Elevance Health Inc (ELV) 2024 Q1 法說會逐字稿

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

女士們、先生們，感謝你們的支持，並歡迎參加 Elevance Health 第一季財報電話會議。 （操作員指示）提醒一下，今天的會議正在錄製中。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 First Quarter 2024 Earning 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; Mark Kaye, our CFO; and Pete Haytaian, President of Carelon; Morgan Kendrick, President of our Commercial 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, recent progress against our strategic initiatives and our updated outlook for the year. Mark 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 2024 年第一季財報電話會議。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)；馬克‧凱 (Mark Kaye)，我們的財務長；和 Carelon 總裁 Pete Haytaian； Morgan Kendrick，我們的商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、我們策略性舉措的最新進展以及我們今年的最新展望。然後馬克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。

Thank you, Steve, and good morning, everyone. We appreciate you joining today's earnings call. I'm pleased to report that Elevance Health delivered first quarter GAAP earnings per share of $9.59 and adjusted diluted earnings per share of $10.64, reflecting growth of 12.5%. These results reflect disciplined execution of our strategic initiatives during a dynamic time for our industry. Given the solid start to the year, we have increased our guidance for adjusted earnings per share by $0.10 to be greater than $37.20. We are making significant progress on our enterprise strategy in 2024 to accelerate capabilities and services, invest in high-growth opportunities and optimize our Health Benefits business.

謝謝你，史蒂夫，大家早安。我們感謝您參加今天的財報電話會議。我很高興地報告，Elevance Health 第一季 GAAP 每股收益為 9.59 美元，調整後攤薄每股收益為 10.64 美元，成長 12.5%。這些結果反映了我們在業界充滿活力的時期嚴格執行策略性舉措的情況。鑑於今年開局良好，我們將調整後每股收益指引上調了 0.10 美元，達到 37.20 美元以上。我們正在 2024 年的企業策略方面取得重大進展，以加速能力和服務、投資高成長機會並優化我們的健康福利業務。

On Monday, we announced the next step in our journey to expand access to high-quality patient-centered value-based care in our local market. After years of experience working closely with care providers to advance value-based care, we are confident that our hyper local approach, which aligns the right incentives, real-time patient information and clinical decision support tools, delivers better health outcomes, improve consumer and provider experience and greater affordability.

週一，我們宣布了下一步計劃，旨在擴大本地市場獲得以患者為中心的高品質護理的機會。經過多年與護理提供者密切合作推進基於價值的護理的經驗，我們相信，我們的超本地化方法結合了正確的激勵措施、實時患者資訊和臨床決策支援工具，能夠提供更好的健康結果，改善消費者和患者的健康狀況。

Accordingly, we entered into an agreement to form a strategic partnership with Clayton, Dubilier & Rice to build a payer-agnostic advanced primary care and physician enablement business, serving consumers across commercial, Medicare and Medicaid health plans, consistent with the diversity of our own medical membership. Upon formation, the combined company will serve nearly 1 million consumers. The new venture will bring together the strength of 3 innovative care provider entities, including certain care delivery and enablement assets of Carelon Health.

因此，我們達成協議，與Clayton, Dubilier & Rice 建立策略合作夥伴關係，建立一個與付款人無關的先進初級保健和醫生支持業務，為商業、醫療保險和醫療補助健康計劃的消費者提供服務，與我們自己的多樣性保持一致醫療會員資格。合併後的公司成立後將為近100萬消費者提供服務。新合資企業將匯集 3 個創新護理提供者實體的實力，包括 Carelon Health 的某些護理服務和支援資產。

Importantly, we have worked closely with these companies and their management teams and are confident in the value they deliver for our Medicare, Medicaid and commercial health plan members and employers. We're excited to collaborate with CD&R and a broad range of care provider partners to accelerate innovation, enhance health care experiences and improve health outcomes for consumers. The collaborative development of the business will advance our enterprise strategy by accelerating the provision of value-based care for our members and consumers more broadly, with our Carelon businesses providing capabilities to integrate and personalize the care delivered. In time, Elevance Health will have full ownership of what we expect will be a leading platform for value-based care delivery and physician enablement at scale across commercial group, ACA, Medicare and Medicaid health plans, advancing our role as a lifetime trusted health partner for the consumers we are privileged to serve.

重要的是，我們與這些公司及其管理團隊密切合作，並對他們為我們的醫療保險、醫療補助和商業健康計劃成員和雇主提供的價值充滿信心。我們很高興與 CD&R 和廣泛的醫療服務提供者合作夥伴合作，以加速創新、增強醫療保健體驗並改善消費者的健康結果。該業務的協作發展將加速為我們的會員和更廣泛的消費者提供基於價值的護理，同時我們的 Carelon 業務提供整合和個性化所提供護理的能力，從而推進我們的企業策略。隨著時間的推移，Elevance Health 將完全擁有我們所期望的領先平台，該平台將在商業集團、ACA、Medicare 和Medicaid 健康計劃中大規模提供基於價值的護理服務和醫生支持，從而提升我們作為終身值得信賴的健康合作夥伴的角色對於我們有幸為消費者服務的消費者。

In the first quarter, we made tangible progress on our strategic initiatives, notably in Carelon, where we continue to scale our flywheel for enterprise growth. CarelonRx closed its acquisition of Paragon Healthcare, a leading provider of infusion services. We are looking forward to expanding its geographic reach and therapeutic coverage to serve more consumers and Elevance Health members for years to come. As CarelonRx furthers our enterprise commitment to address the whole health needs of our members, notably those with chronic and complex conditions, we are accelerating the build-out of our own specialty pharmacy.

第一季度，我們的策略性舉措取得了切實進展，特別是在卡倫，我們繼續擴大飛輪以促進企業成長。 CarelonRx 完成了對領先輸液服務提供商 Paragon Healthcare 的收購。我們期待在未來幾年擴大其地理覆蓋範圍和治療覆蓋範圍，為更多消費者和 Elevance Health 會員提供服務。隨著 CarelonRx 進一步履行我們的企業承諾，滿足會員的整體健康需求，特別是那些患有慢性和複雜疾病的會員，我們正在加速建立我們自己的專業藥房。

For example, we recently entered into an agreement to acquire Kroger Specialty Pharmacy business, the sixth largest specialty pharmacy in the country. The acquisition will bolster the growth of our existing pharmacy and infusion businesses, while increasing CarelonRx' access to limited distribution drugs. Carelon Services is also up to a strong start this year as we implemented and were awarded multiple new contracts, a testament to the value Carelon Services provides. For instance, Carelon Behavioral Health was selected by the Maryland Department of Health to provide behavioral health management services to more than 1.7 million Medicaid members starting in 2025.

例如，我們最近簽訂了收購克羅格特種藥房業務的協議，該業務是全國第六大特種藥房。此次收購將促進我們現有的製藥和輸液業務的成長，同時增加 CarelonRx 獲得有限分銷藥物的機會。 Carelon Services 今年也取得了良好的開局，我們實施並獲得了多份新合同，這證明了 Carelon Services 提供的價值。例如，馬裡蘭州衛生部選擇 Carelon Behavioral Health 從 2025 年開始為超過 170 萬名醫療補助會員提供行為健康管理服務。

And in California, our team will partner with the public school system to expand behavioral health management services for students later this year. This initiative represents a major step forward in addressing the critical need for mental health support in educational settings and demonstrates our commitment to improving the health and well-being of our communities. Momentum with external clients is building and underscores the value Carelon Services is creating for health plan customers to better consumer experiences and improved affordability. Our Health Benefits business is similarly off to a solid start. Commercial margin continues to recover from pandemic era lows, and we are enjoying momentum in membership growth, notably in our individual ACA plans and among large self-insured employers.

在加州，我們的團隊將與公立學校系統合作，在今年稍後為學生擴大行為健康管理服務。這項措施代表著在滿足教育環境中心理健康支持的迫切需求方面向前邁出了重要一步，並表明了我們對改善社區健康和福祉的承諾。與外部客戶的合作勢頭正在增強，並強調了 Carelon Services 為健康計劃客戶創造的價值，以改善消費者體驗並提高負擔能力。我們的健康福利業務同樣也有了一個好的開始。商業利潤率繼續從疫情時代的低點恢復，我們正享受會員成長的勢頭，特別是在我們的個人 ACA 計劃和大型自保雇主中。

Existing clients are demonstrating their confidence in our offerings by consolidating their business with us after years of offering our solutions side-by-side with those of our competitors. In our Medicaid business, we were pleased to be selected in Florida and Virginia to serve beneficiaries across traditional and complex populations statewide, including those with serious mental illness in Florida, and [sole source] foster care in Virginia. These awards and their pull-through opportunities for Carelon Services underscore the distinct value Elevance Health delivers. In the first quarter, our Medicaid business performed in line with our expectations. We estimate that nearly 90% of our members have had their eligibility redetermined.

經過多年與競爭對手並肩提供我們的解決方案後，現有客戶透過鞏固與我們的業務來展示他們對我們產品的信心。在我們的醫療補助業務中，我們很高興被選中在佛羅裡達州和弗吉尼亞州為全州傳統和複雜人群的受益人提供服務，包括佛羅裡達州患有嚴重精神疾病的受益人，以及弗吉尼亞州的[唯一來源]寄養服務。這些獎項及其為 Carelon Services 帶來的機會強調了 Elevance Health 所提供的獨特價值。第一季度，我們的醫療補助業務表現符合我們的預期。我們估計近 90% 的會員的資格已被重新確定。

Further, our team continues to work tirelessly to maximize access to care for Medicaid members subject to eligibility redetermination, helping them to understand their options in the face of ongoing logistical and operational challenges. Holistically, we are proud of the work we have done in contacting more than 4.5 million Medicaid beneficiaries through our omnichannel approach. Nonetheless, a majority of members who have lost coverage for administrative reasons have not yet returned. We're seeing a gradual increase in Medicaid reenrollment and anticipate continued upticks in rejoiner rates as more Medicaid beneficiaries recognize their need to reenroll, aligned with the trends that we have observed in recent months.

此外，我們的團隊將繼續不懈地努力，最大限度地為需要重新確定資格的醫療補助成員提供護理服務，幫助他們在面臨持續的後勤和營運挑戰時了解自己的選擇。總體而言，我們為透過全通路方法聯繫超過 450 萬名醫療補助受益人所做的工作感到自豪。儘管如此，大多數因行政原因失去保險的會員尚未返回。我們看到醫療補助重新註冊人數逐漸增加，並且隨著更多醫療補助受益人認識到他們需要重新註冊，預計重新加入率將持續上升，這與我們近幾個月觀察到的趨勢一致。

Turning to Medicare. We were pleased to announce last month that CMS updated the Star scores for 4 of our contracts, which increased the percentage of our members in 4-star or higher-rated contracts to nearly 50%, up from 34%. While this will improve our Star quality bonus revenue in 2025, our goal is to have our Star quality ratings at the high end of all plans in our local markets, which will be a multiyear journey. Funding for Medicare in 2025 will be challenging for the entire industry. We are disappointed that CMS has decided to cut Medicare Advantage rates for the second consecutive year, which will negatively impact seniors, notably, those at the lower end of the income spectrum who rely on the program for their health and well-being.

轉向醫療保險。上個月我們很高興地宣布，CMS 更新了 4 份合約的星級評分，這將我們的會員在 4 星級或更高級別合約中的比例從 34% 增加到近 50%。雖然這將提高我們 2025 年的星級品質獎金收入，但我們的目標是讓我們的星級品質評級處於本地市場所有計劃的高端，這將是一個多年的旅程。 2025 年醫療保險資金對整個產業來說將是一個挑戰。我們對 CMS 決定連續第二年降低 Medicare Advantage 費率感到失望，這將對老年人產生負面影響，尤其是那些依賴該計劃來維持健康和福祉的收入較低端的老年人。

While we remain committed to serving seniors through plan offerings that focus on their unique needs, we will also continue to demonstrate discipline in our Medicare Advantage bids, seeking to balance growth and margin while continuing to deliver exceptional value for seniors. Across the enterprise, our focus on delivering whole health for the consumers we are privileged to serve remains steadfast. We recently released our 2023 Advancing Health Together Progress Report, which underscores the strides we are making through value-based care. The report showcases examples of our success, facilitated by the unique partnerships that we've created with care providers across the health care ecosystem. I'd like to highlight a particular achievement that underscores our innovative approach to improving quality and value in health care.

雖然我們仍然致力於透過專注於老年人獨特需求的計劃產品來服務他們，但我們也將繼續在我們的 Medicare Advantage 投標中表現出紀律，尋求平衡增長和利潤，同時繼續為老年人提供卓越的價值。在整個企業中，我們始終堅定不移地致力於為我們有幸服務的消費者提供整體健康。我們最近發布了 2023 年共同推進健康進展報告，該報告強調了我們透過基於價值的照護所取得的進步。該報告展示了我們成功的例子，這得益於我們與整個醫療保健生態系統的醫療服務提供者建立的獨特合作夥伴關係。我想強調一項特別的成就，它強調了我們提高醫療保健品質和價值的創新方法。

Recently, Elevance Health was honored by the NCQA with its innovation award featuring quality accelerators in health care for leading-edge strategies that improve quality and value, specifically for our obstetric specialty provider enablement program. The impact of these value-based partnerships and clinical interventions has led to consistent improvements in health outcomes and costs, including reducing preterm birth rates by 12% and low birthweight babies by 20%, all while improving access to timely prenatal care and postpartum follow-up. For those interested in learning more about these transformative initiatives and other examples of our progress, I encourage you to visit our Advancing Health Together website.

最近，Elevance Health 榮獲 NCQA 創新獎，該獎項旨在表彰醫療保健領域的品質加速器，以提高品質和價值的領先策略，特別是針對我們的產科專業提供者支援計劃。這些基於價值的夥伴關係和臨床幹預措施的影響導致健康結果和成本持續改善，包括將早產率降低 12%，將低出生體重嬰兒降低 20%，同時改善及時產前護理和產後追蹤的機會。 。對於有興趣了解更多有關這些變革性舉措和我們進展的其他範例的人，我鼓勵您訪問我們的「共同推進健康」網站。

In closing, I want to extend my deep gratitude to our 100,000 associates who embody our purpose of improving the health of humanity through their tireless commitment. It's also heartening to see their efforts recognized externally. We were honored to be named to Fortune Magazine's 100 Best Companies to Work For list for the fourth year in a row. We were also included in their world's most admired companies and America's most innovative companies list.

最後，我要向我們的 10 萬名員工表示深深的謝意，他們透過不懈的努力體現了我們改善人類健康的宗旨。看到他們的努力得到外部認可也令人振奮。我們很榮幸連續第四年入選《財星》雜誌「100 家最佳雇主」名單。我們也被列入全球最受尊敬的公司和美國最具創新力的公司名單。

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

因此，我想將電話轉給我們的財務長馬克凱 (Mark Kaye)，以提供有關我們的營運業績和前景的更多資訊。標記？

Thank you, Gail. As you heard earlier, our first quarter results reflect solid performance under a dynamic operating environment. We ended March with 46.2 million members, reflecting Medicaid attrition partially offset by ongoing momentum in our commercial business. During the quarter, we added nearly 400,000 commercial fee-based members, driven by strong retention and a successful national account selling season and over 200,000 individual ACA members given our attractive product positioning and coverage transitions away from Medicaid. Medicare Advantage membership declined slightly, as expected, given select market exits and the collective actions we continue to take to establish a strong foundation for profitable and sustainable growth over the long term.

謝謝你，蓋爾。正如您之前所聽到的，我們第一季的業績反映了動態營運環境下的穩健表現。截至 3 月份，我們擁有 4,620 萬會員，這反映出醫療補助的流失被我們商業業務的持續成長勢頭所部分抵消。在本季度，我們增加了近40 萬名商業收費會員，這得益於強勁的保留率和成功的全國帳戶銷售季，以及超過200,000 名個人ACA 會員，因為我們具有吸引力的產品定位和覆蓋範圍從醫療補助轉向。鑑於部分市場退出以及我們繼續採取的集體行動，為長期盈利和可持續增長奠定堅實的基礎，Medicare Advantage 會員數量如預期略有下降。

Operating revenue for the quarter was $42.3 billion, in line with our expectations. The consolidated benefit expense ratio of 85.6% improved 20 basis points year-over-year due to disciplined premium rate adjustments to reflect medical cost trends and the ongoing recovery of commercial margins from pandemic era lows. The adjusted operating expense ratio was 11.4%, consistent with the first quarter of 2023, indicative of our commitment to disciplined expense management and investment prioritization. Solid performance and growth in operating gains for both our Health Benefits and Carelon segments of $138 million and $72 million, respectively, led to growth in consolidated adjusted operating gains of over 7%.

該季度營業收入為 423 億美元，符合我們的預期。由於為反映醫療成本趨勢而進行的嚴格的保費率調整以及商業利潤率從大流行時代的低點持續復甦，85.6%的綜合福利費用率同比提高了20個基點。調整後的營運費用率為 11.4%，與 2023 年第一季一致，顯示我們致力於嚴格的費用管理和投資優先順序。我們的健康福利部門和 Carelon 部門的穩健表現和營運收益成長分別為 1.38 億美元和 7,200 萬美元，導致綜合調整後營運收益成長超過 7%。

Carelon Services had a particularly strong start to the year, with revenue and operating earnings growth driven by risk-based service line expansions and effective cost management, especially in our Carelon Insights and Carelon Behavioral Health businesses, further accelerating our enterprise flywheel or growth. Operating cash flow in the first quarter was $2 billion or approximately 0.9x net income. With respect to the balance sheet, we ended the quarter with a debt-to-capital ratio of 39.4%, in line with our target range preserving ongoing capital allocation flexibility. We repurchased 1.1 million shares of common stock for approximately $566 million during the quarter, underscoring our confidence in the intrinsic value of our shares and the long-term value proposition.

Carelon Services 今年開局尤為強勁，基於風險的服務線擴張和有效的成本管理推動了收入和營業利潤的增長，特別是在我們的Carelon Insights 和Carelon Behavioural Health 業務中，進一步加速了我們的企業飛輪或增長。第一季營運現金流為 20 億美元，約為淨利的 0.9 倍。就資產負債表而言，本季結束時，我們的債務與資本比率為 39.4%，符合我們維持持續資本配置彈性的目標範圍。本季我們以約 5.66 億美元的價格回購了 110 萬股普通股，突顯了我們對股票內在價值和長期價值主張的信心。

We maintained our prudent and consistent approach to reserving. Days in claims payable stood at 49 days as of March 31, up 3 days from the prior year quarter. This increase was largely driven by higher reserves associated with slower claims receipts due to an industry-wide disruption that impacted a major claims clearinghouse. As a reminder, we expect our days in claims payable to be in the low 40s range long term. I'd also like to take a moment to provide additional color on our strategic partnership with Clayton, Dubilier & Rice. We are excited to partner with CD&R to scale what will be a best-in-class payer-agnostic advanced care delivery and enablement platform catering to the unique needs of consumers regardless of their form of coverage.

我們保持審慎一致的預訂方式。截至 3 月 31 日，應付索賠天數為 49 天，比去年同期增加 3 天。這一增長主要是由於與主要索賠清算機構受到影響的全行業混亂導致索賠收款速度放緩導致準備金增加。提醒一下，我們預計應付索賠天數將在 40 多歲左右。我還想花點時間進一步介紹我們與 Clayton, Dubilier & Rice 的策略夥伴關係。我們很高興與 CD&R 合作，擴展一流的與付款人無關的高級護理服務和支援平台，以滿足消費者的獨特需求，無論其保險形式如何。

This collaboration will allow us to advance our local oriented approach to care delivery based on the unique needs of the communities, consumers and employers we are privileged to serve. At the onset, Elevance Health will hold a significant minority position in the combined business with a clear path to first majority and then full ownership in approximately 5 years. The formation of the strategic partnership includes our capital contribution in the form of cash and our equity interest in certain care delivery and enablement assets of Carelon Health as well as the conveyance from CD&R of our apree health and Millennium Physician Group and is subject to customary regulatory approvals.

此次合作將使我們能夠根據我們有幸服務的社區、消費者和雇主的獨特需求，推動以本地為導向的護理服務方法。一開始，Elevance Health 將在合併後的業務中佔據重要的少數地位，並有明確的途徑獲得第一多數股權，然後在大約 5 年內獲得完全所有權。策略夥伴關係的形成包括我們以現金形式出資，以及我們在 Carelon Health 某些護理服務和支持資產中的股權，以及我們的 apree health 和 Millennium Physician Group 的 CD&R 轉讓，並受到慣例監管批准。

Overall, we are pleased with our first quarter performance and a solid start to the year, momentum in our Health Benefits and Carelon businesses. And the balance and resilience of our enterprise underscores our confidence in delivering another year of growth in adjusted diluted earnings per share consistent with our long-term compound annual growth rate of at least 12%. As we look forward to the rest of 2024, our focus will remain on successfully executing our strategy as we accelerate capabilities and services, invest in high-growth opportunities and optimize our health benefits business.

總體而言，我們對第一季度的業績以及今年的良好開局以及健康福利和 Carelon 業務的勢頭感到滿意。我們企業的平衡性和韌性凸顯了我們有信心實現調整後稀釋每股收益再增長一年，與我們至少 12% 的長期複合年增長率保持一致。展望 2024 年剩餘時間，我們的重點將仍然是成功執行我們的策略，加速能力和服務、投資高成長機會並優化我們的健康福利業務。

And with that, operator, please open the call for questions.

那麼，接線員，請打開電話提問。

(Operator Instructions) For our first question, we'll go to the line of Lance Wilkes from Bernstein.

（操作員說明）對於我們的第一個問題，我們將前往 Bernstein 的 Lance Wilkes 線路。

Let me ask a little bit about the value-based care strategy and the execution, that's obviously a really big step forward. Could you talk a little bit about kind of the vision and scope of this? Is this going to be more focused on enablement? Or in particular markets, is practice ownership going to be important? And then maybe if you can kind of color in the picture a little bit as far as leadership, names, which Carelon assets are going to be contributed. And near term, do you see -- which areas of leverage across the membership base of Elevance do you see this being able to penetrate most effectively?

讓我問一下基於價值的照護策略和執行情況，這顯然是向前邁出的一大步。您能談談這個專案的願景和範圍嗎？這是否會更重視賦能？或者在特定市場中，實踐所有權是否重要？然後，也許你可以在領導、名字方面對圖片進行一些著色，卡雷隆的資產將被貢獻。近期，您認為 Elevance 能夠最有效地滲透到 Elevance 會員基礎的哪些領域？

Well, great. Thanks so much for the question, Lance. First, as I shared on in my opening comments, we're very excited about this partnership with CD&R because it is very much the next step in our journey to bring value-based care to more consumers, specifically about partnering closely with care providers and we see it as absolutely consistent, driving greater risk adoption and advancing our specialty enablement strategy as well. So it's very much a first step there. And as you said in your question, this aligns very closely with our strategy and our broad partnership focus to work directly with care providers in our local markets. And our goal again remains to increase more downside risk sharing in our value-based arrangements. I think, to take a step back, what makes this approach unique is that we're enabling value-based care across all lines of business.

嗯，太好了。非常感謝你的提問，蘭斯。首先，正如我在開場白中所分享的那樣，我們對與CD&R 的合作感到非常興奮，因為這在很大程度上是我們為更多消費者帶來基於價值的護理的下一步，特別是與護理提供者和護理人員密切合作。所以這只是第一步。正如您在問題中所說，這與我們的策略以及我們廣泛的合作夥伴關係重點密切相關，即直接與當地市場的護理提供者合作。我們的目標仍然是在我們基於價值的安排中增加更多的下行風險分擔。我認為，退一步來說，這種方法的獨特之處在於我們正在所有業務領域中實現基於價值的照護。

So as I shared, the combined company is going to be payer agnostic, and it's focused on enabling advanced primary care locally. And from the get-go, it's going to serve nearly 1 million consumers, and that's going to be across our commercial, Medicare and Medicaid health plans upon formation. Another thing I think is important is that it provides the opportunity to pull through Carelon Services to support those patients and accelerate that specialty enablement for complex and chronic patients. We have been working with these management teams and these assets for some time, and feel very confident about the alignment of our goals to serve as a lifetime trusted health partner. The goal gets back again to focusing on whole health, the needs of consumers driving greater affordability and fundamentally a differentiated consumer experience.

正如我所分享的，合併後的公司將與付款人無關，並專注於在當地提供先進的初級保健服務。從一開始，它將為近 100 萬消費者提供服務，這將貫穿我們的商業、醫療保險和醫療補助健康計劃。我認為另一件重要的事情是，它提供了透過 Carelon Services 來支持這些患者並加速對複雜和慢性患者的專業支援的機會。我們已經與這些管理團隊和這些資產合作了一段時間，並且對我們成為終身值得信賴的健康合作夥伴的目標非常有信心。我們的目標再次回到關注整體健康、消費者的需求推動更高的負擔能力以及從根本上提供差異化的消費者體驗。

A few things about the partnership, too, and, again, what makes it different for patients? They're going to have access to integrated teams. We're looking at personalized navigation, expanded digital assets and specialized services. The primary care model is going to be built to be very distinctive, including community practices, purpose-built clinics, high-risk clinics and digitally enabled care model. So you can see it's a fairly comprehensive approach. And the last thing I'd say is that employers in market have not historically had access to a lot of these capabilities.

關於這種夥伴關係還有一些事情，以及，是什麼讓這種夥伴關係對病人來說有所不同？他們將能夠接觸到整合的團隊。我們正在考慮個人化導航、擴展的數位資產和專業服務。初級保健模式將建立得非常獨特，包括社區實踐、專門建造的診所、高風險診所和數位化護理模式。所以你可以看到這是一個相當全面的方法。我要說的最後一件事是，市場上的雇主歷來無法獲得很多這些功能。

And we have seen through the work that we're already doing that this dedicated primary care capacity that integrates the clinical and benefits navigation with their specific health and wellness strategies is truly differentiating. So again, this is being purpose built to work across all of the aspects of Medicare, Medicare, commercial, not just a single business. So very much excited. We see this as an opportunity to accelerate innovation in the space and improve health care outcomes and consumer experiences. So thanks very much for the question.

透過我們已經進行的工作，我們看到這種將臨床和福利導航與特定健康和保健策略相結合的專門初級保健能力真正具有差異化。再說一次，這是專門為醫療保險、醫療保險、商業的所有方面而構建的，而不僅僅是單一業務。非常興奮。我們認為這是一個加速該領域創新、改善醫療保健成果和消費者體驗的機會。非常感謝您提出的問題。

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

接下來，我們將前往 A.J.瑞銀的米。

I appreciate Mark's comments about the buildup and a little bit on days in claims payable, but just maybe to flush out a little bit more on the impact of the Change cyberattack on results. Do you have a sense as to what percentage of your claims that you normally see in the first quarter may still be out there? Do you feel like you've got a good handle on that? And anything when you address that in terms of your normal IBNR and maybe you've got a significantly higher level of IBNR because you're allowing for the Change and if you can break out what you're actually seeing a little bit on cost trends versus needing to sort of provision for the unknowns of the Change cyberattack.

我很欣賞馬克對累積索賠以及應付索賠天數的評論，但也許只是為了更多地闡述變革網路攻擊對結果的影響。您是否知道您通常在第一季看到的索賠百分比可能仍然存在？你覺得你能很好地處理這件事嗎？當你用正常的 IBNR 來解決這個問題時，也許你的 IBNR 水平明顯更高，因為你考慮到了變化，並且如果你能在成本趨勢上打破你實際看到的一點與需要為變革網絡攻擊的未知情況做好準備相比。

Thanks for the question, A.J. Let me maybe provide some broad-based comments and then I'll turn it over to Mark to provide a little more specificity on your questions.

謝謝你的提問，A.J.也許讓我提供一些廣泛的評論，然後我會將其轉交給馬克，以針對您的問題提供更具體的資訊。

I want to say, first and foremost, I'm really proud of our teams on how they responded to this issue that occurred with Change quickly and effectively, first, to protect our members and their data and also help our care providers maintain their operations and cash flow. Importantly, I think it's important to note that from a perspective, we were not as significantly impacted by this, and we are back to normal operations in terms of claims flow. Importantly, another thing that's really important to understand is our prior authorization, provider payments and pharmacy claims were not materially impacted as well because they don't go through Change. We don't use Change significantly for those.

我想說，首先也是最重要的是，我為我們的團隊感到自豪，他們如何快速有效地應對變革中發生的這個問題，首先，保護我們的會員及其數據，並幫助我們的護理提供者維持他們的營運和現金流。重要的是，我認為值得注意的是，從一個角度來看，我們並沒有受到如此重大的影響，而且我們在索賠流程方面已恢復正常運作。重要的是，另一件真正需要理解的事情是我們的事先授權、提供者付款和藥房索賠也沒有受到重大影響，因為它們沒有經過變更。對於這些，我們不會大量使用 Change。

So with that, I'll turn it over to Mark to provide a little more comments. But I think framing it overall, we feel that our teams acted quite quickly and really proud of our ability to work in the ecosystem to help support them.

因此，我將把它交給馬克來提供更多評論。但我認為總體而言，我們認為我們的團隊行動相當迅速，並且對我們在生態系統中工作以幫助支持他們的能力感到非常自豪。

As you just heard from Gail, we acted quite responsibly to sever our network connections to Change Healthcare and to protect the data of both our members and providers. While we initially observed a 15% to 20% reduction in the daily volume of electronic data receipts from providers, most of which are claims related. In recent weeks, our extensive efforts have led to a significant catch-up in outstanding claim volumes. And for the quarter, we are effectively caught up on claims receipts and are now working to complete all necessary claims adjudication and processing activities.

正如您剛剛從蓋爾那裡聽到的那樣，我們非常負責任地切斷了與 Change Healthcare 的網路連接，並保護了我們的會員和提供者的資料。雖然我們最初觀察到來自提供者的每日電子資料接收量減少了 15% 到 20%，其中大部分與索賠相關。最近幾週，我們的廣泛努力導致未決索賠數量大幅增加。在本季度，我們有效地處理了索賠收據，目前正在努力完成所有必要的索賠裁決和處理活動。

As such, it's part of the normal reserving practices, we've reflected the appropriate impact of the industry-wide disruption related to Change Healthcare in the reserves we reported for our first quarter financials and that ensures both consistency with historical practice and prudence. And then to your specific question, the impact here was to increase our sequential days in claims payable quarterly result by approximately 1.7 days.

因此，這是正常準備金做法的一部分，我們在第一季財務報告中報告的準備金中反映了與 Change Healthcare 相關的全行業中斷的適當影響，並確保與歷史實踐和審慎性的一致性。然後針對您的特定問題，這裡的影響是我們季度應付索賠結果的連續天數增加了大約 1.7 天。

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 wanted to get back to the partnership with CD&R. And specifically, what alternatives did you evaluate and consider before coming to this arrangement? I think in the past, you were stressing more, and I've heard it today as well that focus on specialty care. So how does that fit in and sort of get bolted on top of this? And maybe where does this fit into your longer-term national approach? And then how important was it that you could serve multiple memberships not just Medicare Advantage.

我想恢復與 CD&R 的合作關係。具體來說，在做出這種安排之前，您評估並考慮了哪些替代方案？我認為過去您的壓力更大，今天我也聽到了關注專業護理的說法。那麼它是如何融入並固定在其之上的呢？也許這與你們的長期國家戰略有何契合點？那麼，您可以為多個會員資格而不僅僅是 Medicare Advantage 提供服務是多麼重要。

Yes. Thanks for the question, Josh, because I think it very much aligns to the strategy that we've laid out. I guess, first and foremost, it's payer agnostic, and it was really important. We've always said that our goal, given the diversity of our business mix is to serve all members across all business lines. Given the depth and density of our membership in our local markets, that is very important. We had a partnership already working with many of these assets. So as I said, we know the membership -- we know the leadership teams. We know the value that can be created. And so we have been working with them and feel quite good about what we can create. This is payer agnostic, which we also think is very important. And again, this will help us continue through having a focus on advanced primary care, it's still very much focused on our chronic patients and complex patients. And we are still building specialty care enablement, which is, again, another very important component of what we're trying to probe through.

是的。感謝喬希提出的問題，因為我認為這非常符合我們所製定的策略。我想，首先也是最重要的是，它與付款人無關，而且非常重要。我們一直說，鑑於我們業務組合的多樣性，我們的目標是為所有業務線的所有成員提供服務。考慮到我們在當地市場的會員資格的深度和密度，這一點非常重要。我們已經與其中許多資產建立了合作夥伴關係。正如我所說，我們了解成員 - 我們了解領導團隊。我們知道可以創造的價值。因此，我們一直在與他們合作，並對我們能夠創造的東西感到非常滿意。這與付款人無關，我們也認為這一點非常重要。再說一次，這將幫助我們繼續專注於先進的初級保健，它仍然非常關注我們的慢性病患者和複雜的患者。我們仍在建立專業護理支持，這又是我們試圖探索的另一個非常重要的組成部分。

So I think from that value-based care across all lines of business, a critical part of our strategy, very consistent, driving value-based care, continuing to drive much more downside risk, which means that we needed strong enablement capabilities to help practices work their way through that. We know that it takes time. It is also a technology-driven model. So one of the nice things about this partnership is that there are embedded technology assets to digitally enable care as well. And then we have a focus on patient access and experience in the adoption of next-generation models. So again, consistent with the strategy that we've had over the last several years, not really a diversion, I think, from that. And I think the timing for us was right because we have been experimenting with multiple models and have a lot of experience in the space right now.

因此，我認為，從所有業務線基於價值的護理來看，我們策略的關鍵部分非常一致，推動基於價值的護理，繼續推動更多的下行風險，這意味著我們需要強大的支持能力來幫助實踐努力解決這個問題。我們知道這需要時間。這也是一種技術驅動的模式。因此，這種合作關係的好處之一是，有嵌入式技術資產也可以實現數位化護理。然後我們重點關注患者在採用下一代模型時的訪問和體驗。再說一次，我認為這與我們過去幾年的策略是一致的，並不是真正的轉移。我認為我們的時機是正確的，因為我們一直在嘗試多種模型，並且現在在該領域擁有豐富的經驗。

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

接下來，我們將邀請加拿大皇家銀行資本市場 (RBC Capital Markets) 的 Ben Hendrix。

Just another question on the CD&R partnership. To what extent are these primary care platforms taking risk currently? Is that something that we will need to see develop as we kind of get more of these digital enablement abilities from Carelon? Just wanted to see over the 5-year horizon to full ownership, if we can expect to kind of get the full capitation on these platforms over that time period?

這是關於 CD&R 夥伴關係的另一個問題。這些初級保健平台目前在多大程度上承擔風險？當我們從 Carelon 獲得更多的數位支援能力時，這是我們需要看到的發展嗎？只是想看看在 5 年內實現完全所有權，我們是否可以期望在這段時間內獲得這些平台的全額投資？

Thanks, Ben. I'm going to have Pete probably provide a lot more context. But just quickly, about 1/3 of the membership is under risk arrangement now. So with that, Pete, why don't you give a little more color into the relationship and how we see it evolve.

謝謝，本。我可能會讓皮特提供更多背景資訊。但很快，大約有1/3的會員現在處於風險安排之中。那麼，皮特，你為什麼不為這段關係以及我們如何看待它的演變提供更多的色彩呢？

That's great. Thanks for the question, Ben. And I'll give you a little bit more color on the assets and the capabilities. They really all have the distinct strengths. We see great opportunities, quite frankly, to cross-pollinate. When you think about MPG, to your question on risk, they really are a leader in managing Medicare and commercial risk. And they've also got a very strong chassis, I think, for future growth and a proven model in that regard in terms of acquiring provider practices. So very strong at managing risk and a lot of capabilities in that regard. What's really interesting about apree, and Gail referenced this is, they've got a differentiating technology and navigation capabilities with a real strong focus on the commercial business. So a really nice entry point for us.

那太棒了。謝謝你的提問，本。我將為您提供有關資產和功能的更多資訊。他們確實都有獨特的優勢。坦白說，我們看到了異花授粉的巨大機會。當你想到 MPG 時，對於你關於風險的問題，他們確實是管理醫療保險和商業風險的領導者。我認為，他們也為未來的成長提供了非常強大的基礎，並在收購供應商實踐方面擁有經過驗證的模式。因此在管理風險方面非常強大，並且在這方面擁有許多能力。蓋爾提到，apree 真正有趣的是，他們擁有差異化的技術和導航功能，並且真正專注於商業業務。這對我們來說是一個非常好的切入點。

We've been working on relationships already in this regard. And I'm really excited about that because we, obviously, as a company, have a really strong commercial footprint, a really nice entry point for us. And then, of course, Carelon Health advanced primary care, which is a leader in managing the complex and the chronic and largely takes risk today. We see a tremendous opportunity in a variety of ways for that. One, from a technology perspective, state-of-the-art EMR that we can upgrade as well as from a growth perspective in terms of partnering with MPG and apree. And then finally, and Gail mentioned this, but I'll reiterate it, a tremendous opportunity to wrap around existing Carelon Services to this arrangement that will create value for all 3 assets. So I appreciate the question.

我們已經在這方面努力建立關係。我對此感到非常興奮，因為顯然，作為一家公司，我們擁有非常強大的商業足跡，這對我們來說是一個非常好的切入點。當然，Carelon Health 推進了初級保健，它是管理複雜疾病和慢性病的領導者，但如今在很大程度上承擔著風險。我們在很多方面都看到了巨大的機會。一是從技術角度來看，我們可以升級最先進的 EMR；從成長角度來看，我們可以與 MPG 和 apree 合作。最後，蓋爾提到了這一點，但我會重申，這是將現有的 Carelon 服務納入這種安排的巨大機會，這將為所有 3 項資產創造價值。所以我很欣賞這個問題。

And then one quick financial remark, just at the end of Pete's comments there, we do expect the consolidated entity once formed to have over $4 billion in annualized debt revenue.

然後，就在 Pete 評論的結尾，我們確實預計合併後的實體一旦成立，將擁有超過 40 億美元的年化債務收入。

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

接下來，我們將請聽聽傑弗里斯 (Jefferies) 的戴夫溫德利 (Dave Windley) 的電話。

I'll switch topics over to Medicaid. Your redetermination enrollment impact seem to maybe pick up some momentum in the quarter. I think you said 90% of members have now been redetermined. I wondered if you could give us some view of kind of how you expect that to gate out over the next several quarters? And then from a risk pool and rate adequacy standpoint, could you update on how that looks now that the membership is whittling down?

我將把話題轉到醫療補助上。您的重新確定入學影響似乎可能在本季有所回升。我想你說現在90%的成員已經重新確定了。我想知道您是否可以向我們介紹一下您預計未來幾季將如何實現？然後，從風險池和利率充足性的角度來看，您能否更新會員資格正在減少的情況？

I'm going to have Felicia Norwood address your questions.

我將請費利西亞·諾伍德回答您的問題。

Thank you for the question. Frankly, right now, we're at a point where our Medicaid business is actually tracking very much in line with our expectations. As you referenced, we believe that about 90% of our members have had their eligibility redetermined. So as we go through the next few months, you certainly see this tapering down as we really wrap up the unwinding process as we get through June. One of the things I want to make sure you understand, the downward trend in membership in the first quarter resulted not just from redeterminations, but footprint changes as well. So it's really the cumulative impact of those two things in terms of the first quarter. When we think about the work that we will continue to do is we will continue to outreach to Medicaid members.

感謝你的提問。坦白說，目前我們的醫療補助業務實際上非常符合我們的預期。正如您所提到的，我們相信大約 90% 的會員的資格已被重新確定。因此，當我們經歷接下來的幾個月時，您肯定會看到這種情況逐漸減少，因為我們在六月真正結束了放鬆過程。我想確保您理解的一件事是，第一季會員數量的下降趨勢不僅是由於重新確定造成的，也是由於足跡變化造成的。所以這其實是第一季這兩件事的累積影響。當我們想到我們將繼續做的工作時，我們將繼續向醫療補助成員伸出援手。

Many members who have lost their membership at this point, did that as a result of really procedural reasons. So the team will continue to be very aggressive around continuing the outreach that's been going on, and we're really proud of the work that we continue to do to really reach out to over 4.5 million people, as Gail referenced in the opening comments, to make sure that individuals who are truly eligible for Medicaid have access to Medicaid and if not, are able to transition to an exchange product and continue coverage. In terms of where we are today with respect to the acuity and mix of that membership, the acuity is in line with what we expected.

許多此時失去會員資格的會員是由於程序原因而這樣做的。因此，團隊將繼續非常積極地繼續進行外展活動，正如蓋爾在開場評論中提到的那樣，我們為我們繼續所做的真正接觸到超過 450 萬人的工作感到非常自豪，確保真正有資格獲得醫療補助的個人能夠獲得醫療補助，如果沒有，能夠過渡到交換產品並繼續承保。就我們今天在該成員的敏銳度和組合方面的情況而言，敏銳度符合我們的預期。

And I will also say that at this point, we have visibility into 75% of our Medicaid rates and premiums for 2024. The vast majority of those are in line with our expectations and are actuarially sound. As you know, we have ongoing conversations with our state partners as we go throughout this process and we expect those rates to continue to be actuarially sound. So we're going to continue to work with our state partners. We're going to continue the efficacy with our members in terms of making sure they have access to care and coverage, and we're going to make sure that we go through this process with a lot of discipline and rigor, understand the mix of our membership and the leverage versus [payers] as we go through this process.

我還要說的是，目前我們已經了解了 2024 年 75% 的醫療補助費率和保費。如您所知，在整個過程中，我們與我們的國家合作夥伴進行了持續對話，我們預計這些費率在精算上將繼續保持合理。因此，我們將繼續與我們的州合作夥伴合作。我們將繼續與我們的會員保持高效，確保他們能夠獲得護理和保險，我們將確保我們以嚴格的紀律和嚴格的方式完成這一過程，了解當我們經歷這個過程時，我們的會員資格以及相對於[付款人]的影響力。

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 was wondering if maybe you could talk about utilization trends by line of business than what you saw in the quarter versus your expectation.

我想知道您是否可以按業務線討論使用率趨勢，而不是您在本季度看到的情況與您的預期。

Lisa, thanks very much for the question. So utilization in the first quarter in our health benefits businesses was in line with our expectation, and that was reflected in our reported benefit expense ratio of approximately 85.6%. In the commercial business, specifically inpatient and outpatient authorization levels year-to-date were aligned with our expectations and our internal year-to-go trend remains unchanged. On Medicare, as expected, we saw utilization related to both the 2 midnight rule for inpatient stays as well as pockets of outpatient authorizations around, for example, radiology and cardiovascular procedures.

麗莎，非常感謝你的提問。因此，我們的健康福利業務第一季的使用率符合我們的預期，這反映在我們報告的約 85.6% 的福利費用率上。在商業業務中，特別是年初至今的住院和門診授權水準與我們的預期一致，我們的內部年度趨勢保持不變。正如預期的那樣，在醫療保險方面，我們看到了與住院住院的午夜 2 點規則以及放射科和心血管手術等門診授權相關的利用率。

And importantly, these trends were broadly planned for as part of our underlying cost trend assumptions. Medicaid, as you heard Felicia talk about a moment ago, did experience increased but state-specific utilization attributed to the redetermination mix impact and we remain very comfortable with what we're seeing there, given those ongoing constructive dialogues with the impacted states. And so overall, we remain confident that both our MA bids for 2024 and our commercial pricing really reflect the appropriate projections for utilization and medical cost trends.

重要的是，這些趨勢是作為我們基本成本趨勢假設的一部分進行廣泛規劃的。正如您剛剛聽到Felicia 談論的那樣，由於重新確定組合的影響，醫療補助確實經歷了增加但特定於州的利用率，考慮到與受影響州正在進行的建設性對話，我們對我們所看到的情況仍然非常滿意。因此，總的來說，我們仍然相信 2024 年的 MA 投標和商業定價確實反映了對利用率和醫療成本趨勢的適當預測。

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. Just wondering if it's not a huge increase in guidance, but would love to kind of hear what was driving the increase in guidance? It's something -- is it on the health plan side? Is it on the Carelon side? And I guess just thoughts about how you thought about providing increases in guidance. It sounds like you believe that visibility is relatively high in claims, but obviously, there's some concern there. So I don't know if there's any conservatism or thought about pace of raises versus what you're actually seeing in the core business today?

偉大的。只是想知道這是否不是指導的大幅增加，但很想聽聽是什麼推動了指導的增加？這是一個問題——是在健康計畫方面嗎？是在卡雷隆這邊嗎？我想只是考慮一下您如何考慮提供更多的指導。聽起來您認為索賠的可見度相對較高，但顯然，存在一些擔憂。因此，我不知道與您今天在核心業務中實際看到的情況相比，是否有任何保守主義或關於加薪速度的想法？

We were pleased to report our adjusted diluted EPS this quarter, which came in slightly better than our seasonal expectation. And that was led by solid performance in both our health benefits and Carelon divisions, where operating margin increased by 30 basis points and 20 basis points, respectively, highlighting what we see as disciplined execution of our initiatives during a dynamic time for the industry. Of specific note, and you referenced this in your question, what is the favorable performance in the first quarter benefit expense ratio and that was driven by commercial margins that continue to recover from pandemic era lows.

我們很高興地報告本季調整後的稀釋每股收益，略好於我們的季節性預期。這得益於我們的健康福利和 Carelon 部門的穩健表現，營業利潤率分別增長了 30 個基點和 20 個基點，突顯了我們在行業動態時期嚴格執行我們的舉措。特別值得注意的是，您在問題中提到了這一點，第一季福利費用率的良好表現是多少，這是由商業利潤率繼續從大流行時代低點恢復推動的。

We're very pleased with the Q1 results. It's still early in the year. And given our business is subject to some variability around medical cost trend, we're intentionally remaining thoughtful and prudent in our outlook and that led us to increase our guide for adjusted EPS by $0.10 to be greater than $37.20.

我們對第一季的結果非常滿意。現在還早。鑑於我們的業務會受到醫療成本趨勢的一些變化的影響，我們有意對前景保持深思熟慮和審慎態度，這導致我們將調整後每股收益的指導提高了 0.10 美元，達到 37.20 美元以上。

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

接下來，我們將前往 Leerink Partners 的 Whit Mayo 系列。

Just wanted to hear any comments on the external revenue growth with Carelon Services. Did that grow faster than the overall segment? You did, I think, referenced some strong external growth. So curious what might be gaining traction in the market. And then just a quick question on guidance. Mark, you've averaged maybe 55% to 56% of earnings in the first half. Any reason that would be different this year?

只是想聽聽 Carelon Services 外部收入成長的任何評論。它的成長速度比整個細分市場的成長速度快嗎？我認為，您確實提到了一些強勁的外部成長。很好奇什麼可能會在市場上受到關注。然後是一個關於指導的簡單問題。馬克，上半年你的平均收入可能是 55% 到 56%。今年有什麼不同的原因嗎？

Great. Why don't I have Pete address sort of the Carelon questions, and then Mark will talk about the earnings percentages. Pete?

偉大的。為什麼我不讓皮特解決一些卡雷隆的問題，然後馬克談談收入百分比。皮特？

Yes, thanks for the question. As it relates to Carelon external growth, we continue to see really nice momentum in our build. I mean for 2024, from an overall sales perspective, we've already at this time of the year, exceeded what we did in all 2023. And you heard Gail mentioned in her prepared remarks, several new wins, which we're really excited about, really growth across the portfolio with some notable wins in behavioral health. She mentioned winning a statewide account in Medicaid for Maryland, which we're really excited about. And then some new innovative solutions with large employers as well as wins in the state of California.

是的，謝謝你的提問。由於它與 Carelon 的外部成長有關，我們繼續看到我們的建設勢頭非常好。我的意思是，從整體銷售的角度來看，2024 年我們已經超過了2023 年全年的表現。非常興奮關於整個投資組合的真正成長，在行為健康方面取得了一些顯著的勝利。她提到為馬裡蘭州贏得了全州醫療補助帳戶，我們對此感到非常興奮。然後是與大型雇主合作的一些新的創新解決方案以及在加州的勝利。

And on the behavioral health side, also some select wins in the crisis space. So areas that we've been really focused on. In addition to that we've had some notable wins with the Blues related to our Insights business. We've talked about this before, but it's really critical that we prove some of our risk arrangements and our differentiated capabilities in Elevance and then port those to the Blues, and we've seen that play through with several notable wins. Lastly, I'd say we're excited about the '25 pipeline. We're obviously actively in the selling season. Our pipeline is very rich. And again, I would say a large focus on our insights businesses as well as our behavioral health businesses.

在行為健康方面，危機領域也取得了一些勝利。這是我們真正關注的領域。除此之外，我們也與藍軍取得了一些與我們的洞察業務相關的顯著勝利。我們之前已經討論過這一點，但至關重要的是，我們要在Elevance 中證明我們的一些風險安排和差異化能力，然後將它們移植到Blues，我們已經看到了這一點，並取得了幾場重大勝利。最後，我想說我們對 '25 管道感到興奮。顯然我們正處於銷售旺季。我們的管道非常豐富。我再說一遍，我們要專注於我們的洞察業務和行為健康業務。

On your second question, the seasonality of the adjusted diluted EPS in 2024 is expected to be consistent with the past several years with approximately 55% of earnings in the first half of the year. I also want to call out that work days seasonality, given it is a leap year did result in a smaller than historically normal impact in the first quarter. But we expect the work days seasonality to put slightly more pressure on the third quarter MLR with an offsetting favorability than in the fourth quarter as those work days normalize.

關於第二個問題，預計2024年調整後稀釋後每股盈餘的季節性與過去幾年一致，上半年收益約佔55%。我還想指出，鑑於是閏年，工作日的季節性確實導致第一季的影響小於歷史正常水平。但我們預計，隨著工作日的正常化，工作日季節性因素將給第三季度國土資源部帶來比第四季稍大的壓力，並產生抵消性的利好。

Thanks, Mark, and thanks for the question, Whit. And I just want to add to Pete's comments about just the momentum that we're seeing inside of Carelon. First, our proof points are within Elevance Health. And then secondarily, now seeing some really nice momentum and traction externally.

謝謝馬克，也謝謝惠特提出的問題。我只想補充一下皮特的評論，即我們在卡雷隆內部看到的勢頭。首先，我們的證據來自 Elevance Health。其次，現在看到一些非常好的外部動力和牽引力。

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. Gail, I wanted to follow up on your comments on the Medicare business and the goal of balancing growth and margins. Could you maybe just elaborate on that given the tougher rate environment that you highlighted. And I think the company has prioritized margin improvement in Medicare this year, does that kind of remain on track for '24? And do you expect to plan for further improvement in 2025?

偉大的。蓋爾，我想跟進您對醫療保險業務以及平衡成長和利潤目標的評論。鑑於您所強調的更嚴峻的利率環境，您能否詳細說明一下這一點。我認為該公司今年優先考慮提高醫療保險的利潤率，這種情況在 24 世紀仍然保持在正軌上嗎？您預計 2025 年會有進一步改進的計畫嗎？

Thanks for the question, Nathan. As I shared in my opening comments, first of all, the Medicare rate announcement, as you've heard, represents second year of consecutive cuts to the program, that we know will result in increased premiums and reduced benefits for seniors with disabilities and particularly those that have really needed this program. Our approach is very consistent. We're going to continue to be disciplined in our approach to the Medicare business. Our focus is to get consistency high-value competitive benefits and balanced growth and margin. We're focused on building a sustainable, attractive long-term business. It's too early to provide specifics for the 2025 bid at this stage.

謝謝你的提問，內森。正如我在開場白中所說，首先，正如您所聽到的，醫療保險費率公告代表了該計劃的連續第二年削減，我們知道這將導致保費增加和殘疾老年人的福利減少，特別是那些真正需要這個計劃的人。我們的做法非常一致。我們將繼續嚴格執行醫療保險業務。我們的重點是獲得一致的高價值競爭優勢以及平衡的成長和利潤。我們專注於建立可持續的、有吸引力的長期業務。現階段提供 2025 年申辦的具體細節還為時過早。

But again, I'm going to repeat, we're looking to really balance growth and margins. And as we talked about in our Investor Day, our focus is on keeping our members Blue for life. And there, we're focused on particularly our 14 Blue states and continuing to prioritize the very significant business we have in [GSNP] where our unique competitive advantage is serving the needs of those consumers with complex conditions. So overall, we're in the midst of the process right now. So we'll have more as we get through the bid process, but thank you very much for the question.

但我要再說一遍，我們希望真正平衡成長和利潤。正如我們在投資者日談到的那樣，我們的重點是讓我們的會員終身保持藍色。在那裡，我們特別關注我們的 14 個藍色州，並繼續優先考慮我們在 [GSNP] 中擁有的非常重要的業務，我們獨特的競爭優勢是滿足那些條件複雜的消費者的需求。總的來說，我們現在正處於這個過程之中。因此，當我們完成投標過程時，我們將獲得更多信息，但非常感謝您提出這個問題。

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）。

Just interested, it seems like now you're talking about at least 12% EPS CAGR as your long-term expectations in both the slides and the prepared remarks. Like obviously, in the past, you've talked about a 12% to 15% EPS growth CAGR target. Just wondering what, if anything, we should be reading into that.

只是感興趣，現在您似乎在幻燈片和準備好的評論中談論至少 12% 的每股收益複合年增長率作為您的長期預期。顯然，過去您談到了 12% 至 15% 的 EPS 複合年增長率目標。只是想知道我們應該讀什麼（如果有的話）。

Thank you very much for the question. You should see these 2 targets as synergistic. We remain firmly committed to achieving a long-term adjusted earnings per share CAGR of 12% to 15% through 2027, as we communicated at our Investor Day event last year. And then as we think more broadly around the long term, we have confidence that through business cycles and over time, the earnings power of our health benefits in Carelon flywheel will generate the momentum and the foundation that's needed to sustain a long-term compound annual growth rate of at least 12%.

非常感謝你的提問。您應該將這兩個目標視為具有協同作用。正如我們在去年的投資者日活動中所傳達的那樣，我們仍然堅定地致力於到 2027 年實現 12% 至 15% 的長期調整後每股收益複合年增長率。然後，當我們更廣泛地思考長期問題時，我們相信，透過商業週期和隨著時間的推移，我們在 Carelon 飛輪中的健康福利的盈利能力將產生維持長期複合年增長率所需的動力和基礎成長率至少為12%。

Next, we'll go to the line of Andrew Mok from Barclays.

接下來，我們將邀請巴克萊銀行的安德魯·莫克（Andrew Mok）。

Hoping you can give us an update on your transition of specialty scripts to BioPlus and help us understand the contribution that, that's expected to have this year.

希望您能為我們提供有關專業腳本向 BioPlus 過渡的最新信息，並幫助我們了解今年預計將做出的貢獻。

Let me have Pete to address your question.

讓我請皮特來回答你的問題。

Yes. Thanks for the question, Andrew. Listen, the integration of BioPlus is going well. As you know, we remain on an accelerated calendar regarding this. I'll just reiterate, we spent last year building out the infrastructure and the team, and we did begin migrating scripts in January of this year. And we're doing so really on a stage basis. So we'll continue to do the migration throughout '24 and into 2025 as it relates to the Elevance Health book of business.

是的。謝謝你的提問，安德魯。聽著，BioPlus 的整合進展順利。如您所知，我們仍在加快處理此事。我重申一下，我們去年花了很多時間建立基礎設施和團隊，並且我們確實在今年 1 月開始遷移腳本。我們確實是在舞台上這樣做的。因此，我們將在 2024 年至 2025 年繼續進行遷移，因為它與 Elevance Health 業務相關。

I'd say overall, things are going well. The infrastructure build is going well in addition to the BioPlus dispensing facilities that are in place. We're live with 1 additional facility now as we speak, and we have 2 more going live this year. So we feel very good about the capacity, not only with respect to the Elevance Health business beyond that. So we're excited we're on a path. And again, it will be staged throughout '24 and '25.

我想說，總體而言，一切進展順利。除了已到位的 BioPlus 配藥設施外，基礎建設也進展順利。就在我們說話的時候，我們現在還有 1 個設施，今年還有 2 個設施將投入使用。因此，我們對 Elevance Health 業務的能力感到非常滿意。所以我們很高興我們走上了一條道路。再次強調，它將在 24 年和 25 年期間上演。

Yes. In addition, I'll just add to what Pete said to BioPlus. As you know, we also announced the acquisition of Kroger Specialty Pharmacy. And that is also well aligned to Carelon's effort to control those levers that matter. So Nick, thank you for the question.

是的。此外，我將補充 Pete 對 BioPlus 所說的話。如您所知，我們也宣布收購克羅格特種藥局。這也與卡倫控制那些重要槓桿的努力非常一致。尼克，謝謝你的提問。

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。

First, I'd like to follow up on Dave's question on Medicaid. And I guess, can you talk about where you think we are in the kind of where in, I guess, in the calendar and the mix of rate determinations versus acuity mix and kind of -- I guess I'm trying to get a sense for how far behind do you think the kind of the rate repricings are versus the changes in acuity mix from redeterminations. And given that you just talked about specialty, I wonder if you could just add a comment on the Kroger deal and if you expect those scripts to transfer over to BioPlus and how you think about the stickiness of those scripts?

首先，我想跟進戴夫關於醫療補助的問題。我想，你能談談你認為我們在日曆中的位置以及速率確定與敏銳度組合的組合以及某種 - 我想我正在嘗試了解情況您認為利率重新定價與重新確定帶來的敏銳度組合的變化相比有多落後。鑑於您剛剛談到了專業性，我想知道您是否可以對克羅格交易添加評論，您是否希望這些腳本轉移到 BioPlus，以及您如何看待這些腳本的粘性？

Yes, George, I think Felicia pretty much covered your question, which is, we think things are quite aligned at this point. So in terms of the acuity and the mix, everything, we have visibility into 75% of our Medicaid premiums. We've had very constructive discussions with our states. So overall, we feel things are lining up. They're actuarially sound, and our conversations are ongoing. So I feel very good about our Medicaid business, just to sort of put a finer point on that. In terms of Kroger, I'm going to ask Pete to comment on Kroger and how that's going to align with our broader pharmacy business.

是的，喬治，我認為費莉西亞幾乎涵蓋了你的問題，也就是說，我們認為目前情況非常一致。因此，就敏銳度和組合而言，我們可以了解 75% 的醫療補助保費。我們與各州進行了非常有建設性的討論。總的來說，我們覺得事情正在順利進行中。它們在精算上是合理的，我們的對話正在進行中。所以我對我們的醫療補助業務感覺非常好，只是為了更好地說明這一點。就克羅格而言，我將請皮特對克羅格發表評論，以及這將如何與我們更廣泛的製藥業務保持一致。

Yes, George, thanks for the question on Kroger. And as Gail alluded to it, we're excited about this deal. It furthers the Carelon and the pharmacy strategy. It certainly is a natural extension of our recent arrangement with BioPlus. And just to give you some background, Kroger Specialty Pharmacy is the largest non-payer owned specialty pharmacy. They do about 500,000 scripts a year. And it really is a natural complement to what we're doing with both BioPlus and Paragon, quite frankly. To give you a sense of what this is going to do for us. It's going to add meaningful scale. It increases our access to more LDDs, limited distribution drugs, which is very important. Certainly strengthens our relationship with manufacturers, enabling us to really provide greater affordability and quality. And in fact, it has a nice presence in Puerto Rico, which could be very helpful to our MMM business.

是的，喬治，謝謝你提出有關克羅格的問題。正如蓋爾提到的那樣，我們對這筆交易感到興奮。它進一步推進了 Carelon 和藥房戰略。這當然是我們最近與 BioPlus 安排的自然延伸。只是為了向您提供一些背景知識，克羅格專業藥房是最大的非付款人擁有的專業藥房。他們每年製作大約 50 萬個劇本。坦白說，這確實是對 BioPlus 和 Paragon 所做工作的自然補充。讓您了解這將為我們帶來什麼。它將增加有意義的規模。它增加了我們獲得更多 LDD（有限分發藥物）的機會，這一點非常重要。當然會加強我們與製造商的關係，使我們能夠真正提供更高的價格和品質。事實上，它在波多黎各擁有良好的業務，這對我們的 MMM 業務非常有幫助。

As it relates to your question on transition of scripts, we feel very good about that. I mean, obviously, in this case, with specialty pharmacy providers and members have choice. But we feel very good about the execution model. We feel very good about the stickiness of the scripts, and we believe the integration and the transition will be straightforward. We expect the arrangement to likely close in Q3-Q4 of this year.

由於這涉及到您關於腳本轉換的問題，我們對此感到非常滿意。我的意思是，顯然，在這種情況下，專業藥局提供者和會員都有選擇。但我們對執行模式感覺非常好。我們對腳本的黏性感覺非常好，我們相信整合和過渡將會很簡單。我們預計該安排可能會在今年第三季至第四季完成。

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。

Just interesting if we could double-click on the Carelon Services margins in the first quarter with the 90 basis points of expansion. Anything specifically that you would call out there and then that pacing does seem to be quite a bit stronger than the full year guidance where you had sort of called for flattish to down 30 basis points. So curious whether you have any updates for us just on how you expect Carelon Services margins to trend for the full year?

如果我們能雙擊 Carelon Services 第一季的利潤率，擴張 90 個基點，那就很有趣了。您會特別指出的任何事情，然後這種節奏似乎確實比全年指導要強得多，您在全年指導中呼籲持平至下降 30 個基點。很好奇您是否有任何關於您預計 Carelon Services 全年利潤率趨勢的最新資訊？

Thank you very much for the question. Margins were better than expected in the first quarter and that aligned very well to a very strong revenue growth in the quarter, given the launch of several new internal risk deals, which we expect to accelerate as the year goes on. We're not seeking to update our full year guidance at this time, given that both the seasonality of the business continues to evolve, as we expand our risk-based revenue and the timing of new product launches is anticipated to result in some transitory quarterly volatility. But let me turn it over to Pete for a couple of minutes to talk about what we're doing.

非常感謝你的提問。第一季的利潤率優於預期，與本季非常強勁的營收成長非常吻合，因為推出了幾項新的內部風險交易，我們預計這些交易將隨著今年的推移而加速。鑑於隨著我們擴大基於風險的收入，業務的季節性不斷變化，並且新產品推出的時間預計將導致一些短暫的季度業績增長，因此我們目前不打算更新全年指引。但讓我把它交給皮特幾分鐘來談談我們正在做的事情。

Yes. No, it's appreciated. And Mark's really covered it. But think about it this way. We are launching some pretty significant risk arrangements this year. We've talked about it, but a full risk arrangement in oncology, a full risk arrangement with the seriously mentally ill. And you should think about this as a natural cadence to launching this throughout the year and that's what's going to impact the margin. So for example, with the seriously mentally ill, we're doing this largely with the Medicaid business. It's not a big bang across all the Medicaid states immediately, as you'd expect. It's more methodical state by state in '24 and '25.

是的。不，這是值得讚賞的。馬克真的涵蓋了它。但這樣想一下。今年我們將推出一些相當重大的風險安排。我們已經討論過，但是腫瘤學的全面風險安排，針對嚴重精神病患者的全面風險安排。您應該將其視為全年推出此產品的自然節奏，這將影響利潤率。例如，對於嚴重的精神疾病患者，我們主要透過醫療補助業務來做到這一點。正如您所期望的那樣，這並不會立即在所有醫療補助州發生大爆炸。 24 年和 25 年各州的情況都更加有條理。

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。

There are some significant changes coming in the Part D space for 2025. I was curious as to your view on what that could mean for premiums. Just maybe you could tell us where you think kind of industry premiums are this year and how significant that increase could be for 2025?

2025 年 D 部分領域將發生一些重大變化。也許您可以告訴我們您認為今年的產業溢價是多少，以及 2025 年的成長幅度有多大？

I'm going to ask Felicia to address that.

我要請費莉西亞解決這個問題。

So Justin, thank you for the question. There are significant changes coming for 2025. And I'll say this, it's early to provide specifics around what our 2025 strategy is going to be. But as Gail mentioned before, we are going to make sure that we have a very balanced approach as we think about the margins around our Medicare business and focus on those things that we believe bring the highest value to our members as we really work to make sure we have a competitive product in market that meets the needs of those members that we're trying to serve with a lot of dynamic changes that are going on in the Medicare environment for 2025. So thank you for the question.

賈斯汀，謝謝你的提問。 2025 年將會發生重大變化。但正如蓋爾之前提到的，我們將確保我們採取非常平衡的方法，因為我們考慮醫療保險業務的利潤，並專注於我們認為為我們的會員帶來最高價值的事情，因為我們真正致力於使確保我們在市場上擁有具有競爭力的產品，可以滿足我們正在努力為2025 年Medicare 環境中發生的許多動態變化提供服務的會員的需求。

Next, we'll go to the line of Ann Hynes from Mizuho.

接下來，我們將前往Mizuho的Ann Hynes系列。

Congrats on retaining the Florida contract, but it looks like you're actually gaining market share. Can you let us know the membership growth. And also looking ahead over the next couple of years, is there any big state renewal risk for Elevance, and alternatively, is there any big RFP opportunities for you?

恭喜您保留了佛羅裡達州的合同，但看起來您實際上正在獲得市場份額。您能否告訴我們會員的成長情況？展望未來幾年，Elevance 是否存在重大的國家更新風險，或者，您是否有任何重大的 RFP 機會？

We are certainly very pleased with the results in Florida. It's a state that we have been partnering in for a long period of time. But certainly, the win here allows us to expand our footprint and additionally serve some complex populations, particularly SMI, which will be very much kind of a collaboration with our Carelon Services business. So very excited about that. We are also very focused on our Virginia Go-live, which is coming up in July as well. So a lot of work happening there. Outstanding at this point is certainly Georgia, where we will be defending our procurement with respect to our core business as well as our foster care business in the State of Georgia and feel very good about the work that we continue to do there in partnership with the state.

我們對佛羅裡達州的結果當然非常滿意。這是我們長期合作的狀態。但當然，這裡的勝利使我們能夠擴大我們的足跡，並額外為一些複雜的人群提供服務，特別是 SMI，這在很大程度上是與我們的 Carelon 服務業務的合作。對此非常興奮。我們也非常關注維吉尼亞州的上線，該項目也將於 7 月上線。所以那裡正在進行很多工作。在這一點上表現出色的當然是佐治亞州，我們將捍衛我們在佐治亞州的核心業務以及寄養業務的採購，並對我們繼續與佐治亞州合作開展的工作感到非常滿意。

In addition, we are very much focused on a couple of new geographies where we are bidding this year and look forward to hearing those results. But on top of that, the states are very much focused on specialty populations, and we see that as the opportunity for growth as we go forward. Medicaid is a very important business for us. Our recent RFP wins, I think, demonstrate the value that we bring to our state partners. But more importantly, the improvement in quality and outcomes that we are providing to Medicaid beneficiaries. So thank you very much for the question.

此外，我們非常關註今年競標的幾個新地區，並期待聽到這些結果。但最重要的是，各州非常關注特殊人群，我們認為這是我們前進的成長機會。醫療補助對我們來說是一項非常重要的事業。我認為，我們最近贏得的 RFP 證明了我們為國家合作夥伴帶來的價值。但更重要的是，我們為醫療補助受益人提供的品質和結果得到了改善。非常感謝你提出這個問題。

Next, we'll go to the line of Gary Taylor from TD Cowen.

接下來，我們將前往 TD Cowen 的 Gary Taylor 線路。

Two quick ones for me. I just wanted to come back to Medicaid for a second. I mean, it's obvious your commercial book is doing very well, but you had expected Medicaid margins to come down this year, but you're saying the rate adjustments you're getting are actuarially sound for the acuity changes. So should we think about the lower Medicaid margins this year, primarily just the deleveraging, the OpEx impact of losing the revenue and enrollment and that MLR is going to be fairly stable? And then just my second question was, Mark made this comment. John made this comment for years about how days claims payable would eventually come down into the low 40s.

對我來說兩個快點。我只是想再回到醫療補助計劃上來。我的意思是，很明顯你的商業書籍做得很好，但你預計今年醫療補助利潤率會下降，但你說你得到的費率調整在精算上對於敏銳度的變化是合理的。那麼，我們是否應該考慮今年醫療補助利潤率的下降，主要是去槓桿化、失去收入和註冊人數對營運支出的影響以及 MLR 將相當穩定？然後我的第二個問題是，馬克發表了這樣的評論。多年來，約翰一直在評論索賠應付天數最終會降至 40 多歲以下。

That's a lot of inherent or embedded earnings power that could come through the P&L at some point over time. Can you give us any sort of sense of what long-term means in terms of seeing the reserves move lower?

隨著時間的推移，許多固有的或內在的獲利能力可能會透過損益表體現出來。您能否讓我們了解儲備金下降的長期意義？

Let me start maybe with the margins, and let me bring it up to the health benefits business segment to talk about first. So in terms of health benefits, the margins this quarter were very much in line with our expectations. It puts us squarely on track to achieve our guidance for the full year of an increase between 25 and 50 basis points. Not looking necessarily to comment on a single businesses margin, but you could expect Medicaid margins to normalize given we already have line of sight, and you heard Felicia talk about this, into approximately 75% of the Medicaid premiums for 2024 and that we are comfortable with the actuarial soundness of the rates that we are seeing.

讓我先從利潤開始，然後讓我先談談健康福利業務部門。因此，就健康效益而言，本季的利潤率非常符合我們的預期。這使我們完全有可能實現全年成長 25 至 50 個基點的目標。不一定要對單一企業的利潤率發表評論，但考慮到我們已經看到了醫療補助利潤率將正常化，而且你聽到Felicia 談到這一點，預計2024 年醫療補助保費將佔到75% 左右，我們對此感到滿意以及我們所看到的利率精算的合理性。

Over the long term, Medicaid continues to normalize, as we spoke about last quarter, and it is performing as expected. On DCP for 2024, if we look out through the end of the year, we anticipate remaining in the mid- to upper 40s range given Medicaid membership is expected to decline to within our guidance range of 8.8 million to 9.2 million members. And as you know, Medicaid has a slightly lower relative DCP compared to commercial, for example. And then over time to reiterate the guidance, we do expect over the long term DCPs to return to that more normalized range in the low 40s.

從長遠來看，正如我們上季度談到的那樣，醫療補助繼續正常化，並且其表現符合預期。就 2024 年 DCP 而言，如果我們展望今年年底，我們預計將保持在 40 多歲的範圍內，因為醫療補助會員人數預計將下降到我們 880 萬至 920 萬會員的指導範圍內。如您所知，例如，與商業相比，醫療補助的相對 DCP 略低。然後隨著時間的推移重申這一指導意見，我們確實預計長期 DCP 將回到 40 多歲以下的更正常化的範圍。

One more question, please.

請再問一個問題。

And for our final question, we'll go to the line of Sarah James from Cantor Fitzgerald.

對於我們的最後一個問題，我們將轉向康托·菲茨杰拉德的莎拉·詹姆斯。

Just wanted to clarify a couple of things. One, on the reserve boost, are you saying that 1.7 days is fully related to conservatism via change because that seems like about a $600 reserve boost to us. So I wanted to see if there was any other factors in that 1.7 days. And second, could you give us a sense of your Medicaid rate seasonality? Like what percent of your book renews in 1Q versus 2Q versus 3Q?

只是想澄清一些事情。一，關於準備金增加，您是否說 1.7 天與透過變化實現的保守主義完全相關，因為這對我們來說似乎增加了約 600 美元的準備金增加。所以我想看看這1.7天裡是否還有其他因素。其次，您能否讓我們了解您的醫療補助費率的季節性？例如您的圖書在第一季、第二季和第三季的續訂百分比是多少？

On your first question, the sequential increase in days in claims payable a quarter result of 1.7 days is primarily related to the Change Healthcare. I just want to -- maybe one clarification around this. It's worth noting that neither the decrease in claims receipts that we saw during the quarter or the reserve accrual that we took related to Change Healthcare had any discernible impact on our benefit expense ratio or P&L and that's because we believe the reserve represents an amount you would otherwise have paid had there been no disruption. So you should think about this as overall for the quarter, incurred claims are completely consistent with our expectations. Given some of the notes that came out this morning, I also like to just reiterate that we do expect operating cash flow to be at least $8.1 billion for the full year, reiterating our earlier guidance.

關於你的第一個問題，季度應付索賠天數較上季增加 1.7 天，主要與 Change Healthcare 有關。我只是想——也許對此做出一個澄清。值得注意的是，我們在本季看到的索賠收據的減少或我們與Change Healthcare 相關的準備金應計額都沒有對我們的福利費用比率或損益產生任何明顯的影響，這是因為我們相信準備金代表了您將要支付的金額。因此，您應該考慮到本季總體而言，發生的索賠與我們的預期完全一致。鑑於今天早上發布的一些說明，我還想重申，我們確實預計全年營運現金流至少為 81 億美元，並重申了我們先前的指導。

And Sarah, just on your question with respect to our Medicaid states and when our rates are up for renewal, we have roughly 10 states that renew in January, another state that renews in April, another 9 that renew in July. And then the last 2 renew in the back half of the year in September and October.

莎拉，就你關於我們的醫療補助州的問題以及當我們的更新費率上升時，我們大約有10 個州在1 月更新，另一個州在4 月更新，另外9 個州在7 月更新。然後最後 2 個在下半年的 9 月和 10 月更新。

Well, thank you very much for your questions. Just in some closing thoughts. We're very pleased to be off to a solid start this year, and we're confident, as you heard in the ongoing execution of our strategy and the balance and resilience of our diverse set of businesses positions us well for 2024 and beyond. We're very excited about the future and look forward to sharing more on our progress with you in the coming year. Thank you for your interest in Elevance Health, and have a great rest of your week.

嗯，非常感謝您的提問。只是一些結束的想法。我們很高興今年有一個良好的開端，我們充滿信心，正如您在我們不斷執行的策略中所聽到的那樣，我們多元化業務的平衡和彈性使我們在 2024 年及以後保持良好的地位。我們對未來感到非常興奮，並期待在未來一年與您分享更多我們的進展。感謝您對 Elevance Health 的關注，祝您本週休息愉快。

Ladies and gentlemen, a recording of this conference will be available for replay after 11:00 a.m. today through May 17, 2024. You may access the replay system at any time by dialing (800) 876-4955. International participants can dial (203) 369-3997. 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 2024 年 5 月 17 日期間進行重播。國際參與者可撥打 (203) 369-3997。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。