Elevance Health Inc (ELV) 2024 Q2 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to our second quarter Elevance Health Inc earnings conference call. (Operator Instructions) As a reminder, today's conference is being recorded.

女士們、先生們，感謝你們的支持，歡迎參加我們第二季 Elevance Health Inc 的收益電話會議。 （操作員指示）提醒一下，今天的會議正在錄製中。

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

我現在想將會議轉交給公司管理階層。請繼續。

Good morning, and welcome to Elevance Health second quarter 2024 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; Mark Kaye, our CFO; Pete Haytaian, President of President of Carelon; Morgan Kendrick, President of our Commercial Health Benefits business; and Felicia Norwood, President of our government health benefits business.

早安，歡迎參加 Elevance Health 2024 年第二季財報電話會議。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； Pete Haytaian，Carelon 總裁； 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費利西亞·諾伍德 (Felicia Norwood)。

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

蓋爾將在電話會議開始時簡要討論本季以及我們策略性舉措的最新進展。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 under elevancehealth.com.

在電話會議期間，我們將參考某些非公認會計原則措施。這些非 GAAP 衡量標準與最直接可比較的 GAAP 衡量標準的對帳可在我們的網站 elevancehealth.com 上找到。

We will also be making some forward-looking statements on this call. Listeners are cautioned that these statements are subject 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.

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。

We advise listeners to carefully review the risk factors discussed in today's press release and in our quarterly filings with the SEC.

我們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 now turn the call over to Gail.

我現在把電話轉給蓋爾。

Thank you, Steve, and good morning, everyone. We appreciate you joining today's earnings call. This morning, we reported second quarter results, including adjusted diluted earnings per share of $10.12, reflecting 12% growth year on year.

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。今天上午，我們公佈了第二季業績，其中調整後攤薄每股收益為 10.12 美元，年增 12%。

These results reflect solid execution in a dynamic operating environment as well as the unique strengths of our enterprise, including the power of our diverse set of businesses, we have reaffirmed our guidance of at least $37.20, which represents 12% growth year over year.

這些結果反映了動態營運環境中的堅實執行力以及我們企業的獨特優勢，包括我們多元化業務的力量，我們重申了至少 37.20 美元的指導，這意味著同比增長 12%。

We have prudently maintained our full year outlook given industry wide dynamics we are navigating in our Medicaid business and the investments we're making to support business transformation and deepen capabilities within CarelonRx.

鑑於我們在醫療補助業務方面的行業動態以及我們為支持業務轉型和深化 CarelonRx 能力而進行的投資，我們謹慎地維持了全年展望。

Our health benefits segment demonstrated balance and resilience in the quarter. In commercial we continue to make progress on our margin recovery initiative and are delivering solid membership growth, notably in our individual ACA business, which has grown substantially year over year.

我們的健康福利部門在本季表現出平衡和彈性。在商業方面，我們繼續在利潤恢復計劃方面取得進展，並實現了會員的穩健增長，特別是在我們的個人 ACA 業務中，該業務逐年大幅增長。

We've also extended our momentum in national accounts where the business is tracking to historically high retention levels and new customer acquisition remains strong. Year to date, we've consolidated business with additional existing employer group clients who previously only worked with us on a slice of their business, a testament to the unique value we deliver to the market.

我們也擴大了國民帳戶領域的發展勢頭，業務保留率達到歷史最高水平，新客戶獲取依然強勁。今年迄今為止，我們已經與其他現有雇主集團客戶整合了業務，這些客戶以前只與我們合作了一部分業務，這證明了我們為市場提供的獨特價值。

In Medicaid we are pleased with our recent new business wins and re-procurements success positioning us for future growth. We launched the Indiana pathways for aging program just weeks ago and are proud to be the largest payers in this important program in our home state, serving nearly 40% of all eligible cruisers.

在醫療補助方面，我們對最近贏得的新業務和重新採購的成功感到高興，這為我們未來的成長奠定了基礎。幾週前，我們啟動了印第安納州老齡化之路計劃，並很自豪能夠成為我們家鄉這一重要計劃的最大付款人，為所有符合條件的遊輪的近 40% 提供服務。

Indiana pathways plays directly to our strengths, serving populations with chronic and complex needs. We were also privileged to be awarded to KanCare Kansas Medicaid RFP this quarter, working in partnership alongside to Blue partners as Healthy Blue.

印第安納途徑直接發揮我們的優勢，為有長期和複雜需求的人群提供服務。我們也很榮幸在本季獲得 KanCare 堪薩斯醫療補助 RFP，與 Blue 合作夥伴作為 Healthy Blue 合作。

Turning to Medicaid redeterminations. While nearly all of our members have had their eligibility redetermine since the process resume last year, our work is not done with approximately 70% of coverage losses attributable to administrative challenges.

轉向醫療補助重新確定。儘管自去年恢復程序以來，我們幾乎所有會員的資格都被重新確定，但我們的工作尚未完成，大約 70% 的承保損失歸因於行政方面的挑戰。

We continue our proactive outreach to me members to maximize access to care and minimize barriers to Whole Health. We expect this enroll members to re-enroll throughout the year, albeit on a longer lag than expected when redeterminations resume last year, we are seeing the percentage of return are steadily increase, especially in our Blue states where we offer both commercial and Medicaid health plans.

我們繼續積極主動地向我的會員提供服務，以最大限度地提高獲得護理的機會，並最大限度地減少影響 Whole Health 的障礙。我們預計該註冊會員將在全年重新註冊，儘管比去年恢復重新確定時的預期有更長的滯後時間，但我們看到返回的百分比正在穩步增加，特別是在我們提供商業和醫療補助醫療服務的藍色州計劃。

As a result of redeterminations are Medicaid membership mix has shifted resulting in increased acuity, and we are working actively with our state partners to ensure rates remain actuarially sound. In Medicare, we were pleased with the recent ruling regarding our challenge of the initial 2024 star ratings.

由於重新確定，醫療補助會員結構發生了變化，導致了敏銳度的提高，我們正在與我們的州合作夥伴積極合作，以確保精算費率保持合理。在 Medicare 方面，我們對最近關於我們挑戰 2024 年初始星級評級的裁決感到滿意。

As a result, our enterprise weighted average rating has increased to four star, and we now expect approximately 56% of our members will be in plans rated at least four star or in contracts to new to be rated debt will be reimbursed similarly in payment year 2025.

因此，我們的企業加權平均評級已提高至四星級，我們現在預計約 56% 的會員將參與至少被評為四星級的計劃，或者新評級債務的合約將在付款年以類似方式償還2025年。

This outcome will help offset funding cuts to the Medicare Advantage program for the second consecutive year, which we believe will result in increased premiums and or reduce benefits for seniors and people with disabilities who rely on Medicare Advantage for their health and well-being.

這一結果將有助於抵消 Medicare Advantage 計劃連續第二年的資金削減，我們認為這將導致保費增加和/或減少依賴 Medicare Advantage 來維持健康和福祉的老年人和殘疾人的福利。

For our part, we maintained our disciplined approach to 2025 bids. We will be offering highly valued and competitive benefits as we seek to balance growth and margins and remain focused on building an attractive and sustainable Medicare Advantage business for the year long term.

就我們而言，我們對 2025 年投標保持了嚴格的態度。我們將提供高價值和有競爭力的福利，尋求平衡成長和利潤，並繼續專注於建立具有吸引力和可持續的醫療保險優勢業務。

In our Health Services businesses, we are making progress on our key strategic priority to scale our enterprise flywheel for growth. Carelon services delivered robust growth in operating revenue and earnings in the quarter as we gain traction with external clients, both through new business wins and the expansion of risk-based services to existing customers.

在我們的健康服務業務中，我們正在擴大企業飛輪以實現成長的關鍵策略重點方面取得進展。 Carelon 服務在本季度實現了營業收入和收益的強勁增長，因為我們透過贏得新業務並向現有客戶擴展基於風險的服務，贏得了外部客戶的青睞。

For example, we recently secured a significant win with an existing Blue Cross Blue Shield partner and deploy new behavioral and medical benefit management services to state and third party payer clients. These awards are a testament to the value we deliver and an affirmation of our strategy of proving value internally before driving growth externally.

例如，我們最近與現有的 Blue Cross Blue Shield 合作夥伴取得了重大勝利，並向州和第三方付款人客戶部署了新的行為和醫療福利管理服務。這些獎項證明了我們所提供的價值，也是對我們在推動外部成長之前先在內部證明價值的策略的肯定。

Turning to CarelonRx, we are integrating recent acquisitions and scaling key value drivers as we invest to control the levers that matter to deliver greater value and enhance consumer experiences for our members.

談到 CarelonRx，我們正在整合最近的收購並擴大關鍵價值驅動因素，因為我們進行投資以控制重要的槓桿，從而為我們的會員提供更大的價值並增強消費者體驗。

Our margin performance in the second quarter reflects elevated investment, specifically around infrastructure and service levels as we remain committed to providing best in class home delivery and specialty Rx services. We see significant opportunity to grow and scale these assets are again excited about the growth potential of CarelonRx.

我們第二季的利潤率表現反映了投資的增加，特別是在基礎設施和服務水準方面的投資，因為我們仍然致力於提供一流的送貨上門和專業治療服務。我們看到了成長和擴展這些資產的重大機會，並再次對 CarelonRx 的成長潛力感到興奮。

We are making progress in our enterprise strategy in 2024 to accelerate capabilities and services, invest in high-growth opportunities and optimize our health benefits business and have robust long-term growth potential embedded in each of these imperatives. We are delivering strong and accelerating growth and Carelon services with a long runway ahead.

我們正在 2024 年的企業策略中取得進展，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，並在每項要求中都擁有強勁的長期成長潛力。我們正在提供強勁且加速的成長和 Carelon 服務，未來還有很長的路要走。

Meanwhile, our guidance for 2024 embeds significant investment in growth, notably and CarelonRx and government health plan operating margins below the long-term average with meaningful upside to our targets.

同時，我們對 2024 年的指導包含了對成長的大量投資，特別是 CarelonRx 和政府健康計畫的營運利潤率低於長期平均水平，這對我們的目標來說具有顯著的上升空間。

Our focused execution reflects our confidence in Carelon as our flywheel for enterprise growth and the embedded earnings power of our businesses, which together will enable us to deliver strong growth in adjusted diluted earnings per share over the long term.

我們專注的執行反映了我們對 Carelon 作為企業成長飛輪的信心以及我們業務的內在盈利能力，這將使我們能夠在長期內實現調整後稀釋每股收益的強勁增長。

In closing, I want to thank our community partners who share our purpose and dedication as well as our associates who work hard every day to make Elevance Health a lifetime trusted health partner for the members we are privileged to serve.

最後，我要感謝與我們有著共同目標和奉獻精神的社區合作夥伴，以及每天努力工作的員工，使 Elevance Health 成為我們有幸服務的會員一生值得信賴的健康合作夥伴。

Their collective passion is reflecting a recent external recognition, including as one of America's greatest workplaces in 2024 by Newsweek were Elevance Health earned five out of five stars well as our inclusion among the best companies to work for 2024 by US News & World Report.

他們的集體熱情反映了最近的外部認可，包括《新聞周刊》將Elevance Health 評為2024 年美國最偉大的工作場所之一，並獲得五顆星中的五顆星，以及《美國新聞與世界報道》將我們列入2024 年最佳工作公司之一。

With that, I'd like to turn the call over to our CFO, Mark Kaye, to discuss our financial results and outlook in greater detail. Mark?

因此，我想將電話轉給我們的財務長馬克凱 (Mark Kaye)，更詳細地討論我們的財務表現和前景。標記？

Thank you, Gail, and good morning to everyone. On the line of Gabriel shared, we reported second quarter results, including GAAP diluted earnings per share of $9.85 and adjusted diluted earnings per share of $10.12, representing growth of 12% year over year.

謝謝你，蓋爾，祝大家早安。在Gabriel分享的線上，我們公佈了第二季業績，其中GAAP稀釋每股收益為9.85美元，調整後稀釋每股收益為10.12美元，比去年同期成長12%。

We ended the second quarter with 45.8 million members, principally reflecting attrition in our Medicaid membership by 354,000 lives year over year, reflecting the distinctive value we provide to sell for employers and the strength of the Blue Cross Blue Shield brand additions, but thoughtful positioning of our individual ACA products has proven effective in ensuring robust and profitable growth.

截至第二季末，我們擁有4580 萬名會員，主要反映了我們的醫療補助會員人數同比減少了354,000 人，反映了我們為雇主提供的獨特價值以及Blue Cross Blue Shield 品牌附加功能的實力，但深思熟慮的定位事實證明，我們的 ACA 產品能夠有效確保強勁且獲利的成長。

Total operating revenue for the quarter was $43.2 billion, approximately flat year over year. As we approach the tail end of Medicaid redeterminations we anticipate growing operating revenue in the second half of the year, driven by growth in premiums and CarelonRx product revenue related to higher external membership and the acquisition of Paragon Healthcare. Killam's services momentum accelerated in the quarter.

該季度總營業收入為 432 億美元，與去年同期基本持平。隨著醫療補助重新確定接近尾聲，我們預計下半年營業收入將成長，這得益於與外部會員人數增加和收購 Paragon Healthcare 相關的保費和 CarelonRx 產品收入的成長。 Killam 的服務勢頭在本季加速。

Operating revenue grew by over 26% and operating earnings increased by more than 30% due to growth in risk based services provided to internal and external clients, prudent pricing and strong execution.

由於向內部和外部客戶提供的基於風險的服務的增長、審慎的定價和強大的執行力，營業收入增長了 26% 以上，營業利潤增長了 30% 以上。

The consolidated benefit expense ratio was 86.3% for the second quarter, an improvement of 10 basis points year over year. This improvement was driven by several factors, including premium rate adjustments in recognition of medical cost trends, disciplined medical management, and a shift in our mix of business towards commercial.

第二季綜合福利費用率為86.3%，年增10個基點。這項改善是由多種因素推動的，包括根據醫療成本趨勢調整保費率、嚴格的醫療管理以及我​​們的業務組合向商業的轉變。

This was partially offset by our Medicaid business where acuity has increased due to attrition of healthier members. Elevance health adjusted operating expense ratio was 11.5% in the second quarter, an increase of 50 basis points relative to the second quarter of 2023.

這部分被我們的醫療補助業務所抵消，由於健康會員的流失，醫療補助業務的敏銳度有所提高。 Elevance health第二季調整後營運費用率為11.5%，較2023年第二季增加50個基點。

We absorbed elevated investment costs, notably in CarelonRx and this, along with other strategic initiatives, will position our Company for long-term sustainable growth. We anticipate significant improvement in our operating expense ratio in the second half of this year.

我們吸收了增加的投資成本，特別是在 CarelonRx 上，這與其他策略性舉措一起將使我們公司實現長期可持續成長。我們預計今年下半年營業費用率將顯著改善。

Adjusted Operating gain for the enterprise grew approximately 6% year over year, led by Carelon services. We have maintained a prudent posture with respect to reserves. Days in claims payable end of the second quarter stood at 45.3 days above our long-term target range in the low 40s.

在 Carelon 服務的帶動下，該企業的調整後營運收益較去年同期成長約 6%。我們在儲備方面一直保持審慎的態度。第二季末的應付理賠天數為 45.3 天，高於我們 40 多天的長期目標範圍。

As a reminder, days in claims payable in the first quarter included approximately 1.7 days related to the industry wide delays in claims receipts.

需要提醒的是，第一季的應付索賠天數包括大約 1.7 天，與行業範圍內的索賠收據延遲有關。

With respect to our outlook, we are closely monitoring acuity and cost trends, notably in Medicaid and are working collaboratively with states to ensure rates remain actuarially sound. We are, however, expecting second half utilization to increase in Medicaid.

就我們的前景而言，我們正在密切關注敏銳度和成本趨勢，特別是在醫療補助方面，並與各州合作以確保精算費率保持合理。然而，我們預計下半年醫療補助的使用率將會增加。

And as a result, we anticipate our full year benefit expense ratio in the year in the upper half of our initial guidance range. Nonetheless, we expect to achieve our full year adjusted diluted earnings per share guidance of at least $37.20.

因此，我們預計今年全年福利費用率將位於初始指導範圍的上半部。儘管如此，我們預計全年調整後攤薄每股收益指引將至少達到 37.20 美元。

Before I close, I'd like to briefly talk through our enterprise growth algorithm, which we have included in the supplemental earnings presentation provided this morning.

在結束之前，我想簡要談談我們的企業成長演算法，我們已將其包含在今天早上提供的補充收益演示中。

Our commitment to growing adjusted diluted earnings per share by at least 12% annually on average incorporates upper single digit growth in operating revenue, underpinned by membership growth.

我們致力於使調整後的攤薄每股收益平均每年增長至少 12%，其中包括在會員增長的支持下實現營業收入的高個位數增長。

Geographic expansion and momentum in Carelon as we scale our enterprise flywheel. Our commitment to disciplined underwriting and operating expense management across all lines of business will drive the improvement inherent in our enterprise operating margin target of 6.5% to 7% by 2027.

隨著我們擴展企業飛輪，卡雷隆的地理擴張和勢頭。我們對所有業務線嚴格承保和營運費用管理的承諾將推動我們的企業營運利潤率目標在 2027 年之前實現 6.5% 至 7% 的改善。

Taken together, we are targeting growing operating earnings in the upper single digit to low double digit percent range annually on average over time.

總而言之，我們的目標是隨著時間的推移，營業收入平均每年增長在高個位數到低兩位數的百分比範圍內。

Finally, we expect capital deployment to consistently deliver one-third of our targeted adjusted diluted earnings per share growth rate.

最後，我們預期資本部署將持續實現我們目標調整後稀釋每股盈餘成長率的三分之一。

Overall, our results in the first half of the year are consistent with our initial guidance, and we will maintain a steadfast focus on execution and operating efficiency over the balance of the year.

總體而言，我們上半年的業績與我們最初的指導一致，我們將在今年餘下時間裡繼續堅定不移地關注執行力和營運效率。

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

那麼，接線員，請開始提問。

(Operator Instructions)

（操作員說明）

A.J. Rice, UBS.

A.J.賴斯，瑞銀。

Hi, everybody. Maybe just to kick it off here. I know you laid out your older growth objectives, but all I wonder if it was early day, you're prepared to call it a little more on any plans you have accelerated growth in '25. However, though the tabloid is a redeterminations and other things this year, what's your thought about ability to get back to that growth trajectory of existing seeking long term in '25?

大家好。也許只是為了在這裡開始。我知道您設定了較早的成長目標，但我想知道這是否為時過早，您是否準備好在 25 年加速成長的任何計劃中進一步提及這一目標。然而，儘管小報今年做出了重新決定和其他事情，但您對在 25 年回到現有尋求長期增長軌蹟的能力有何看法？

Great. Thanks, A.J. Thanks very much for the question this morning. You know, I think let me start with what Mark outlined as our enterprise growth algorithm because I think that really frames for everyone how we are thinking about our business.

偉大的。謝謝，A.J.非常感謝今天早上的提問。你知道，我想讓我從馬克概述的我們的企業成長演算法開始，因為我認為這真正框架了每個人我們如何思考我們的業務。

And also, as you think about 2024 in our results, the balance and resilience of our complementary businesses that has allowed us to grow in multiple ways and many type of different macroeconomic environments.

而且，當你在我們的業績中思考 2024 年時，我們互補業務的平衡和彈性使我們能夠以多種方式和多種不同的宏觀經濟環境實現成長。

While it is early for '25, I'd like to at least frame sort of how we're thinking about 2025. We do expect to accelerate revenue growth across all of our businesses.

雖然 25 年還為時過早，但我至少想框架一下我們對 2025 年的看法。

Specifically in our health business, we see a lot of really strong momentum in commercial, and that's been ongoing part of that, though the targeted expansion of our individual ACA footprint, in some cases, adding new geographies that helps support what's happening in the Medicaid redeterminations, the Medicare Advantage, as we said in our opening comments.

特別是在我們的健康業務中，我們看到了商業方面的許多真正強勁的勢頭，這一直是其中的一部分，儘管我們有針對性地擴大了個人ACA 足跡，在某些情況下，增加了新的地區，以幫助支持醫療補助中正在發生的事情正如我們在開場評論中所說，重新決定，即醫療保險優勢。

We feel that we've positioned ourselves for sustainable growth and margins and look at that as a very good long-term business and then Medicaid we're nearing the end of the redetermination cycle and we do anticipate a return to growth and you've heard about some of our early wins this year, which we are very pleased with.

我們認為我們已經為可持續增長和利潤做好了定位，並將其視為一項非常好的長期業務，然後醫療補助我們已接近重新確定週期的結束，我們確實預計會恢復增長，並且您已經聽說我們今年取得了一些早期的勝利，我們對此感到非常滿意。

We also do believe that some of those that were redetermined, based on administrative reasons will be coming back, albeit it's taken a little bit longer than we originally thought.

我們也確實相信，基於行政原因重新確定的一些內容將會回來，儘管花費的時間比我們最初想像的要長一些。

Then I'd like to close these comments about our excitement around Carelon and the growth that we're seeing and how we've progressed, you saw some of that comes through in the second quarter. And Carelon services we are seeing some very strong external growth in the quarter, and we see expanded opportunities as we continue to build our capabilities, particularly in the risk market.

然後，我想結束這些關於我們對 Carelon 的興奮、我們所看到的成長以及我們如何取得進展的評論，你們看到了其中一些在第二季度取得的進展。對於 Carelon 服務，我們在本季度看到了一些非常強勁的外部成長，並且隨著我們繼續增強我們的能力，特別是在風險市場上，我們看到了更多的機會。

And what we're seeing here is our ability to prove it on our own businesses first and then take it to the market commercially has been a really strong selling point for us, and we're very excited about that.

我們在這裡看到的是，我們有能力首先在自己的業務上證明這一點，然後將其推向商業市場，這對我們來說是一個非常強大的賣點，我們對此感到非常興奮。

And then finally, CarelonRx is our ability to scale, especially on the specialty side, including the integration of some of our recent capabilities such as Paragon Healthcare, BioPlus specialty pharmacy and we're looking forward to adding the Kroger specialty pharmacy business as well as we continue to diversify.

最後，CarelonRx 是我們的擴展能力，特別是在專業方面，包括整合我們最近的一些功能，例如 Paragon Healthcare、BioPlus 專業藥房，我們期待增加克羅格專業藥房業務以及我們繼續多元化。

So overall, as we think about acceleration of revenue growth and '25, we do expect that across all of our business and are extremely positive about what we're seeing in our business.

因此，總的來說，當我們考慮收​​入成長加速和 25 年時，我們確實預計我們所有業務都會出現這種情況，並對我們在業務中看到的情況非常樂觀。

So thank you for the question, and next question please.

謝謝你提出這個問題，請下一個問題。

Nathan Rich, Goldman Sachs.

內森·里奇，高盛。

Thanks for the questions. I wanted to ask on Medicaid. I think about a quarter of your book is due to set rates in the back half of the year.

感謝您的提問。我想問一下醫療補助。我認為您的書大約有四分之一是由於下半年設定的費率。

Could you maybe just talk about what your guidance assumes for these rate updates on and maybe anything you've seen the kind of so far you think about on the updates for July or October to the extent you have visibility. And I guess, Mark, on your comment on Medicaid utilization, have you seen in the level of care on a same member basis increase? Or is the issue really just the timing dynamic between where fee rates are and the level of acuity that you're seeing in your population?

您能否談談您對這些利率更新的指導假設，以及您迄今為止所看到的任何您在 7 月或 10 月更新中所看到的內容（在您能見度的範圍內）。我想，馬克，關於您對醫療補助利用的評論，您是否看到同一會員的護理水平有所增加？或者問題真的只是費率和您在人群中看到的敏銳度之間的時間動態嗎？

Well, thanks. Thanks for the questions. They've been a lot in there. So let me ask Felicia Norwood who leads government first and then have Mark, respond to the second part of the question. Felicia?

非常感謝。感謝您的提問。他們在那裡待過很多次。因此，讓我請先領導政府的費利西亞·諾伍德（Felicia Norwood），然後請馬克回答問題的第二部分。費利西亞？

So good morning, Nathan. You are absolutely right. The way our rate timing works, we have about half of our states where we have rates in the first half of the year in this the other half in the back half of the year with a core group, certainly in Q4.

早安，內森。你是絕對正確的。以我們的利率計時方式，我們大約有一半的州在上半年實施利率，另一半在下半年有一個核心群體，當然在第四季。

At this point, we have visibility into nearly all of our Medicaid premium for 2024 and the rate conversations with our states are very constructive.

目前，我們已經了解了 2024 年幾乎所有醫療補助保費，並且與我們各州的費率對話非常有建設性。

With that said, not all of our rates are final. We are in constant conversations with our states and providing them with information, updated information that we see in terms of the experience almost weekly to make sure that they are saying -- what we are saying from an overall change perspective as we wind down redeterminations, which certainly has been a lot of the largest transformative things that have happened in Medicaid for some period of time.

話雖如此，並非我們所有的價格都是最終價格。我們正在與我們的州不斷對話，並向他們提供信息，我們幾乎每週都會看到更新的信息，以確保他們所說的——當我們逐步結束重新決定時，我們從整體變革的角度所說的，這無疑是一段時間以來醫療補助中發生的許多最大的變革性事情。

I will say that the conversations are ongoing. We fully expect our rates to remain actuarially sound. So we acknowledge the potential for a short term, disconnect between the timing of our rates in the emerging acuity in our populations and that's certainly been reflected in our updates for the year.

我想說的是，對話正在進行中。我們完全期望我們的費率在精算上保持合理。因此，我們承認，短期內我們人口中新興敏銳度的比率時間之間存在脫節的可能性，這肯定反映在我們今年的更新中。

I will say that we continue to make sure that states and their actuaries have the most recent data that we have, and we will continue to have that engagement as we go through the fourth quarter rate process with the few very large states that remain in negotiations with us.

我要說的是，我們將繼續確保各州及其精算師掌握我們所掌握的最新數據，並且在我們與仍在談判中的少數幾個非常大的州進行第四季度利率流程時，我們將繼續進行這種接觸和我們。

And with that, I will turn it over to Mark to talk about the rest of the issues around utilization.

接下來，我將把它交給馬克來討論有關利用率的其餘問題。

Thanks so much, Felicia and good morning. Medicaid utilization in the quarter, as you heard from Felicia, reflected higher acuity as expected, we are also seeing signs of increased utilization across the broader Medicaid population, including in outpatient home health radiology, durable medical equipment as well as some elective procedures.

非常感謝，費莉西亞，早安。正如您從Felicia 那裡聽到的那樣，本季度的醫療補助利用率反映了預期的更高敏銳度，我們還看到了更廣泛的醫療補助人群利用率增加的跡象，包括門診家庭健康放射學、耐用醫療設備以及一些選擇性手術。

I just wanted to add here, just as we noted in our prepared remarks, the full year outlook does allow for both this shift in acuity and increased utilization in the second half of the year, including the rate timing mismatch that Felicia spoke to.

我只是想在這裡補充一點，正如我們在準備好的發言中指出的那樣，全年展望確實考慮到了下半年敏銳度的轉變和利用率的增加，包括費利西亞談到的利率時機不匹配。

Thank you. Next question, please.

謝謝。請下一個問題。

Lance Wilkes, Bernstein.

蘭斯威爾克斯，伯恩斯坦。

Yes. Could you talk a little bit about CarelonRx in particularly interested in contracting approach, for the CVS contract that underlies parts to that as your intuition things? And then just a quick update on the status of the integration rollout to the Anthem members and other members of bioprocessing Paragon and the status of kroger. Thanks.

是的。您能否談談 CarelonRx，特別對合約方法感興趣，因為 CVS 合約是您直覺的一部分？然後快速更新 Anthem 成員和生物加工 Paragon 的其他成員的整合部署狀態以及 kroger 的狀態。謝謝。

Great. Well, thanks, Lance, I'm going to ask Pete Haytaian who leads Carelon to address your question.

偉大的。好吧，謝謝，蘭斯，我要請領導卡雷隆的皮特·海泰安（Pete Haytaian）來回答你的問題。

Yes, thanks. Thanks a lot for the question, Lance. We feel very good about the overall strategy as it relates to pharmacy. I'll start with how we're performing on the core and growth in the core of our strategy is resonating in the marketplace there continues to be a lot of interest in what we're doing as it relates to the strategic levers that matter and how we're in-sourcing and diversifying our business.

對了謝謝。非常感謝你的提問，蘭斯。我們對與製藥相關的整體策略感覺非常好。我將從我們在核心方面的表現開始，我們戰略核心的成長在市場上引起共鳴，人們對我們正在做的事情仍然很感興趣，因為它與重要的戰略槓桿有關，並且我們如何內包並實現業務多元化。

I think our value story is really resonating integrated value story, and that's really playing through with highly competitive pricing and again, we continue to perform very well on the core PBM, downmarket and middle market. So we feel very good about that.

我認為我們的價值故事確實是引起共鳴的綜合價值故事，這確實透過極具競爭力的定價發揮作用，而且我們繼續在核心 PBM、低端市場和中端市場上表現出色。所以我們對此感覺非常好。

As it relates to our diversification and your question on our assets, things are going very well. As we talked about with regard to specialty, we spent the last year building out our infrastructure to be able to handle the capacity -- to have the capacity to handle the Elevance Scripps.

由於這與我們的多元化以及您對我們資產的問題有關，所以一切進展順利。正如我們談到的專業一樣，我們去年花了一年的時間建立我們的基礎設施，以便能夠處理能力——有能力處理 Elevance Scripps。

And we feel very good about that. We began to migrate Scripps at the beginning of this year as it relates to specialty and we continue to move forward in that regard.

我們對此感覺非常好。我們在今年年初開始遷移斯克里普斯，因為它與專業相關，我們將繼續在這方面取得進展。

And importantly, we are preparing right now and continue to make investments around the Kroger close. And I'm assuming those Scripps as well. Right now, we're projecting that to close Q3, Q4 this year and again, a lot of preparation and investment to make sure that we will do that really well.

重要的是，我們現在正在準備並繼續圍繞克羅格關閉進行投資。我假設那些史克里普斯也是如此。目前，我們預計今年第三季和第四季將再次結束，需要進行大量準備和投資，以確保我們能夠做得很好。

And then finally, as it relates to on Paragon, again, just to reiterate the opportunity there because we feel very, very good about that.

最後，與《Paragon》有關，再次重申那裡的機會，因為我們對此感覺非常非常好。

We're talking about $16 billion of infusion spend as it relates to Elevance Health and with about 50% of that being in the hospital setting. So again, a great opportunity for us to have care be provided in a more appropriate setting being a bit in an ambulatory side or on the home.

我們談論的是與 Elevance Health 相關的 160 億美元輸液支出，其中約 50% 用於醫院環境。因此，這對我們來說是一個很好的機會，可以在更合適的環境中（即門診或家中）提供護理。

And we feel very good about our positioning in the density that we have in our markets as it relates to that. And importantly, as part of that strategy, we are targeting at a ZIP code level on the standup of ambulatory sites to be able to provide that care.

我們對我們在市場中的密度定位非常滿意，因為它與此相關。重要的是，作為該策略的一部分，我們的目標是建立流動站點的郵政編碼級別，以便能夠提供這種護理。

We're launching one imminently, and then we are preparing and building our strategies to launch others into 2025. So overall, we feel very good about our strategy of in-sourcing this strategic levers that matter in the growth opportunity that exists.

我們即將推出一個產品，然後我們正在準備和製定策略，以便在2025 年推出其他產品。關重要。

Thanks, Pete, and thanks again, Lance for the question. And just I think that's a great example of our flywheel for growth in our ability to scale these assets, which were very excited about. And again, I'm thinking about this is the opportunity to drive a differentiated cost of care for our health plans within Elevance Health, but also better experience for members and support our partners across the ecosystem. So again, a really important part of our flywheel.

謝謝皮特，再次感謝蘭斯提出的問題。我認為這是我們飛輪擴展這些資產的能力成長的一個很好的例子，我們對此感到非常興奮。我再次認為，這是一個機會，可以在 Elevance Health 內推動我們的健康計劃的差異化護理成本，同時也為會員提供更好的體驗，並支持我們整個生態系統的合作夥伴。再說一次，這是我們飛輪非常重要的一部分。

Next question, please.

請下一個問題。

Kevin Fischbeck, Bank of America.

凱文‧菲施貝克，美國銀行。

Okay, great. Thanks. I guess in your prepared remarks, you mentioned that some of the results here were somewhat burdened by, I guess three things. One; your investments in Carelon for growth and then you had a below average margins and Medicaid and below-average margins in Medicare Advantage.

好的，太好了。謝謝。我想在您準備好的發言中，您提到這裡的一些結果在某種程度上受到了以下三件事的影響。一;您對 Carelon 的投資是為了實現成長，然後您的醫療補助和醫療補助利潤率低於平均水平，醫療保險優勢的利潤率也低於平均水平。

Can you help size those things? How should we think about where those margins are today relative to kind of, where they should be from a target perspective? Thanks.

你能幫忙確定這些東西的尺寸嗎？我們應該如何考慮這些利潤目前相對於目標角度應該在哪裡？謝謝。

Thanks very much for the question. We're going to comment on in detail. We are a single lines in our business operating margin, May land, given our combined health benefits reporting segment. But however to your question, let me give you a little bit of color.

非常感謝您的提問。我們將詳細評論。考慮到我們的綜合健康福利報告部門，我們的業務營運利潤率五月土地上只有一條線。但無論如何，對於你的問題，讓我給你一點顏色。

We do expect the Medicaid margins to compress year over year. There are key factors driving this, including beyond the industry wide dynamics that we're navigating. And those include what we spoke to a moment to go around the timing mismatch rates relative to acuity and the higher acuity itself associated with the Medicaid membership mix and booking.

我們確實預期醫療補助利潤率將逐年壓縮。推動這一趨勢的關鍵因素包括我們正在探索的行業範圍之外的因素。這些包括我們在討論與敏銳度相關的時間不匹配率以及與醫療補助會員組合和預訂相關的更高敏銳度本身時所談到的內容。

As you heard us talk just a moment ago, we are holding very constructive conversations with the states to ensure those rates remained actuarially sound.

正如您剛才聽到我們所說的那樣，我們正在與各州進行非常有建設性的對話，以確保這些利率在精算上保持合理。

In Medicare we do continue to expect margins are going to improve in 2024 compared to 2023. They will still remain below our long-term target margin range. And then finally, we are very pleased with the progress of our 2024 commercial pricing initiatives and our disciplined pricing practices.

在醫療保險方面，我們確實繼續預計 2024 年的利潤率將比 2023 年有所改善。最後，我們對 2024 年商業定價計畫的進展和嚴格的定價實踐感到非常滿意。

And we've spoken about this before, but it's worth emphasizing 2023 were marked at first the end of that first full year of our efforts to recover margins. And you're seeing some of that benefit together with the actions that we're taking in 2024 come through our numbers.

我們之前已經談到過這一點，但值得強調的是，2023 年首先標誌著我們恢復利潤率的第一個全年努力的結束。您將透過我們的數據看到其中的一些好處以及我們在 2024 年採取的行動。

Thank you. Next question, please.

謝謝。請下一個問題。

Josh Raskin, Nephron Research.

喬許·拉斯金，腎單位研究。

Hi, thanks. Good morning. What are your expectations for market level growth in MA for 2025? And I know it's early, but maybe any headwinds, tailwinds and how we should expect Elevance to grow market share relative to the overall market in MA for 2025?

你好謝謝。早安.您對 2025 年 MA 市場水準成長的預期是什麼？我知道現在還為時過早，但也許有什麼逆風、順風以及我們應該如何預期 Elevance 在 2025 年相對於 MA 整體市場的市場份額增長？

I'll ask Felicia to comment on that, Josh. Thank you.

喬什，我會請費利西亞對此發表評論。謝謝。

Good morning, Josh, and thank you. you know it's an incredibly dynamic time in Medicare Advantage and now more than ever, we think it's important to be very thoughtful and rational as we planned for 2025.

早安，喬什，謝謝你。您知道，現在是 Medicare Advantage 的一個充滿活力的時期，現在比以往任何時候都更重要的是，我們認為在 2025 年計劃時保持深思熟慮和理性非常重要。

Despite this environment, Medicare Advantage enrollment is that an all-time high and over 50% of individuals are still choosing MA. And that means there's still a clear value for what MA offers. And we're committed in the long term to having an operating a profitable and sustainable MA business.

儘管存在這種環境，Medicare Advantage 的註冊人數仍創歷史新高，超過 50% 的人仍在選擇 MA。這意味著 MA 提供的服務仍然具有明顯的價值。我們致力於長期經營可獲利且可持續的 MA 業務。

You know, it's a little early to talk about 2025 in terms of growth expectations are that were recently submitted to CMS and frankly, we are still getting feedback on that.

您知道，就最近提交給 CMS 的成長預期而言，現在談論 2025 年還為時過早，坦白說，我們仍在收到相關回饋。

In addition to that, the industry wide submissions are known yet. We build encouraged by commentary from peers that everybody is going to kind of price rationally and have benefit rationalization as we head into 2025.

除此之外，業界範圍內的提交內容尚為已知。我們受到同行評論的鼓舞，認為進入 2025 年，每個人都會理性定價並實現利益合理化。

But we still have to wait and see what emerges, what we have greater information from our competitors. So at this point, there's a lot of unknowns.

但我們仍然需要等待，看看會發生什麼，看看我們從競爭對手那裡獲得了更多資訊。所以目前來說，還有很多未知數。

I will tell you we maintained a very disciplined approach offering competitive benefits while we are balancing growth and margins, I think we were very thoughtful in the plan designs that we put out there to make sure that we were focusing on profitable growth in the sustainability of that this program for the long term, we are very focused on our [D-Stat] business, which is where we believe that we have a strong advantage, but we think about our Medicaid and Medicare positioning.

我會告訴你，我們在平衡成長和利潤的同時，保持了一種非常嚴格的方法，提供有競爭力的利益，我認為我們在計劃設計中非常周到，以確保我們專注於可持續性的盈利成長。

And we also did prioritization around our products in terms of our local market dynamics. So it's still early to determine what growth it's going to look like for 2025. We feel very good about how we position our business on the heels of our strategy in 2024 to make sure that we have a sustainable long-term business and Medicare Advantage. Thank you.

我們還根據當地市場動態對我們的產品進行了優先排序。因此，現在確定 2025 年的成長還為時過早。謝謝。

Next question, please.

請下一個問題。

Lisa Gill, JP Morgan.

麗莎·吉爾，摩根大通。

Thanks very much and good morning. I wanted to stick with Medicare Advantage for a minute. Can you talk about what you saw specifically in the quarter around trend? And then Felicia maybe you can comment on what you included around trend assumption in your MA bids as we think about 2025.

非常感謝，早安。我想暫時堅持使用 Medicare Advantage。您能談談您在本季具體看到的趨勢嗎？然後，Felicia 也許您可以評論一下您在 MA 出價中包含的有關趨勢假設的內容，就像我們對 2025 年的看法一樣。

Great. I'll ask Mark to comment on your question.

偉大的。我會請馬克對你的問題發表評論。

Thanks very much for the additional question here on Medicaid. First, we are seeing a larger than typical pull forward effect, and that's really driven by the increased numbers of Medicaid members who are losing coverage because think about this is beneficiaries who are facing an imminent losses coverage in the month or so proceeding that coverage lost picking up additional benefits.

非常感謝您提出有關醫療補助的附加問題。首先，我們看到了比典型的拉動效應更大的影響，這實際上是由失去保險的醫療補助成員數量增加所推動的，因為考慮到這是受益人，他們在保險失去的一個月左右的時間裡面臨著迫在眉睫的損失保險獲得額外的好處。

Second; on characterization among the core expansion and specialized population has caused some localized revenue pressure. Some members expect to regain coverage after previously being determined ineligible and the third on the topic of Medicaid elevated to outpatient trends of elective procedures.

第二;核心擴張和特殊人群的特徵造成了一些局部收入壓力。一些成員希望在先前被確定不符合資格後重新獲得保險，第三個關於醫療補助的主題上升到選擇性手術的門診趨勢。

Steve just flagged me to talk about Medicare, so I apologize for that. On the Medicare the answer is very short trains developed in line with expectations.

史蒂夫剛剛標記我談論醫療保險，所以我為此道歉。在醫療保險方面，答案是按照預期開發非常短的列車。

Thank you. Our next question, please.

謝謝。請我們下一個問題。

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究中心。

Thanks. Appreciate the question. First, can you saw on the embedded to the trend increase that you're seeing here? And then second, I just wanted to follow up on Kevin's question on government margins.

謝謝。感謝這個問題。首先，您能看到您在這裡看到的嵌入式趨勢的成長嗎？其次，我只想跟進凱文關於政府利潤的問題。

Understand you don't want to give a specific job out margin levels, but was wondering if you could share your expectation of the trajectory of margins in Medicare Advantage Medicaid for 2025 versus 2024. Thanks.

了解您不想給出具體的利潤水平，但想知道您是否可以分享您對 2025 年與 2024 年 Medicare Advantage Medicaid 利潤軌蹟的預期。

Thanks very much for the question. Segment, margins in the quarter improved by 20 basis points year over year. And I'd argue that the first half results here are consistent with our initial guidance range, and we expect full year margins to end within our initial outlook, up 25 basis points to 50 basis points, primarily driven by the ongoing recovery of our commercial business.

非常感謝您的提問。該部門的利潤率年增了 20 個基點。我認為，上半年的業績與我們最初的指導範圍一致，我們預計全年利潤率將在我們最初的預期範圍內，上漲25 個基點至50 個基點，這主要是由我們商業業務的持續復甦推動的。

From a seasonality perspective, there are two key comments, I wanted to draw out -- draw out here. For modeling purposes second quarter revenue growth is going to mark the low point for the year, and we expect third and fourth quarter operating revenue and premium revenue growth rates to improve.

從季節性的角度來看，有兩個關鍵的評論，我想在這裡畫出來。出於建模目的，第二季營收成長將標誌著今年的低點，我們預計第三季營業收入和保費收入成長率將有所改善。

And secondly just on the analog, the ties directly to your question. We now expect the third quarter MLR out to be near the high end of our full year guidance range. And I note the specifically, Justin, the current third quarter consensus estimate does not appear to capture the calendar date calendar day shift associated with the leap year.

其次，就模擬而言，這與你的問題直接相關。我們現在預計第三季國土資源貸款將接近我們全年指引範圍的高端。我特別指出，賈斯汀，目前第三季的共識估計似乎沒有捕捉到與閏年相關的日曆日期日曆日移。

And that's going to have approximately a 70 basis point impact on the third quarter MLR.

這將對第三季國土資源利率產生約 70 個基點的影響。

Thank you. Next question, please.

謝謝。請下一個問題。

Erin Wright, Morgan Stanley.

艾琳·賴特，摩根士丹利。

Hey, thanks for taking my question. Can you talk a little bit about the investments you're making around Carelon are at and how you're thinking about the trend line in terms of scaling specialty? And are there are ample opportunities out there for you to like Kroger and Paragon out there?

嘿，謝謝你回答我的問題。您能否談談您圍繞 Carelon 進行的投資以及您如何看待專業擴展方面的趨勢線？您是否有足夠的機會喜歡克羅格和Paragon？

Well, thanks. Thanks, Erin, and welcome to our call. I think that's the first time you've been on our call. So it's great to hear from you. I'll ask Pete to comment.

非常感謝。謝謝艾琳，歡迎打電話給我們。我想這是你第一次接聽我們的電話。很高興收到您的來信。我會請皮特發表評論。

Yes, no, thank you. We feel very good about our specialty strategy, and I appreciate the question. I'll turn out to repeat what I said before and give you a little bit more context. But as I noted as it related to our specialty, some strategy we acquire BioPlus last year in 2023.

是的，不，謝謝。我們對我們的專業策略感覺非常好，我很欣賞這個問題。我將重複我之前說過的話，並為您提供更多背景資訊。但正如我所指出的，由於這與我們的專業相關，我們去年在 2023 年收購了 BioPlus。

And again, we spent a lot of time on last year and building out the infrastructure and the capacity to be able to assume Elevance Scripps. And as it relates to the near term, is being able to migrate Elevance Scripps, which will occur through this year and into 2025.

再說一次，我們去年花了很多時間來建立基礎架構和能力，以便能夠承擔 Elevance Scripps 的任務。與近期相關的是，能夠遷移 Elevance Scripps，這將在今年持續到 2025 年。

As you as you noted, we're going to be opportunistic and we have been as it relates to things like Kroger, that provides additional scale for us to give you a little bit of color on Clover, it's about 500,000 incremental Scripps.

正如您所指出的，我們將採取機會主義態度，並且我們一直在處理像克羅格這樣的事情，這為我們提供了額外的規模，可以為您在Clover 上提供一點顏色，大約是500,000 增量Scripps。

They also give us access to additional LDDs as well as having a presence in places like Puerto Rico, which could help us as well. And so we'll continue to be opportunistic as it relates to our specialty strategy and really our focus to deliver our Whole Health.

他們也讓我們能夠接觸到更多的 LDD，並在波多黎各等地開展業務，這也可以幫助我們。因此，我們將繼續保持機會主義，因為這與我們的專業策略以及我們致力於提供整體健康的真正重點有關。

We are anticipating, as I noted earlier, that Kroger, we closed Q3, Q4 of this year, and we're preparing for that and continuing to make investments around that.

正如我之前指出的，我們預計克羅格將在今年第三季和第四季結束，我們正在為此做好準備，並繼續圍繞這一點進行投資。

But I'd say as we move forward more broadly, and Gail touched upon this as it relates to our specialty strategy . There's a real focus on patient differentiation and on health. We have a wonderful opportunity as we move forward to really drive Whole Health and capture on all the value of Carolan, including things like integrating behavioral health and other services.

但我想說，當我們更廣泛地向前邁進時，蓋爾談到了這一點，因為它與我們的專業策略有關。真正關注患者的差異化和健康。我們有一個絕佳的機會，我們將繼續真正推動 Whole Health 並抓住 Carolan 的所有價值，包括整合行為健康和其他服務等。

And so that's going to be our volume of our goals and focus moving forward. We feel very bullish about it. We feel very bullish about our growth. We feel very bullish about delivering on the Carelon strategy and WholeHealth as we move forward.

這將是我們的目標和前進的重點。我們對此感到非常樂觀。我們對我們的成長感到非常樂觀。隨著我們的前進，我們對實現 Carelon 策略和 WholeHealth 感到非常樂觀。

Next question, please. Thank you, Pete.

請下一個問題。謝謝你，皮特。

Michael Hall, Baird.

麥可霍爾，貝爾德。

Thank you. Just wanted to ask about your long-term growth target in your deck. You now have a slight decline in health benefits, long-term growth Kroger. Apologies if I missed your comments, but could you provide what color what's driving that and a Medicaid premium or in our commercial? And then I also think you reaffirmed our long-term targets on Carelon.

謝謝。只是想問一下您的長期成長目標。你現在的健康效益略有下降，克羅格長期成長。如果我錯過了您的評論，我深表歉意，但是您能否提供是什麼顏色推動了這一點以及醫療補助溢價或在我們的廣告中？然後我還認為您重申了我們對卡雷隆的長期目標。

But over the past year and carried Investor Day since hitting our partnership, BioPlus the acquisition of Paragon pending grow the business seemingly have taken a very positive step forward in Gabon mission.

但在過去的一年裡，自從我們建立合作關係以來，BioPlus 收購了 Paragon，並在投資者日進行了業務增長，這似乎在加彭使命中邁出了非常積極的一步。

Would it be fair to say your prior target at Investor Day, most of those consumption within your guide or long-term targets did not contemplate all the new development and specifically Carelon therapy and revenue per consumer serve a 50% growth target by '27 now appears like there's much, much higher runway. So just overall even though you are reaffirming your target, it's just true that now today, there's many greater attentional embedded power with Carelon verses out last two years that could be unlock your future years. Thank you.

公平地說，您在投資者日的先前目標，您的指南或長期目標中的大部分消費都沒有考慮到所有新的發展，特別是Carelon 療法和每位消費者的收入，到27 年將達到50% 的成長目標看起來跑道要高得多。因此，總的來說，即使你重申了你的目標，但事實上，今天，卡隆過去兩年的詩句中蘊藏著許多更大的注意力，可以解鎖你未來的歲月。謝謝。

This quarter, we are pleased to introduce our growth algorithm, which underpins our adjusted diluted earnings per share target of average annual growth of at least 12% over time.

本季度，我們很高興推出我們的成長演算法，該演算法支援我們調整後的攤薄每股收益隨著時間的推移平均年增長率至少為 12% 的目標。

You asked a little bit about the revision. And we have revised our enterprise revenue growth target from the high single to low double digits to high single digits percent range and that's primarily to reflect Medicaid related attrition that has occurred to date and the impact of the prudent actions that we're taking in our 2024 in 2025 Medicare Advantage bids in response to the risk model decisions.

你問了一些關於修訂的問題。我們已將企業收入成長目標從高個位數百分比範圍修改為低兩位數百分比範圍，再到高個位數百分比範圍，這主要是為了反映迄今為止發生的與醫療補助相關的人員流失以及我們在我們的業務中採取的審慎行動的影響。

Accordingly, Health Benefits segment revenue, CAGR should now be in the will now be in the mid to upper single digit percent range.

因此，健康福利部門的收入複合年增長率現在應該處於中上個位數百分比範圍內。

But the key point here is a positive move at the same and that really mean that we're expecting high single digit, low double digit percent growth in operating earnings in the key point here to the second half of your question, with approximately one-third contribution from capital deployment and at capital deployment can come through in the form of inorganic activity to support our key alone businesses.

但這裡的關鍵點同時也是一個積極的舉措，這實際上意味著我們預計在問題後半部分的關鍵點上，營業收入將出現高個位數、低兩位數的百分比增長，大約有一個-來自資本部署和資本部署的第三個貢獻可以以無機活動的形式實現，以支援我們的關鍵業務。

Thank you. Next question, please.

謝謝。請下一個問題。

Andrew Mok, Barclays.

安德魯·莫克，巴克萊銀行。

Hi, good morning. I wanted to follow up on some of the Medicaid comments. It sounds like you're optimistic about rates get better in the back half, but also acknowledge a temporary disconnect that persists and expect higher Medicaid utilization in the back half. So if we translate that into MLR expectations. Does guidance assume that Medicaid MLR peaks into 2Q, it gets better from here with potentially better rates?

早安.我想跟進一些醫療補助評論。聽起來您對後半段的費率改善持樂觀態度，但也承認暫時的脫節仍然存在，並預計後半段的醫療補助利用率會更高。因此，如果我們將其轉化為國土資源部的期望。指導是否假設醫療補助 MLR 在第二季度達到頂峰，從這裡開始變得更好，利率可能會更高？

Or do you expect that to pick up some point in the back half of the year? Thanks.

或者您預計這種情況會在今年下半年有所回升嗎？謝謝。

Great question and the opening comments there are completely consistent with the way that we're thinking about it. You should really think about this as we now expect our full year benefit expense ratio to be in the upper half of that initial guidance range to 87% to 87.5%, principally because of the Medicaid dynamic that we're navigating. We're not looking to provide specific quarter-by-quarter guidance.

很好的問題和開場評論與我們的思考方式完全一致。您應該認真考慮這一點，因為我們現在預計全年福利費用比率將位於初始指導範圍的上半部分，即 87% 至 87.5%，這主要是因為我們正在推動醫療補助動態。我們不希望提供具體的季度指引。

Next question, please.

請下一個問題。

Ryan Langston from Cowen.

來自考恩的瑞安·蘭斯頓。

Hi, good morning. Just a quick one for me. Prior year development was a bit more favorable than we expected. Can you maybe give us a sense on if that's just mostly from the fourth quarter? And if so, any kind of a particular pockets of utilization you'd call out as maybe coming in better than expected? Thanks.

早安.對我來說只是一個快速的。去年的發展比我們預期的要好一些。您能否讓我們了解一下這是否主要來自第四季？如果是這樣，您認為任何特定的利用率可能會比預期更好？謝謝。

Thanks very much for the question. Let me put the prior year development in the context of the medical claims payment change this quarter's. I think that's more instructive to understand the dynamics here and useful medical claims payable in the quarter go down by approximately $1.3 billion versus the first quarter.

非常感謝您的提問。讓我將去年的發展與本季的醫療索賠支付變化聯繫起來。我認為了解這裡的動態更有啟發性，本季應付的有用醫療索賠比第一季減少了約 13 億美元。

They're really several factors that drove this and then ultimately drove PYD development. And they include the reserve rental due to Medicaid membership decline. The catch-up in claims paid associated with elevated reserves for industry wide claim receipt delays in the first quarter and then the improved operational efficiency element that's reflected through our shorter cycle times.

實際上有幾個因素推動了這一點，並最終推動了 PYD 的發展。其中包括由於醫療補助會員資格下降而產生的儲備租金。已支付索賠的追趕與第一季全行業索賠接收延遲的準備金增加有關，然後透過我們更短的周期時間反映了營運效率的提高。

The key point here is that MCP, which is why it's more instructive, remains at historically high levels, both in aggregate and on a fully insured PMPM basis and it indicates the continuity of our historical prudent reserving practices and our strong balance sheet.

這裡的關鍵點是，MCP（這就是為什麼它更具指導性）仍然處於歷史高位，無論是在總體上還是在完全保險的PMPM 基礎上，它表明了我們歷史上審慎準備金實踐和強勁資產負債表的連續性。

Thank you, Mark. And Ryan, welcome to our call for the first time. It's great to have you. Next question, please.

謝謝你，馬克。 Ryan，歡迎您第一次致電我們。很高興有你。請下一個問題。

Stephen Baxter, Wells Fargo.

史蒂芬‧巴克斯特，富國銀行。

Hi, thanks very much around the come back to their Medicaid utilization comments. I think you are making in response to an earlier question of us to expand a little bit on that.

您好，非常感謝您回到醫療補助利用評論。我認為您是在回答我們之前提出的問題，對此進行了一些擴展。

I can you comment perhaps on how much of the pressures geographically isolated and some of your markets versus maybe more broad based? I think you're speaking to you also have some utilization of care from people that were expecting to lose coverage.

我能否請您評論地理上孤立的壓力以及您的一些市場與可能更廣泛的市場之間的壓力有多大？我認為您正在與您交談的情況下，也有一些原本希望失去保險的人利用了護理服務。

Would you be expecting that dynamic to slow a little bit as redeterminations? And or is that potentially offset by rejoined our dynamics are factors like that? Thank you.

您是否期望隨著重新決定，這種動態會稍微放緩？或者說，這種情況是否可能被重新加入我們的動態等因素所抵消？謝謝。

Thanks for the question and appreciate the opportunity to provide additional clarification here. And certainly we expect to be larger than typical pull-forward effect that we've seen in the second quarter to abate as the year goes on, principally because we're through the tail end of redeterminations at this point that we are obviously working with the states to ensure that the timing and rate mismatches appropriately adjusted.

感謝您提出問題，並感謝有機會在這裡提供額外的說明。當然，我們預計，隨著時間的推移，我們在第二季度看到的典型拉前效應會減弱，這主要是因為我們目前正處於重新決定的尾聲，我們顯然正在努力解決這一問題各州確保對時間和費率不匹配的情況進行適當調整。

On the member mis categorization, this is really ensuring that those members who were initially categorised, for example, is tenants and are putting the more appropriate and cohort for purposes of rates to think about ABD, for example.

例如，關於會員錯誤分類，這確實確保了最初分類的那些會員是租戶，並出於費率目的考慮 ABD 等更合適的群體。

And then what we are real, we're seeing elevate as the year goes on the outpatient trends in elective procedures, and that's something that we fully accounted for in our MLR guide for the full year.

然後我們看到的是，隨著時間的推移，擇期手術的門診趨勢有所上升，我們在全年 MLR 指南中充分考慮了這一點。

Next question, please.

請下一個問題。

Scott Fidel, Stephens.

斯科特·菲德爾，史蒂芬斯。

Hi, thanks. Good morning. I was hoping you could drill a bit more into the $4.3 billion of timing items that impacted operating cash flow on and Just wanted to see whether you expect all those to reverse in the back half of the year end and whether you're comfortable reaffirming your full year? CFO, targeted at least $8.1 billion on and if not, where you expect job operating cash flow to land for the year. Thanks.

你好謝謝。早安.我希望您能對影響營運現金流的 43 億美元時間項目進行更多深入研究，只是想看看您是否預計所有這些都會在今年下半年扭轉，以及您是否願意重申您的觀點。財務長的目標是至少 81 億美元，如果沒有，您預計今年的工作營運現金流將達到多少。謝謝。

Appreciate the question this morning. Year-to-date operating cash flow is $2.4 billion. And to your point, there is a decrease of approximately $6 billion year over year.

感謝今天早上提出的問題。年初至今的營運現金流為 24 億美元。就您而言，年比減少了約 60 億美元。

The key point here is that this includes $4.3 billion of timing related items and approximately $1.3 billion of net cash outflows that are primarily associated with the runoff of our Medicaid reserves and the improvement in the operational environment, which is reflected by a short shorter cycle times.

這裡的關鍵點是，這包括43 億美元的時間相關項目和約13 億美元的淨現金流出，這些淨現金流出主要與我們的醫療補助儲備金的流失和營運環境的改善有關，這反映在較短的周期時間上。

The timing related item reflects the additional month of premiums that we received from CMS in the year ago period. And so not a concern from our perspective. On a full-year basis, we do expect operating cash flow outlook to be slightly north of $7 billion, and that really reflects the year to date reductions in working capital.

與時間相關的項目反映了我們去年同期從 CMS 收到的額外月份保費。因此，從我們的角度來看，這不是一個問題。從全年來看，我們確實預計營運現金流前景將略高於 70 億美元，這確實反映了今年迄今營運資本的減少。

And specifically, as I mentioned a moment ago that decreasing MCP driven by Medicare membership attrition.

具體來說，正如我剛才提到的，醫療保險會員流失導致 MCP 減少。

Next question, please.

請下一個問題。

Sarah James, Cantor Fitzgerald.

莎拉詹姆斯，康托費茲傑拉。

Thank you. Saw in the prepared remarks, you guys mentioned a significant win with Blue Cross Blue Shield partner. I was wondering if you can help us size your pipeline there and give us any clarity on how penetrated you are in to that market. How many of your Blues Brothers, do you currently have contracts with? And what's the opportunity look like to expand this?

謝謝。在準備好的發言中看到，你們提到了與藍十字藍盾合作夥伴的重大勝利。我想知道您是否可以幫助我們確定您在那裡的管道規模，並讓我們清楚地了解您對該市場的滲透程度。您目前與多少位布魯斯兄弟簽訂了合約？擴大這範圍的機會是什麼？

Great. Thanks Sarah . Thanks a lot for the question. Appreciate it. And yes, we're really pleased with how services growth is going. We mentioned 26% growth on the quarter on a clear path of achieving our long-term objective. So we feel very good about the.

偉大的。謝謝莎拉。非常感謝您的提問。欣賞它。是的，我們對服務成長的進展感到非常滿意。我們提到本季 26% 的成長是實現我們長期目標的明確途徑。所以我們感覺非常好。

As it relates to your question, again, our focus is a skill set earlier building capabilities internally and importing them externally, and we're seeing that play through and you referenced the Blues. I would say that we are currently engaged with most of the Blues, and our strategy with regard to that is really from landing and expanding to be quite frank.

因為它與您的問題相關，所以我們的重點是早期在內部建立能力並將其導入外部的技能集，我們正在看到這一點，您提到了藍軍。我想說的是，我們目前正在與大多數藍軍接觸，坦白說，我們的策略實際上是從登陸和擴張開始。

And this is a great example of that where we have got an existing relationship with the client, we continue to grow those services with that -- with that particular Blue, they see the value and that we were able to convert some of those capabilities to risk.

這是一個很好的例子，我們與客戶建立了現有的關係，我們繼續以此來發展這些服務——透過特定的藍色，他們看到了價值，並且我們能夠將其中一些功能轉換為風險。

And I'll remind you that that is a very big part of our strategy, no assumption of risk, both on a category of service basis as well as a full risk basis and so on, you'll see that continue to move forward. As it relates to the pipeline from this year, we're doing very well. '24 growth year over year is very, very strong functional. You'll see really nice improvement from that perspective.

我會提醒您，這是我們策略的一個非常重要的部分，不承擔風險，無論是在服務類別的基礎上還是在完整的風險基礎上等等，您都會看到這種情況繼續向前發展。就今年的管道而言，我們做得很好。 '24 年成長的功能性非常非常強。從這個角度來看，你會看到非常好的改進。

And as you would expect, we're already selling into 2025, a real focus in 2025, our behavioral health capabilities of our post-acute capabilities and then some of our Carelon health businesses. So appreciate the question time.

正如您所期望的那樣，我們已經在銷售到 2025 年，這是 2025 年真正的重點，我們的行為健康能力、急性後能力，然後是我們的一些 Carelon 健康業務。所以感謝提問時間。

Yes. Thanks, Pete, and thanks to the question, Sarah, in, as you heard from Pete, it's an idea of exciting opportunities to deepen our penetration because we do work with most of the Blue other Blues today and also some other payers, quite frankly, and state partners has been a great opportunity for Carelon broadly, and you're seeing that come through.

是的。謝謝皮特，謝謝莎拉的問題，正如您從皮特那裡聽到的那樣，這是一個加深我們滲透的令人興奮的機會的想法，因為坦率地說，我們今天確實與大多數藍隊其他藍隊以及其他一些付款人合作以及州合作夥伴對 Carelon 來說是一個巨大的機會，你會看到它的實現。

So thanks for the question. We're excited about the opportunity there. Next question, please.

謝謝你的提問。我們對那裡的機會感到很興奮。請下一個問題。

George Hill, Deutsche Bank.

喬治·希爾，德意志銀行。

Hey, good morning, guys. I appreciate you taking the question. I guess, Mark, I was just going to ask if you could bridge a little bit when we think about the 2027 OP margin targets in the MCO segments. So like how you think about the sources of the margin expansion there.

嘿，早上好，夥計們。我很感謝你提出這個問題。我想，馬克，我只是想問一下，當我們考慮 MCO 領域的 2027 年 OP 利潤率目標時，您是否可以提供一點幫助。就像您如何看待利潤擴張的來源一樣。

And I'd be interested in particular if you would talk about what your expectations are around the extreme subsidies, nuclear to the exchange business.

如果您能談談您對極端補貼（對交易所業務至關重要）的期望，我會特別感興趣。

Thank you very much for the question to George and certainly happy to talk through the algorithm it a little bit of a high-level. Thinking about this is being driven by upper single digit growth in revenue. Enterprise operating margin expansion to 6.5% to 7%, and then the balanced approach to capital deployment, increases of share repurchase, buses and strategic M&A.

非常感謝您向喬治提出的問題，並且很高興與您討論演算法，它有點高級。考慮到這一點是由收入高個位數成長所推動的。企業營業利潤率擴張至6.5%至7%，然後以均衡方式進行資本配置、增加股份回購、巴士和策略併購。

On the revenue side, revenue growth is going to be driven by increased membership in the health benefits business, geographic expansion efforts and improving pricing to cover cost trend.

在收入方面，收入成長將由健康福利業務會員數量的增加、地理擴張努力以及改善定價以覆蓋成本趨勢來推動。

And then similarly in Carelon key drivers are going to include the expansion of risk-based revenue and Carelon services and the continued growth and CarelonRx membership. On the margin side, expansion is going to reflect the disciplined operating expense management and the transformation of some of our business processes, leveraging new technologies and including AI.

同樣，在 Carelon 中，關鍵驅動因素將包括基於風險的收入和 Carelon 服務的擴張以及持續增長和 CarelonRx 會員資格。在利潤方面，擴張將反映出嚴格的營運費用管理以及我​​們一些業務流程的轉型，利用新技術（包括人工智慧）。

And that coupled together with that, we'll at least the way to think about effective medical management. It's an underwriting disciplines where they can enable us to achieve the enterprise operating margin target.

再加上這一點，我們至少會思考有效的醫療管理的方式。這是一種承保紀律，可以使我們實現企業營運利潤率目標。

And then finally, consistent with our 2023 Investor Day guidance, we do expect to achieve approximately a third of our adjusted diluted EPS growth rate through capital deployment.

最後，根據我們 2023 年投資者日的指導，我們確實預計透過資本部署實現調整後稀釋每股盈餘成長率的約三分之一。

Thank you, Mark. And to your second part of the question around our exchange business, as you have heard us talk about, we have done, I think, very disciplined in our approach to expanding that business. We have had very strong results are individually up 30% -- 35% year over year, with the ACA growing almost 40%.

謝謝你，馬克。關於我們的交易所業務問題的第二部分，正如您所聽到的，我認為，我們在擴展業務的方法上非常嚴格。我們取得了非常強勁的業績，單獨同比增長了 30% 至 35%，其中 ACA 增長了近 40%。

So as you think about that, our goal is to serve our members throughout their coverage transitions. We see a significant opportunity to continue that expansion, including geographic draft, geographic expansion, particularly to our members that were historically in Medicaid and now need other coverage.

因此，正如您所想，我們的目標是在會員的承保範圍過渡期間為他們提供服務。我們看到了繼續擴張的重要機會，包括地理草案、地理擴張，特別是對我們歷史上參加過醫療補助但現在需要其他保險的會員。

So again, a really nice opportunity. You'll see that same sort of just on approach that we've shown throughout the ACA. Next question, please.

再說一遍，這是一個非常好的機會。您將看到我們在整個 ACA 中展示的同樣的方法。請下一個問題。

Whit Mayo, Leerink Partners.

惠特·梅奧，Leerink 合夥人。

Hi, thanks. Just quickly on mid-year renewals, just remind us how much of the commercial risk book renews in the second half of this year, just how you're thinking about retention, membership ability to take the record price action that you need?

你好謝謝。請快速介紹一下年中續訂，請提醒我們今年下半年商業風險手冊的續訂量，您如何考慮保留率以及採取您所需的創紀錄價格行動的會員能力？

And just as a clarification, is it fair that commercial is performing better than our expectations on margin with government worse, at least the first off? I just wanted to make sure are appropriately got this. Thanks.

需要澄清的是，商業銀行的利潤率表現好於我們的預期，而政府的表現更差，至少在第一階段，這公平嗎？我只是想確保我們正確地得到了這個。謝謝。

All right. Thank you. I'm going to ask Morgan Kendrik who leads our commercial business address your questions.

好的。謝謝。我將請負責我們商業業務的摩根·肯德里克（Morgan Kendrik）回答您的問題。

Whit thanks for the question. We think about it that cohort of business that we renew in July, about 25% of the risk-based large group business into to stamp onto that, you do with it performed as expected. In fact, we're seeing persistence up a bit.

惠特感謝您的提問。我們認為，我們在 7 月更新的業務群中，約 25% 的基於風險的大型集團業務進入了這一階段，您的表現符合預期。事實上，我們看到持久性有所提高。

We talked about attrition in the large group risk as with our January cohort on the first quarter call, that's abated, and we're seeing persistency improved and we're seeing the margins coming through. So we feel really good about how we're positioned for continued growth and expansion in that business moving forward.

我們討論了大型集團風險的流失，就像我們在第一季度電話會議上一月份的群組一樣，這種風險已經減弱，我們看到持久性得到改善，我們看到利潤率正在上升。因此，我們對如何在該業務中實現持續成長和擴張感到非常滿意。

Next question, please.

請下一個問題。

Dave Windley, Jefferies.

戴夫·溫德利，杰弗里斯。

Thanks for taking my question. I believe you have a cost savings plan targeting around $750 million. That's maybe a relatively near term initiative. I'm wondering if you could describe your progress against that. And then also, should we think about the benefits of those savings dropping through? Or are you mostly reinvesting those savings and some of your growth initiatives? Thank you.

感謝您提出我的問題。我相信您有一個目標為 7.5 億美元左右的成本節約計劃。這可能是個相對近期的舉措。我想知道您是否可以描述一下您的進展。然後，我們是否應該考慮這些節省下來的好處？或者您主要將這些儲蓄和一些成長計劃進行再投資？謝謝。

Dave. Good morning. Thanks very much for the question. In terms of the 2023 business optimization activity, we are on track to realize the gross run rate expense efficiency improvement of approximately $750 million that we committed to do, and that's going to benefit both our operating performance this year. And it's going to help to establish the strong foundation for growth in 2025 and beyond.

戴夫.早安.非常感謝您的提問。就 2023 年業務優化活動而言，我們有望實現我們承諾的約 7.5 億美元的總運行率費用效率改進，這將有利於我們今年的營運表現。這將有助於為 2025 年及以後的成長奠定堅實的基礎。

If I step back just for a moment and we covered this a bit in our prepared remarks, we do anticipate significant improvement in our operating expense ratio in the second half of the year.

如果我退後一步，我們在準備好的發言中對此進行了一些討論，我們確實預計下半年我們的營運費用率將出現顯著改善。

As we continue to take additional steps to enhance operational efficiency and we'll begin to see and realize those incremental run rate improvements over time. Thank you.

隨著我們繼續採取額外措施來提高營運效率，我們將開始看到並實現隨著時間的推移逐步提高運行率。謝謝。

Thank you, Mark and Dave. I might maybe just spend a moment because I think it's a great opportunity to share a little bit about how we're going about this. We, first of all, have been very disciplined about our expense management.

謝謝你們，馬克和戴夫。我可能會花一點時間，因為我認為這是一個很好的機會來分享我們如何解決這個問題。首先，我們對費用管理非常嚴格。

More importantly, we believe the opportunity around generative AI. for our business is expensive, and it's going to materially impact all parts of our organization. We've enhanced experiences while driving costs down but also fueling future expansion.

更重要的是，我們相信生成式人工智慧的機會。因為我們的業務成本高昂，而且會對我們組織的所有部門產生重大影響。我們增強了體驗，同時降低了成本，同時也推動了未來的擴張。

And I would say over the last few months, we've really accelerated those internal efforts. And again, this has been a journey, so it's not new, but we are going to start seeing that absolute impact of the AI technology and digitization around our significant operational areas.

我想說，在過去的幾個月裡，我們確實加快了這些內部努力。再說一遍，這是一個旅程，所以這並不新鮮，但我們將開始看到人工智慧技術和數位化對我們重要營運領域的絕對影響。

And just a couple of things maybe to make this real as we transform and there's kind of three areas around the engagement model that we think about members, providers and our own associates who are critical to this journey with us.

在我們轉型的過程中，只需做幾件事就可以使這一目標成為現實，圍繞參與模式，我們考慮了會員、提供者和我們自己的同事，他們對我們的旅程至關重要。

On the member side, we look at each interactions of our members, and we're using AI to make those much more unique and personalized integrating and across our member touch points. Oftentimes, there's disconnects in those touch points and that's a huge opportunity for us to take really personalized digital service and enrich that experience.

在會員方面，我們關注會員的每一次互動，並且我們正在使用人工智慧來使這些互動在我們的會員接觸點上更加獨特和個性化。通常，這些接觸點會出現脫節，這對我們來說是一個巨大的機會，可以提供真正個人化的數位服務並豐富這種體驗。

And what does that do? I mean, the real impact you see it as improved access to care, better claims processing, less error rates, reduction of our calls use of chat. So those are some very tangible ways that we're deploying that and have been over the last year. You're going to start seeing that come through based on what Mark just shared.

那有什麼作用呢？我的意思是，您認為它的真正影響是改善了獲得護理的機會、更好的索賠處理、更少的錯誤率、減少了我們的通話使用聊天。這些是我們去年部署的一些非常實際的方式。根據馬克剛剛分享的內容，您將開始看到這一點。

The provider side is an area that I'm particularly excited about because we are looking at reimagining and streamlining all of our admin tax at tests rather on an end to end basis with the provider lifecycle. That's a lot.

提供者方面是我特別興奮的一個領域，因為我們正在考慮重新構想和簡化測試時的所有管理稅，而不是在提供者生命週期的端到端基礎上。好多啊。

But as you think about the impacts there with touch, not just providers, but also members and some very specific things like automating the onboarding process of how they come into our plans, refining roster management, specifically around data and how that tries downstream to claims, also enhancing contract administration.

但是，當您考慮觸摸的影響時，不僅是提供者，還包括會員和一些非常具體的事情，例如自動化他們如何進入我們的計劃的入職流程，完善花名冊管理，特別是圍繞數據以及如何嘗試下游索賠，同時加強合約管理。

And we think those interactions are going to improve our member experiences, but also improve our relationship and our ability to work and value-based care with our care providers and more seamless and then I'll end with associates because we know that they need to be part of this journey.

我們認為這些互動將改善我們的會員體驗，同時也改善我們的關係以及我們與護理提供者的工作能力和基於價值的護理，並且更加無縫，然後我將以員工結束，因為我們知道他們需要成為這個旅程的一部分。

It's also a cultural journey on AI, that's going to drive, I think, greater efficiency. And we rolled out our Spark, which is our internal chat, GPT tool to over 50,000 of our associates for the day, can harness the capability, use it and improve their own productivity, and we're seeing really nice results from that.

這也是人工智慧的文化之旅，我認為這將提高效率。我們當天向超過 50,000 名員工推出了 Spark，這是我們的內部聊天 GPT 工具，可以利用該功能，使用它並提高他們自己的生產力，我們從中看到了非常好的結果。

So again, I wanted to just share that because at the -- I think our expense focus and efficiency is driven a lot by the impact we're going to see from that and what we have a lot of opportunities, we're trying to look at the end to end impact of where we can take friction out of the system and fundamentally improve what we're doing.

再次強調，我想分享這一點，因為我認為我們的支出重點和效率在很大程度上是由我們從中看到的影響以及我們有很多機會驅動的，我們正在努力看看我們可以在哪些方面消除系統中的摩擦並從根本上改進我們正在做的事情的端到端影響。

So hopefully, that gives you a sense of how we're going about achieving the goals that we said. And we see huge opportunities going forward and embedded into our growth algorithm for the future.

希望這能讓您了解我們將如何實現我們所說的目標。我們看到了未來的巨大機遇，並將其嵌入到我們未來的成長演算法中。

Next question, please.

請下一個問題。

Ann Hynes, Mizuho Securities.

安·海因斯，瑞穗證券。

Hi, good morning. And I just want to focus on specialty. I know that Elevance with the acquisitions are in-sourcing was specialty not only on the dispensing side, but also the distribution side. So I'm just I'm curious about your strategy longer term getting gets more opportunity for space royalty on the distribution side.

早安.我只想專注於專業。我知道 Elevance 的收購是內包的，不僅在配藥方面很專業，而且在分銷方面也很專業。所以我只是對你們的長期策略感到好奇，以獲得更多的分銷方面的空間使用費機會。

And if you think there is any therapeutic area and you're focused on? Thanks.

如果您認為有任何治療領域是您所關注的？謝謝。

Thanks for the question. And we think there's a tremendous opportunity as it relates to specialty, as I said earlier, are our priority in the near term is some of the Elevance Scripps and absorbing the Elevance scripts to effectively.

謝謝你的提問。我們認為，正如我之前所說，與專業相關的是一個巨大的機會，我們近期的首要任務是一些 Elevance Scripps 並有效地吸收 Elevance 腳本。

And then also, as we talked about what we're doing with Kroger, we continue to see operation entities to cover more LDDs. And then in addition to that, as it relates to Whole Health, we are very focused on the patient experience. We are very focused on centers of excellence and how we can care for the members of a differentiated way by wrapping around additional assets.

此外，當我們談論我們與克羅格所做的事情時，我們繼續看到營運實體涵蓋更多的 LDD。除此之外，由於它與整體健康有關，我們非常關注患者的體驗。我們非常關注卓越中心以及如何透過附加資產以差異化的方式照顧會員。

Longer term, again, we will be opportunistic. But right now, we have a lot in front of us and we want to execute against that effectively as it relates to specialty.

從長遠來看，我們將再次採取機會主義態度。但現在，我們面臨著許多挑戰，我們希望有效地執行這些任務，因為它與專業相關。

Thanks, Pete. And I just want to highlight one point that Pete said, it's really an integration strategy. Specialty has a long runway for us. But the integration to our Carelon services and what we did deliver better value for our health plan members is really critical to our strategy. I think that is unique.

謝謝，皮特。我只想強調皮特所說的一點，這確實是一種整合策略。專業對我們來說有很長的跑道。但與我們的 Carelon 服務的整合以及我們所做的為我們的健康計劃會員提供更好的價值對於我們的策略來說確實至關重要。我認為這是獨一無二的。

Our ability to take both the specialty pharmacy, but all the specialty services around the time disease categories we think is differentiating. So thank you. Last question we're going to take now, please.

我們有能力接受專業藥房，但我們認為圍繞時間疾病類別的所有專業服務是差異化的。所以謝謝。我們現在要回答最後一個問題，請。

Ben Hendrix, RBC Capital Markets.

本‧亨德里克斯，加拿大皇家銀行資本市場部。

Hi, thank you very much. I just wanted a quick follow-up on for Felicia's comments on MA bids for next year. I realize it's too early to talk about growth, but I think we've I think earlier in the year, you had talked about long-term in a growth focus toward Carelon markets.

你好，非常感謝你。我只是想快速跟進 Felicia 對明年 MA 投標的評論。我意識到現在談論成長還為時過早，但我認為我們已經在今年早些時候談到了 Carelon 市場的長期成長關注。

And I just wanted to see if you could provide any color on how your bids contemplate your geographic footprint evolving and also your density, the towards Carelon markets in 2025? Thanks.

我只是想看看您是否可以提供任何顏色，說明您的出價如何考慮您的地理足跡的演變以及您的密度，以及 2025 年卡倫市場的情況？謝謝。

So Ben, thank you for the question. We've always been very strategic around where we want to see our MA growth as we go forward. As you recall this past year, we've made very deliberate decisions around markets that we wanted to exit because we wanted to make sure that we positioned ourselves to long term growth and performance.

本，謝謝你的提問。我們一直非常注重策略，希望在前進的過程中看到我們的 MA 成長。正如你所記得的，去年，我們圍繞著我們想要退出的市場做出了非常深思熟慮的決定，因為我們希望確保我們能夠實現長期成長和業績。

Where we think about our strategy today is certainly in those areas where we have Medicare and Medicaid business because the D-Stat business is incredibly important for us. And as you think about where things are going long term, having alignment around Medicare and Medicaid is critical for us.

我們今天考慮我們的策略的地方肯定是我們擁有 Medicare 和 Medicaid 業務的領域，因為 D-Stat 業務對我們來說非常重要。當您考慮事情的長期發展方向時，圍繞醫療保險和醫療補助保持一致對我們至關重要。

But ultimately, it's absolutely about being able to deliver for the Carelon's life will as well, the members that we are focused on, particularly the step, another step product are very complex populations. And if we think about will help, we've been working very collaboratively with Pete and the team to make sure that we are able to deliver a full health for those that we are very privileged to serve.

但最終，這絕對是為了能夠為 Carelon 的生命提供服務，我們所關注的成員，特別是一步，另一步產品是非常複雜的人群。如果我們認為會有所幫助，我們一直在與皮特和團隊密切合作，以確保我們能夠為我們非常榮幸服務的人們提供全面的健康。

So the flip print really is focused on debt cities, certainly in our Blue markets, but being able to be focused on our Medicaid markets as well in places where we see opportunities to grow strategically with Carelon in the future.

因此，翻頁印刷確實專注於債務城市，當然是我們的藍色市場，但也能夠專注於我們的醫療補助市場以及我們認為未來有機會與 Carelon 進行戰略增長的地方。

And that's the pathway and framework that we've established when we think about the long-term growth for our Medicare Advantage business, which we continue to be incredibly excited about as we think about being a lot of time trusted partner for those we serve. So thank you for the question.

這就是我們在考慮 Medicare Advantage 業務的長期成長時所建立的途徑和框架，當我們考慮成為我們服務對象的長期值得信賴的合作夥伴時，我們仍然對此感到非常興奮。謝謝你的提問。

So thank you for your questions, everyone, and thank you for all of you for joining us today for your interest in your support. We look forward to sharing more about our progress that we're making on our enterprise strategy with you in the coming quarters and are confident that the balanced and resilience of our diverse set of business dispositions as positions as well.

感謝大家提出的問題，也感謝大家今天加入我們並給予我們支持。我們期待在未來幾季與您分享更多關於我們在企業策略方面的進展，並對我們多樣化的業務配置和職位的平衡性和彈性充滿信心。

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

感謝您對 Elevance Health 的關注，祝您本週休息愉快。

Ladies and gentlemen, a recording of this conference will be available for replay after 11:00 AM today through August 17 2024.

女士們、先生們，本次會議的錄音將於今天上午 11 點至 2024 年 8 月 17 日期間可供重播。

You may access the replay system at any time by dialing (800) 391-9851. International participants can dial (203) 369-3269.

您可以隨時撥打 (800) 391-9851 存取重播系統。國際參與者可撥打 (203) 369-3269。

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

我們今天的會議到此結束。感謝您的參與與使用 Verizon Conferencing。您現在可以斷開連線。