Elevance Health Inc (ELV) 2023 Q3 法說會逐字稿

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

女士們、先生們，感謝你們的支持，並歡迎參加 Elevance Health 第三季財報電話會議。 （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階層。請繼續。

Good morning, and welcome to Elevance Health's Third 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; John Gallina, our CFO; Peter Haytaian, President of Carelon; Morgan Kendrick, President of our Commercial and Specialty Health Benefits business; and Felicia Norwood, President of our Government Health Benefits business. Gail will begin the call with a brief discussion of the quarter and recent progress against our strategic initiatives. John will then discuss our financial results and outlook in greater detail. After our prepared remarks, the team will be available for Q&A.

早安，歡迎參加 Elevance Health 2023 年第三季財報電話會議。我是史蒂夫‧塔納爾，投資人關係副總裁。今天早上與我們一起參加財報電話會議的是總裁兼執行長蓋爾‧布德羅 (Gail Boudreaux)；約翰‧加利納 (John Gallina)，我們的財務長； Peter Haytaian，Carelon 總裁； Morgan Kendrick，我們的商業和專業健康福利業務總裁；以及我們政府健康福利業務總裁 Felicia Norwood。蓋爾將在電話會議開始時簡要討論本季以及我們策略性舉措的最新進展。然後約翰將更詳細地討論我們的財務表現和前景。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. We will also be making some forward-looking statements on this call. Listeners are cautioned that these statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond the control of Elevance Health. These risks and uncertainties can cause actual results to differ materially from our current expectations. We advise listeners to carefully review the risk factors discussed in today's press release and in our quarterly filings with the SEC.

在電話會議期間，我們將參考某些非公認會計原則措施。這些非 GAAP 衡量標準與最直接可比較的 GAAP 衡量標準的對帳可在我們的網站 elevancehealth.com 上找到。我們也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。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有重大差異。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're pleased to share that Elevance Health delivered another solid quarter of financial and operational performance, reflecting the strength and resilience of our diversified portfolio of businesses.

謝謝史蒂夫，大家早安。今天，我們很高興地與大家分享，Elevance Health 又一個季度實現了穩健的財務和營運業績，反映了我們多元化業務組合的實力和彈性。

Third quarter GAAP earnings per share was $5.45, including a charge we took during the quarter that I will discuss in detail in a moment. Adjusted earnings per share was $8.99, reflecting growth of approximately 20% over the third quarter of 2022. Our results demonstrate our ability to execute on our enterprise strategy of delivering whole health solutions that are affordable, personalized and simple.

第三季 GAAP 每股收益為 5.45 美元，其中包括我們在本季收取的費用，我稍後將詳細討論這筆費用。調整後每股收益為 8.99 美元，較 2022 年第三季成長約 20%。我們的業績顯示我們有能力執行我們的企業策略，即提供價格實惠、個人化且簡單的整體健康解決方案。

Based on our strong year-to-date results and confidence in our outlook, we are increasing our guidance for adjusted earnings per share to be greater than $33 for 2023, which includes incremental investments planned for the fourth quarter that will accelerate our strategy and enhance the performance of our Medicare Advantage business. It is the strength and resilience of our diverse businesses that provides comfort in our outlook, while the earnings power of our health benefits and Carelon division provides us the confidence to reiterate our commitment to our long-term target compound annual growth rate in adjusted earnings per share of 12% to 15%.

基於我們今年迄今的強勁業績和對前景的信心，我們將2023 年調整後每股收益的指導提高到33 美元以上，其中包括計劃在第四季度進行的增量投資，這將加速我們的戰略並增強我們的 Medicare Advantage 業務的表現。我們多元化業務的實力和韌性為我們的前景提供了安慰，而我們的健康福利和 Carelon 部門的盈利能力使我們有信心重申我們對調整後每股收益複合年增長率的承諾。佔12%至15%。

Let me now turn to some highlights from our business segments. Starting with our Health Benefits division, which delivered robust third quarter results as we continue optimizing our diverse set of businesses while responding to a dynamic and evolving business environment.

現在讓我談談我們業務部門的一些亮點。首先是我們的健康福利部門，該部門在我們不斷優化多元化業務的同時應對動態和不斷變化的商業環境，第三季業績強勁。

In our commercial risk business, we are successfully executing on our goal to deliver operating margins in line with pre-pandemic norms. Retention has been consistent with our expectations, and we're pleased with our progress, which we expect will extend well into 2024.

在我們的商業風險業務中，我們成功實現了營業利潤率符合疫情前標準的目標。保留率符合我們的預期，我們對我們的進展感到滿意，我們預計這種情況將持續到 2024 年。

In the employer market, we're delivering differentiated value where it matters for employers, affordability, experience and simplicity. Over the past 3 years, we've become the sole source medical benefits provider for 32 of our national clients, including 9 additional customers who will be consolidating their coverage with us effective January 2024. For large employers, we continue to deliver differentiated value and are seeing employers move away from point solutions and sliced offerings to selecting Elevance Health as their strategic partner for the integration of all of their medical benefits.

在雇主市場，我們在對雇主、負擔能力、體驗和簡單性至關重要的方面提供差異化的價值。在過去3 年裡，我們已成為32 名全國客戶的唯一醫療福利提供者，其中包括9 名另外的客戶，他們將於2024 年1 月起與我們合併保險。對於大型雇主，我們繼續提供差異化的價值和雇主正在放棄單點解決方案和切片產品，轉而選擇 Elevance Health 作為策略合作夥伴，以整合其所有醫療福利。

Consistent with these results, our advocacy solutions business, which provides personalized guidance and support to help members both navigate the complex health care system and optimize their health and well-being, will add 37 new clients in 2024 covering more than 550,000 members. This includes 2 large employers who are returning to Elevance Health after previously testing third-party advocacy vendors.

與這些結果一致，我們的倡導解決方案業務將在2024 年增加37 個新客戶，覆蓋超過550,000 名會員，該業務提供個性化指導和支持，幫助會員應對複雜的醫療保健系統並優化他們的健康和福祉。其中包括 2 家大型雇主，他們在之前測試了第三方倡導供應商後又回到了 Elevance Health。

In the individual market, we are seeing strong growth in plans that offer affordable and comprehensive coverage designed around the needs of consumers in our communities, including those transitioning from Medicaid to individual ACA coverage. Year-to-date, our individual membership has grown by 27%. Through the first half of this year, the latest period for which industry data is available, our individual ACA membership growth rate more than tripled that of our competitors in our 14 Blue states.

在個人市場，我們看到一些計劃強勁增長，這些計劃圍繞我們社區消費者的需求而設計，提供價格實惠且全面的保險，包括從醫療補助計劃過渡到個人平價醫療保險 (ACA) 保險的計劃。今年迄今為止，我們的個人會員數量增加了 27%。截至今年上半年（可獲得產業數據的最新時期），我們的 ACA 個人會員成長率是 14 個藍色州競爭對手的三倍多。

Our government business also posted a strong quarter. In our Medicaid business, rates are actuarially appropriate, but we are absorbing a membership headwind related to the pace of Medicaid redeterminations, especially in states that have adopted accelerated time lines. Nearly 3/4 of all Medicaid beneficiaries terminated in our markets to date have less coverage for administrative reasons and 37% of the attrition from our own health plans has been driven by individuals under 18 years of age, many of whom may still be eligible for Medicaid benefits. We are doing all we can to ensure continuity of coverage for as many consumers as possible, working closely with our state partners to ensure individuals eligible for Medicaid retain coverage while also offering affordable ACA exchange plans in nearly all of our blue counties.

我們的政府業務季度也表現強勁。在我們的醫療補助業務中，費率在精算上是適當的，但我們正在吸收與醫療補助重新確定步伐相關的會員逆風，特別是在採用加速時間表的州。迄今為止，在我們市場中終止的所有醫療補助受益人中，有近3/4 因行政原因而承保範圍較小，而我們自己的健康計劃中37% 的人員流失是由18 歲以下的個人造成的，其中許多人可能仍然有資格獲得醫療補助醫療補助福利。我們正在盡一切努力確保為盡可能多的消費者提供承保的連續性，與我們的州合作夥伴密切合作，確保符合醫療補助資格的個人保留承保範圍，同時還在我們幾乎所有的藍色縣提供負擔得起的ACA 交換計劃。

We are seeing encouraging signs. In some of our Blue states where we offer Medicaid and commercial coverage, we have seen 30% or more of our Medicaid members who were terminated prior to the end of June return or retain coverage with Elevance Health, albeit with gaps in coverage that can extend for several months. We expect re-enrollment to accelerate in the coming quarters as we continue with our omnichannel approach to outreach and engagement, ensuring our members are aware of their options. Accordingly, we anticipate the rate of membership attrition associated with redeterminations will slow considerably in the coming quarters.

我們看到了令人鼓舞的跡象。在我們提供醫療補助和商業保險的一些藍色州，我們發現 30% 或更多在 6 月底之前被終止的醫療補助會員返回或保留了 Elevance Health 的保險，儘管保險範圍上的差距可以延長幾個月了。我們預計，隨著我們繼續採用全通路的推廣和參與方式，確保我們的會員了解他們的選擇，未來幾季重新註冊的速度將會加快。因此，我們預計與重新決定相關的會員流失率將在未來幾季大幅放緩。

In Medicare, we continue to offer high-quality plans that provide seniors access to comprehensive and coordinated care, and we are committed to doing so for the long term. We're disappointed, however, with our Star's performance for measurement year 2022, which is the basis for star ratings that will impact the 2025 payment year and specifically, with our decline in consumer survey scores and the way in which CMS applied a new statistical methodology that resulted in significant increases to many Star measure cut points.

在醫療保險方面，我們繼續提供高品質的計劃，為老年人提供全面和協調的護理，並且我們致力於長期這樣做。然而，我們對 2022 年衡量年的星級表現感到失望，這是影響 2025 年付款年的星級評級的基礎，特別是我們消費者調查得分的下降以及 CMS 應用新統計數據的方式導致許多星級衡量標準顯著增加的方法。

To improve our performance in future periods, we have already commenced investments in 4 primary areas: service, product, network access and operations. For example, in July of this year, we built on the success of our innovative advocacy model in the employer market by adapting it for the unique needs of Medicare eligible consumers. This new program, My Health Advocate, is a comprehensive, personalized and relationship-based customer service model that enables our members to effectively navigate the health care system, their benefits and ultimately, to improve their overall health and well-being.

為了提高未來業績，我們已經開始在 4 個主要領域進行投資：服務、產品、網路存取和營運。例如，今年 7 月，我們在創新倡議模式在雇主市場取得成功的基礎上，對其進行了調整，以滿足符合醫療保險資格的消費者的獨特需求。這個名為「我的健康倡導者」的新計劃是一個全面、個人化和基於關係的客戶服務模式，使我們的會員能夠有效地了解醫療保健系統及其福利，並最終改善他們的整體健康和福祉。

Furthermore, we have enhanced our core and supplemental benefits to reduce members out-of-pocket costs for prescription medications simplified our dental benefits and strengthened our grocery and over-the-counter benefits. We're also simplifying consumer and provider experiences through the automation and elimination of certain prior authorizations, accelerating our work with value-based care provider partners and improving clinical decision appeal rates. Collectively, these actions and the ongoing investments should enhance our performance in key star measures and ultimately increase member satisfaction with our plans. We are actively pursuing all our options and exploring actions to mitigate the direct financial impact on payment year 2025, including through contract diversification, operating efficiency and capital deployment alternatives. We will provide updates on our action plans and progress in future engagements in advance of 2025.

此外，我們還增強了核心和補充福利，以減少會員處方藥的自付費用，簡化了我們的牙科福利，並加強了我們的雜貨和非處方藥福利。我們也透過自動化和消除某些事先授權來簡化消費者和提供者的體驗，加速我們與基於價值的照護提供者合作夥伴的合作，並提高臨床決策上訴率。總的來說，這些行動和持續的投資應該會提高我們在關鍵明星指標方面的表現，並最終提高會員對我們計劃的滿意度。我們正在積極尋求所有選擇，並探索採取行動減輕對 2025 年付款年的直接財務影響，包括透過合約多元化、營運效率和資本部署替代方案。我們將在 2025 年之前提供有關我們行動計劃和未來合作進展的最新資訊。

Moving to Carelon. We are pleased with our momentum in the business as it continues to advance its strategy of integrated physical, behavioral, social and pharmacy services to deliver whole health affordably. Carelon services delivered particularly strong growth in operating earnings, led by the expansion of our post-acute care management solutions. We also extended our service offerings in adjacent areas, including durable medical equipment and wound care, further enhancing our customer value proposition and differentiation.

搬到卡倫。我們對我們的業務勢頭感到滿意，因為它繼續推進其綜合物理、行為、社會和藥學服務的策略，以經濟實惠的方式提供整體健康服務。在我們的急診後護理管理解決方案的擴展的帶動下，Carelon 服務的營業收入成長尤為強勁。我們也擴展了鄰近領域的服務範圍，包括耐用醫療設備和傷口護理，進一步增強了我們的客戶價值主張和差異化。

Carelon Rx continues to make significant progress towards the near-term rollout of multiple new capabilities that will enhance the affordability and experience of pharmacy for our members and Carelon Rx customers. One of these capabilities is Insure-RX, an integrated benefit for commercial pharmacy members. That compares the benefit cost for over 50 covered generic medications to our network of multiple cash discount cards then automatically applies the lowest cost at any pharmacy. The program launches early next year, and we will save our customers money while enhancing their experience. Insure-RX will also capture claim data to ensure full safety checks and maintain the integrity of our data.

Carelon Rx 繼續在近期推出多項新功能方面取得重大進展，這些新功能將提高我們的會員和 Carelon Rx 客戶的藥房負擔能力和體驗。其中一項功能是 Insure-RX，這是為商業藥房會員提供的全面福利。它將 50 多種承保非專利藥物的福利成本與我們的多個現金折扣卡網路進行比較，然後自動應用任何藥房的最低成本。該計劃將於明年初啟動，我們將為客戶節省資金，同時增強他們的體驗。 Insure-RX 還將捕獲索賠數據，以確保全面的安全檢查並保持數據的完整性。

We're also pleased with the integration of BioPlus, which continues to track ahead of schedule. And we expect to begin migrating specialty scripts from our legacy pharmacy platform early next year.

我們也對 BioPlus 的整合感到高興，該整合繼續提前進行。我們預計明年初開始從我們的傳統藥房平台遷移專業腳本。

Finally, we remain on track to launch our advanced home delivery capability in the fourth quarter. Together, these businesses will allow us to deliver even better consumer experiences and enhance affordability while creating additional shareholder value over time.

最後，我們仍有望在第四季推出先進的送貨上門服務。這些業務將使我們能夠提供更好的消費者體驗並提高負擔能力，同時隨著時間的推移創造額外的股東價值。

Now I'd like to address the actions we took during the quarter to transform our cost structure and enhance our operating efficiency. With affordability of health care, a paramount concern for all of our customers and more uncertainty in the business environment heading into 2024, we took proactive and decisive action in the third quarter to increase our financial and operational flexibility and to ensure we will remain well positioned to deliver on our commitments to all of our stakeholders.

現在我想談談我們在本季為改變成本結構和提高營運效率所採取的行動。由於醫療保健的可負擔性是我們所有客戶最關心的問題，而且進入2024 年商業環境的不確定性更大，我們在第三季度採取了積極果斷的行動，以提高我們的財務和營運靈活性，並確保我們保持有利地位履行我們對所有利害關係人的承諾。

Specifically, we completed a strategic review of our operations, assets and the investments we've made over the years to identify opportunities to increase efficiency and enhance focus, all while driving greater impact from our programs at scale. This resulted in workforce and asset optimization that will make us more nimble, focused and efficient and allow us to concentrate our resources on the most promising programs while further optimizing our physical footprint. The pace of technological innovation is rapid and accelerating, and we are committed to keeping pace.

具體來說，我們完成了對多年來我們的營運、資產和投資的策略審查，以確定提高效率和加強重點的機會，同時推動我們的計劃產生更大的影響。這導致了勞動力和資產的優化，這將使我們更加靈活、專注和高效，並使我們能夠將資源集中在最有前途的項目上，同時進一步優化我們的實體足跡。科技創新的步伐迅速且不斷加快，我們致力於跟上腳步。

As we pivot away from some legacy projects, including those tied to systems that are being replaced with cloud-based models, we are also scaling key digital programs for greater impact. One example is Health OS, a key enabler of our strategy that is helping to change the way care providers deliver care while reducing administrative burden. Health OS is our digital platform for health that allows us to exchange data bidirectionally with providers in real time and essential to a number of our priorities, including our approach to value-based care.

當我們擺脫一些遺留項目（包括那些與正在被基於雲端的模型取代的系統相關的項目）時，我們也在擴展關鍵的數位項目以產生更大的影響。 Health OS 就是一個例子，它是我們策略的關鍵推動者，有助於改變照護提供者提供照護的方式，同時減輕管理負擔。 Health OS 是我們的健康數位平台，使我們能夠與提供者即時雙向交換數據，這對於我們的許多優先事項至關重要，包括我們基於價值的護理方法。

We are also in the early stages of rolling out new AI capabilities and large language models that are helping us personalize member experiences and automate administrative tasks. We're excited about the possibilities of the rapid technological innovation that is underway and are committed to continuous improvement, innovation and the ongoing optimization of our processes reengineering much of what we do while delivering more personalized experiences to our members along the way. Before I close -- and are committed to continuous improvement innovation and the ongoing optimization of our processes, reengineering much of what we do while delivering more personalized experiences to our members along the way.

我們也處於推出新的人工智慧功能和大型語言模型的早期階段，這些功能和大型語言模型正在幫助我們個人化會員體驗並自動化管理任務。我們對正在進行的快速技術創新的可能性感到興奮，並致力於不斷改進、創新和持續優化我們的流程，重新設計我們所做的大部分工作，同時為我們的會員提供更個性化的體驗。在我結束之前，我們致力於持續改善創新和流程的持續優化，重新設計我們所做的大部分工作，同時為我們的會員提供更個人化的體驗。

Before I close, I'd like to note that we remain confident in our ability to close the acquisition of Blue Cross Blue Shield of Louisiana. We're actively working with local regulators and stakeholders to address any remaining questions. The deal offers tremendous value and opportunity for the people of Louisiana, including through the creation of a multibillion dollar foundation focused on improving their health and lives, and we look forward to the privilege of serving as their lifetime trusted health partner.

在結束之前，我想指出，我們對完成對路易斯安那州 Blue Cross Blue Shield 的收購的能力仍然充滿信心。我們正在積極與當地監管機構和利益相關者合作，以解決任何剩餘問題。該交易為路易斯安那州人民提供了巨大的價值和機會，包括創建一個數十億美元的基金會，專注於改善他們的健康和生活，我們期待有幸成為他們終生值得信賴的健康合作夥伴。

As you will hear from John in just a moment, the balance of our diverse set of businesses, the momentum of our enterprise strategy and the decisive actions we have taken to enhance our operating efficiency give us confidence in our ability to deliver strong growth in adjusted earnings per share in 2024.

正如您稍後將聽到約翰所說，我們多元化業務的平衡、企業策略的勢頭以及我們為提高營運效率而採取的果斷行動，使我們對在調整後的業務中實現強勁增長的能力充滿信心. 2024 年 每股收益。

In closing, I want to thank all of our associates around the world for their dedication and hard work. In the third quarter, we were also pleased to be named one of America's greatest workplaces by Newsweek and the #1 Best Large Workplace in Health Care by Fortune. It is the work our associates do every day on behalf of the individuals we are privileged to serve that allows us to deliver strong operating results in service of our bold purpose to improve the health of humanity. Collectively, we are fueled by passion for having a positive impact on our communities, our members and the environment.

最後，我要感謝我們世界各地所有員工的奉獻和辛勤工作。第三季度，我們也很高興被《新聞週刊》評為美國最偉大的工作場所之一，並被《財星》雜誌評為醫療保健領域排名第一的最佳大型工作場所。正是我們的員工每天為我們有幸服務的個人所做的工作，使我們能夠取得強勁的經營業績，以服務我們改善人類健康的大膽目標。總的來說，我們熱衷於對社區、會員和環境產生正面影響。

With that, I'd like to turn the call over to John to provide more on our operating results and outlook. John?

因此，我想將電話轉給約翰，以提供有關我們的營運業績和前景的更多資訊。約翰？

Thank you, Gail. And good morning to everyone on the line. As Gail mentioned earlier, we reported strong third quarter results. Given outperformance against our initial expectations year-to-date, we have increased our outlook for adjusted earnings per share in 2023 to be greater than $33, reflecting growth consistent with our long-term compound annual target of 12% to 15%.

謝謝你，蓋爾。祝在線的每個人早安。正如蓋爾之前提到的，我們報告了強勁的第三季業績。鑑於今年迄今的表現超出了我們最初的預期，我們將 2023 年調整後每股收益的預期上調至 33 美元以上，反映出成長與我們 12% 至 15% 的長期複合年度目標一致。

Our outlook includes incremental investments we have planned for the fourth quarter to support growth in Medicare Advantage in 2024 and beyond. Based on our updated guidance, our 5-year compound annual growth rate in earnings per share is expected to be 16%, which makes Elevance Health the only company in our sector to have exceeded 15% over that time frame.

我們的展望包括我們計劃在第四季度進行的增量投資，以支持 2024 年及以後 Medicare Advantage 的成長。根據我們最新的指引，我們的每股盈餘 5 年複合成長率預計為 16%，這使得 Elevance Health 成為該行業中唯一一家在此期間成長率超過 15% 的公司。

We ended the third quarter with 47.3 million members, an increase of 42,000 members year-over-year, driven by growth in Blue Card and ACA membership. During the quarter, medical membership declined by 664,000, driven by attrition in Medicaid due to eligibility redeterminations and a new entrant into one of our state programs in July, which resulted in a loss of approximately 140,000 Medicaid members. We are now 3 to 4 months into redeterminations of most of our states, and this enrollment in many appears to be front loaded with approximately 3/4 of those terminated from Medicaid having lost coverage for administrative reasons. We are seeing many consumers return to Medicaid after being temporarily disenrolled while others are experiencing gaps in coverage before transitioning on to ACA exchange plans. Given the patterns we have observed to date, we expect re-enrollment in the Medicaid and transitions to ACA exchange plans to accelerate.

截至第三季末，在藍卡和 ACA 會員數量成長的推動下，我們擁有 4,730 萬名會員，年增 42,000 名會員。本季度，醫療補助會員人數減少了 664,000 名，原因是資格重新確定導致醫療補助計劃中的人員流失，以及 7 月份新加入我們的一項州計劃，導致醫療補助會員人數減少約 140,000 名。現在，我們大多數州的重新確定工作已經進行了 3 到 4 個月，許多州的登記似乎是提前完成的，其中約 3/4 的醫療補助終止者因行政原因而失去了承保範圍。我們看到許多消費者在暫時退出醫療補助計劃後重返醫療補助計劃，而其他消費者則在轉向 ACA 交換計劃之前遇到承保缺口。鑑於我們迄今為止觀察到的模式，我們預計重新加入醫療補助計劃以及向 ACA 交換計劃的過渡將會加速。

Operating revenue in the third quarter was $42.5 billion, an increase of 7.2% over the prior year quarter. Growth was driven by rate increases to cover overall trend in our health benefits business, coupled with double-digit top line growth in Carelon Rx, driven by growth in pharmacy customers and the acquisition of BioPlus. The consolidated benefit expense ratio for the third quarter was 86.8%, an improvement of 40 basis points compared to the third quarter of last year, driven by premium rate adjustments to cover medical cost trend and solid performance within our government business.

第三季營業收入為425億美元，比去年同期成長7.2%。成長的推動因素是費率上漲，以涵蓋我們的健康福利業務的整體趨勢，再加上 Carelon Rx 的兩位數營收成長，這得益於藥房客戶的成長和 BioPlus 的收購。第三季的綜合福利費用率為86.8%，比去年第三季提高了40個基點，這得益於為涵蓋醫療成本趨勢而進行的保費調整以及我們政府業務的穩健表現。

Now I would like to spend a moment discussing the business optimization charge we announced as part of our results this morning. As Gail mentioned earlier, we took decisive action during the quarter to position our company for long-term success by enhancing operating efficiency, refining the focus of our investments and optimizing our physical footprint. These actions will ensure we stay well positioned to provide affordable products while delivering on our commitments to all of our stakeholders.

現在，我想花點時間討論我們今天早上宣布的業務優化費用，作為我們結果的一部分。正如蓋爾之前提到的，我們在本季度採取了果斷行動，透過提高營運效率、完善投資重點和優化我們的實體足跡，使我們的公司獲得長期成功。這些行動將確保我們保持有利地位，提供價格實惠的產品，同時履行我們對所有利害關係人的承諾。

As a result of this strategic review, we incurred a business optimization charge of approximately $700 million, comprised of write-offs and write-downs of internally developed software and related assets, severance and leases associated with optimizing our physical footprint. These actions will result in gross annual run rate operating expense savings of approximately $750 million per year, a portion of which will be reinvested in growth opportunities including Medicare Advantage and the accelerated rollout of certain digital capabilities. We are committed to doing even better, and we'll continue to evaluate opportunities to enhance operating efficiency further.

此次策略審查的結果是，我們產生了約 7 億美元的業務優化費用，包括內部開發的軟體和相關資產的沖銷和減記、與優化我們的實體足跡相關的遣散費和租賃費。這些行動將導致每年節省約 7.5 億美元的總營運費用，其中一部分將再投資於成長機會，包括 Medicare Advantage 和加速推出某些數位功能。我們致力於做得更好，並將繼續評估進一步提高營運效率的機會。

Elevance Health's adjusted operating expense ratio in the third quarter was 11.1%, a decrease of 30 basis points over the prior year quarter. However, the third quarter last year included additional out-of-period quality improvement expenses due to the accounting realignment we announced then. Excluding out-of-period quality improvement expenses in the third quarter of last year, our adjusted operating expense ratio would have been unchanged. Adjusted operating gain for the enterprise grew 12.6%, led by our health benefits business, which delivered double-digit growth as we continue to optimize premium rates and products while enhancing operating efficiency across the segment.

Elevance Health第三季調整後營運費用率為11.1%，比去年同期下降30個基點。然而，由於我們當時宣布的會計調整，去年第三季包括了額外的期外品質改進費用。剔除去年第三季的期外品質改善費用，我們調整後的營業費用率將維持不變。在我們的健康福利業務的帶動下，企業調整後的營運收益成長了 12.6%，隨著我們繼續優化保費率和產品，同時提高整個部門的營運效率，該業務實現了兩位數的成長。

Operating margin for our Health Benefits business improved by 30 basis points year-over-year consistent with our expectations. Carelon also delivered a strong quarter with growth in pharmacy customers and the acquisition of BioPlus propelling Carelon Rx to 17.5% revenue growth. Carelon Rx operating earnings included investments to support the build-out of our specialty pharmacy and advanced home delivery capabilities, both of which will ramp up in the coming months.

我們的健康福利業務的營業利潤率年增了 30 個基點，符合我們的預期。 Carelon 的季度業績也表現強勁，藥局客戶數量成長，收購 BioPlus 推動 Carelon Rx 營收成長 17.5%。 Carelon Rx 的營業收入包括用於支持我們專業藥房建設和先進的送貨上門能力的投資，這兩項業務都將在未來幾個月內得到提升。

In addition, comparisons to the third quarter of 2022 have been negatively affected by the out-of-period fee-based revenue realized in the third quarter of last year. In Carelon services, strong growth in operating earnings was driven by expansion of Carelon post-acute solutions and growth in our behavioral health business.

此外，與 2022 年第三季相比，去年第三季實現的期外收費收入也受到了負面影響。在 Carelon 服務中，營業收入的強勁成長是由 Carelon 急性後解決方案的擴張和行為健康業務的成長所推動的。

Turning to our balance sheet. We ended the third quarter with debt-to-capital ratio of 39.2%, in line with our expectations and consistent with our target range. During the quarter, we repurchased approximately 1.1 million shares of common stock for $480 million. Year-to-date, we repurchased 3.8 million shares of common stock for $1.7 billion, pacing ahead of our full year outlook of approximately $2 billion. We will remain opportunistic with share repurchases, especially considering the share price and recent volatility in the market. As noted in our earnings release, we ended the quarter with $5.1 billion of board-approved share repurchase authorization remaining.

轉向我們的資產負債表。第三季末，我們的負債資本比率為 39.2%，符合我們的預期，也符合我們的目標範圍。本季度，我們以 4.8 億美元回購了約 110 萬股普通股。年初至今，我們以 17 億美元的價格回購了 380 萬股普通股，超出了我們約 20 億美元的全年預期。我們將在股票回購方面保持機會主義，特別是考慮到股價和近期市場的波動。正如我們在財報中所指出的，本季結束時，我們還剩 51 億美元的董事會批准的股票回購授權。

We continue to maintain an appropriately prudent posture with respect to reserves. Days and claims payable stood at 48.6 days at the end of the third quarter, an increase of 2.1 days sequentially and an increase of 0.9 days year-over-year. As a reminder, we continue to expect days in claims payable to be in the low 40s range over time and anticipate normalization towards this range in the coming quarters as cycle times shortened and COVID-related claims uncertainty recedes.

我們在儲備方面繼續保持適度審慎的姿態。第三季末應付天數和應付理賠為48.6天，較上季增加2.1天，較去年同期增加0.9天。提醒一下，我們仍然預計隨著時間的推移，應付索賠天數將在40 多秒的範圍內，並預計隨著週期時間的縮短和與新冠病毒相關的索賠不確定性的消退，未來幾個季度將趨於正常化。

Operating cash flow was approximately $2.6 billion or 2x net income in the third quarter of 2023. Excluding the impact of the business optimization charge I discussed earlier, operating cash flow would have been 1.4x net income.

2023 年第三季的營運現金流約為 26 億美元，即淨利潤的 2 倍。排除我之前討論的業務優化費用的影響，營運現金流將是淨利潤的 1.4 倍。

Given strong performance year-to-date, we are planning to make incremental investments in the fourth quarter in Medicare Advantage marketing and retention and in capabilities and services that we expect will enhance customer satisfaction, supporting our growth in 2024 and beyond. While we are disappointed in the outcome of the recently released Star quality ratings, we remain committed to this important line of business for the long term and are exploring all options to mitigate the financial impact on 2025.

鑑於今年迄今的強勁業績，我們計劃在第四季度對 Medicare Advantage 行銷和保留以及能力和服務進行增量投資，我們預計這些投資將提高客戶滿意度，支持我們在 2024 年及以後的成長。儘管我們對最近發布的星級品質評級結果感到失望，但我們仍致力於長期致力於這一重要業務領域，並正在探索減輕 2025 年財務影響的所有選擇。

Turning to 2024. Although we are not planning to provide specific guidance on this call, I would like to review some of the tailwinds and headwinds that are known at this time, starting with our tailwinds. We continue to optimize our Health Benefits business, including by executing a multiyear margin recovery in our commercial risk-based margins to return to pre-pandemic levels and expect margin improvement will continue next year. We also anticipate improvement in Medicare earnings, driven in part by corrective actions taken in our 2024 Medicare Advantage bids to improve financial performance in Puerto Rico, where we experienced significant challenges this year.

談到 2024 年。雖然我們不打算就這次電話會議提供具體指導，但我想回顧一下目前已知的一些順風和逆風，從我們的順風開始。我們繼續優化我們的健康福利業務，包括透過對基於商業風險的利潤率執行多年利潤率恢復，以恢復到大流行前的水平，並預計明年利潤率將繼續改善。我們也預期 Medicare 收入將有所改善，部分原因是我們在 2024 年 Medicare Advantage 投標中採取的糾正行動，以改善波多黎各的財務業績，我們今年在波多黎各遇到了重大挑戰。

We expect continued momentum in Carelon, including growth in Carelon services, driven by new product launches and opportunities for meaningful external growth across businesses and the ramp-up of BioPlus and the launch of Carelon advanced home delivery, both of which to supplement ongoing momentum within Carelon Rx. We also expect to enhance operating efficiency as a result of the actions we took during the third quarter, and we'll continue to look for opportunities to drive efficiency as we transform our cost structure over the long term. And we expect today's higher interest rate environment to drive growth in investment income.

我們預計Carelon 將繼續保持成長勢頭，包括Carelon 服務的成長，這得益於新產品的推出和跨業務的有意義的外部成長機會以及BioPlus 的成長和Carelon 高級送貨上門的推出，這兩者都補充了Carelon 的持續成長勢頭卡倫 Rx。我們也期望透過第三季採取的行動來提高營運效率，並且我們將在長期轉變成本結構時繼續尋找提高效率的機會。我們預期當今較高的利率環境將推動投資收益的成長。

Our tailwinds will be partially offset by our headwinds, which all relate to the Medicaid business where we anticipate membership attrition associated with ongoing eligibility redeterminations and the net loss of approximately 930,000 additional members associated with changes in our footprint. While Medicaid rates remain actuarially sound, we're also mindful of the risks associated with evolving risk pools, and we'll continue to monitor and manage these dynamics closely. Beyond 2024, Medicaid offers attractive long-term growth opportunities, notably in specialized populations, and we anticipate a return to growth in 2025 and beyond.

我們的順風將被我們的逆風部分抵消，這些逆風都與醫療補助業務有關，我們預計與正在進行的資格重新確定相關的會員流失以及與我們足蹟的變化相關的約 930,000 名額外會員的淨流失。雖然醫療補助費率在精算上仍然合理，但我們也注意到與不斷變化的風險池相關的風險，我們將繼續密切監控和管理這些動態。 2024 年之後，醫療補助將提供有吸引力的長期成長機會，特別是在特殊人群中，我們預計 2025 年及以後將恢復成長。

Most importantly, 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 divisions position us to deliver on our long-term growth commitments. At this point in time, we believe the current consensus estimate for adjusted earnings per share of approximately $37 in 2024 is appropriate, and we anticipate delivering another year of growth consistent with our long-term compound annual growth rate target next year. We look forward to providing more specific guidance on our fourth quarter earnings call.

最重要的是，我們多元化業務的平衡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 部門的盈利能力使我們能夠兌現長期增長承諾。目前，我們認為目前對 2024 年調整後每股收益約為 37 美元的共識估計是合適的，並且我們預計明年將實現與我們的長期複合年增長率目標一致的又一個增長年。我們期待在第四季財報電話會議上提供更具體的指導。

Finally, as many of you know, this will be my last earnings call as CFO of Elevance Health. It has been a pleasure to serve this organization for more than 29 years, including the past 7 in my current role. I have been involved in 88 quarterly earnings calls since Anthem went public in 2001, including 30 of them as Chief Financial Officer. Every year has had its opportunities and challenges, and 2024 is no different. We serve our members while furthering our mission, and we'll continue to meet and exceed our shareholder commitments. The balance and resilience of our businesses has created numerous tailwinds and has allowed us to overcome various headwinds, and I'm confident we will continue to do so.

最後，正如你們許多人所知，這將是我作為 Elevance Health 財務長的最後一次財報電話會議。我很高興為這個組織服務超過 29 年，其中包括我目前擔任職務的過去 7 年。自 Anthem 2001 年上市以來，我參加了 88 場季度財報電話會議，其中 30 場是擔任財務長。每一年都有機會與挑戰，2024年也不例外。我們為會員服務，同時推動我們的使命，我們將繼續履行並超越我們的股東承諾。我們業務的平衡性和彈性創造了許多順風，並使我們能夠克服各種逆風，我相信我們將繼續這樣做。

I feel fortunate to have been part of what I believe to be the best leadership team in the industry and to be leading the finance organization in an even stronger position than when I took over. I've enjoyed engaging with all of you over the years. I want to thank you for your support. I look forward to supporting Mark Kaye as he assumes the role of CFO, ensuring a smooth transition before retiring to spend more time with my family in the first quarter of next year.

我很幸運能夠成為我認為是業內最好的領導團隊的一員，並且能夠以比我接手時更強大的地位領導財務組織。這些年來我很高興與你們大家交往。我要感謝您的支持。我期待支持馬克凱 (Mark Kaye) 擔任首席財務官，確保他在明年第一季退休之前能夠順利過渡，以便花更多時間陪伴家人。

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

那麼，接線員，請開通提問線路。

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

（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。瑞銀的米。

John, I wish you the best in the retirement. It's been great working with you, and I really appreciate all the help over the years. I want to maybe just ask on the commercial margin improvement story and what you've been doing there. Is -- if you ex out that year this quarter, what was the underlying cost trend for you? Did you see any pockets of variance and utilization that are worth calling out. And you guys have said on the recorded or the message so far several times that you have -- that there will be some additional benefits on the commercial margin improvement story into next year. Is there any way to size that or talk about that relative to how much gain you had this year from that repricing and the other things you're doing to improve the margin on the commercial side?

約翰，我祝福你退休後一切順利。與您合作非常愉快，我非常感謝這些年來所提供的所有幫助。我想問一下商業利潤率改善的故事以及你們在那裡所做的事情。如果您在本季退出當年的業務，那麼您的基本成本趨勢是什麼？您是否看到任何值得指出的差異和利用率？到目前為止，你們已經在錄音或訊息中多次說過，明年的商業利潤率改善故事將會帶來一些額外的好處。有沒有什麼方法可以衡量這個規模，或者談論一下你今年從重新定價中獲得的收益以及你為提高商業方面的利潤而採取的其他措施？

Thank you for the kind words at the beginning. In terms of answering your question specifically though, we're certainly obviously very pleased with the performance of our Health Benefits businesses in the third quarter as well as year-to-date. As you know, we've increased margins quite significantly. And the health benefit segment margins, we guided to improve those 30 to 60 basis points year-over-year, and we're very much on track to deliver on that.

謝謝你一開始的客氣話。不過，就具體回答您的問題而言，我們顯然對第三季以及年初至今的健康福利業務表現感到非常滿意。如您所知，我們的利潤率大幅提高。至於健康福利細分市場的利潤率，我們預計將年比提高 30 至 60 個基點，我們非常有望實現這一目標。

From a line of business, in particular, we're not providing specific margin information and specific detail on commercial versus Medicaid versus Medicare since we are operating this as a holistic Health Benefit segment. But we do expect continued improvement in the commercial margins into'24 as we continue to work on our strategy of ensuring that the pricing truly reflects the underlying cost structure as well as additional penetrations in the fee-based businesses what we used to call the 5:1 to 3:1 strategy. So we feel very good about where we're heading and our trajectory into 2024. So thank you for the question.

特別是從業務範圍來看，我們不會提供具體的利潤資訊以及商業與醫療補助與醫療保險的具體細節，因為我們將其作為整體健康福利部門來運作。但我們確實預期商業利潤率將在 24 年繼續改善，因為我們將繼續制定策略，確保定價真正反映潛在的成本結構以及我們過去所說的 5 收費業務的額外滲透。 :1 到 3:1 策略。因此，我們對 2024 年的前進方向和軌跡感到非常滿意。所以謝謝你的提問。

Yes. Thanks for the question, A.J., and I'll just reiterate John's comments on commercial. I think the team has done a really nice job. As we shared, this is a multiyear journey in terms of the commercial business, and we feel like we're right on track. And the team has done a really nice job of balancing both membership retention as well as getting our margins in line where we believe they need to be. So thanks for the question.

是的。謝謝 A.J. 的提問，我只想重申約翰對廣告的評論。我認為團隊做得非常好。正如我們所分享的，就商業業務而言，這是一個多年的旅程，我們覺得我們正走在正軌上。團隊在平衡會員保留和使我們的利潤符合我們認為需要的水平方面做得非常好。謝謝你的提問。

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

接下來，我們將邀請高盛 (Goldman Sachs) 的內森·里奇 (Nathan Rich)。

Great. And let me just echo my congratulations, John, on your retirement. I wanted to ask on the Medicare business. Could you talk about the goal for improving Star scores? Are you investing to kind of get back to the level that you are out with 65% of members in 4-star plans. And over what period are you thinking? And how should we think about the magnitude of the incremental investments planned for the fourth quarter as well as into next year? And any comment on the kind of how long it would take to reach the run rate of optimization savings, the $750 million that you talked about? It would be helpful as well.

偉大的。約翰，讓我再次祝賀你退休。我想問一下醫療保險業務。您能談談提高Star分數的目標嗎？您的投資是否是為了恢復到 65% 的會員參與 4 星級計畫的水平？您在想什麼時期？我們應該如何看待第四季以及明年計畫的增量投資規模？對於需要多長時間才能達到優化節省的運行率（您談到的 7.5 億美元）有何評論？這也會有幫助。

Thanks for the question, Nathan. Let me -- I anticipate a number of questions around Star, so perhaps I'll just address that topic holistically. Improving stars for us is an enterprise priority, so I want to start with that. And we have a long-term commitment to the MA business and are committed to offering high-quality plans for seniors. But as I said in my opening comments, we're extremely disappointed on the recent results of the Stars and the decline that we saw in the number of our members in 4-star plans for payment year '25.

謝謝你的提問，內森。讓我——我預計會有很多圍繞 Star 的問題，所以也許我會從整體上解決這個主題。提高我們的星級是企業的首要任務，所以我想從這個開始。我們對 MA 業務有著長期的承諾，致力於為老年人提供高品質的計劃。但正如我在開場白中所說，我們對 Stars 最近的結果以及我們在 25 年付款的 4 星計劃中看到的會員數量的下降感到非常失望。

Just a little background, I think, it might help. We experienced some declines in the CAP survey scores, which were the most heavily weighted measures. And we were also impacted by that new CMS statistical methodology, which caused some significant increases in cut points. As you think about our performance, we improved in about half of the Star measures, but those were not enough to offset the impact of the heavily weighted measures and the higher cut points, therefore, having 3 of our largest contracts suffered in our star ratings, which you've noted.

我想，只要有一點背景知識，可能會有所幫助。我們的 CAP 調查分數有所下降，這是權重最大的指標。我們也受到新的 CMS 統計方法的影響，該方法導致切點顯著增加。當你思考我們的表現時，我們在大約一半的星級指標上取得了進步，但這些還不足以抵消權重較高的指標和更高的削減點的影響，因此，我們最大的3 份合約的星級評級受到了影響，你已經注意到了。

As I shared, we have already started making those investments. And earlier this year, we were specifically addressing areas around the heightened focus for CAPS that drove the decline. One of the very specific examples is scaling the My Health Advocate model, which, again, I shared a little bit about that in my opening remarks. The model is unique and highly personalized customer service, and it's tailored specifically to help members with problems central to CAPS improvement. It's a model that we've had in place in our commercial business and has been incredibly successful.

正如我所分享的，我們已經開始進行這些投資。今年早些時候，我們專門解決了導致下降的 CAPS 高度關注領域。其中一個非常具體的例子是擴展「我的健康倡導者」模型，我在開場白中再次分享了一些相關內容。此模式是一種獨特且高度個人化的客戶服務，專為幫助會員解決 CAPS 改進的核心問題而量身定制。這是我們在商業業務中採用的模式，並且取得了令人難以置信的成功。

Other areas that we saw on the data were about enhancing our core and supplemental benefits to reduce members out-of-pocket costs, which showed up in our Stars results and also simplifying how those members use our over-the-counter benefits. We bought on a journey around value-based care as we've shared with you, and we're going to continue to accelerate that and embed some of those results as well into our contracting process. And we also may take steps last year to improve the processes around clinical decision appeals, which was also an area around the higher cut points.

我們在數據中看到的其他領域是增強我們的核心和補充福利，以減少會員的自付費用，這體現在我們的星級結果中，並簡化了這些會員如何使用我們的非處方福利。正如我們與您分享的那樣，我們圍繞著基於價值的護理進行了購買，我們將繼續加速這一過程，並將其中一些結果嵌入到我們的簽約流程中。去年我們也可能採取措施改善臨床決策上訴的流程，這也是圍繞著更高切點的一個領域。

In terms of financial impact, we expect a reduction in 2025 quality bonus revenue of approximately $500 million after offsets from our contracting provisions. As John and I both shared, we've already aggressively begun to mitigate that headwind for '25, and we do have a number of levers at our disposal, including contract diversification, operating expense efficiencies, capital deployment and looking at targeted network and product enhancements.

就財務影響而言，我們預計在抵銷合約條款後，2025 年品質獎金收入將減少約 5 億美元。正如約翰和我所分享的那樣，我們已經開始積極地開始緩解 25 年的不利因素，而且我們確實擁有許多可供使用的槓桿，包括合約多元化、營運費用效率、資本部署以及尋找目標網路和產品增強功能。

Overall, we're going to continue to work on that. Our time lines have already begun on this feel. We have a very, very good line of sight to the opportunities that we have. And again, because of the diversified business model that we've talked to you about, we feel that the earnings power of our combined businesses between health benefits and Carelon allow us to continue to feel comfortable about our adjusted earnings per share growth annually of 12% to 15% over the long term. So thanks again for the question. Appreciate the opportunity to holistically address what we're doing about Stars.

總的來說，我們將繼續為此努力。我們的時間線已經從這種感覺開始了。我們對我們所擁有的機會有非常非常好的視野。再次，由於我們與您討論過的多元化業務模式，我們認為健康福利和 Carelon 之間合併業務的盈利能力使我們能夠繼續對每年 12 的調整後每股收益增長感到滿意長期來看，會增加%至15%。再次感謝您的提問。感謝有機會全面討論我們正在為星星所做的事情。

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。

This is Cal on for Lisa. I just want to add my thanks to John wishing all the best. Switching to Medicaid. I appreciate all the color on the redeterminations and the front-loaded disenrollment trends. Can you talk about how membership is trending relative to what you expected earlier this year and how acuity mix is trending? And then related on the commercial side, how membership growth is tracking in the employer group and individual businesses. Are you guys getting the growth you anticipated? And is there anything to call out on the margin side as you think about this year into 2024?

這是卡爾為麗莎主持的節目。我只想向約翰表示感謝並祝一切順利。切換到醫療補助。我很欣賞重新決定和提前退出趨勢的所有色彩。您能否談談相對於您今年稍早的預期，會員資格的趨勢如何，以及敏銳度組合的趨勢如何？然後在商業方面，雇主團體和個人企業的會員成長如何。你們有達到預期的成長嗎？考慮到今年到 2024 年，在利潤方面有什麼值得指出的嗎？

Thank you for the question, Cal, and certainly appreciate all the commentary. But first of all, on Medicaid, the Medicaid disenrollment, as we said, has been very much front loaded. And in terms of how that compares to our expectations, our expectations were that it would have been more normalized over a 12- to 14-month process. We -- what we are seeing is that there's administrative churn and that a lot of people are losing Medicaid coverage temporarily. And then they're coming back on. We're reenrolling folks 30, 60, 90 days after they were disenrolled. And that was -- that dynamic was not part of the original thought process, but it's certainly part of the reality.

謝謝你的提問，卡爾，當然也謝謝所有的評論。但首先，在醫療補助方面，正如我們所說，醫療補助的退出在很大程度上是提前進行的。就與我們的預期相比而言，我們的預期是在 12 至 14 個月的過程中會更加正常化。我們 - 我們看到的是行政管理的混亂，許多人暫時失去了醫療補助覆蓋範圍。然後他們又回來了。我們將在人們退出後 30 天、60 天、90 天重新註冊。那就是——這種動態不是最初思考過程的一部分，但它肯定是現實的一部分。

I'd like to say, September 30 or December 31 for that matter is just going to be one point in time over a 12- to 14-month process. What we have not seen and maybe the most important element is that, at the beginning of the year, when we discussed that we think that we're going to retain about 40% to 45% of all Medicaid members who received coverage during the PHE, we still believe that is a very good estimate. And by the time the dust settles in the third quarter of 2024, we feel good about that estimate. It's just going to be a little bumpier or rockier along the way because of the gaps in coverage and because of the administrative churn.

我想說，9 月 30 日或 12 月 31 日只是 12 至 14 個月過程中的一個時間點。我們沒有看到的，也許是最重要的因素是，在今年年初，當我們討論時，我們認為我們將保留在公共衛生期間接受保險的所有醫療補助成員中約 40% 至 45% ，我們仍然認為這是一個非常好的估計。到 2024 年第三季塵埃落定時，我們對此估計感到滿意。由於覆蓋範圍的差距和行政人員的變動，一路上只會變得更加坎坷或更坎坷。

And on the commercial side, we're actually seeing really excellent growth in the individual ACA. Once that redeterminations began in a particular state, the level of applications on the ACA products were up 3x the amount that they were prior to that. And so that really does point to the fact that we do have the catcher's mitt in action.

在商業方面，我們實際上看到個人 ACA 的成長非常出色。一旦某個州開始重新確定，ACA 產品的申請量就會比之前增加 3 倍。所以這確實表明我們確實有捕手的手套在起作用。

The employer-sponsored side, that's actually going maybe a little bit less than we had anticipated. So individual ACA is going a little bit faster. Employers sponsored a little bit slower. But all in, we really do believe that by the time we get through this entire process, which won't be completed until sometime in the third quarter of 2024, that the estimates that we provided at the beginning of the year will prove to be pretty good estimates. So hopefully, that helps.

雇主資助的方面，實際上可能比我們預期的要少一些。所以個人 ACA 的進展要快一些。雇主贊助的速度稍慢一些。但總而言之，我們確實相信，當我們完成整個過程時（整個過程要到 2024 年第三季的某個時候才能完成），我們在年初提供的估計將被證明是相當不錯的估計。希望這會有所幫助。

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

接下來，我們將前往富國銀行的史蒂芬‧巴克斯特（Stephen Baxter）。

Wanted to follow up on the Medicaid redeterminations question there. So I appreciate all that commentary you just made. Would it be fair to say that at this point in part driven by the fact that you've got seemingly good and actuarially sound rate updates from your states that you haven't really seen all that much normalization of your margins in 2023? I believe you came into the year thinking that you performed in 2022 above your long-term targeted range, and there might be some pressure. I would love to just get an update on how that's performed in 2023 and how you're thinking or potentially considering that in your comments on 2024.

想跟進那裡的醫療補助重新確定問題。所以我很感謝你剛才發表的所有評論。可以公平地說，在這一點上，部分是因為您從各州獲得了看似良好且精算合理的利率更新，但您並沒有真正看到 2023 年利潤率有那麼大的正常化？我相信您在進入這一年時認為 2022 年的表現超出了長期目標範圍，並且可能會面臨一些壓力。我很想了解 2023 年的最新情況，以及您在 2024 年的評論中如何思考或可能考慮這一點。

Yes, sure. Thank you very much for that question. And actually, I think Cal did ask about acuity as well. So hopefully, I'll address both of those here with this answer. Medicaid continues to be doing very well, very much in line with our expectations and in line with what we saw coming. The one thing that I will reinforce is that in the rating formulas in the future or currently now is an acuity factor that's supposed to take changes in acuity into consideration. That factor was not in place in 2019. So comparisons to 2019 really aren't all that relevant at this point in time for that purpose.

是的，當然。非常感謝你提出這個問題。事實上，我認為卡爾確實也問過關於敏銳度的問題。所以希望我能用這個答案來解決這兩個問題。醫療補助持續表現良好，非常符合我們的預期，也符合我們所看到的未來​​。我要強調的一件事是，在未來或現在的評級公式中，有一個敏銳度因素，應該考慮敏銳度的變化。這個因素在 2019 年並不存在。因此，目前與 2019 年的比較其實並沒有那麼重要。

What we've seen thus far though is very little change in the overall acuity of the book. We are taking a very close look at that. And as I stated in my prepared comments, we're going to be monitoring that extremely closely and working with our states. So I'm very happy to report that all of the renewals that we've had with the discussions we've had with the states thus far, we have been provided actuarially sound rates. And we believe with actuarially sound rates, we can continue to deliver on Medicaid consistent with how we have in the past, providing a lot of benefits to the beneficiaries and providing returns to the shareholders. So thank you.

到目前為止，我們看到這本書的整體敏銳度幾乎沒有改變。我們正在密切關注這一點。正如我在準備好的評論中所說，我們將非常密切地監控這種情況並與我們的州合作。因此，我很高興地向大家報告，迄今為止，我們與各州討論的所有續約，都獲得了精算合理的費率。我們相信，憑藉精算合理的費率，我們可以繼續以過去的方式提供醫療補助，為受益人提供大量福利，並為股東帶來回報。所以謝謝。

Yes. Thanks, John. And I think as -- just to put a sort of summary on that, we feel we've got great visibility into the rest of this year. And the discussions around '24 have been incredibly productive with about 50% of our premiums with good visibility there. So we think that those conversations are going well, and things are tracking according to expectations. So thanks for the question.

是的。謝謝，約翰。我認為——只是對此進行一些總結，我們認為我們對今年剩餘時間有了很大的了解。圍繞 '24 的討論非常富有成效，我們大約 50% 的保費在那裡具有良好的可見性。因此，我們認為這些對話進展順利，事情正在按照預期進行。謝謝你的提問。

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

接下來，我們將聽聽加拿大皇家銀行資本市場公司 (RBC Capital Markets) 的 Ben Hendrix 的演講。

I just also want to reiterate congratulations to John and thank you for all the help. just wanted to circle up with a quick follow-up on MA. Appreciate all the questions on My Health Advocate and efforts there. I just wanted to know if there's any early thoughts on how much of the headwind you can mitigate with contract diversification and then kind of what the time line is for getting all those approvals at the state level to carry that forward.

我還想再次祝賀約翰並感謝您提供的所有幫助。只是想對 MA 進行快速跟進。感謝有關“我的健康倡導者”的所有問題以及其中的努力。我只是想知道是否有任何關於透過合約多元化可以減輕多少阻力的早期想法，然後是獲得州一級所有這些批准以推進這一目標的時間線。

Yes. Thanks for the question, Ben. As we think about that, as I said, we've got a number of levers at our disposal. And so I would focus on that. But in terms of contract diversification, about 1/3 of the members affected were in the group contracts. So we'll look at moving those potentially to a 4-star contract. But again, I just want to reiterate, it's just one lever in our toolbox. And so we're not just looking at that, but we're looking across all of the things to have a mitigation for 2025.

是的。謝謝你的提問，本。正如我所說，當我們思考這個問題時，我們有許多可以使用的槓桿。所以我會重點關注這一點。但從合約多元化來看，受影響的成員中約有1/3是團體合約。所以我們會考慮將這些潛在的球員轉為四星級合約。但我想再次重申，這只是我們工具箱中的一個槓桿。因此，我們不僅關注這一點，而且正在考慮所有因素，以便在 2025 年採取緩解措施。

So thanks again for the question. And again, a lot happening in our enterprise around the efforts there to make sure that we remediate and stay very focused. This is an enterprise priority for us.

再次感謝您的提問。同樣，我們的企業中也發生了很多事情，以確保我們能夠進行補救並保持高度專注。這是我們企業的首要任務。

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

接下來，我們將邀請美國銀行的 Kevin Fischbeck。

Great. And I was to add to my congratulations to John as well. I guess as far as the cost cutting, this cost cut was quite large. And I guess I just want to get a little more color at exactly kind of what's driving this. It sounds like this was all before your new stars was going to be off for '25, because it sounds like it was more a '24 issue. I think in the comments, you said something on the line that it's going to help you deliver lower cost to customers, but also addresses some of the uncertainty in 2024. So I just want a little more color on that. How much of this is going to improve benefits in MA versus, I think you made technology investments? Just a little more rationale for the move why it's so big. And then if the -- if you're doing it this move now, how do you think about your ability to find significant savings to offset Stars 2025?

偉大的。我還要向約翰表示祝賀。我想就成本削減而言，這次成本削減是相當大的。我想我只是想對推動這一現象的確切原因有更多的了解。聽起來這一切都是在你的新明星即將在 25 年退休之前發生的，因為聽起來這更像是 24 年的問題。我認為在評論中，您在線上說了一些話，這將幫助您為客戶提供更低的成本，同時也解決 2024 年的一些不確定性。所以我只是想對此有更多的了解。與我認為您進行的技術投資相比，這將在多大程度上提高 MA 的效益？只是稍微解釋一下為什麼此舉如此之大。然後，如果您現在就採取這一舉措，您如何看待自己是否有能力找到大量節省資金來抵消 2025 年明星計劃的影響？

Yes. Thanks for the question, Kevin. I think -- let me put this in a little perspective because it's important to note, we're always evaluating our cost structure. And as we headed into 2024, we took very proactive and decisive action in the third quarter. We wanted a couple of things. One, increase our financial and operational flexibility and also ensure that we're positioned to deliver on our commitments to stakeholders. So if you look at the charge in total, I mean it really is kind of focused in 3 areas of cost management. And I think it's prudent to continue to always look at your cost structure, something we've been doing, obviously, as we've been looking to manage that.

是的。謝謝你的提問，凱文。我想——讓我從一個角度來看這個問題，因為值得注意的是，我們總是在評估我們的成本結構。在邁入 2024 年之際，我們在第三季採取了非常積極和果斷的行動。我們想要一些東西。第一，提高我們的財務和營運靈活性，並確保我們有能力兌現對利害關係人的承諾。因此，如果你看總費用，我的意思是它確實集中在成本管理的三個領域。我認為謹慎的做法是繼續始終關注您的成本結構，顯然，我們一直在這樣做，因為我們一直在尋求管理它。

And let me go through the 3 pieces because I think it's important. First, as you know and we've talked about quite a bit on these calls, we've been investing over the past several years in modernizing our infrastructure, particularly around digital capabilities and migrating a lot of our applications to the cloud, consolidating our systems and our data and now most recently, use cases on using AI to drive greater efficiencies. The pace of technological innovation has changed, and it continues to accelerate. And again, as I said, we're committed to deploying those responsibly quickly in our company. So what you're seeing in that first bucket is the write-down of some of those legacy processes that have now been replaced with our support -- that support our long-term goals with digital and AI and other things. And we've gone through that first phase that we've been talking about over the last several years on consolidation, data aggregation, et cetera.

讓我來介紹一下這 3 部分，因為我認為這很重要。首先，正如您所知，我們在這些電話會議上已經討論過很多，過去幾年我們一直在投資於基礎設施現代化，特別是圍繞數位功能並將大量應用程式遷移到雲，從而鞏固我們的基礎設施。系統和我們的數據，以及最近使用人工智慧來提高效率的用例。技術創新的步伐已經改變，並且持續加速。正如我所說，我們再次致力於在公司中負責任地快速部署這些人員。因此，您在第一個桶中看到的是一些遺留流程的減記，這些流程現在已被我們的支援所取代——這些流程透過數位、人工智慧和其他事物來支持我們的長期目標。我們已經經歷了過去幾年我們一直在談論的整合、資料聚合等第一階段。

The second adjustments were really to our workforce. And that, again, last year, we aligned our structure on benefits and services. This gave us an opportunity to look at redundancies across our business and our processes and eliminate handoffs, streamlined, very focused on ensuring that members because of our large benefit businesses can move between those businesses. It's an integral part of our strategy. And so that's been an important part of streamlining our work processes, simplifying our member experiences. And so as you think about the investments that we've been making in technology, particularly our front door applications and things that automate some of our work, this was an opportunity for us to make sure that we had the right scaling of our workforce. And again, in the bigger scheme, these are not significant numbers. But again, I think it's really important that we constantly look at our cost structure.

第二次調整其實是針對我們的員工隊伍。去年，我們再次調整了福利和服務的結構。這使我們有機會審視我們業務和流程中的冗餘，並消除交接，簡化流程，非常注重確保會員因為我們的大利益業務可以在這些業務之間流動。這是我們策略的一個組成部分。因此，這是簡化我們的工作流程、簡化我們的會員體驗的重要部分。因此，當你想到我們一直在技術方面進行的投資時，特別是我們的前門應用程式和使我們的一些工作自動化的東西，這對我們來說是一個機會，可以確保我們的勞動力規模得到適當的擴展。再說一次，在更大的計劃中，這些並不是重要的數字。但我再次認為，不斷檢視我們的成本結構非常重要。

And then the last part is we went to a hybrid work environment. We've been evaluating the size and locations of our work sites, and we took the opportunity to further optimize those to make sure that we were located in the right places and had the right footprint.

最後一部分是我們進入了混合工作環境。我們一直在評估工作地點的規模和位置，並藉此機會進一步優化它們，以確保我們位於正確的位置並擁有正確的佔地面積。

So you think about all those, it's an approximately $700 million of charges, and it results in a run rate of about $750 million. Again, as John said, it doesn't all drop to the bottom line, but that we think is important to support our long-term growth in our enterprise strategy. So that gives you a bit of a sense of how we thought about these as an ongoing opportunity to continue to optimize our cost, which we think is important for affordability in health care. So thanks very much for the question.

所以你想想所有這些，這大約是 7 億美元的費用，而它的運行率約為 7.5 億美元。同樣，正如約翰所說，這並沒有全部下降到底線，但我們認為這對於支持我們企業策略的長期成長很重要。因此，這讓您了解我們如何將這些視為繼續優化成本的持續機會，我們認為這對於醫療保健的可負擔性非常重要。非常感謝您提出的問題。

Next, we'll go to the line of Sarah James from Cantor Fitzgerald.

接下來，我們將轉到康托·菲茨傑拉德 (Cantor Fitzgerald) 的莎拉·詹姆斯 (Sarah James) 的詩句。

Echo my congratulations to John. I was hoping that you guys could give a little bit more context around the recapture rate of the terminated Medicaid lives. So are you seeing recapture within Medicaid from the appeal process yet?

轉達我對約翰的祝賀。我希望你們能夠提供更多關於終止醫療補助生命的重新獲得率的背景資訊。那麼您是否看到醫療補助計劃從上訴程序中重新恢復過來？

And then on the ACA side, how do you think about the 30% recapture maturing into '24 with your members, but then also potentially there's more people looking for ACA plans in '24?

然後在 ACA 方面，您如何看待與您的會員一起在 24 年重新奪回 30% 的計劃，但也可能有更多的人在 24 年尋找 ACA 計劃？

Thank you for the question, Sarah. So in terms of the Medicaid redeterminations, as I stated, we're 3 to 4 months into the process. And it's a little early to have definitive in very specific data points, but we do have certainly the bias. We've seen 10% to 20% of the members who lost coverage in Medicaid in June reenrolled with us in the third quarter. So we certainly expect trends like that to continue. That's just one data point and certainly, there's more time. But there are gaps in coverage.

謝謝你的提問，莎拉。因此，就醫療補助重新確定而言，正如我所說，我們需要 3 到 4 個月的時間才能完成該過程。現在對非常具體的數據點做出明確的判斷還為時過早，但我們確實存在偏見。我們發現，6 月失去醫療補助覆蓋範圍的會員中有 10% 到 20% 在第三季重新加入了我們。因此，我們當然預期這樣的趨勢將會持續下去。這只是一個數據點，當然還有更多時間。但覆蓋範圍存在差距。

And then on the individual ACA, we are seeing by the time that folks leave Medicaid. There's typically a couple of month gap before they become enrolled in ACA plan. So some of the membership disenrollment is temporary, and there's gaps in coverage. So we've seen that throughout. But we think we have a great opportunity in our 14 Blue states. You look at the number of members that were added to Medicaid in our 14 Blue states, that was about 8 million people across all 14 states. About 1.5 million of those were enrolled in Elevance Health Medicaid plans, which means that those other 6.5 million that went to a different carrier, if that different carrier is able to retain 40% to 45% of those Medicaid similar to us, which I think is a reasonable expectation, that means that over half of the 6.5 million are in play. And we have leading market share in virtually every market we operate in, both in employer-sponsored as well as very strong in the ACA products.

然後在個人平價醫療法案上，我們看到人們離開醫療補助。他們加入 ACA 計劃之前通常會有幾個月的時間間隔。因此，一些會員資格的退出是暫時的，而且覆蓋範圍也存在差距。所以我們自始至終都看到了這一點。但我們認為我們在 14 個藍州擁有很好的機會。你看看我們 14 個藍色州加入醫療補助的會員人數，所有 14 個州約有 800 萬人。其中大約 150 萬人參加了 Elevance Health Medicaid 計劃，這意味著另外 650 萬人去了不同的運營商，如果該不同的運營商能夠保留 40% 到 45% 的與我們類似的 Medicaid，我認為是一個合理的預期，這意味著650 萬玩家中超過一半都在玩遊戲。我們幾乎在我們經營的每個市場都擁有領先的市場份額，無論是在雇主贊助的市場還是在 ACA 產品方面都非常強大。

And so we do believe that you will see an acceleration of individual ACA membership in the early '24 and mid-'24 for Elevance Health. So hopefully, that answers your questions. Thank you for the question.

因此，我們確實相信，您將在 24 世紀 24 年初和 24 年中期看到 Elevance Health 個人 ACA 會員數量的增長。希望這能回答您的問題。感謝你的提問。

Yes. Thanks, John. And Sarah, I think just to sort of put a bow on this. I think it's really important just to frame it, almost 75% are administrative disenrollments and then over almost 37% are children under 18. So those are 2 areas, obviously, we're intensely focused on. And there's a timing issue associated with this. So there's some delays in coverage and some coverage gaps, and we've been working really closely with our states. But as John said, we are seeing some encouraging signs where that 30% or more of our Medicaid members who are terminated prior to the end of June are now returning and retaining coverage with Elevance.

是的。謝謝，約翰。莎拉，我想只是對此表示敬意。我認為框架非常重要，幾乎 75% 是行政註銷，超過近 37% 是 18 歲以下的兒童。因此，顯然，這是我們密切關注的兩個領域。還有一個與此相關的時間問題。因此，覆蓋範圍存在一些延遲和一些覆蓋缺口，我們一直在與各州密切合作。但正如 John 所說，我們看到了一些令人鼓舞的跡象，即 30% 或更多在 6 月底之前終止醫療補助計劃的會員現在已返回並保留 Elevance 的承保範圍。

So we expect that re-enrollment to accelerate in the coming quarters. So I think that's important to keep in mind as we're all working through this process and certainly, the states are working through this process. And we have been continuing to adapt how we get to these members, particularly the ones that were disenrolled for administrative reasons. So again, we feel pretty comfortable with the numbers that we shared and the guidelines we showed, and we are seeing pickup certainly in the individual business as this progresses. So thanks again for the question.

因此，我們預計未來幾季重新註冊的速度將會加快。因此，我認為記住這一點很重要，因為我們都在經歷這個過程，當然，各州也在經歷這個過程。我們一直在繼續調整聯繫這些會員的方式，特別是那些因行政原因而被註銷的會員。再說一次，我們對我們分享的數字和我們展示的指導方針感到非常滿意，隨著這一進展，我們肯定會看到個別業務的回升。再次感謝您的提問。

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

接下來，我們請聽聽摩根士丹利的麥可霍爾 (Michael Hall) 的電話。

Congrats to John as well. I wanted to ask a quick question first regarding BioPlus. I wanted to confirm, did you mention you're going to start migrating specialty scripts away from your legacy platform early next year? Would that imply you've made the decision to in-source your specialty drug spend away from CBS?

也祝賀約翰。我想先問一個關於 BioPlus 的簡單問題。我想確認一下，您是否提到您將在明年初開始將專業腳本從舊平台遷移出來？這是否意味著您已決定將您的特殊藥物支出從 CBS 外包出去？

And then my real question, just regarding MA and Star ratings, in terms of the improvement efforts for CAP specifically, how much of the overall underperformance would you attribute to the providers strictly? And how can you fix those results for that without actually having ownership of providers? I mean how can you effectively drive your provider network to make the necessary changes to improve your results? Curious what the plan is there.

然後我真正的問題是，就 MA 和星級評級而言，具體而言，就 CAP 的改進工作而言，您會將整體表現不佳的情況歸咎於供應商有多少？在沒有真正擁有提供者所有權的情況下，如何解決這些結果？我的意思是，您如何有效地推動您的提供者網路做出必要的改變以改變您的結果？很好奇那裡有什麼計畫。

Thanks for the question, Michael. I'll have Pete start, and then I'll address your question on MA.

謝謝你的提問，麥可。我將讓皮特開始，然後我將回答您關於 MA 的問題。

Thanks for the question, Michael. Yes, to answer your question directly, we are beginning the migration to BioPlus starting January 1. And again, just to reiterate, we've been very, very focused on the last year with regard to implementation and integration of BioPlus as it relates to our specialty strategy. A lot of the focus this year has been building the infrastructure and the team, so that we have the appropriate scale and capacity to take on the Elevance Health volume. And we feel very good about that. As Gail noted in her prepared remarks, we are accelerating the time line in that regard, and we are moving forward with that for January 1. And again, this is all a part of our strategy in pharmacy, just to reiterate, and that is to in-source the strategic levers that matter. Specialty pharmacy is very critical to that as well as what we're doing in advanced home delivery. So again, excited about that. And yes, it is launching January 1.

謝謝你的提問，麥可。是的，為了直接回答您的問題，我們將從 1 月 1 日開始遷移到 BioPlus。再次重申，去年我們非常非常關注 BioPlus 的實施和集成，因為它涉及我們的專業策略。今年的重點是建立基礎設施和團隊，以便我們擁有適當的規模和能力來承擔 Elevance Health 的數量。我們對此感覺非常好。正如蓋爾在她準備好的演講中指出的那樣，我們正在加快這方面的時間表，我們正在推進 1 月 1 日的計劃。重申一下，這都是我們製藥戰略的一部分，那就是內源重要的策略槓桿。專業藥局對此以及我們在高級送貨上門所做的工作都非常重要。再次對此感到興奮。是的，它將於 1 月 1 日推出。

Yes. And to the second part of your question is we have delved in and really looked deeply at sort of what the drivers -- especially around the 3 contracts and sort of what the cut points were. I guess I would say there's a couple of things. One has been easier navigation for our members. So I would not say it's because of ownership or lack of ownership, but I will address sort of value-based care. Remember, this was measurement around year '22. We've made significant progress around moving a lot of our contracts to value-based care and embedding that into the way we do it. We've also worked closely with aggregators and have been building, quite frankly, the numbers in that. So we do feel that our strategies are intensely focused, and our health navigator will significantly help them.

是的。對於你問題的第二部分，我們已經深入研究並真正深入研究了驅動因素，特別是圍繞三份合約以及削減點。我想我會說有幾件事。其中之一是為我們的會員提供更輕鬆的導航。所以我不會說這是因為所有權或缺乏所有權，但我會解決基於價值的照護。請記住，這是 22 年左右的測量結果。我們在將許多合約轉向基於價值的護理並將其嵌入到我們的工作方式方面取得了重大進展。我們也與聚合商密切合作，坦白說，我們一直在增加這方面的數字。因此，我們確實認為我們的策略非常集中，我們的健康導航器將為他們提供很大幫助。

The other area, quite frankly, around the cut points that impacted us was appeals and grievances in some of our processes back in 2022. Those were very high-performing contracts in the past, and the cut points while still good performance for us, we're below the cut point. So I think those are very specific things that we can address.

坦白說，圍繞著影響我們的切點的另一個領域是2022 年我們的一些流程中的上訴和不滿。這些在過去是表現非常出色的合同，而切點雖然對我們來說仍然表現良好，但我們低於切點。所以我認為這些是我們可以解決的非常具體的問題。

I want to take a moment, though, I think, to talk about where we are in value-based care because I think it is important. It's a Medicare Advantage, an area that we've been intensely focused on. So I mentioned on the primary care side, we've been working with a number of aggregators, plus increasing the amount of value-based care, but more importantly, embedding in those contracts, quality and outcome measures as well as access and service. And I think those will have it -- continued, I guess, have an important impact on those.

不過，我想，我想花點時間談談我們在基於價值的護理方面所處的位置，因為我認為這很重要。這是醫療保險優勢，也是我們一直密切關注的領域。因此，我提到在初級保健方面，我們一直在與許多聚合商合作，增加基於價值的護理數量，但更重要的是，將品質和結果衡量標準以及獲取和服務納入這些合約中。我認為這些將會持續產生重要影響。

The other opportunity that we have is around specialty care, and we have been doing quite a bit of work on aggregation of specialty care and particularly carving in high complex areas on specialty medical spend. That's an area where we see significant opportunities and don't see that as a really mature part of the market today.

我們擁有的另一個機會是圍繞專科護理，我們在專科護理的聚合方面做了相當多的工作，特別是在高度複雜的領域進行專科醫療支出。我們在這個領域看到了巨大的機遇，但並不認為它是當今市場中真正成熟的部分。

For example, Carelon is launching in January in oncology, specialized care model with our affiliated health plans, and it's allowing us also to more broadly commercialize that opportunity. We also see opportunities in musculoskeletal, renal and more. And I think this is a really differentiated focus because as we think about where members are very focused on access is around specialty care, and I think we have a unique opportunity from both our innovation, our technology and the clinical expertise we offer to run that through Carelon with our health benefits, particularly in Medicare, but also across all of our lines of business. And that's going to be an important strength for us, and that's an area that I think in the specialty enablement will help our Medicare Advantage stars, but also help our patients get better access to that care. So that's -- we think it's a differentiator.

例如，Carelon 將於一月份推出腫瘤學專業護理模式以及我們附屬的健康計劃，這也使我們能夠更廣泛地將這一機會商業化。我們也看到了肌肉骨骼、腎臟等的機會。我認為這是一個真正與眾不同的重點，因為當我們考慮會員非常關注專科護理的獲取機會時，我認為我們從我們的創新、我們的技術和我們提供的臨床專業知識中獲得了獨特的機會來運行該服務透過 Carelon 提供我們的健康福利，特別是在醫療保險方面，而且還涵蓋我們所有的業務線。這將成為我們的重要優勢，我認為在專業支援方面，這將幫助我們的醫療保險優勢明星，同時也幫助我們的患者更好地獲得這種護理。所以我們認為這是一個差異化因素。

But overall, your question, I think we're very focused on the areas that drove some of the areas within those 3 contracts, and we feel we have a very good line of sight to what they were. And a lot of them were easier navigation for our members and making sure that it was a much more personalized experience than we've had in the past. And then again, ensuring that our supplemental benefits and over the counter are simpler and easier to use, and we shared a little bit of that. And we made those changes actually in our bids over the last couple of years. So thanks very much for the question, Michael.

但總的來說，你的問題，我認為我們非常關注推動這三份合約中某些領域發展的領域，而且我們覺得我們對它們的內容有很好的了解。其中許多都為我們的會員提供了更輕鬆的導航，並確保這是比我們過去更個人化的體驗。話又說回來，確保我們的補充福利和非處方藥更簡單、更容易使用，我們分享了一些內容。在過去的幾年裡，我們實際上在投標中做出了這些改變。非常感謝你提出這個問題，邁克爾。

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。

I'll add my congrats for 88 quarters for John as well. My question, can you speak to the strategy of how Carelon and Benefits segments aimed to really work together over time? I'm specifically interested in how you tie sort of the various companies within Carelon together and then also on that care delivery side as part of the answer.

我也將祝賀約翰 88 個季度。我的問題是，您能否談談 Carelon 和 Benefits 部門如何隨著時間的推移真正合作的策略？我特別感興趣的是如何將 Carelon 內的各個公司聯繫在一起，然後在護理服務方面也將其作為答案的一部分。

And then lastly, are there certain any capabilities -- certain capabilities that you think are missing or would be helpful for Elevance in terms of putting together that totality of strategy?

最後，是否有某些能力——您認為缺少的某些能力或在整合整體策略方面對 Elevance 有幫助的能力？

Yes. Thanks for that question, Josh. We'd love to share more about our strategy. I'm going to have Pete Haytaian talk about it. As you know, he leads that part of our business.

是的。謝謝你提出這個問題，喬許。我們很樂意分享更多有關我們策略的資訊。我將請皮特·海泰安（Pete Haytaian）談談這個問題。如您所知，他領導我們這部分業務。

Yes. No, thanks for the question. I really appreciate it. I think it is a good opportunity to talk about our strategy holistically. As Gail mentioned in her prepared remarks, we talk about whole health and integrated care and driving affordability. But I really want to tag off of what Gail just talked about because I really do believe it's what we're focused on and differentiating ourselves on, and that is looking at high cost, high spend areas at health care. We face off with our health plan partners. We identify those areas, specialty care as a tremendous opportunity and a real differentiator. Gail mentioned some areas that are critically important to us as we move forward, and this is across all lines of business, not one particular line of business. But when you think about high-spend areas like oncology, like MSK, like renal, we have a wonderful opportunity to manage the member holistically and take full risk on those members.

是的。不，謝謝你的提問。對此，我真的非常感激。我認為這是一個很好的機會來全面討論我們的策略。正如蓋爾在她準備好的演講中提到的，我們談論整體健康和綜合護理以及提高負擔能力。但我真的想談談蓋爾剛才談到的內容，因為我確實相信這是我們關注的重點並讓我們與眾不同，那就是專注於醫療保健領域的高成本、高支出領域。我們與我們的健康計劃合作夥伴面對面。我們將這些領域、專業護理視為巨大的機會和真正的差異化因素。蓋爾提到了一些在我們前進過程中對我們至關重要的領域，這涉及所有業務線，而不是某一特定業務線。但是，當您想到像腫瘤學、MSK 斯隆、腎臟病這樣的高支出領域時，我們有一個絕佳的機會來全面管理會員並為這些會員承擔全部風險。

Now importantly, that's -- it's a big part of our strategy in terms of assuming full risk on those categories, driving earnings through Carelon, our unregulated entity, and also focusing on areas and profit pools that are growing where we have a wonderful commercialization opportunity. And how this all plays together is we face off with Elevance Health. We identify these areas. We drive capitated full risk in many of these instances, and then we deploy those capabilities externally. This is really playing through in a nice way, and we're seeing that play through in terms of our growth trajectory.

現在重要的是，這是我們策略的一個重要組成部分，即承擔這些類別的全部風險，透過我們不受監管的實體Carelon 推動收益，並專注於我們擁有絕佳商業化機會的正在增長的領域和利潤池。而這一切如何共同發揮作用，就是我們與 Elevance Health 的對決。我們確定這些領域。在許多此類情況下，我們會推動資本全額風險，然後在外部部署這些功能。這確實以一種很好的方式發揮作用，我們正在看到它在我們的成長軌跡中發揮作用。

To just, again, reiterate what Gail said, in January of this year, we're going to be launching an oncology program at full risk. We are also looking at taking full risk on the seriously mentally ill in behavioral health where we're not only managing the behavioral health, but the physical health side. And this is all the type of thing that is playing through into our external pipeline, which we're seeing grow nicely.

再次重申蓋爾在今年 1 月所說的話，我們將冒著全部風險啟動腫瘤學計畫。我們也考慮在行為健康方面對嚴重精神疾病患者承擔全部風險，我們不僅管理行為健康，還管理身體健康。這就是我們外部管道中正在發揮作用的所有類型的事情，我們看到它成長良好。

So I really appreciate the question, Josh. I think -- oh yes, and by the way, you did ask questions around additional capabilities. I would say that M&A also is an important part of our strategy as we move forward. And when you think about these highly specialized areas of care, we're not naive to think that we have the capabilities internally to handle all of it. When you think about MSK, when you think about renal, even what we're doing around the seriously mentally ill, we will be looking to not only partnerships but acquisitions that can help us in that regard.

所以我真的很感激這個問題，喬許。我想——哦，是的，順便說一句，您確實提出了有關附加功能的問題。我想說，隨著我們前進，併購也是我們策略的重要組成部分。當你想到這些高度專業化的護理領域時，我們並不天真地認為我們內部有能力處理所有這些問題。當您想到 MSK 斯隆，當您想到腎臟疾病，甚至是我們針對嚴重精神疾病患者所做的事情時，我們不僅會尋求合作夥伴關係，還會尋求能夠在這方面為我們提供幫助的收購。

Thanks, Pete, and thanks for the question. And I think if I just summarize everything Pete said, we're really working in Carelon across kind of 4 major areas. Obviously, pharmacy with Carelon Rx and then three pillars inside of our Carelon services business, care delivery, our insights and our behavioral health. And all of those come together in all of Pete said. And we have a great opportunity to provide greater certainty and cost management to our owned health businesses, but externally commercialize that and seen a lot of momentum going into '24 on that, prove it on ourselves and then show the market the capabilities, particularly around the Blue system. So thanks again for the question, Josh, and this will be our last question.

謝謝皮特，也謝謝你的提問。我認為，如果我總結一下皮特所說的一切，我們實際上在卡倫的四個主要領域開展工作。顯然，藥房有 Carelon Rx，然後是我們 Carelon 服務業務的三大支柱：護理服務、我們的見解和我們的行為健康。所有這些都匯集在皮特所說的所有內容中。我們有一個很好的機會為我們擁有的健康業務提供更大的確定性和成本管理，但在外部將其商業化，並在24 世紀看到了很大的動力，向我們自己證明這一點，然後向市場展示我們的能力，特別是圍繞藍色系統。再次感謝喬希提出的問題，這將是我們的最後一個問題。

And for our final question, we'll go to the line of Justin Lake from Wolfe Research.

對於我們的最後一個問題，我們將求助於沃爾夫研究中心的賈斯汀·萊克（Justin Lake）。

Thanks for squeezing me in, and I'll ask there my thanks to John for everything over the years. Really appreciate it, bud. Along those lines, Gail, maybe you can give us a little color around the CFO search and what you expect Mark to bring to the organization. And then just curious if you have any early views on 2024 Medicare Advantage membership growth, both for Elevance and the market overall?

感謝您邀請我加入，我將向約翰多年來所做的一切表示感謝。真的很感激，夥計。沿著這些思路，蓋爾，也許你可以給我們一些關於財務長搜尋的信息，以及你期望馬克為組織帶來什麼。然後只是想知道您對 2024 年 Medicare Advantage 會員增長（無論是對於 Elevance 還是整個市場）是否有任何早期看法？

Well, thanks for the question, Justin. And first of all, I will also offer my appreciation to John for his guidance and his counsel and honestly, our partnership over the time that I have been CEO. John and Mark has been here now for about a month. We're excited about having Mark Kaye join us. As you know, he was the CFO of Moody's. Mark brings -- he's an actuary by training, brings an incredible insight to our business. He and John have been working hand-in-hand on the transition, and John will be continuing as an adviser to me through the first quarter, as you heard in his opening remarks.

好吧，謝謝你的提問，賈斯汀。首先，我還要感謝約翰的指導和建議，老實說，感謝我擔任執行長期間我們的合作關係。約翰和馬克已經在這裡待了大約一個月了。我們很高興馬克·凱加入我們。如你所知，他是穆迪的財務長。馬克是一名受過訓練的精算師，他為我們的業務帶來了令人難以置信的洞察力。他和約翰一直在攜手致力於過渡，約翰將在第一季繼續擔任我的顧問，正如您在他的開場白中聽到的那樣。

I think we're at an incredible time in our business. We have great growth. We have a very diversified business, and I'm excited about Mark joining our team and excited about the whole team. And thank John, we will all miss him, but he deserves time with his family and an opportunity to do things and work on his golf game, as you know, Justin. So from that -- and I'm going to ask Felicia to comment a little bit about Medicare Advantage. As you know, AEP has just started. So it's really very early in days, so maybe Felicia can share a few comments about her thoughts on what we expect.

我認為我們的業務正處於一個難以置信的時期。我們有很大的成長。我們的業務非常多元化，我很高興馬克加入我們的團隊，也為整個團隊感到興奮。感謝約翰，我們都會想念他，但他應該有時間與家人在一起，並有機會做一些事情並致力於他的高爾夫比賽，正如你所知，賈斯汀。因此，我將請 Felicia 對 Medicare Advantage 發表一些評論。如您所知，AEP 才剛開始。所以現在還為時過早，也許 Felicia 可以分享一些她對我們期望的想法的評論。

Justin, thank you. We are actually very excited about AEP. As Gail referenced, we are only 3 days in, but we're actually very pleased with the response we have from our brokers regarding the competitive positioning of our benefits, and we believe that we will be able to grow membership above the market in excess of some strategic decisions that we made around targeted market exit. So I want to point out that we made the very intentional and discrete decision to leave some markets that have been underperforming for us for some period of time. Strategically, it was the right thing to do so that we can make sure we are focused on those markets where we have an opportunity to be very successful, deliver strong benefits for the members that we're privileged to serve.

賈斯汀，謝謝你。事實上，我們對 AEP 感到非常興奮。正如蓋爾所提到的，我們只有 3 天的時間，但我們實際上對經紀人關於我們福利的競爭定位的反應感到非常滿意，並且我們相信我們將能夠以超出市場的水平增加會員數量我們圍繞目標市場退出做出的一些策略決策。因此，我想指出的是，我們做出了非常有意和謹慎的決定，離開了一些在一段時間內對我們來說表現不佳的市場。從策略上講，這是正確的做法，這樣我們就可以確保我們專注於那些我們有機會取得非常成功的市場，為我們有幸服務的會員帶來豐厚的利益。

So as we think about where we are today, we feel good about our positioning. As I said, we're very early in terms of where we are. But we believe as we head into 2024, we're going to be able to deliver solid growth. As I said, I believe that will be above the overall market rate based on where we're positioned. So thank you very much for the question.

因此，當我們思考我們今天所處的位置時，我們對自己的定位感到滿意。正如我所說，就目前的情況而言，我們還處於早期階段。但我們相信，進入 2024 年，我們將能夠實現穩健成長。正如我所說，我相信根據我們的定位，這將高於整體市場利率。非常感謝你提出這個問題。

Well, thank you, Felicia. And thank you to all of you on the line for your continued support and for joining us. 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 clients, consumers and the communities we serve, advancing our strategy of becoming a lifetime trusted health partner while delivering on our commitments to all of our stakeholders. Thank you for your interest in Elevance Health, and have a great rest of the week.

嗯，謝謝你，費莉西亞。感謝線上所有人的持續支持和加入我們。透過堅定地專注於整體健康以及我們多樣化且不斷擴展的產品和解決方案，我們將繼續滿足客戶、消費者和我們所服務的社區的需求，推進我們成為終身值得信賴的健康合作夥伴的策略，同時履行我們的承諾致我們所有的利害關係人。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 November 17, 2023. You may access the replay system at any time by dialing (866) 405-7293, and international participants can dial (203) 369-0605. This concludes our conference for today. Thank you for your participation and for using Verizon conferencing. You may now disconnect.

女士們、先生們，本次會議的錄音將於今天上午11:00 後至2023 年11 月17 日期間進行重播。您可以隨時撥打(866) 405-7293 訪問重播系統，國際與會者可以撥打( 203）369-0605。我們今天的會議到此結束。感謝您的參與和使用 Verizon 會議。您現在可以斷開連線。