出一些看法，因為該流程已經開始，但還處於流程的早期階段。那麼費利西亞？

Yes. Thank you, Gail. And Dave, thank you for the question. As we talked at Investor Day, we've been hard at work at this for some period of time with our state partners, all with the goal of trying to make sure that those individuals who have had access to health care coverage continue to maintain that access, whether or not that's on the Medicaid side or certainly on the Commercial side and an exchange product.

是的。謝謝你，蓋爾。戴夫，謝謝你提出這個問題。正如我們在投資者日所說的那樣，一段時間以來，我們一直在與我們的州合作夥伴一起努力工作，所有這些都是為了努力確保那些能夠獲得醫療保險的人繼續保持這一點訪問，無論是在醫療補助方面還是在商業方面和交換產品。

So as we think about where we are today, our teams are engaged in almost weekly meetings with our state partners. We have been advancing a lot of thought leadership around outreach and contact with members, being able to shore up administrative processes around addresses, making sure we're able to reach out to members wherever they are and also being able to have processes that help to provide a seamless transition where possible between our Medicaid business and then what happens on the Commercial side.

因此，當我們思考我們今天所處的位置時，我們的團隊幾乎每週都會與我們的州合作夥伴舉行會議。我們一直在圍繞外展和與成員的聯繫推進許多思想領導，能夠支持圍繞地址的管理流程，確保我們能夠接觸到無論身在何處的成員，並且能夠擁有有助於在可能的情況下，在我們的醫療補助業務與商業方面發生的事情之間提供無縫過渡。

We're very fortunate of the collaboration we've had here with Morgan and his team, and I think that positions us well for how we capture members as they move from Medicaid over to a Commercial product. Gail mentioned earlier, our [Ready Set renew] campaign, the mobile initiatives that we've developed, all trying to meet members wherever they are in this process and then have the ability with our state partners to be able to align around the kinds of ways that we can outreach to Medicaid members in ways that we haven't done before.

我們非常幸運能夠與 Morgan 和他的團隊在這裡進行合作，我認為這使我們能夠很好地了解我們如何在會員從 Medicaid 轉移到商業產品時吸引他們。蓋爾之前提到，我們的 [Ready Set renew] 活動，我們開發的移動計劃，都試圖在這個過程中與成員會面，無論他們身在何處，然後有能力與我們的州合作夥伴能夠圍繞各種我們可以以前所未有的方式接觸醫療補助成員。

So we feel fully prepared. We are pleased to see the engagement of beneficiaries as they are reaching out to understand what this process means for them, ultimately with the goal of trying to make sure that we continue coverage for as many of those individuals as we possibly can. At the end of the day, we have strong collaboration with our states at this point. Great visibility in terms of how we are positioned around trying to maintain actuarially sound rates through this process and being able to work closely as we move through redeterminations, albeit early, but very vigilantly and diligent with our state partners as we move through this over the next 12 to 14 months.

所以我們覺得已經做好了充分的準備。我們很高興看到受益人的參與，因為他們正在伸出手來了解這個過程對他們意味著什麼，最終目標是努力確保我們繼續為盡可能多的人提供保險。歸根結底，我們在這一點上與各州有著強有力的合作。在我們如何定位通過這個過程保持精算合理的利率方面，以及在我們通過重新確定時能夠密切合作方面的可見性，儘管很早，但在我們通過這個過程中與我們的國家合作夥伴非常警惕和勤奮接下來的 12 到 14 個月。

Next, we'll go to the line of Kevin Caliendo from UBS.

接下來，我們將轉到來自瑞銀的 Kevin Caliendo 的台詞。

Really appreciated the answer on the DCPs. And I guess just in the commentary that trend is normal and you're not really seeing anything extraordinary there. I guess my question is why are MLRs not really beating anymore. We're hearing trend is normal. We understand Days in Claims Payable and why they're coming down. It just feels like the risk to MLR right now is greater.

非常感謝關於 DCP 的回答。而且我猜只是在評論中，趨勢是正常的，你並沒有真正看到那裡有什麼特別之處。我想我的問題是為什麼 MLR 不再真正跳動了。我們聽說趨勢是正常的。我們了解應付索賠天數及其下降的原因。只是感覺現在 MLR 的風險更大。

Is there -- is it a pricing issue? Is it a mix issue? Is it just that this is the new normal, and we're sort of back to where trend and pricing are much more similar, and maybe we just got spoiled through the years of COVID?

有——這是一個定價問題嗎？是混合問題嗎？僅僅是因為這是新常態，我們又回到了趨勢和定價更加相似的地方，也許我們只是在 COVID 的歲月裡被寵壞了？

Thank you for that question, Kevin. And I guess the first thing I really do have to say is we feel very good about where MLR came in and where trend came in, and it actually was a bit better than our expectations. So when I look at what we have been projecting as of the beginning of the year, our 86.8% is actually positive to those expectations.

謝謝你提出這個問題，凱文。我想我真正要說的第一件事是我們對 MLR 的出現和趨勢的出現感覺非常好，實際上比我們的預期要好一點。因此，當我查看我們年初的預測時，我們的 86.8% 實際上對這些預期是積極的。

In terms of pricing, our goal is always to price to cover forward trend and then to guide that way. We had said that for Commercial that there were some underlying cost structures associated with COVID that we needed to ensure that our pricing reflected not only forward trend, but also that so that our total pricing reflected the overall cost structure. I think we've done a very, very good job now here at the end of the first quarter of really trying to get -- hit that sweet spot of pricing to really retain a nice large cohort of our membership as well as to see the margin expansion.

在定價方面，我們的目標始終是定價以涵蓋前向趨勢，然後引導趨勢。我們曾說過，對於 Commercial，有一些與 COVID 相關的潛在成本結構，我們需要確保我們的定價不僅反映未來趨勢，而且還要確保我們的總定價反映整體成本結構。我認為我們在第一季度末在這裡做得非常非常好，真正試圖獲得 - 達到定價的最佳點，以真正保留我們的大量會員並看到保證金擴張。

So we actually feel very, very good about where the results are and do believe that we're a bit better than we had anticipated even 90 days ago.

所以我們實際上對結果感到非常非常好，並且相信我們比 90 天前的預期要好一點。

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

接下來，我們將轉到來自美國銀行的 Kevin Fischbeck 的台詞。

Wanted to ask about the exchange presence. Obviously, you're growing that well, expanding into markets. The market always loves growth, but then there becomes a time when growth could be too much growth. So I wanted to get a little more color on kind of how membership or equality data you have around? What that performance looks like so far? And then how you're thinking about the risk profile of the redetermination population back on to the exchanges? Is that something that you think would have a normal margin, a higher margin or lower margin than the exchange business overall?

想詢問交換存在。顯然，你的成長很好，正在向市場擴張。市場總是喜歡增長，但有時增長可能會過度增長。因此，我想了解更多關於您擁有的會員資格或平等數據的類型？到目前為止的表現如何？然後你如何考慮重新確定人口回到交易所的風險狀況？你認為這是一個正常的利潤率，比整個交易所業務更高或更低的利潤率嗎？

Yes. Thanks for the question, Kevin. I'll start and then ask Morgan to share his perspective. I think one of the things about our presence in the exchange marketplace is that we've been very consistent around sort of where we started. We've always been in that business. Quite frankly, we've never lost money in that business. So we've been very careful about the expansion, and we've done it, I would say, on a very paced way.

是的。謝謝你的問題，凱文。我將開始，然後請摩根分享他的觀點。我認為關於我們在交易所市場存在的一件事是我們在我們開始的地方一直非常一致。我們一直從事這項業務。坦率地說，我們從未在該業務中虧本過。所以我們對擴張非常謹慎，而且我們已經做到了，我會說，以一種非常有節奏的方式。

So over the last several years, we've added counties as we've understood them, recontracted, make sure the network was specifically curated. I think we've done a nice job of understanding the risk adjustment mechanisms and all of those things. So in total, as we -- this year added more counties, that was a very paced and understood expansion. So we feel very good about it, quite frankly. We feel very good about the performance profile of the members in there because we have a really good handle on who they are and kind of what our expectations are.

因此，在過去的幾年裡，我們添加了我們所了解的縣，重新簽約，確保網絡是專門策劃的。我認為我們在理解風險調整機制和所有這些方面做得很好。所以總的來說，隨著我們 - 今年增加了更多的縣，這是一個非常有節奏和理解的擴張。所以坦率地說，我們對此感覺非常好。我們對那裡成員的表現感到非常滿意，因為我們非常了解他們是誰以及我們的期望是什麼。

And as they come in from Medicaid, obviously, we know the Medicaid profile as well because we're big in those states, too. So I guess my answer would be, look, we aren't someone who just came into the exchanges and one big fell swoop and wanted to make a big hit 1 year. We've had a very paced and measured progression of both our growth as well as our expansion, so feel very good about that. But maybe Morgan, if you want to add a couple of more comments about that.

當他們來自醫療補助計劃時，很明顯，我們也知道醫療補助計劃的概況，因為我們在這些州也很重要。所以我想我的回答是，看，我們不是剛進入交易所並一舉成名並想在 1 年內大獲成功的人。我們的增長和擴張都取得了非常有節奏和有節制的進展，所以對此感覺非常好。但也許是 Morgan，如果你想對此添加更多評論。

Kevin, thanks for the question, and Gail. I don't know there's a whole lot to add. Back to the comment around pace and sustainability of the business, Kevin. We took this very measured approach, certainly, looking at Medicaid redeterminations, we sort of wanted to make sure we were expanding into the areas where we could serve as many members as we could in our 14 geographies. That said, the interesting thing about this cycle, we had a lot of ins and outs in the market with competitors that had come in and then left.

凱文，謝謝你提出這個問題，還有蓋爾。我不知道還有很多要補充的。回到關於業務發展速度和可持續性的評論，凱文。我們採取了這種非常慎重的方法，當然，看看醫療補助計劃的重新決定，我們有點想確保我們正在擴展到我們可以在 14 個地區為盡可能多的成員提供服務的領域。也就是說，關於這個週期的有趣之處在於，我們在市場上有很多來龍去脈的競爭對手，這些競爭對手進來了又離開了。

So it left a lot of movement in the market that perhaps ordinarily wouldn't have occurred. So back to Gail's comments, we feel good about where we're positioned. We feel good about the economics behind it and are positioned well for when redetermination begins.

因此，它在市場上留下了很多通常不會發生的波動。回到蓋爾的評論，我們對自己的定位感到滿意。我們對其背後的經濟學感覺良好，並且在重新確定開始時處於有利位置。

And for a final question, we'll go to the line of Stephen Baxter from Wells Fargo.

對於最後一個問題，我們將轉到 Wells Fargo 的 Stephen Baxter 的路線。

I was hoping to get a quick update on how the Government business performed in the first quarter. I think you previously had talked about Medicare Advantage as being a margin tailwind year-over-year for 2023, but I didn't necessarily see that in the release or the prepared remarks as a driver on the MLR line. So I just want to understand that a little bit better.

我希望快速了解政府業務在第一季度的表現。我想你之前曾談到 Medicare Advantage 是 2023 年同比利潤率的順風，但我不一定在發布或準備好的評論中看到這一點作為 MLR 系列的驅動力。所以我只想更好地理解這一點。

Yes. Thanks, Steve. I appreciate the question. And as you think about the -- some of the tailwinds that we have in 2023, it certainly includes the repricing of Commercial to better reflect the overall cost structure. We're still doing fine in Medicaid. And then as you pointed out, the Medicare Advantage, we now have a higher percent star revenue than we did the year before, and our risk-adjusted scores are getting back to more normalized levels.

是的。謝謝，史蒂夫。我很欣賞這個問題。當你想到 - 我們在 2023 年擁有的一些順風時，它肯定包括商業的重新定價以更好地反映整體成本結構。我們在醫療補助方面仍然做得很好。然後正如你所指出的，醫療保險優勢，我們現在的明星收入百分比比前一年更高，我們的風險調整分數正在回到更正常的水平。

So it definitely is one of the tailwinds that we are -- that we do have for 2023. So the fact that it wasn't in the prepared comments, don't read anything into that specifically other than to say that it's really -- it's a very good line of business. It can be a growing line of business for us over the next several years, and we feel very, very good about how well positioned we are. And then with the 3-year phase-in of the rate notice, I think we can certainly manage through that as well. So Medicare Advantage continues to be a very important line of business for us.

所以這絕對是我們的順風之一——我們在 2023 年確實有。所以事實上它不在準備好的評論中，除了說它真的——這是一個非常好的行業。在接下來的幾年裡，這對我們來說可能是一個不斷增長的業務線，我們對自己的定位感到非常非常滿意。然後隨著費率通知的 3 年逐步實施，我認為我們當然也可以解決這個問題。因此，Medicare Advantage 仍然是我們非常重要的業務線。

Yes. And thanks for the question. Thanks, John. And overall, I guess, reiterate we do feel the Government business performed better than expectations. So we feel very good about to be specific to your question.

是的。謝謝你的提問。謝謝，約翰。總的來說，我想，重申我們確實認為政府業務的表現好於預期。因此，我們很樂意針對您的問題進行具體說明。

Now I'd like to close by saying thank you. We're pleased to have delivered a strong start to 2023, and we're confident that the ongoing execution of our strategy positions us to continue delivering against the financial targets that we shared with you at our investor conference last month.

現在我想說聲謝謝作為結束。我們很高興在 2023 年取得了良好的開端，我們相信，我們戰略的持續執行將使我們能夠繼續實現我們在上個月的投資者會議上與您分享的財務目標。

Through a steadfast focus on Whole Health and our diverse and expanding suite of products and solutions, we will continue to meet the needs of consumers, customers and the communities that we serve, advancing our strategy of becoming a lifetime trusted health partner. We'll keep executing with focus and discipline to bring increasing value to all of our stakeholders.

通過堅定不移地關注 Whole Health 以及我們多樣化和不斷擴展的產品和解決方案套件，我們將繼續滿足消費者、客戶和我們所服務社區的需求，推進我們成為終生值得信賴的健康合作夥伴的戰略。我們將繼續以專注和紀律執行，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 11:00 a.m. today through May 19, 2023. You may access the replay system at any time by dialing (866) 361-4942 and international participants can dial (203) 369-0190. 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，今天上午 11:00 後至 2023 年 5 月 19 日，可以重播本次會議的錄音。您可以隨時撥打 (866) 361-4942 訪問重播系統，國際與會者可以撥打 (203 ) 369-0190。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。