Elevance Health Inc (ELV) 2023 Q2 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Elevance Health Second 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，並歡迎參加 Elevance Health 第二季度收益電話會議。 （操作員指示）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.

我現在想將會議轉交給公司管理層。請繼續。

Good morning, and welcome to Elevance Health's second quarter 2023 earnings call. This is Steve Tanal, Vice President of Investor Relations.

早上好，歡迎參加 Elevance Health 2023 年第二季度財報電話會議。我是史蒂夫·塔納爾，投資者關係副總裁。

And with us this morning on the earnings call are Gail Boudreaux, President and CEO; John Gallina, our CFO; Peter Haytaian, President of Carelon, Morgan Kendrick, President of our Commercial and Specialty Health Benefits division; and Felicia Norwood, President of our Government Health Benefits division.

今天早上與我們一起參加財報電話會議的是總裁兼首席執行官蓋爾·布德羅 (Gail Boudreaux)；約翰·加利納 (John Gallina)，我們的首席財務官； Peter Haytaian，Carelon 總裁，Morgan Kendrick，我們的商業和專業健康福利部門總裁；以及我們政府健康福利部門總裁費利西亞·諾伍德 (Felicia Norwood)。

Gail will begin the call with a brief discussion of the quarter and recent progress against our strategic initiatives. John will then discuss our financial results and outlook in greater detail. After our prepared remarks, the team will be available for Q&A.

蓋爾將在電話會議開始時簡要討論本季度以及我們戰略舉措的最新進展。然後約翰將更詳細地討論我們的財務業績和前景。在我們準備好發言後，團隊將可以進行問答。

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.

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 GAAP 衡量標準與最直接可比的 GAAP 衡量標準的對賬可在我們的網站 elevancehealth.com 上找到。

We will also be making some forward-looking statements on this call. Listeners are cautioned that these statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond the control of Elevance Health.

我們還將在這次電話會議上發表一些前瞻性聲明。請聽眾注意，這些陳述存在一定的風險和不確定性，其中許多風險和不確定性難以預測，並且通常超出 Elevance Health 的控制範圍。

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.

這些風險和不確定性可能導致實際結果與我們當前的預期存在重大差異。我們建議聽眾仔細審查今天的新聞稿以及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 are pleased to share that Elevance Health delivered strong second quarter results driven by solid execution and continued progress towards our strategy of becoming a lifetime trusted health partner focused on the whole health needs of the consumers we are privileged to serve.

謝謝史蒂夫，大家早上好。今天，我們很高興地與大家分享，Elevance Health 在堅實的執行力和持續進步的推動下取得了強勁的第二季度業績，我們的戰略是成為終身值得信賴的健康合作夥伴，專注於我們有幸服務的消費者的整體健康需求。

Second quarter GAAP earnings per share was $7.79 and adjusted earnings per share was $9.04, reflecting double-digit growth year-over-year. As a result of the strong performance in the first half of the year and momentum across Elevance Health, we are increasing our adjusted earnings per share outlook for the year to be greater than $32.85.

第二季度 GAAP 每股收益為 7.79 美元，調整後每股收益為 9.04 美元，同比實現兩位數增長。由於今年上半年的強勁表現和 Elevance Health 的發展勢頭，我們將今年調整後每股收益預期上調至 32.85 美元以上。

The balance and resilience of our diverse businesses provides confidence in our near-term outlook, while the earnings power of our Health Benefits and Carelon businesses position us to deliver on our long-term growth commitments.

我們多元化業務的平衡性和彈性為我們的近期前景提供了信心，而我們的健康福利和 Carelon 業務的盈利能力使我們能夠兌現長期增長承諾。

With respect to the second quarter, our Health Benefits business delivered particularly strong results as we continued to optimize our products, pricing and operations. We are successfully executing against the planned margin recovery of our commercial risk and Medicare Advantage businesses back toward pre-pandemic levels, and we are pleased with the performance of our Medicaid business.

第二季度，隨著我們繼續優化產品、定價和運營，我們的健康福利業務取得了特別強勁的業績。我們正在成功地將商業風險和醫療保險優勢業務的利潤率恢復到大流行前的水平，我們對醫療補助業務的表現感到滿意。

With Medicaid eligibility redeterminations now underway, our teams are working tirelessly to promote continuity of coverage for consumers through an omnichannel approach, working closely with our state partners. Our Medicaid and commercial colleagues are collaborating to educate members and communities on the process through in-person and online events, ensuring members know how to renew their Medicaid coverage when eligible, or enroll in other forms of coverage, including our own individual ACA plans.

隨著醫療補助資格重新確定正在進行中，我們的團隊正在不懈努力，與我們的州合作夥伴密切合作，通過全渠道方法促進消費者承保的連續性。我們的醫療補助和商業同事正在合作，通過面對面和在線活動對會員和社區進行相關流程的教育，確保會員知道如何在符合資格時更新其醫療補助保險，或參加其他形式的保險，包括我們自己的個人 ACA 計劃。

To date, we have contacted more than 1.5 million of our Medicaid members. Meanwhile, our web-based digital decision support tool is seeing healthy utilization. The tool assesses eligibility for a wide variety of federal and state programs beyond health insurance to support consumers' whole health journey, including the federal Supplemental Nutrition Assistance Program, state-based programs that assist with food and security, housing and childcare programs and more with links that can route consumers to websites where they can enroll in these programs.

迄今為止，我們已聯繫了超過 150 萬醫療補助會員。與此同時，我們基於網絡的數字決策支持工具得到了良好的利用。該工具評估健康保險之外的各種聯邦和州計劃的資格，以支持消費者的整個健康之旅，包括聯邦補充營養援助計劃、協助食品和安全的州計劃、住房和兒童保育計劃以及更多可將消費者引導至可以註冊這些計劃的網站的鏈接。

More than half of the people using our support tool who qualify for commercial, or Medicare coverage are clicking through embedded links to shop for plans and more than 60% of consumers eligible for Medicaid are clicking through to their state site for recertification. This body of work is especially important since many of the people who have lost access to Medicaid so far are losing it for administrative reasons. We expect many of these consumers will reenroll in Medicaid over time.

使用我們的支持工具且有資格獲得商業或醫療保險保險的人中有一半以上會點擊嵌入的鏈接來購買計劃，超過 60% 有資格獲得醫療補助的消費者會點擊其州網站進行重新認證。這項工作尤其重要，因為許多迄今為止無法獲得醫療補助的人都是因為行政原因而失去的。我們預計，隨著時間的推移，這些消費者中的許多人將重新加入醫療補助計劃。

Transitions of coverage are not typically immediate, but emerging data points suggest consumers losing Medicaid are starting to transition on to ACA exchange plans. It's still early in the process and our expectations for coverage transitions remain unchanged, our deep local roots and diversified product portfolio positions us uniquely well to meet consumers' needs regardless of age or socioeconomic status.

保險範圍的轉變通常不會立即發生，但新出現的數據點表明，失去醫療補助的消費者開始轉向 ACA 交換計劃。目前還處於早期階段，我們對覆蓋範圍轉型的期望保持不變，我們深厚的本地根基和多元化的產品組合使我們能夠獨特地滿足消費者的需求，無論年齡或社會經濟地位如何。

Carelon continued to advance its strategy of integrating physical, behavioral, social and pharmacy services to deliver whole health affordably with ongoing investments and capabilities focused on serving people across their entire health care journey, connecting them to the care, support and resources they need.

Carelon 繼續推進整合身體、行為、社會和藥學服務的戰略，通過持續的投資和能力，以經濟實惠的方式提供整體健康服務，重點是在整個醫療保健過程中為人們提供服務，將他們與他們所需的護理、支持和資源聯繫起來。

Carelon Services delivered solid organic growth led by the expansion of post-acute care management solutions with our Medicare health plans, while Carelon Behavioral Health extended its leadership position through multiple external business wins with new and existing customers.

Carelon Services 通過我們的 Medicare 健康計劃擴展急症後護理管理解決方案，實現了穩健的有機增長，而 Carelon Behavioural Health 通過贏得新老客戶的多項外部業務擴大了其領導地位。

New business awards and successful execution in these fast-growing, high-cost areas of trend underscore the value Carelon provides to health plans and the expanding earnings power and attractive growth profile of the Carelon Services business.

新業務獎項和在這些快速增長、高成本趨勢領域的成功執行突顯了 Carelon 為健康計劃提供的價值以及 Carelon 服務業務不斷擴大的盈利能力和有吸引力的增長前景。

Carelon Rx also continued to grow nicely, while investing in key value drivers, specifically specialty pharmacy and advanced home delivery. Revenue grew nearly 20% year-over-year, and we posted solid operating earnings, while absorbing investments in support of our long-term strategy.

Carelon Rx 也繼續保持良好增長，同時投資於關鍵價值驅動因素，特別是專業藥房和先進的送貨上門服務。收入同比增長近 20%，我們公佈了穩健的營業利潤，同時吸收了支持我們長期戰略的投資。

The integration of the BioPlus Specialty Pharmacy is now tracking ahead of schedule, and we expect to begin migrating scripts early next year. Additionally, we remain on track to launch advanced home delivery by the end of 2023. Together, these capabilities will create additional shareholder value, while allowing us to deliver even better consumer experiences in specialty and maintenance pharmacy.

BioPlus Specialty Pharmacy 的整合目前正在提前進行，我們預計將於明年初開始遷移腳本。此外，我們仍有望在 2023 年底之前推出先進的送貨上門服務。這些功能將共同創造額外的股東價值，同時使我們能夠在專業藥房和維護藥房提供更好的消費者體驗。

Expanding and more deeply integrating value-based care across the care continuum is foundational to our enterprise strategy. We are making significant progress in many key areas, including maternal health, where we have continued to expand our obstetrics practice consultants and quality incentive programs to additional markets given outstanding early results.

在整個護理連續體中擴展和更深入地整合基於價值的護理是我們企業戰略的基礎。我們在許多關鍵領域取得了重大進展，包括孕產婦健康，鑑於早期成果出色，我們繼續將我們的產科實踐顧問和質量激勵計劃擴展到其他市場。

These programs have helped improve timeliness to and adequacy of prenatal care and increased postpartum visit compliance contributing to a reduction in preterm birth of 12% and low birth weight deliveries of 20% in participating Medicaid populations. These programs have driven cost savings per delivery and first year mom and baby costs of 5% to 10%, and we are now offering them in 24 Medicaid and 11 commercial markets across the country.

這些計劃有助於提高產前護理的及時性和充分性，並提高產後就診依從性，有助於將參與醫療補助人口的早產率降低 12%，將低出生體重分娩率降低 20%。這些計劃節省了每次分娩的成本以及第一年母嬰費用 5% 至 10%，我們現在在全國 24 個醫療補助計劃和 11 個商業市場提供這些計劃。

We are also working with care provider partners to enable acute care in the home, a patient-centered care alternative to traditional care in the hospital that improves cost, quality and patient experiences.

我們還與護理提供商合作夥伴合作，實現家庭急症護理，這是一種以患者為中心的護理替代醫院傳統護理的方法，可提高成本、質量和患者體驗。

For select patients, acute care at home is safe, improves patient satisfaction and provides high-value care, resulting in approximately a 20% reduction in cost, a 25% decrease in readmissions and a 50% reduction in time spent in bed.

對於特定患者來說，家庭急症護理是安全的，可以提高患者滿意度並提供高價值護理，從而使成本降低約 20%，再入院率降低 25%，臥床時間減少 50%。

We have partnerships with a number of major health systems in our markets with strong results and have significant interest from other health systems to expand this work.

我們與市場上的許多主要衛生系統建立了合作夥伴關係，取得了良好的成果，並且其他衛生系統對擴大這項工作表現出濃厚的興趣。

Connectivity with care provider partners is crucial to supporting our value-based care strategy, and to enabling personalized hybrid and virtual care. We are continuing to expand bidirectional data exchanges between our systems and care providers EMRs. Across 24 markets, we are now connected with over 1,700 hospitals.

與護理提供商合作夥伴的連接對於支持我們基於價值的護理策略以及實現個性化混合和虛擬護理至關重要。我們正在繼續擴大我們的系統和護理提供者電子病歷之間的雙向數據交換。我們現在與 24 個市場的 1,700 多家醫院建立了聯繫。

In addition to enabling physicians to practice value-based care more effectively, these arrangements have simplified common business practices, resulting in more than 60% fewer requests for clinical information and more than 80% less provider appeals. This has not only enhanced operating efficiency for our clinicians and care provider partners, it has also accelerated care approval processes for consumers.

除了使醫生能夠更有效地實施基於價值的護理之外，這些安排還簡化了常見的業務實踐，從而使臨床信息請求減少了 60% 以上，提供者上訴減少了 80% 以上。這不僅提高了我們的臨床醫生和護理提供者合作夥伴的運營效率，還加快了消費者的護理審批流程。

Automation remains an area of focus and opportunity across Elevance Health and deep data sets like ours are foundational for generative artificial intelligence. Our data is centralized, and cleanse and we are in the process of scaling digital solutions for greater impact and testing the application of new technologies.

自動化仍然是 Elevance Health 的重點領域和機遇，而像我們這樣的深度數據集是生成人工智能的基礎。我們的數據是集中的、經過清理的，我們正在擴展數字解決方案以產生更大的影響並測試新技術的應用。

We're harnessing our adaptive artificial intelligence solution to promote identification and access to whole health services during physical health procedures like surgery. Our approach allows us to cast a broad net to perform initial screening for depression and other social drivers of health to ensure we are addressing our members' whole health needs.

我們正在利用我們的自適應人工智能解決方案來促進在手術等身體健康程序期間識別和獲得整體健康服務。我們的方法使我們能夠撒下一張廣泛的網，對抑鬱症和其他健康社會驅動因素進行初步篩查，以確保我們滿足會員的整體健康需求。

Our digital chronic concierge care program is a cloud-based care management platform that connects the patient's entire care management team to triage, monitor and engage with patients through convenient digital channels. Fully digital enrollment, engagement and support alongside key behavioral health components provides members with highly personalized, proactive concierge like experiences, while reducing the overall cost of care for members with chronic conditions.

我們的數字慢性禮賓護理計劃是一個基於雲的護理管理平台，它將患者的整個護理管理團隊連接起來，通過便捷的數字渠道對患者進行分類、監控和互動。全數字化註冊、參與和支持以及關鍵的行為健康組件為會員提供高度個性化、主動的禮賓服務體驗，同時降低患有慢性病的會員的總體護理成本。

We're also using large language models to assist our call center agents, improving their efficiency, accuracy and quality. We're excited about these opportunities and the positive impact they will have on consumers, care provider partners and the operating efficiency of Elevance Health.

我們還使用大型語言模型來協助我們的呼叫中心代理，提高他們的效率、準確性和質量。我們對這些機會以及它們將對消費者、護理提供商合作夥伴以及 Elevance Health 的運營效率產生的積極影響感到興奮。

Guided by our enterprise strategy, we are fueled by a passion for making a positive difference in the world. Accordingly, environmental, social and governance frameworks are embedded in our enterprise strategy. We continue to lead our sector with respect to ESG ratings from 3 of the most prominent corporate governance research, readings and analytics firms, and we were pleased that USA Today recently ranked Elevance Health fifth out of 400 organizations in its inaugural America's Climate Leaders based on core emissions reductions year-over-year and core greenhouse gas reduction.

在我們的企業戰略的指導下，我們滿懷為世界帶來積極改變的熱情。因此，環境、社會和治理框架已融入我們的企業戰略中。我們在 3 家最著名的公司治理研究、閱讀和分析公司的 ESG 評級方面繼續引領我們的行業，我們很高興《今日美國》最近根據核心減排量和核心溫室氣體減排量，將 Elevance Health 在其首屆美國氣候領導者評選中的 400 家組織中排名第五。

Before I turn the call over to John, I'd like to thank our more than 100,000 associates for the work that they do every day on behalf of the members, we are privileged to serve, their dedication is what allows us to advance our strategy and deliver strong operating results in service of our bold purpose to improve the health of humanity. Collectively, our passion to improve lives and communities is unwavering.

在我把電話轉給約翰之前，我要感謝我們超過 100,000 名員工每天代表會員所做的工作，我們很榮幸能夠為會員服務，他們的奉獻精神使我們能夠推進我們的戰略並取得強勁的經營成果，以服務於我們改善人類健康的大膽目標。總的來說，我們對改善生活和社區的熱情是堅定不移的。

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，了解有關我們經營業績的更多信息。約翰？

Thank you, Gail, and good morning to everyone on the line. As Gail mentioned earlier, we reported strong second quarter results, including GAAP earnings per share of $7.79 and adjusted earnings per share of $9.04. We were pleased to deliver another quarter of double-digit growth in revenue, operating income and adjusted earnings per share, driven by the focused execution of our strategy.

謝謝你，蓋爾，祝在線的每個人早上好。正如蓋爾之前提到的，我們報告了強勁的第二季度業績，其中 GAAP 每股收益為 7.79 美元，調整後每股收益為 9.04 美元。在集中執行我們的戰略的推動下，我們很高興在收入、營業收入和調整後每股收益方面再次實現兩位數增長。

Our results exceeded our expectations and the balance and resilience of our diverse set of businesses provides confidence in our outlook. As a result, we have increased our adjusted earnings per share guidance to be greater than $32.85 in 2023, reflecting strong growth consistent with our long-term targeted compound annual growth rate.

我們的業績超出了我們的預期，我們多元化業務的平衡性和彈性讓我們對前景充滿信心。因此，我們將 2023 年調整後每股收益指引提高至 32.85 美元以上，反映出與我們長期目標複合年增長率相一致的強勁增長。

We ended the second quarter with 48 million members, up 938,000 year-over-year. During the quarter, medical membership declined by 135,000 members as the majority of our Medicaid states-initiated eligibility redeterminations, while we are still very early in the redetermination process. At this time, we are seeing many Medicaid members losing coverage for administrative reasons.

截至第二季度末，我們的會員數量為 4,800 萬人，同比增加 938,000 人。本季度，由於大多數醫療補助州啟動了資格重新確定，而我們仍處於重新確定過程的早期階段，醫療會員人數減少了 135,000 名。目前，我們看到許多醫療補助成員因行政原因而失去保險。

Many of these consumers will likely reenroll in Medicaid in the near to intermediate term. In fact, many Medicaid beneficiaries who lose coverage for administrative reasons have 30 to 90 days to reenroll depending on the state with coverage retroactive to their termination date.

其中許多消費者可能會在中短期內重新加入醫療補助。事實上，許多因行政原因失去保險的醫療補助受益人有 30 至 90 天的時間重新加入，具體取決於保險可追溯至終止日期的州。

Meanwhile, we are seeing encouraging early indications that Medicaid beneficiaries losing coverage or transitioning into ACA exchange plans. But transitions of coverage are not always immediate, and our expectation is that commercial membership growth will reaccelerate in the back half of this year and into 2024.

與此同時，我們看到令人鼓舞的早期跡象表明醫療補助受益人失去保險或過渡到 ACA 交換計劃。但覆蓋範圍的轉變並不總是立竿見影的，我們預計商業會員增長將在今年下半年和 2024 年重新加速。

Overall, we believe our prior outlook for coverage transitions remains appropriate. We continue to expect by the end of the initial redetermination cycle that 40% to 45% of net new beneficiaries on Medicaid as a result of the suspension of redeterminations during the public health emergency will stay on Medicaid.

總體而言，我們認為我們之前對覆蓋範圍過渡的展望仍然是合適的。我們仍然預計，在最初的重新確定週期結束時，由於公共衛生緊急情況期間暫停重新確定而導致的醫療補助淨新受益人中，有 40% 至 45% 將繼續享受醫療補助。

But most importantly, we are well positioned to provide people who lose Medicaid coverage with alternative plan offerings. We believe it is essential that these individuals have access to quality health care coverage, and we are positioned to meet their needs.

但最重要的是，我們有能力為失去醫療補助覆蓋的人們提供替代計劃。我們認為，讓這些人獲得優質的醫療保健覆蓋至關重要，我們有能力滿足他們的需求。

With respect to our membership outlook, please note that a new entrant into one of our state Medicaid programs will result in a loss of approximately 140,000 members in that state in the third quarter. This was known as of last year and was factored into our 2023 planning and initial membership guidance.

關於我們的會員前景，請注意，我們州醫療補助計劃之一的新加入者將導致第三季度該州失去約 140,000 名會員。這是去年已知的，並已納入我們的 2023 年規劃和初始會員指南中。

Second quarter operating revenue of $43.4 billion increased $4.9 billion or approximately 12.7% year-over-year. Growth was driven by premium rate increases to cover overall trend in our health benefits businesses along with higher premium revenue driven by membership growth in Medicaid and Medicare.

第二季度營業收入為 434 億美元，同比增加 49 億美元，增幅約為 12.7%。增長的推動因素是保費率上漲，以涵蓋我們健康福利業務的總體趨勢，以及醫療補助和醫療保險會員增長推動的保費收入增加。

Our services business, Carelon, continues to produce strong results with double-digit top line growth in Carelon Rx and Carelon Services as we continue to execute on our strategy of becoming a lifetime trusted health partner.

隨著我們繼續執行成為終生值得信賴的健康合作夥伴的戰略，我們的服務業務 Carelon 繼續取得強勁業績，Carelon Rx 和 Carelon Services 的收入實現兩位數增長。

Execution of our strategy is diversifying our revenue streams, creating greater earnings power and consistency and enabling us to deliver strong growth regardless of the prevailing economic environment.

我們戰略的執行正在使我們的收入來源多樣化，創造更大的盈利能力和一致性，並使我們無論當前的經濟環境如何都能實現強勁增長。

The consolidated benefit expense ratio for the second quarter was 86.4%, a meaningful improvement year-over-year driven by premium rate adjustments in our commercial risk-based business to better reflect the post-pandemic medical cost structure, offset in part by a charge we took in the second quarter associated with a court ruling in a certain state holding health plans liable for certain COVID cost, retroactive to the beginning of the pandemic. We strongly disagree with this ruling, and it is currently on appeal, but we recorded the potential charge in the meantime.

第二季度的綜合福利費用率為 86.4%，同比出現顯著改善，這是由於我們基於商業風險的業務進行保費調整，以更好地反映大流行後的醫療成本結構，部分抵消了我們在第二季度收取的費用，該費用與某個州的法院裁決要求健康計劃承擔一定的新冠病毒費用有關，追溯至大流行開始。我們強烈不同意這項裁決，目前正在上訴，但我們同時記錄了可能的指控。

With respect to our current performance, we, of course, are closely monitoring utilization and trend factors, which remain consistent with our expectations overall and within each line of business. In the context of our upwardly revised guidance for adjusted earnings per share, we are reiterating our initial outlook for our full year consolidated benefit expense ratio.

就我們當前的業績而言，我們當然正在密切監控利用率和趨勢因素，這些因素與我們的總體預期和每個業務範圍內的預期保持一致。在我們上調調整後每股收益指引的背景下，我們重申對全年綜合福利費用率的初步預期。

Elevance Health's adjusted operating expense ratio was 11% in the second quarter, down 10 basis points year-over-year. The decrease was driven by expense leverage associated with strong growth in operating revenue, partially offset by additional operating expenses in support of growth, as we continue to execute our enterprise strategy.

Elevance Health第二季度調整後運營費用率為11%，同比下降10個基點。這一下降是由與營業收入強勁增長相關的費用槓桿推動的，隨著我們繼續執行我們的企業戰略，支持增長的額外營業費用部分抵消了費用槓桿。

Operating gain for the enterprise grew 12% year-over-year in the second quarter, led by our Health Benefits business, which delivered double-digit top line growth and strong margin improvement. Operating margin for our Health Benefits business expanded by 50 basis points year-over-year, consistent with our full year outlook, despite absorbing the charge I mentioned earlier associated with the adverse court ruling in a certain state.

在健康福利業務的帶動下，第二季度企業運營收益同比增長 12%，實現了兩位數的營收增長和強勁的利潤率改善。儘管吸收了我之前提到的與某個州不利的法院裁決相關的費用，但我們的健康福利業務的營業利潤率同比增長了 50 個基點，與我們的全年展望一致。

Carelon delivered a strong quarter as well, with healthy top line growth for Carelon Rx and Carelon Services. Carelon Rx operating earnings include investments in support of our strategy, including scaling our recently acquired Specialty Pharmacy and the build-out of our advanced home delivery business, which is set to launch later this year.

Carelon 也實現了強勁的季度業績，Carelon Rx 和 Carelon Services 的營收實現健康增長。 Carelon Rx 運營收益包括支持我們戰略的投資，包括擴大我們最近收購的專業藥房規模以及擴大我們將於今年晚些時候推出的先進送貨上門業務。

Carelon Rx also benefited from a favorable out-of-period item in the second quarter of 2022, which had the effect of depressing its year-on-year operating earnings growth rate this quarter. Carelon Services had a strong second quarter, led by organic growth in Carelon post-acute management.

Carelon Rx 還受益於 2022 年第二季度一項有利的期外項目，這抑制了其本季度營業利潤同比增長率。 Carelon Services 第二季度表現強勁，主要得益於 Carelon 後期管理的有機增長。

Turning to our balance sheet. We ended the second quarter with a debt-to-capital ratio of 39.6%, in line with our expectations and consistent with our target range. During the quarter, we repurchased 1.4 million shares of our common stock at a weighted average share price of $457.34 for approximately $646 million. Year-to-date, we have repurchased 2.7 million shares for $1.3 billion, pacing ahead of our full year outlook of approximately $2 billion. We expect to remain opportunistic given recent weakness in our share price and the attractive valuation levels offered by the market.

轉向我們的資產負債表。第二季度末，我們的債務資本比率為 39.6%，符合我們的預期，也符合我們的目標範圍。本季度，我們以 457.34 美元的加權平均股價、約 6.46 億美元的價格回購了 140 萬股普通股。年初至今，我們已以 13 億美元的價格回購了 270 萬股股票，超出了我們約 20 億美元的全年預期。鑑於近期我們的股價疲軟以及市場提供的有吸引力的估值水平，我們預計將保持機會主義態度。

We continue to maintain a prudent posture with respect to reserves. Days in Claims Payable stood at 46.5 days at the end of the second quarter, an increase of 0.5 days sequentially and a decrease of 1.3 days year-over-year. As we disclosed in the second quarter of last year, the timing of certain provider pass-through payments and corresponding reserves had the effect of increasing Days in Claims Payable by approximately 1.8 days in the prior year quarter.

我們在儲備方面繼續保持審慎的態度。二季度末應付賠款天數為46.5天，環比增加0.5天，同比減少1.3天。正如我們在去年第二季度所披露的，某些提供商轉手付款和相應準備金的時間安排導致應付索賠天數比去年同期增加了約 1.8 天。

Excluding that dynamic, Days in Claims Payable would have increased by 0.5 days year-over-year and medical claims payable would have grown by 11.9% compared with growth in premium revenue of 10.6%.

排除這一動態，應付索賠天數將同比增加 0.5 天，應付醫療索賠將增長 11.9%，而保費收入增長 10.6%。

As a reminder, we continue to expect Days in Claims Payable be in the low-40 range long-term and anticipate normalization towards this range in the coming years, as cycle times shortened, and COVID-related uncertainty recedes.

提醒一下，我們仍然預計應付索賠天數將長期保持在 40 天以下的範圍內，並預計隨著周期時間的縮短以及與新冠病毒相關的不確定性的消退，未來幾年將趨於這一範圍的正常化。

Operating cash flow was approximately $2 billion or 1.1x net income in the second quarter of 2023. Year-to-date, excluding an extra payment received from CMS, our operating cash flow was $4.9 billion or 1.3x net income. Overall, we are pleased with our second quarter and our year-to-date performance.

2023 年第二季度的運營現金流約為 20 億美元，即淨利潤的 1.1 倍。年初至今，不包括從 CMS 收到的額外付款，我們的運營現金流為 49 億美元，即淨利潤的 1.3 倍。總的來說，我們對第二季度和今年迄今為止的表現感到滿意。

As we look to the second half of the year, we are excited for the pending acquisition of Blue Cross Blue Shield of Louisiana, the launch of our Carelon Rx pharmacy, a differentiated digital first home delivery model and the continued scaling of BioPlus, as it prepares to serve more Elevance Health members in early 2024.

展望今年下半年，我們對即將收購路易斯安那州 Blue Cross Blue Shield、推出我們的 Carelon Rx 藥房、差異化的數字首次送貨上門模式以及 BioPlus 的持續擴展感到興奮，因為它準備在 2024 年初為更多 Elevance Health 會員提供服務。

Given the strong start to the year, the diversity of our assets in the balance and resilience of our enterprise, we have raised our full year outlook for adjusted earnings per share to greater than $32.85, reflecting growth that is consistent with our long-term target compound annual growth rate. We have consistently delivered on our financial commitments and have the conviction that we will continue to do so.

鑑於今年開局強勁、資產的多樣性以及企業的韌性，我們將全年調整後每股收益預期上調至 32.85 美元以上，反映出與我們長期目標複合年增長率一致的增長。我們始終如一地履行我們的財務承諾，並堅信我們將繼續這樣做。

We will remain focused on the execution of our strategy to become a lifetime trusted health partner by serving the whole health needs of the consumers we are privileged to serve. The better job we do serving our members, the better we will do for all of our stakeholders.

我們將繼續專注於執行我們的戰略，通過滿足我們有幸服務的消費者的整體健康需求，成為終身值得信賴的健康合作夥伴。我們為會員提供的服務越好，我們就能為所有利益相關者做得更好。

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

接線員，現在我們將開放提問熱線。

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

（操作員說明）對於我們的第一個問題，我們將轉到 A.J. 的線路。瑞士信貸的大米。

I appreciate the good performance on the medical loss ratio line and that you're benefiting from your repricing in the commercial book, which you've been talking about for a while. You didn't really call out anything as deviating from your underlying expectations relative to Medicare Advantage, commercial and Medicaid.

我很欣賞醫療損失率方面的良好表現，並且您從商業書籍中的重新定價中受益，您已經談論了一段時間了。您並沒有真正指出任何與您對 Medicare Advantage、商業和 Medicaid 相關的潛在期望的偏離。

I just wondered if you would maybe flush that out a little more. Are you seeing any trend changes or anything on the horizon? And how did you think about the MA bids in light of anything you saw there on the utilization front?

我只是想知道你是否可以再把它沖掉一點。您是否看到任何趨勢變化或即將發生的事情？根據您在利用率方面看到的情況，您如何看待 MA 出價？

Thank you for the kind words, A.J., and good morning, everyone. And I really do appreciate the question and the opportunity to provide clarity on these issues. We're obviously very pleased with our results for the second quarter, which is really following the delivery of strong results also in the first quarter.

謝謝你的客氣話，A.J.，大家早上好。我真的很感謝你提出這個問題，也很感謝有機會澄清這些問題。顯然，我們對第二季度的業績非常滿意，這是繼第一季度也取得了強勁業績之後的結果。

And related to your question and the issues on trend, I do think part of the confusion out there is trying to understand what is happening versus what is expected, or what was expected. We've noted previously, when you combine COVID, non-COVID cost, the overall cost of the health care system is more expensive than if COVID had never occurred, something we've been talking about and analyzing and stating for a while now.

與你的問題和趨勢問題相關，我確實認為部分困惑在於試圖了解正在發生的事情與預期的情況，或者預期的情況。我們之前已經指出，當你將新冠病毒和非新冠病毒的成本結合起來時，醫療保健系統的總體成本比新冠病毒從未發生時要昂貴，這一點我們已經討論、分析和陳述了一段時間了。

So given that fact, we had already included the elevated cost structure into our pricing, into our projections and into our guidance. And quite honestly, this is true for all lines of business within the Health Benefit segment. So if you look at the first and second quarter in particular, there really isn't anything all that surprising for all that different from our overall expectations. Costs continue to be higher than compared to a baseline as if COVID never existed.

因此，考慮到這一事實，我們已經將升高的成本結構納入我們的定價、預測和指導中。老實說，這對於健康福利領域的所有業務線都是如此。因此，如果你特別關注第一季度和第二季度，就會發現與我們總體預期的不同確實沒有什麼令人驚訝的。成本繼續高於基線，就好像新冠病毒從未存在過一樣。

So we -- obviously, we're very well positioned. And as you know, based on this morning's call, we raised our guidance by $0.15, the $32.85 per share. And those expectations fall solidly within our 12% to 15% compound annual long-term growth rate target. But I think just as importantly, as you heard in my prepared comments, we reaffirmed our original guidance for the full year 2023 benefit expense ratio. So anyway, thanks for the question, A.J. And operator next question, please?

所以我們——顯然，我們處於非常有利的位置。如您所知，根據今天早上的電話會議，我們將指導意見上調了 0.15 美元，即每股 32.85 美元。這些預期完全落在我們 12% 至 15% 的複合年長期增長率目標之內。但我認為同樣重要的是，正如您在我準備好的評論中聽到的那樣，我們重申了對 2023 年全年福利費用比率的最初指導。不管怎樣，謝謝你的提問，A.J.接線員下一個問題可以嗎？

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蘭斯·威爾克斯（Lance Wilkes）系列。

Could you talk a little bit about in Carelon, the combination of where you're getting those wins, the types of organizations you're winning with a self-insured employers or other Blues? And then where you are as far as the build-out of the pharmacy capabilities, the advanced home delivery? And how, if at all, that impacts your recontracting -- upcoming recontracting for PBM?

你能談談在卡雷隆，你在哪裡獲得這些勝利的組合，你與自我保險的雇主或其他藍調贏得的組織類型嗎？那麼，在藥房能力的建設和先進的送貨上門方面，你們的進展如何？如果有的話，這會如何影響您的重新簽約——即將進行的 PBM 重新簽約？

Thanks very much Lance for the question. I'm going to have Pete Haytaian address it, but I think you hit a couple of key areas around Carelon, both Services and Rx, where we feel that we're advancing the strategy that we laid out at Investor Day and feel really good about the progress.

非常感謝蘭斯的提問。我將請 Pete Haytaian 發表講話，但我認為您談到了 Carelon 的幾個關鍵領域，包括服務和 Rx，我們認為我們正在推進我們在投資者日制定的戰略，並對進展感到非常滿意。

So Pete, why don't you talk about both of those areas?

那麼皮特，你為什麼不談談這兩個領域呢？

Yes. No, thanks, Gail, and thanks, Lance, I really appreciate the question.

是的。不，謝謝蓋爾，謝謝蘭斯，我真的很感激這個問題。

And you know this, we've talked a lot about it, but a big part of our strategy is obviously to focus on managing high-cost, high-trend areas, Gail talked about it today in her prepared remarks, and then obviously capitating risk down to -- through Elevance -- with Elevance Health first in mind. And we are -- part of our strategy was to drive that value through Elevance Health first, and then have that translate externally. And we are seeing that play through very, very nicely.

你知道這一點，我們已經討論了很多，但我們戰略的很大一部分顯然是專注於管理高成本、高趨勢領域，蓋爾今天在她準備好的講話中談到了這一點，然後顯然將風險降低到——通過 Elevance——首先考慮到 Elevance Health。我們的戰略的一部分是首先通過 Elevance Health 推動這一價值，然後將其轉化為外部。我們看到這一過程非常非常順利。

So I'll give you a sense of quickly what's happening internally, and then Lance to your question how that translates externally. Internally, we're working very closely with the P&Ls, and we continue to accelerate a lot of opportunity. We talked about finalizing the post-acute care initiative this year. That's over 1.2 million Medicare members.

因此，我將讓您快速了解內部發生的情況，然後蘭斯回答您的問題，這如何轉化為外部。在內部，我們與損益表密切合作，並繼續加速創造大量機會。我們討論了今年完成急症後護理計劃的事宜。超過 120 萬 Medicare 會員。

We just launched a new durable medical equipment offering as well with our Medicare business, and we're expanding that to commercial. And in our medical benefits management, which is formerly AIM, we've in-sourced a lot of critical services around genetic testing and things like oncology. So a lot of energy around that. And then, of course, the behavioral health, physical health opportunity and assuming full risk on that is a tremendous opportunity as well.

我們剛剛推出了一種新的耐用醫療設備產品以及我們的醫療保險業務，並且我們正在將其擴展到商業領域。在我們的醫療福利管理（以前稱為 AIM）中，我們內購了許多圍繞基因檢測和腫瘤學等方面的關鍵服務。周圍有很多能量。當然，行為健康、身體健康機會以及承擔全部風險也是一個巨大的機會。

And interestingly enough, we are -- where we're having a lot of success internally, that is actually translating in our external pipeline and specifically with the Blues. As we talk about the Blues and they see us having a lot of confidence and good performance internally in Elevance, they're interested in some of those same solutions.

有趣的是，我們在內部取得了很大的成功，這實際上正在我們的外部管道中轉化，特別是在藍軍方面。當我們談論 Blues 時，他們看到我們在 Elevance 內部擁有很大的信心和良好的表現，他們對其中一些相同的解決方案很感興趣。

So I would say at the top of the list, when you look at our pipeline and the growth in our pipeline, the Home Solutions through myNEXUS, now called Carelon post-acute care solutions is getting a lot of visibility. The post-acute care offering that we just launched in our Medicare business internally is also driving a lot of excitement in the pipeline. And I would also say that there is a decent amount of interest in some of the innovations around payment integrity. So I think a lot of opportunity, not only still internally, but that will translate as it relates to the Blues.

因此，我想說的是，在列表的頂部，當您查看我們的管道和管道的增長時，通過 myNEXUS 提供的家庭解決方案（現在稱為 Carelon 急性後護理解決方案）正在獲得很高的知名度。我們剛剛在內部醫療保險業務中推出的急症後護理產品也引起了人們的興奮。我還想說，人們對圍繞支付完整性的一些創新抱有相當大的興趣。所以我認為有很多機會，不僅是內部機會，而且會轉化為與藍軍相關的機會。

As it relates to advanced home delivery and the launch of Carelon Rx pharmacy, the second part of your question. Again, really, really excited about this initiative. And as we've talked about overall for our pharmacy strategy, it's to in-source the strategic levers that really matter. And we're doing that both with obviously what we're doing in specialty and in-sourcing this activity, but I wouldn't look at this as only in-sourcing mail. I would look at it more broadly in terms of what we're trying to do to get closer to the member and differentiate in terms of our experience overall with our consumers.

因為它涉及先進的送貨上門和 Carelon Rx 藥房的推出，這是你問題的第二部分。再次，我對這一舉措感到非常非常興奮。正如我們所討論的整體製藥戰略，內包真正重要的戰略槓桿。我們正在做的事情顯然是我們在專業領域所做的事情和內包這項活動，但我不認為這只是內包郵件。我會從更廣泛的角度來看待它，即我們試圖做些什麼來拉近與會員的距離，並在我們與消費者的整體體驗方面實現差異化。

Think of the capabilities that we're deploying. Number one, this is going to be connected to Sydney, our consumer engagement platform. There's going to be a convenient quick scheduling of medications. If you think about access to pharmacists and how critical that is, we're going to have access to a pharmacist 24/7. So that's a big differentiator.

想想我們正在部署的功能。第一，這將連接到我們的消費者參與平台悉尼。將會有一個方便快捷的藥物安排。如果您考慮與藥劑師的聯繫以及這有多重要，我們將可以 24/7 與藥劑師聯繫。所以這是一個很大的區別。

And then importantly, I think a lot of people know that the experience with mail isn't necessarily always smooth. And so we're going to have an easy view of where delivery stands. And Uber-like experience, quite frankly, so you know where your pharmaceuticals stand in terms of their delivery. So a lot in that regard in terms of really differentiating ourselves on experience, and we're excited about that. And as Gail said, we're ready to launch that headed into 2024.

然後重要的是，我認為很多人都知道郵件體驗並不一定總是順利。這樣我們就可以輕鬆了解交付情況。坦率地說，還有類似 Uber 的體驗，讓您知道您的藥品在交付方面處於什麼位置。因此，在這方面，我們在經驗上真正與眾不同，我們對此感到興奮。正如蓋爾所說，我們已準備好在 2024 年推出該項目。

Yes. Thank you, Pete. As you can hear from the excitement, I think, from Pete and all the things we're doing at both Carelon Services and Carelon Rx, there's a lot going on to really build our strategy and, I think, execute on it. And I guess I would just punctuate 2 things that, Pete talked about, one, the behavioral health area. We really see ourselves as a leader in the crisis management area as well as we're seeing a lot of internal or external validity of that strategy.

是的。謝謝你，皮特。我認為，正如你從 Pete 以及我們在 Carelon Services 和 Carelon Rx 所做的所有事情中聽到的那樣，在真正制定我們的戰略並執行它方面，還有很多事情要做。我想我只想強調皮特談到的兩件事，一是行為健康領域。我們確實將自己視為危機管理領域的領導者，並且我們看到該策略在許多內部或外部有效性。

And I think starting to pull through not just in its historic government business, but also on the commercial side, where they're integrating physical and behavioral in particular, which is a core part of our whole health strategy.

我認為，不僅在其歷史悠久的政府業務中開始取得進展，而且在商業方面也開始取得進展，特別是在整合身體和行為方面，這是我們整個健康戰略的核心部分。

And then on the pharmacy side, again, we're really trying to make sure that the value and strategic levers are coming through, and you heard that and what Pete talked about. So thanks for the question, Lance. And next question, please.

然後在製藥方面，我們再次努力確保價值和戰略槓桿能夠實現，你也聽到了皮特所說的。謝謝你的提問，蘭斯。請提出下一個問題。

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

接下來，我們將前往沃爾夫研究中心的賈斯汀·萊克（Justin Lake）系列。

First, I just wanted to follow up on A.J.'s question. Just see if you can give us a little color. You're saying trend is above normal and you priced for it. We appreciate that color. Just any kind of incremental that you can give us on how much higher and what you've seen 1Q to 2Q might be helpful?

首先，我只是想跟進 A.J. 的問題。看看你能否給我們一點顏色。你說趨勢高於正常水平並且你為此定價。我們很欣賞這種顏色。您可以向我們提供的任何增量信息，例如您在第一季度到第二季度所看到的情況，以及您所看到的情況，可能會有幫助嗎？

And then my question is just take that to the margin side, right? Can you tell us how margins are running versus the expectations coming into the year? I know you had expected improvement in Medicare and commercial and obviously some volatility in Medicaid. Can you tell us how those are running in specifically? Anything on Medicare beyond Puerto Rico is as you've discussed in the second quarter would be helpful? Or how that's trending?

然後我的問題是把它帶到邊際，對吧？您能否告訴我們今年的利潤率與預期相比如何？我知道您預計醫療保險和商業方面會有所改善，並且醫療補助方面顯然會出現一些波動。您能告訴我們這些具體是如何運行的嗎？正如您在第二季度討論的那樣，關於波多黎各以外的醫療保險的任何內容都會有幫助嗎？或者說趨勢如何？

Yes. Thank you for the question, Justin, and I'm happy to the follow-up. As I said, I'll start out by reiterating, we did raise our EPS guidance and proactively reaffirmed MLR guidance for the year. So I think that actually has a forward view of trend inherent in it.

是的。謝謝你的提問，賈斯汀，我很高興接受後續跟進。正如我所說，我首先要重申，我們確實提高了每股收益指引，並主動重申了今年的國土資源部指引。所以我認為這實際上具有內在的前瞻性趨勢。

But having said that, I'm not so sure that we're really seeing anything that much differently than some other folks have been saying. We've been expecting the cost of health care to be elevated compared to the baseline as if COVID never existed. I'm not going to provide a specific point estimate, but only to say that we've seen it, we price for it, and we've included and factored it into our expectations.

但話雖如此，我不太確定我們所看到的情況是否與其他人所說的有很大不同。我們一直預計醫療保健成本會比基線更高，就好像新冠病毒從未存在過一樣。我不會提供具體的點估計，而只是說我們已經看到了它，我們為它定價，並且我們已將其納入我們的預期中。

And this is the second time this year we've raised guidance and reaffirming the MLR outlook. So I think we're in pretty good position. Associated with the margins, Commercial is doing very well. I'll start out with Health Benefits in total. That's our Health Benefits segment. Margins improved 50 basis points year-over-year and are on track to hit the guidance of greater than -- improvement of 30 to 60 basis points.

這是我們今年第二次提出指導意見並重申國土資源部的前景。所以我認為我們處於非常有利的位置。與利潤率相關，商業業務表現非常好。我將從總體健康益處開始。這就是我們的健康福利部分。利潤率同比提高 50 個基點，有望達到 30 至 60 個基點的指導值以上。

I do want to note, in my prepared comments, I had a comment about a court ruling that we disagree with that we took a charge. Without that charge, the margin improvement would have been higher than the high end of the 30 to 60 basis point improvement year-over-year. So Health Benefits margins are going quite well.

我確實想指出，在我準備好的評論中，我對法院的一項裁決發表了評論，我們不同意我們提出指控。如果沒有這筆費用，利潤率改善將高於同比 30 至 60 個基點改善的上限。因此，健康福利的利潤率相當不錯。

The commercial repricing effort. Medicaid is very much in line with expectations. And Medicare Advantage is actually relatively in line with expectations. Aside from the one geography that had been pointed out that really is not all that material or significant to the overall results of Elevance Health, but it's an area that we're focused on, and it will obviously be improvement opportunities for 2024.

商業重新定價工作。醫療補助非常符合預期。而Medicare Advantage其實也比較符合預期。除了已經指出的一個地理位置之外，這對 Elevance Health 的整體結果來說確實並不是那麼重要或重要，但這是我們關注的一個領域，而且顯然這將是 2024 年的改進機會。

So all in, we are very pleased with our performance and very bullish on our expectations for the rest of the year.

總而言之，我們對我們的表現非常滿意，並對今年剩餘時間的期望非常樂觀。

Yes. Thanks, John, and thanks for the question, Justin. I think it's important. We've been very consistent all year. We haven't changed our view of how we see MLR and feel very comfortable, as John said, in the guidance that we gave and where we're heading on margins. So thanks again for the question and opportunity to comment. Next question, please.

是的。謝謝約翰，也謝謝賈斯汀的提問。我認為這很重要。我們這一整年都非常穩定。正如約翰所說，在我們提供的指導以及我們的利潤率方向上，我們對 MLR 的看法並沒有改變，並且感覺非常舒服。再次感謝您的提問和發表評論的機會。請下一個問題。

Next, we'll go to the line of Michael Ha from Morgan Stanley.

接下來，我們請聽摩根士丹利的 Michael Ha 的電話。

Regarding Medicaid redetermination. I fully appreciate. I understand how it's too early to really extrapolate any current results. But thus far, number one, how is the acuity mix shift tracking relative to your expectations? Number two, how do you view this enrollment so far? Florida looks positive, but the recent Texas data, does that concern you at all? Number three, with the number of states going through midyear rate renewals, are you seeing acuity adjustments in these draft rates, and would that represent upside to your guidance?

關於醫療補助重新確定。我完全欣賞。我理解現在真正推斷當前結果還為時過早。但到目前為止，第一，敏銳度組合變化跟踪相對於您的期望如何？第二，到目前為止，您如何看待這次招生？佛羅里達州看起來很樂觀，但德克薩斯州最近的數據是否讓您擔心？第三，隨著越來越多的州進行年中利率更新，您是否看到這些草案利率發生了敏銳的調整，這是否意味著您的指導有上行空間？

I'm going to ask Felicia Norwood, who leads our government business to comment on Medicaid?

我要問負責我們政府事務的費利西亞·諾伍德 (Felicia Norwood) 對醫療補助有何評論？

So Michael, good morning. I appreciate the opportunity to talk about redeterminations where our teams have certainly spent quite a bit of time trying to make sure that individuals who are eligible for Medicaid continue to maintain their eligibility.

邁克爾，早上好。我很高興有機會談論重新確定，我們的團隊確實花了相當多的時間來努力確保有資格享受醫療補助的個人繼續保持其資格。

So it is still very early. And it's important that we don't draw conclusions based on a few months in because the redetermination cycle is going to extend well into 2024. And with that said, I will say what we have seen so far is certainly relative consistent with our expectations, albeit with a great deal of variability as you go from state-to-state.

所以現在還很早。重要的是，我們不要根據幾個月就得出結論，因為重新確定週期將延長到 2024 年。話雖如此，我想說的是，我們到目前為止所看到的肯定與我們的預期相對一致，儘管各個州之間存在很大的差異。

At the end of the day, however, we still believe that the guidance that we provided is certainly appropriate. As you know, CMS gave states guidelines to really do this over a 14-month period. But at the end of the day, states are taking their own approach. And some of those have certainly front-loaded or accelerated the redetermination process based on members that they believe are no longer eligible.

然而，歸根結底，我們仍然相信我們提供的指導肯定是適當的。如您所知，CMS 為各州提供了在 14 個月內真正做到這一點的指導方針。但歸根結底，各州正在採取自己的做法。其中一些肯定會根據他們認為不再符合資格的成員提前加載或加速重新確定過程。

As we take a look at this today, we do expect that many of these members will return to Medicaid once we continue our outreach and they're able to provide the documentation to the states that they need. So when we look at where we are today, those members could come back over a 30- to 90-day period and we are very much focused on advocacy with our community-based organizations, our care provider partners to federally qualified health centers, all of those entities that impact our members every single day.

當我們今天審視這一點時，我們確實預計，一旦我們繼續開展外展活動，其中許多成員將返回醫療補助，並且他們能夠向各州提供所需的文件。因此，當我們看看今天的情況時，這些會員可能會在 30 到 90 天內回來，我們非常注重與我們的社區組織、聯邦合格醫療中心的護理提供者合作夥伴以及所有每天影響我們會員的實體進行宣傳。

With that said, I will say that some of the front loading that occurred has happened in some of the states where we don't have Elevance Health in terms of a Blue state platform. And so we haven't fully seen the appreciation of our catchers met, but we are fully prepared in collaboration with our commercial partners to be able to do that.

話雖如此，我想說的是，發生的一些前置加載發生在一些我們沒有藍色州平台的 Elevance Health 的州。因此，我們還沒有完全看到捕手的讚賞，但我們已做好與商業合作夥伴合作的充分準備，能夠做到這一點。

In terms of your question with respect to rates, we are always fully engaged with our state partners in terms of the rate setting process. At this point, we have visibility into almost all of our rates for 2023 and many of them for '24. What we are seeing so far is in line with our expectations. States are certainly taking acuity into the rate setting process that we see and certainly, they have the ability to work collaboratively with us if we see things that they don't see.

關於您關於費率的問題，我們始終在費率制定過程中與我們的國家合作夥伴充分接觸。此時，我們幾乎可以了解 2023 年的所有費率以及其中許多 24 年的費率。目前我們看到的情況符合我們的預期。各國肯定會敏銳地關注我們所看到的利率制定過程，當然，如果我們看到他們沒有看到的事情，他們有能力與我們合作。

But our early read on acuity for our kind of levers versus stayers is in line with the expectations that we've seen so far. So at this point, we feel good about where we are from a rate perspective for 2023. The collaboration with our state partners remain strong. Shifts in acuity are now a standard input into the rate setting process. So we've been very much pleased with how that's going with our state partners, and we will continue to work very strongly to make sure that individuals who are truly eligible for Medicaid continue to have access to coverage, and those who aren't that they are able to have coverage through one of our exchange or commercial-based products. So thank you for the question.

但我們對槓桿與固定器類型的敏銳度的早期解讀與我們迄今為止所看到的預期一致。因此，目前，從利率角度來看，我們對 2023 年的狀況感到滿意。與我們的州合作夥伴的合作仍然強勁。敏銳度的變化現在是速率設定過程的標準輸入。因此，我們對我們與州合作夥伴的進展感到非常滿意，我們將繼續大力合作，確保真正符合醫療補助資格的個人繼續獲得保險，而那些沒有資格的人也能夠通過我們的一種交換或商業產品獲得保險。謝謝你的提問。

Yes. So Michael, as you heard from Felicia, there is a lot there, and there's incredible work across our enterprise going into this. But overall, it's aligned very closely with the expectations we set. So thank you for the question.

是的。所以邁克爾，正如您從費利西亞那裡聽到的那樣，有很多事情，我們整個企業都在這方面做了令人難以置信的工作。但總體而言，它與我們設定的期望非常吻合。謝謝你的提問。

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

接下來，我們將討論 Nephron Research 的 Josh Raskin 的系列。

The margin pressure in Carelon year-over-year as in the press release was attributed to what was a higher medical cost trends and the nonrecurrence of an out-of-pocket -- out-of-period favorable adjustment last year. Could you just explain the higher medical cost and maybe what specific line items that is, if that's behavioral or Rx or something?

正如新聞稿中所述，Carelon 的利潤率同比壓力歸因於醫療成本上升趨勢以及去年自付費用-期外有利調整不再發生。您能否解釋一下更高的醫療費用，以及具體的項目是什麼，如果是行為或治療或其他什麼？

Yes. Thanks for the question, Josh. It's Pete Haytaian here. First of all, in terms of Carelon overall -- the Carelon Services overall performance from an operating perspective, we're very pleased. Our team saw a nice improvement year-over-year. And just to be clear, as it relates to our margin profile for the year, we're very confident in achieving the 25 to 50 basis points guidance that we gave in terms of margin improvement over the year.

是的。謝謝你的提問，喬什。我是皮特·海泰安。首先，就 Carelon 整體而言——從運營角度來看，Carelon Services 的整體表現，我們非常滿意。我們的團隊逐年取得了很大的進步。需要明確的是，由於這與我們今年的利潤率狀況相關，我們非常有信心實現我們在今年利潤率改善方面給出的 25 至 50 個基點的指導。

In terms of the variation there, a lot of this has to do with seasonality and as seasonality continues to evolve, we are sort of seeing differences there. This year, what's different than previous years is we're driving a lot more business through the government business.

就那裡的變化而言，很大程度上與季節性有關，隨著季節性的不斷發展，我們看到了那裡的差異。今年與往年不同的是，我們通過政府業務推動了更多業務。

So as I talked about in my earlier comments, in terms of the post-acute care initiative with our Medicare teams as well as the durable medical equipment opportunity. These are examples of things where we're driving a lot more business through the government business, and that's translating into earnings really being weighted to the back half of the year. So that's sort of the differences.

正如我在之前的評論中談到的，就我們的醫療保險團隊的急性後護理計劃以及耐用醫療設備的機會而言。這些都是我們通過政府業務推動更多業務的例子，這轉化為收益真正被加權到今年下半年。這就是差異所在。

In terms of the onetime issue, I think you're probably referencing pharmacy. And in the case of pharmacy, again, to speak about how we're performing there, we're very pleased overall with how that's going in terms of our margin performance. The 6% to 6.5% range in terms of margin performance for the year-end guidance that we gave, we still feel very comfortable with that.

就一次性問題而言，我認為您可能指的是藥房。就藥房而言，再次談談我們在那裡的表現，我們對我們的利潤率表現總體上非常滿意。就我們給出的年終指引的利潤率表現而言，6%至6.5%的範圍，我們仍然對此感到非常滿意。

The onetime issue that occurred in terms of the year-over-year difference, Q2 '22 versus this year was a onetime favorable positive impact that we experienced in pharmacy last year that we're not seeing this year. But overall, pharmacy is performing very, very well, and we feel very comfortable with the 6%, 6.5% guidance for the year.

就同​​比差異而言，22 年第二季度與今年相比發生的一次性問題是我們去年在藥房經歷過的一次有利的積極影響，但今年我們沒有看到。但總體而言，製藥業的表現非常非常好，我們對今年 6%、6.5% 的指導感到非常滿意。

Next question please.

請下一個問題。

Next, we'll go to the line of George Hill from Deutsche Bank.

接下來，我們將前往德意志銀行的喬治希爾線。

As it relates to Medicare Advantage, I'm wondering if we can kind of revisit an old topic, which is the changes to the risk model that CMS announced at the beginning of April. I guess as you guys have had more time to kind of digest the proposed risk model changes.

由於它與 Medicare Advantage 相關，我想知道我們是否可以重溫一個老話題，即 CMS 在四月初宣布的風險模型的變化。我想你們有更多的時間來消化擬議的風險模型變化。

Can you talk a little bit about how it makes you guys think about '24 just as some of your peers have kind of talked about the risk model kind of driving meaningful changes to kind of both benefit design and the bid process. Would love any update you could provide around that.

您能否談談它如何讓你們思考 '24，就像您的一些同行談到風險模型推動福利設計和投標流程發生有意義的變化一樣。希望您能提供有關該問題的任何更新。

Good morning, George. Felicia Norwood. When we take a look at the risk model changes for 2024, they certainly were an integral part of our strategy as we thought about our bid process, but let me start by saying that we feel good about our bids for 2024. I believe when we step back and take a look at where we are, we continue to recognize the importance of stability in our offerings to seniors.

早上好，喬治。費利西亞·諾伍德。當我們審視 2024 年的風險模型變化時，在我們考慮申辦流程時，它們無疑是我們戰略不可或缺的一部分，但首先我要說的是，我們對 2024 年的申辦感覺良好。我相信，當我們退後一步看看我們所處的位置時，我們將繼續認識到我們為老年人提供的服務的穩定性的重要性。

And I think that we have submitted bids that take into consideration both the risk model changes as well as the importance of having those benefits that are critical to seniors as we go forward. It's always going to be a very highly competitive environment in Medicare Advantage. We always expect that. But from our perspective, this is something that we've had the opportunity to be very thoughtful about. And as we put our bids together each year, we're always taking a very balanced approach between our aspirations for growth as well as with respect to margins.

我認為我們提交的標書既考慮了風險模型的變化，也考慮了在我們前進的過程中獲得對老年人至關重要的福利的重要性。 Medicare Advantage 始終是一個競爭非常激烈的環境。我們一直期待著這一點。但從我們的角度來看，這是我們有機會深思熟慮的事情。當我們每年進行投標時，我們總是在增長願望和利潤率之間採取非常平衡的方法。

And I think that we have landed in a place where we're going to be offering attractive plans for our seniors that provide sustainable economics for us for the long-term. So thank you very much for the question.

我認為我們已經達到了一個目標，我們將為老年人提供有吸引力的計劃，為我們提供長期可持續的經濟。非常感謝你提出這個問題。

Next question, please.

請下一個問題。

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麗莎·吉爾 (Lisa Gill) 的線路。

I just want to go back to a comment that John made. And that's around higher cost if COVID never happened. And so one, I just want to understand, is there a pent-up demand because of COVID. Is that the reason for that comment? And then secondly, both at your Analyst Day and I think at another conference, you called out GLP-1 is running higher. Can you maybe just put that into perspective for us as to how much that can add to it to a medical cost trend? And does that benefit your pharmacy side of your benefit business as you see that higher utilization?

我只想回到約翰的評論。如果新冠疫情從未發生過，那麼成本就會更高。因此，我只想了解，是否存在因新冠疫情而被壓抑的需求。這就是評論的原因嗎？其次，在您的分析師日和我認為在另一次會議上，您都指出 GLP-1 正在走高。您能否為我們解釋一下這會給醫療費用趨勢帶來多少影響？當您看到更高的利用率時，這對您的福利業務的藥房方面有好處嗎？

Thanks for the question, Lisa. Associated with trends and COVID existing versus not existing and what the baseline might have been. It's really not a lot of pent-up demand or deferred care, there certainly can be small pockets of that. But in general, the health care system was pretty much open for business quite significantly in 2022. There may have been some staffing shortages that impacted that ever so slightly, but not all that significantly, we don't believe. And we just think that it's really, it's an overall increase in cost structure.

謝謝你的提問，麗莎。與趨勢和新冠病毒存在與不存在以及基線可能是什麼相關。這實際上並不是大量被壓抑的需求或延期護理，當然可能會有一小部分。但總的來說，到 2022 年，醫療保健系統對業務的開放程度相當大。我們認為，可能存在一些人員短缺的影響，影響很小，但不會那麼嚴重。我們只是認為這確實是成本結構的整體增加​​。

COVID is not gone. It still exists. It's just no longer the big significant driving force that it had been for the past several years. And so as we look at things in total, we see a higher cost structure in general.

新冠病毒尚未消失。它仍然存在。它只是不再像過去幾年那樣是重要的推動力。因此，當我們從總體上看時，我們發現總體成本結構較高。

And then associated with the GLP-1 drugs, that is one element of a multitude developments as part of an overall trend conversation. And as I said, trend overall is consistent with our expectations. So we feel very good about that. And can there be an upside on Carelon Rx. Well, certainly a small one, but not enough to really change that trajectory at this point. So thank you for the questions.

然後與 GLP-1 藥物相關聯，這是作為總體趨勢對話一部分的眾多發展的要素之一。正如我所說，總體趨勢與我們的預期一致。所以我們對此感覺非常好。 Carelon Rx 有什麼好處嗎？嗯，當然是一個小問題，但目前還不足以真正改變這一軌跡。謝謝你的提問。

Next question, please.

請下一個問題。

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

接下來，我們將請到美國銀行的 Kevin Fischbeck。

I just want to go back to redeterminations and how you're thinking about that. I think you said that you expected to keep about 40% to 45% of the Medicaid determination growth, which I think is something close to about 4% CAGR since 2019, which seems a little high to me, given that total employment is up about 3 million over that time period.

我只想回到重新決定以及你是如何看待這個問題的。我想你說過你預計醫療補助決心的增長將保持在 40% 到 45% 左右，我認為自 2019 年以來複合年增長率接近 4% 左右，這對我來說似乎有點高，因為同期總就業人數增加了約 300 萬。

So can you just maybe refresh how you're thinking about keeping those people wide and stay on, and then maybe the other 55%, if you can kind of give an update on anything you're seeing there about how those people reenroll and through the year, how we should expect them to come on? You mentioned some delays. Is there a way to think about Q2 this enrollment, when do they show up on either employer coverage or the exchanges?

那麼，您是否可以更新一下您如何考慮讓這些人廣泛並留下來，然後也許是其他 55%，如果您可以提供有關這些人如何重新註冊以及全年的最新信息，我們應該如何期望他們繼續加入？你提到了一些延誤。有沒有辦法考慮第二季度的註冊情況，他們什麼時候出現在雇主報導或交易所上？

Yes. Thanks, Kevin. Appreciate the question. Associated with the 40% to 45%, I'm not positive about the CAGR you're looking at from '19 and exactly what's in the baseline and what all the thought processes are versus qualifications and eligibility requirements. But as we do our review in our work and certainly access a lot of independent studies as well, we feel very comfortable that we believe that 40% to 45% will stay on. And that's really a projection for what will be the ultimate result a year from now after the entire redetermination process occurs and things shake out.

是的。謝謝，凱文。感謝這個問題。與 40% 到 45% 相關，我對您從 19 年開始看到的複合年增長率以及基線中的具體內容以及所有思維過程與資格和資格要求的關係並不樂觀。但當我們在工作中進行審查並且當然也訪問了大量獨立研究時，我們感到非常放心，我們相信 40% 到 45% 的人會留下來。這實際上是對一年後最終結果的預測，在整個重新確定過程發生並且事情發生變化之後。

So I think it's a very reasonable expectation, and we feel very good about it. And then in terms of the overall coverage patterns, everything else, one thing to point out that might be inherent in your question is as we look at the second quarter of 2023, actually, many of our states -- Medicaid states that are not Blue states, actually went a little bit earlier on in the beginning of the redetermination.

所以我認為這是一個非常合理的期望，我們對此感覺非常好。然後就整體覆蓋模式而言，其他一切，需要指出的一點可能是您的問題所固有的，當我們看到 2023 年第二季度時，實際上，我們的許多州——不是藍州的醫療補助州，實際上在重新確定開始時就提前了一點。

So everybody will have started to redeterminations by now. But when you look at who started in the April, May time frame, for us, it was more heavily weighted to the states that are not our Blue state. So we still feel very good about our overall catchers met and the fact that we think 20% to 25% of these folks will ultimately end up on employer-sponsored plans, 20% to 25% will ultimately end up in an individual ACA product, 40%, 45% will stay on Medicaid. And that's what we're tracking to, and we actually have some insights into the states that are starting in June looks very promising that our thought process is going to be validated. So thank you for the question.

所以現在每個人都會開始重新決定。但是，當你看看誰在四月、五月的時間範圍內開始時，對我們來說，除了我們的藍州之外的州的權重更大。因此，我們仍然對我們的總體捕手感到非常滿意，事實上我們認為這些人中的 20% 到 25% 最終將採用雇主資助的計劃，20% 到 25% 最終將採用個人 ACA 產品，40%、45% 將繼續採用醫療補助。這就是我們正在追踪的，實際上我們對 6 月份開始的州有一些見解，看起來非常有希望，我們的思維過程將得到驗證。謝謝你的提問。

Yes. Thanks. And the only thing I'd add to that is, again, there is a timing lag here, but we feel our expectations are very much aligned. And we are seeing, particularly in the individual exchange, the early states that our applications are up at a much higher rate than they were prior to redeterminations, which you would expect and given our commercial market share in our Blue states, so very well positioned in the ACA market for those that will ultimately not keep Medicaid coverage.

是的。謝謝。我唯一要補充的是，這裡存在時間滯後，但我們覺得我們的期望非常一致。我們看到，特別是在個人交易所，早期表明我們的申請增長速度比重新確定之前要高得多，這是您所期望的，並且考慮到我們在藍色州的商業市場份額，對於那些最終不會保留醫療補助覆蓋範圍的人來說，在 ACA 市場中處於非常有利的地位。

But again, as I shared in my early remarks, we're working really hard to make sure that everyone who's going through this process in conjunction with our state partners understands the options that are available to us, and that's been very positive. We're seeing a lot of really good uptake. And we're actually contacting, having great success rates in contacting individuals where we have the information.

但正如我在前面的發言中所分享的那樣，我們正在非常努力地確保與我們的國家合作夥伴一起經歷這一過程的每個人都了解我們可以選擇的選項，這是非常積極的。我們看到很多非常好的採用。我們實際上正在聯繫，在聯繫我們掌握信息的個人方面有很高的成功率。

So those are very encouraging early signs to us. And again, we'll continue to update as we get through this process because many of the states are really just in the throes of it, certainly our Blue states. But thanks very much for the question.

所以這些對我們來說是非常令人鼓舞的早期跡象。再說一次，我們將在完成這個過程時繼續更新，因為許多州確實正處於陣痛之中，當然是我們的藍色州。但非常感謝你的提問。

Next question, please.

請下一個問題。

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

接下來，我們將轉到史蒂芬斯的斯科特·菲德爾的路線。

I was hoping, first, if you could just maybe touch on the EPS split expected for 3Q versus 4Q? And then my main question is just sort of taking the discussion we're having on the cost structure for medical costs in 2023. Just interested in how you're thinking about that rolling forward into 2024. We're already starting to capture a lot of early data points on commercial premium pricing. It looks like the environment is hardening quite a bit in terms of pricing trends. So just interested how you're sort of thinking about sort of pricing for cost trends for '24?

首先，我希望您能否談談第三季度與第四季度的預期每股收益分配？然後我的主要問題是我們正在討論 2023 年醫療費用的成本結構。只是想知道您如何考慮將其推進到 2024 年。我們已經開始收集有關商業保費定價的大量早期數據點。就定價趨勢而言，環境似乎正在變得更加嚴峻。所以只是感興趣您如何考慮 24 世紀成本趨勢的定價？

Yes. Thanks for the question. In terms of our EPS guidance, as you know, we raised it to $32.85 or greater than $32.85. And I think that would assume that a little bit more than 56% of our earnings will have occurred in the first half of the year.

是的。謝謝你的提問。就我們的 EPS 指導而言，如您所知，我們將其提高至 32.85 美元或高於 32.85 美元。我認為，這是假設我們的收入的 56% 以上將發生在今年上半年。

So when you look at the last 6 months of the year, we are actually pretty comfortable with what the current consensus estimates have associated with the third quarter, and with the seasonality that the current consensus estimates have inherent in it, and that is that the third quarter will be a bit more profitable than the fourth quarter, which is very consistent with the typical seasonality of our business.

因此，當你看看今年的最後 6 個月時，我們實際上對當前共識預測與第三季度的關聯以及當前共識預測所固有的季節性感到非常滿意，也就是說，第三季度的利潤將比第四季度高一些，這與我們業務的典型季節性非常一致。

And then for '24, as you know, it's just really premature to go into a 2024 conversation at this time. We'll provide a lot more insights on that at the end of the year, a little bit more in the third quarter, and a lot more at the end of the year and have a more robust conversation about 2024 at that time.

然後，對於 24 年，如您所知，現在進入 2024 年對話還為時過早。我們將在今年年底提供更多有關此方面的見解，在第三季度提供更多見解，在年底提供更多見解，並在那時就 2024 年進行更深入的對話。

Yes. Thanks again for that question. And again, on just your pricing question, we've had a very consistent approach to pricing, and we're going to keep that discipline as we project our forward view costs. So I don't think anything has changed though. There's not a whole lot more that's new, but we're very disciplined about our projection and how we see that, and that's how we price to you. So thanks for the question. And next question.

是的。再次感謝你提出這個問題。再說一遍，就您的定價問題而言，我們採用了非常一致的定價方法，並且在預測前瞻性成本時我們將保持這一原則。所以我認為沒有任何改變。沒有太多新內容，但我們對我們的預測以及我們如何看待它非常嚴格，這就是我們向您定價的方式。謝謝你的提問。下一個問題。

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

接下來，我們將介紹來自巴克萊銀行的 Steven Valiquette。

This was touched on a little bit with your comment though that commercial membership growth should reaccelerate in the back half of '23 and into the '24. Just curious, if you could remind us whether or not that's due almost all to the potential tailwinds from redeterminations, or are there other factors that are just very (inaudible) such a more favorable market dynamics related to lower employment or any potential expectation of market share gains for Elevance, thinking for '24 that might help your commercial membership growth acceleration outlook?

儘管您的評論提到了這一點，但商業會員增長應該會在 23 世紀後半段和 24 世紀重新加速。只是好奇，您能否提醒我們，這是否幾乎全部歸因於重新確定的潛在有利因素，或者是否有其他因素非常（聽不清）與就業率下降或 Elevance 市場份額增長的任何潛在預期相關的更有利的市場動態，考慮 24 可能有助於您的商業會員增長加速前景？

Sure. I'll ask Morgan Kendrick, who leads our commercial business maybe to comment a little bit about commercial and what we're seeing in the marketplace.

當然。我會請負責我們商業業務的摩根·肯德里克（Morgan Kendrick）對商業以及我們在市場上看到的情況發表一些評論。

Yes. Thanks for the question, Steve. Morgan here. I want to address -- I would say that our expectations for membership growth are in line with what we projected and discussed in other instances.

是的。謝謝你的提問，史蒂夫。摩根在這裡。我想說的是，我們對會員增長的期望與我們在其他情況下的預測和討論是一致的。

One of the things that's interesting, though, is we're wrapping up the -- our national cycle. And so that's almost complete. One thing notably this year, it felt like the receipts were coming in slower or later, and the actual decisions were made longer, which isn't terribly inconsistent with what we see during an economic shift if you think of things and where the affordability really matters.

不過，有趣的事情之一是我們正在結束我們的國家週期。這樣就差不多完成了。今年值得注意的一件事是，感覺收據來得更慢或更晚，實際決策的時間也更長，如果你考慮一下事情以及負擔能力真正重要的地方，這與我們在經濟轉型期間看到的情況並不太不一致。

Our local market right now, we're just now getting into 4Q when we think about our business and 3Q, 4Q and then [one, one] all of which look promising. We've gotten into some of the bigger lower market wins for next year, and we're pleased with how the assets are resonating. And when I go back and speak to National, we've had just an unbelievable run for the past several years. That's not different this year, but we've talked many times about each 1 of these cycles have nuances.

我們現在的本地市場，當我們考慮我們的業務時，我們剛剛進入第四季度，第三季度、第四季度，然後[一、一]所有這些看起來都充滿希望。我們已經在明年取得了一些更大的低端市場胜利，我們對這些資產的共鳴感到滿意。當我回去接受國家黨採訪時，我們在過去幾年中取得了令人難以置信的成績。今年也不例外，但我們已經多次討論過每個週期都有細微差別。

There are 3 things that I think are important to note. Number one, this cycle for us when we think about our largest employers that will be the end of the year and into next year, there was a very, very large cohort of in-force business. So this is a very strong retention year for our company. That's been quite successful, which again reinforces how the assets are being -- are resonating with some of the most discerning buyers in the country.

我認為有 3 件事需要注意。第一，這個週期對我們來說，當我們想到年底和明年最大的雇主時，有一個非常非常大的有效業務群體。因此，對於我們公司來說，今年是非常強勁的保留年。這是相當成功的，這再次強化了資產的現狀——與國內一些最挑剔的買家產生了共鳴。

Secondly, our win share continues at the rate that we've seen, albeit on a lower pipeline and smaller case count. But then lastly, I think the notable conclusion of the notable piece that we've shared in the past several years, we're continuing to see strong growth internally, where employers are consolidating their benefit partners from one vendor -- from multiple vendors to one. So that's continuing with us.

其次，我們的勝利份額繼續以我們所看到的速度增長，儘管管道數量較少且案件數量較少。但最後，我認為我們在過去幾年中分享的值得注意的文章的顯著結論是，我們繼續看到內部的強勁增長，雇主正在將他們的福利合作夥伴從一個供應商整合到一個供應商。我們將繼續這樣做。

So all in, we feel good about our continued trajectory in the business. And as noted earlier, our pricing activities to continue with our forward view of trend. So we're quite optimistic at this point. Thanks again for the question.

總而言之，我們對業務的持續發展感到滿意。如前所述，我們的定價活動將繼續我們對趨勢的前瞻性看法。所以我們目前非常樂觀。再次感謝您的提問。

Thanks, Morgan. And again, just reiterating something that Morgan just said, I think, is important is the consolidation trend where we become single source has been accelerating over the last few years, and we continue to see that. That's a notable trend this year. And I think what's important is we're also seeing it not just in medical coverage, but beginning to consolidate with Carelon Services as well. So that's a very positive trend for the strategy around the whole health that we laid out.

謝謝，摩根。再次重申摩根剛才所說的，我認為重要的是，我們成為單一來源的整合趨勢在過去幾年中一直在加速，而且我們將繼續看到這一點。這是今年的一個顯著趨勢。我認為重要的是我們不僅在醫療保險方面看到了這一點，而且還開始與 Carelon Services 進行整合。因此，對於我們制定的圍繞整體健康的戰略來說，這是一個非常積極的趨勢。

Thank you. Next question. I think this will be our last question.

謝謝。下一個問題。我想這將是我們的最後一個問題。

Our final question comes from Nathan Rich from Goldman Sachs.

我們的最後一個問題來自高盛的內森·里奇。

I wanted to ask on the Carelon Rx margins. I think they were down sequentially from the first quarter. Could you maybe just elaborate a bit more on what drove that margin step down? I know you had BioPlus rolling in, but do you still expect margins to be flattish for the full year?

我想問一下 Carelon Rx 的利潤率。我認為它們比第一季度連續下降。您能否詳細說明一下導致利潤率下降的原因？我知道你們已經開始使用 BioPlus，但你們仍然預計全年利潤率會持平嗎？

And then on biosimilars, how is the pricing of biosimilar Humira come in relative to expectations? And is that a significant swing factor kind of in the outlook for that segment?

那麼在生物仿製藥方面，生物仿製藥 Humira 的定價相對於預期如何？這是否是該細分市場前景中的一個重要搖擺因素？

Yes. Nathan, thanks for the question. This is Pete. Again, when we think about our operating performance in Carelon Rx, I'll just say it front, we're confident in our pharmacy business. And if you exclude BioPlus, we will come in at that 6% to 6.5% range. So flattish as we talked about.

是的。內森，謝謝你的提問。這是皮特。再次，當我們考慮 Carelon Rx 的運營業績時，我只想說，我們對我們的製藥業務充滿信心。如果排除 BioPlus，我們的比例將在 6% 到 6.5% 之間。正如我們所說的那樣平坦。

And as Gail mentioned in her prepared remarks, we're continuing to invest and things like BioPlus and advanced on delivery. BioPlus, our original guidance did not include BioPlus. And so that, as we talked about that, that's had a bit of dilution. But again, outside of BioPlus, we're very confident in coming in into the 6% to 6.5% range.

正如蓋爾在她準備好的講話中提到的那樣，我們將繼續投資 BioPlus 和提前交付等項目。 BioPlus，我們最初的指南不包括 BioPlus。因此，正如我們所討論的那樣，這已經被稀釋了一些。但同樣，在 BioPlus 之外，我們非常有信心進入 6% 至 6.5% 的範圍。

As it relates to your question on Humira and biosimilars. Again, as we said, we're very excited about biosimilars coming into the marketplace and how that's going to drive overall cost and affordability down the road. We and Carelon Rx have been very, very focused on driving lowest net cost.

因為這與您關於 Humira 和生物仿製藥的問題有關。正如我們所說，我們對生物仿製藥進入市場以及這將如何推動整體成本和可負擔性感到非常興奮。我們和 Carelon Rx 一直非常非常專注於降低淨成本。

We obviously were well aware of what occurred in July in terms of the launches, and we've been staying very, very close to that. And as we've said before, we have historically supported biosimilars alongside our reference brand.

顯然，我們很清楚 7 月份的發布情況，並且我們一直非常非常接近這一點。正如我們之前所說，我們歷來支持生物仿製藥和我們的參考品牌。

On Humira, we do expect to include a biosimilar or biosimilars in a similar formulary position as Humira this year. We're not going to go into more specifics in terms of timing, where specifically what we're going to do, but we will do that. And I would finally say that with the addition of BioPlus in our portfolio, I think we're now in a much better position to directly manage specialty pharmacy more holistically. So I appreciate your questions.

關於修美樂，我們確實預計今年將一種或多種生物仿製藥納入與修美樂類似的處方位置。我們不會在時間方面透露更多細節，特別是我們要做什麼，但我們會這麼做。最後我想說，隨著 BioPlus 添加到我們的產品組合中，我認為我們現在處於更好的位置，可以更全面地直接管理專業藥房。所以我很感激你的問題。

Thank you, Pete. Now I'd like to close by saying thank you. We're pleased with our performance year-to-date, and we're confident that the ongoing execution of our strategy positions us well for the balance of 2023 and in the years to come.

謝謝你，皮特。現在我想以感謝來作為結束。我們對今年迄今為止的表現感到滿意，並且相信，我們戰略的持續執行將使我們在 2023 年和未來幾年中處於有利地位。

Through a steadfast focus on whole health and our diverse and expanding suite of products and solutions, we'll continue to meet the needs of clients, consumers and communities we serve, advancing our strategy of becoming a lifetime trusted health partner.

通過堅定地關注整體健康以及我們多樣化且不斷擴展的產品和解決方案，我們將繼續滿足我們所服務的客戶、消費者和社區的需求，推進我們成為終身值得信賴的健康合作夥伴的戰略。

Thank you all for your interest in Elevance Health, and have a great rest of the week.

感謝大家對 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 August 18, 2023. You may access the replay system at any time by dialing (800) 391-9853, and international participants can dial to 203-369-3269.

女士們、先生們，本次會議的錄音將於今天上午 11:00 後至 2023 年 8 月 18 日期間進行重播。您可以隨時撥打 (800) 391-9853 訪問重播系統，國際參會者可撥打 203-369-3269。

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

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