Elevance Health Inc (ELV) 2024 Q4 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Elevance Health fourth-quarter earnings conference call. (Operator Instructions)

女士們、先生們，感謝大家的支持，歡迎參加 Elevance Health 第四季財報電話會議。（操作員指令）

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.

提醒一下，今天的會議正在錄音。現在我想將會議移交給公司管理階層。請繼續。

Good morning, and welcome to Elevance Health's fourth-quarter 2024 earnings conference call. My name is Nathan Rich, Vice President of Investor Relations. With us this morning on the earnings call are Gail Boudreaux, President and CEO; Mark Kaye, CFO; Peter Haytaian, 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 年第四季財報電話會議。我叫 Nathan Rich，是投資人關係副總裁。今天早上參加財報電話會議的有總裁兼執行長 Gail Boudreaux；凱耶（Mark Kaye），財務長； Carelon 總裁 Peter Haytaian；摩根‧肯德里克 (Morgan Kendrick)，我們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。

Gail will begin the call with a review of the progress we've made against our strategic initiatives and the discussion of the quarter and our 2025 outlook. Mark will then discuss our financial results and guidance in greater detail. After our prepared remarks, the team will be available for Q&A.

蓋爾將在電話會議上首先回顧我們在戰略舉措方面取得的進展以及本季度的討論和 2025 年的展望。然後馬克將更詳細地討論我們的財務表現和指導。在我們發表準備好的發言後，團隊將進行問答。

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.

在通話過程中，我們將參考某些非公認會計準則指標。這些非 GAAP 指標與最直接可比較的 GAAP 指標的對帳表可在我們的網站 elevancehealth.com 上查閱。我們也會在本次電話會議上做出一些前瞻性的陳述。

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 expectations. We advise listeners to carefully review the risk factors discussed in today's press release and in our quarterly filings with the SEC. I will now turn the call over to Gail.

請聽眾注意，這些聲明受制於某些風險和不確定性，其中許多難以預測且通常超出了 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的預期有重大差異。我們建議聽眾仔細閱讀今天的新聞稿和我們向美國證券交易委員會提交的季度文件中討論的風險因素。現在我將電話轉給蓋爾。

Thank you, Nate, and good morning, everyone. Before we begin, I'd like to extend our deepest sympathies to the millions of people affected by the Southern California wildfires. With over 9 million members and over 6,000 Elevance Health associates in the State of California, we are especially grateful to the first responders who are working tirelessly to support the ongoing recovery efforts.

謝謝你，內特，大家早安。在我們開始之前，我想向遭受南加州野火影響的數百萬人們表示最深切的同情。Elevance Health 在加州擁有超過 900 萬名會員和超過 6,000 名員工，我們特別感謝那些不知疲倦地支持持續復原工作的急救人員。

At Elevance Health, our teams quickly mobilized to facilitate access to essential health resources and provide much-needed aid to the communities impacted by this devastating event. This moment underscores our shared humanity, reminding us that above all, we are a community dedicated to supporting people's health and well-being.

在 Elevance Health，我們的團隊迅速動員起來，為受此災難性事件影響的社區提供基本衛生資源並提供急需的援助。這一刻凸顯了我們共同的人性，提醒我們最重要的是，我們是一個致力於支持人民健康和福祉的社會。

Our purpose as a company of improving the health of humanity remains resolute, and we will demonstrate steadfast leadership in health care marked by compassion, dedication, and a profound commitment to improving the lives of the people we serve.

作為一家改善人類健康的公司，我們的目標始終堅定不移，我們將在醫療保健領域展現堅定的領導力，以同情心、奉獻精神和對改善我們服務對像生活的深刻承諾為標誌。

For our members, we play a critical role in ensuring simple, affordable, and accessible care. We recognize that the healthcare ecosystem is grappling with significant challenges, including rising costs, administrative complexity, and disparities in access to care. These issues are compound by evolving consumer expectations and the need for a more integrated approach to physical, behavioral, and social health.

對於我們的會員，我們在確保簡單、負擔得起且可獲得的護理方面發揮關鍵作用。我們認識到醫療保健生態系統正面臨重大挑戰，包括成本上升、管理複雜性以及獲得醫療服務的不平等。這些問題因消費者不斷變化的期望以及對身體、行為和社會健康採取更全面的方法的需求而變得更加複雜。

In collaboration with our partners across the industry, we're addressing these challenges with great urgency, focusing on streamlining processes, reducing costs, and improving the overall experience for our members. We are reimagining how we connect with consumers to personalize experiences, tailor recommendations to meet their specific needs, and simplify the healthcare journey.

透過與整個產業的合作夥伴合作，我們正在緊急應對這些挑戰，重點是簡化流程、降低成本並改善會員的整體體驗。我們正在重新構想與消費者的聯繫方式，以個人化體驗、客製化建議以滿足他們的特定需求並簡化醫療保健流程。

Targeted digital interactions through our Sydney app closed critical gaps in care and saved members an estimated 1.5 million hours in 2024, time they would have otherwise spent trying to find the care they needed.

透過我們的雪梨應用程式進行有針對性的數位互動彌補了護理方面的關鍵差距，並在 2024 年為會員節省了約 150 萬小時，否則他們將花費這些時間尋找所需的護理。

Health insurers play a vital role in keeping health care affordable by ensuring our members have access to high-quality care at reasonable costs, and designing benefit structures that encourage preventative care and early intervention. Through the valued partnerships we have with care providers, we reduced inefficiencies, drive better health outcomes, and lower overall cost for members.

健康保險公司透過確保我們的會員能夠以合理的費用獲得高品質的醫療服務，並設計鼓勵預防性護理和早期幹預的福利結構，在保持醫療費用可負擔方面發揮著至關重要的作用。透過與護理提供者建立的寶貴合作關係，我們減少了效率低下的問題，推動了更好的健康結果，並降低了會員的整體成本。

In our Medicare Advantage portfolio for 2025, 90% of our plans have no monthly premium and nearly all plans offer $0 co-pays for primary care visits and access to supplemental benefits. These innovative plan designs demonstrate how we align affordability with improved member health. Our data demonstrates that dually eligible members who utilize supplemental benefits are 40% more likely to access preventative services and nearly 15% less likely to have an inpatient admission.

在我們 2025 年的醫療保險優勢計劃組合中，90% 的計劃沒有每月保費，幾乎所有計劃都提供 0 美元的初級保健就診自付費用和補充福利。這些創新的計劃設計展示了我們如何將負擔能力與改善會員健康狀況結合起來。我們的數據表明，利用補充福利的雙重合格會員獲得預防服務的可能性高出 40%，住院可能性降低近 15%。

Solutions like our Total Health, Total You advocacy program enable personalized outreach through digital channels and address whole person care before complex health needs arise. Employers recognize the value this program brings, reflected in a net promoter score of 82.

諸如我們的「全方位健康、全方位你」宣傳計劃之類的解決方案能夠透過數位管道實現個人化推廣，並在複雜的健康需求出現之前解決全人護理問題。雇主認可該計劃帶來的價值，淨推薦值達到 82。

For our care providers, we create a real impact on health by going beyond the contract, and we strive to be an active partner in the care of our members. Our value-based programs account for nearly two-thirds of care today, with over 35% taking downside risk compared to less than 20% just three years ago.

對於我們的護理提供者，我們透過超越合約來對健康產生真正的影響，並且我們努力成為我們會員護理的積極合作夥伴。目前，我們基於價值的計畫佔醫療照護的近三分之二，其中承擔下行風險的計畫超過 35%，而三年前這一比例還不到 20%。

Over the past year, we broadened our capabilities through the launch of Mosaic Health in partnership with CD&R. Mosaic Health serves nearly 1 million consumers across 19 states and provides the foundation for us to expand our advanced primary care and physician enablement solutions to serve a growing number of people in the years to come.

在過去的一年裡，我們與 CD&R 合作推出了 Mosaic Health，從而拓寬了我們的能力。Mosaic Health 為 19 個州的近 100 萬消費者提供服務，並為我們擴展先進的初級保健和醫生支持解決方案以服務未來幾年越來越多的人奠定了基礎。

We have invested significant resources in partnering with hospitals and physicians to provide real-time insights and tools that ease administrative burdens and allow care providers to devote more time to caring for patients.

我們投入了大量資源與醫院和醫生合作，提供即時見解和工具，以減輕管理負擔，並允許護理人員投入更多時間照顧病人。

In cases where we have aligned data sharing with the health system, we have nearly eliminated claims denied due to incorrect or incomplete information, significantly easing the administrative burden for these systems. We are making good progress in expanding the solution to more partners. When health plans and care providers have access to the same information, we make the same decision.

在我們與醫療系統協調資料共享的情況下，我們幾乎消除了由於資訊不正確或不完整而拒絕的索賠，大大減輕了這些系統的管理負擔。我們在向更多合作夥伴擴展解決方案方面取得了良好進展。當健康計劃和護理提供者能夠獲得相同的資訊時，我們會做出相同的決定。

We are working in concert with our many vital partners across the healthcare ecosystem to promote solutions that enhance outcomes and empower healthier communities. With this unified voice, we can more effectively advocate for holistic solutions that address the physical, behavioral, and social drivers of health. We are on a promising path and will work tirelessly in the coming years to achieve our bold purpose to improve the health of humanity.

我們正在與整個醫療保健生態系統中的眾多重要合作夥伴攜手合作，以推廣能夠改善結果並增強社區健康的解決方案。有了這種統一的聲音，我們可以更有效地倡導解決健康的身體、行為和社會驅動因素的整體解決方案。我們正走在一條充滿希望​​的道路上，並將在未來幾年不懈地努力，實現改善人類健康的宏偉目標。

Now, turning to our results. Today, we reported fourth quarter GAAP diluted earnings per share of $1.81 and adjusted diluted earnings per share of $3.84, consistent with the expectations we shared back in October. These results reflect the immediate actions we took in response to unprecedented cost trends in our Medicaid business.

現在，來談談我們的結果。今天，我們報告第四季度 GAAP 稀釋每股收益為 1.81 美元，調整後每股稀釋收益為 3.84 美元，與我們 10 月的預期一致。這些結果反映了我們為因應醫療補助業務前所未有的成本趨勢而採取的緊急行動。

Our Medicaid business serves as a cornerstone in advancing health outcomes for individuals managing chronic and complex conditions. Our complex care management programs provide the support of a dedicated care team and digital resources that have led to a reduction in inpatient admissions by 7%. We are uniquely equipped to drive better health outcomes through complementary capabilities of our integrated health benefits and Carelon platforms.

我們的醫療補助業務是改善患有慢性和複雜疾病的個人的健康狀況的基石。我們的綜合護理管理計劃提供了專門護理團隊和數位資源的支持，使住院患者人數減少了 7%。我們擁有獨特的優勢，能夠透過全面健康福利和 Carelon 平台的互補能力來推動改善健康結果。

Fourth-quarter Medicaid cost trend remained elevated at levels aligned to the outlook we provided last quarter. We are grateful for the continuous and constructive collaboration of our state partners. While rates today remain insufficient to cover the elevated level of cost trend we are experiencing, we remain confident that rates will ultimately reflect the underlying acuity of our Medicaid membership over time.

第四季的醫療補助成本趨勢仍然保持在高位，與我們上個季度提供的預測一致。我們感謝國家合作夥伴的持續和建設性合作。儘管今天的費率不足以彌補我們正在經歷的成本上升趨勢，但我們仍然相信，費率最終將反映出我們醫療補助成員長期以來的潛在敏銳度。

In Medicare, benefit reductions and market exits in 2024 create a strong foundation for profitable growth. During annual open enrollment this year, seniors value the stability in our benefit offerings, evidenced by improved retention. We anticipate Medicare Advantage membership growth in the range of 7% to 9%, consistent with our prior expectations and inclusive of new wins in group MA. We remain confident in our ability to balance growth and margin performance in 2025.

在醫療保險領域，2024 年的福利減少和市場退出為獲利成長奠定了堅實的基礎。在今年的年度開放招生期間，老年人看重我們福利的穩定性，這從他們保留率的提高就可以看出。我們預計 Medicare Advantage 會員數量將增加 7% 至 9%，與我們先前預期的一致，並且包括 MA 組的新成員。我們仍然對 2025 年平衡成長與利潤表現的能力充滿信心。

We are pleased with the performance of our commercial businesses in 2024. Our integrated medical and pharmacy offering is resonating in the market. We welcomed 18 new national accounts who chose Elevance Health for 2025, including several who selected us as the sole source provider to manage their medical and pharmacy benefits, continuing a trend we have seen in the last few years.

我們對 2024 年商業業務的表現感到滿意。我們綜合的醫療和藥房服務在市場上引起迴響。我們歡迎 18 個新的國家客戶選擇 Elevance Health 作為 2025 年合作夥伴，其中有幾家選擇我們作為管理其醫療和藥房福利的唯一來源提供商，這延續了我們在過去幾年中看到的趨勢。

We also saw record retention in our national accounts business for 2025, a testament to the differentiated value we provide the market's largest and most sophisticated clients who value simplicity and affordability. Our individual exchange business experienced strong growth of more than 30% in 2024. We delivered innovative, affordable products that resonated with consumers. And as we enter 2025, we anticipate another year of strong growth in this market.

我們也看到了2025年國民帳戶業務的記錄保留，這證明了我們為市場上最大、最成熟的、重視簡單性和可負擔性的客戶提供差異化價值。我們的個人交易所業務在 2024 年實現了 30% 以上的強勁成長。我們推出了創新且價格合理的產品，引起了消費者的共鳴。隨著我們進入 2025 年，我們預計該市場將再迎來強勁成長的一年。

Turning to Carelon, in 2024, we made progress against our strategy to further scale our enterprise flywheel for growth. In the fourth quarter, we closed on the acquisition of CareBridge, which will bolster our home- and community-based services for chronic and complex members and serve as a foundation for Carelon's home health business.

談到 Carelon，2024 年，我們在進一步擴大企業飛輪成長的策略方面取得了進展。第四季度，我們完成了對 CareBridge 的收購，這將增強我們為慢性病和複雜疾病會員提供的家庭和社區服務，並為 Carelon 的家庭保健業務奠定基礎。

CareBridge's innovative approach aligns well with our enterprise focus on whole health, utilizing technology and comprehensive clinical support to improve care quality and efficiency, while enhancing patient outcomes and independence. The expanding breadth and diversity of our pharmacy, advanced primary care, and home- and community-based solutions will serve members and drive greater alignment with our health plans. Carelon Services experienced impressive internal and external growth in 2024, and we are positioned for revenue growth above our long-term target range for this segment in the year ahead.

CareBridge 的創新方法與我們企業對整體健康的關注非常契合，利用技術和全面的臨床支援來提高護理品質和效率，同時提高患者的治療效果和獨立性。我們的藥房、先進的初級保健以及家庭和社區解決方案的廣度和多樣性不斷擴大，將為會員提供服務，並推動與我們的健康計劃更好地保持一致。2024 年，Carelon Services 經歷了令人矚目的內部和外部成長，我們預計在未來一年實現該部門營收成長超過長期目標範圍。

Shifting to our expectations for 2025. We are providing guidance for adjusted diluted earnings per share to be in the range of $34.15 to $34.85. We will navigate 2025 with the same focus and discipline that has been central to the long-term success of Elevance Health.

轉向我們對 2025 年的期望。我們預計調整後每股攤薄收益在 34.15 美元至 34.85 美元之間。我們將以同樣的專注和紀律迎接 2025 年，這也是 Elevance Health 長期成功的關鍵。

We will continue to manage cost trend for our clients, deepen the impact of our Carelon assets, and execute on the growth opportunities ahead of us. The actions we are taking now will enhance the long-term earnings power of our enterprise and underscore our confidence in returning to at least 12% adjusted EPS growth annually on average over time.

我們將繼續為客戶管理成本趨勢，深化 Carelon 資產的影響力，並抓住未來的成長機會。我們現在採取的行動將增強企業的長期獲利能力，並強調我們對隨著時間的推移每年平均調整後每股收益成長至少 12% 的信心。

Finally, I would like to express my deepest gratitude to our extraordinary team of over 100,000 associates and their unwavering efforts during this dynamic period for the industry. Our associates went above and beyond last year, logging over 280,000 hours of volunteer time in our communities, setting a record for Elevance Health.

最後，我要向我們超過 10 萬名員工的傑出團隊表示最深切的感謝，感謝他們在這個行業充滿活力的時期所做的不懈努力。去年，我們的員工表現出色，在社區中擔任志工超過 28 萬小時，創下了 Elevance Health 的紀錄。

This remarkable dedication underscores our collective commitment to improving the health of humanity by making a tangible positive impact on the people we are privileged to serve and the communities we call home. As we advance our mission, we remain focused on being our members' lifetime trusted health partner and ensuring our work elevates health beyond health care.

這種非凡的奉獻精神凸顯了我們共同的承諾，即透過對我們有幸服務的人民和我們稱之為家園的社區產生切實的積極影響，改善人類健康。在推進我們的使命的同時，我們始終致力於成為會員終身值得信賴的健康夥伴，並確保我們的工作將健康提升到醫療保健以外的更高水平。

I'll now hand over the call to our CFO, Mark Kaye, who will provide more details on our financial results and guidance. Mark?

我現在將電話轉交給我們的財務長馬克凱耶，他將提供有關我們的財務結果和指導的更多詳細資訊。標記？

Thank you, Gail, and good morning, everyone. As Gail noted, we reported fourth-quarter adjusted diluted earnings per share of $3.84 and full-year adjusted diluted earnings per share of $33.04, with fourth quarter results consistent with our October expectations. Our disciplined operational execution helped us navigate an elevated cost environment, primarily within our Medicaid business.

謝謝你，蓋爾，大家早安。正如蓋爾所指出的，我們報告第四季度調整後每股攤薄收益為 3.84 美元，全年調整後每股攤薄收益為 33.04 美元，第四季度業績與我們 10 月份的預期一致。我們嚴謹的營運執行幫助我們應對了成本上升的環境，主要是在我們的醫療補助業務中。

We concluded the year with 45.7 million members, a decrease of 1.1 million year over year, but roughly flat sequentially. This annual decline was driven by membership reduction stemming from Medicaid redeterminations and changes in our geographic footprint, partially offset by continued growth in our employer group fee-based offerings and our ACA health plan products. These areas of growth demonstrate our ability to deliver compelling value in competitive market segments.

截至今年底，我們的會員總數為 4,570 萬，年減 110 萬，但與上一季基本持平。這一年度下降是由於醫療補助重新確定和地理覆蓋範圍變化導致的會員人數減少，但被雇主團體收費產品和 ACA 健康計劃產品的持續增長部分抵消。這些成長領域證明了我們有能力在競爭激烈的細分市場中提供引人注目的價值。

Turning to revenue, we generated $175.2 billion in total operating revenue for 2024, up approximately 3% from the prior year. This topline growth reflects premium rate adjustments in recognition of higher cost trends as well as expanding customer relationships within our Carelon businesses, partially offset by lower Medicaid membership.

談到收入，我們 2024 年的總營業收入為 1,752 億美元，比前一年成長約 3%。這一營業額成長反映了為了適應成本上升趨勢而進行的保費率調整，以及 Carelon 業務中客戶關係的不斷擴大，但被醫療補助會員人數的減少部分抵消。

We also benefited from acquisitions that further our goals in pharmacy services and home health, enhancing our enterprise flywheel. A priority for the coming year will be integrating these assets to unlock greater value for the members we are privileged to serve, particularly as we drive ambitious growth in Carelon.

我們也受益於收購，這進一步實現了我們在藥局服務和家庭保健方面的目標，增強了我們的企業飛輪。明年的首要任務是整合這些資產，為我們有幸服務的會員創造更大的價值，特別是在我們推動 Carelon 雄心勃勃的成長的同時。

Our consolidated benefit expense ratio for the fourth quarter was 92.4%, bringing our full year ratio to 88.5%, in line with our guidance. As noted previously, we continue to see elevated cost trends within the Medicaid population, which remains stable at the levels we experienced exiting the third quarter.

我們第四季的綜合福利費用率為 92.4%，使得全年福利費用率達到 88.5%，符合我們的預期。如前所述，我們繼續看到醫療補助人群的成本上升趨勢，該趨勢保持穩定在第三季末的水平。

We are encouraged by the rate adjustments from our state partners, which are helping to better align premiums with current care costs. As these adjustments become more fully reflected, we expect Medicaid margins to improve over the course of 2025.

我們對州合作夥伴的費率調整感到鼓舞，這有助於更好地將保費與當前的照護成本保持一致。隨著這些調整得到更全面的體現，我們預計醫療補助利潤率將在 2025 年得到改善。

Elevance Health's adjusted operating expense ratio stood at 9.9% for the fourth quarter and 10.6% for the full year, an improvement of 170 basis points and 70 basis points respectively versus the prior year. This reflects our continued focus on disciplined expense management and operating efficiencies.

Elevance Health 第四季調整後營業費用率為 9.9%，全年調整後營業費用率為 10.6%，分別比去年改善了 170 個基點和 70 個基點。這反映了我們對嚴格的費用管理和營運效率的持續關注。

For the year, operating cash flow was $5.8 billion or approximately 1 times GAAP net income. Our year-end days in claims payable was 42.9 days, essentially flat compared to the third quarter and aligns with our long-term target range in the low 40s.

全年營運現金流為 58 億美元，約為 GAAP 淨收入的 1 倍。我們的應付理賠年末天數為 42.9 天，與第三季基本持平，與我們 40 多天的長期目標範圍一致。

In the fourth quarter, we opportunistically repurchased 4.5 million shares for a total of $1.8 billion, bringing full-year repurchases to $2.9 billion and exceeding our initial forecast. We remain committed to returning capital to shareholders while also investing in our strategic initiatives.

第四季度，我們抓住機會回購了450萬股，回購總額達18億美元，使得全年回購額達到29億美元，超過了我們最初的預測。我們將繼續致力於向股東返還資本，同時投資於我們的策略計畫。

Looking ahead to 2025, we are introducing a range for our adjusted diluted earnings per share of $34.15 to $34.85 to provide greater specificity around our view of expected performance for the year. We project total Medical membership of 45.8 million to 46.6 million by year-end 2025, driven by expected growth in our commercial fee-based membership, ACA exchange plans, and Medicare Advantage.

展望 2025 年，我們引入了調整後每股攤薄收益 34.15 美元至 34.85 美元的範圍，以便更具體地了解我們對今年預期業績的看法。我們預計，到 2025 年底，醫療會員總數將達到 4,580 萬至 4,660 萬，這主要得益於商業收費會員、ACA 交換計畫和 Medicare Advantage 的預期成長。

Following an annual enrollment period in line with our expectations, we anticipate ending 2025 with Medicare Advantage membership of 2.2 million to 2.25 million, reflecting planned growth in group MA and high single-digit expansion in individual MA.

在我們預期的年度註冊期之後，我們預計到 2025 年底，醫療保險優勢計劃的會員人數將達到 220 萬至 225 萬，這反映了團體 MA 的計劃增長和個人 MA 的高個位數擴張。

In terms of topline performance, we anticipate operating revenue to grow in the high single to low double digit percent range, bolstered by acquisitions like CareBridge. We expect our consolidated medical loss ratio to be around 89.1%, plus or minus 50 basis points, roughly a 60 basis point increase at the midpoint. This incorporates the persistence of elevated cost trends, particularly within Medicaid as well as impacts from recent acquisitions and Medicare Part D benefit redesign changes.

就營業收入而言，我們預計，在 CareBridge 等收購的推動下，營業收入將實現高個位數至低兩位數百分比的成長。我們預計綜合醫療損失率約為 89.1%，上下浮動 50 個基點，中間值大約增加 60 個基點。這包括成本持續上升的趨勢，特別是在醫療補助計劃中，以及最近的收購和醫療保險 D 部分福利重新設計變化的影響。

Our adjusted operating expense ratio is expected to be 10.4%, plus or minus 50 basis points, implying a slight year-over-year improvement as we pursue targeted actions to enhance our cost structure. For 2025, we anticipate a more normalized operating cash flow of roughly $8 billion, or 1.1 times GAAP net income.

我們的調整後營業費用率預計為 10.4%，上下浮動 50 個基點，這意味著隨著我們採取有針對性的行動來改善我們的成本結構，營業費用率將同比略有改善。到 2025 年，我們預計營業現金流將更加正常化，約為 80 億美元，或 GAAP 淨收入的 1.1 倍。

We plan to allocate approximately $2.3 billion towards share repurchases with a bias towards the first half of the year. Regarding earnings seasonality, we expect to earn just over 60% of our adjusted EPS in the first half of 2025, with slightly more than half of that first-half figure coming in the first quarter.

我們計劃撥出約 23 億美元用於股票回購，主要集中在上半年。就獲利季節性而言，我們預計 2025 年上半年調整後每股盈餘將略高於 60%，其中略多於一半的收益將來自第一季。

I'm also pleased to announce that our Board of Directors has approved a 5% increase in our quarterly dividend to $1.71 per share, our 14th consecutive annual increase. This speaks to our commitment to delivering strong shareholder returns and reflects the balance and resilience of our business model.

我還很高興地宣布，我們的董事會已批准將季度股息增加 5% 至每股 1.71 美元，這是我們連續第 14 年增加股息。這顯示我們致力於實現豐厚的股東回報，也反映了我們商業模式的平衡性和彈性。

We remain confident in our ability to execute on our strategic priorities in 2025, while meeting our financial objectives. With continued investments in our diversified business model and the expansion of Carelon's capabilities, we are building a strong foundation to deliver even greater value to our members, providers, and shareholders and position Elevance Health for long-term sustainable growth. Thank you for your time today. I will now turn the call back to the operator for your questions.

我們對自己在 2025 年執行策略重點並實現財務目標的能力充滿信心。透過對我們多元化業務模式的持續投資以及 Carelon 能力的擴展，我們正在建立強大的基礎，為我們的會員、供應商和股東提供更大的價值，並使 Elevance Health 實現長期永續發展。感謝您今天抽出時間。我現在將把電話轉回給接線員以回答您的問題。

(Operator Instructions) AJ Rice, UBS.

(操作員指示) AJ Rice，瑞銀。

Hi everybody. Thanks for the comments. Maybe -- I know it's not your biggest business, but there certainly has been a lot of discussion in the financial community about your Medicare Advantage business enrollment looks like you're targeting sort of mid 7% to 8% or so for the year.

大家好。感謝您的評論。也許吧——我知道這不是你們最大的業務，但金融界確實對你們的醫療保險優勢計劃業務登記進行了大量討論，看起來你們今年的目標是達到 7% 到 8% 左右。

Is that fully reflective of which you've got the full view of open enrollment at this point? So you think from here, it's just age-ins largely? And what are you seeing as you drill down in that demographic of the types of members you've attracted in the open enrollment?

這是否充分反映了您目前對開放註冊的全面了解？所以您認為從現在來看，這很大程度只是年齡問題？當您深入研究您在開放註冊過程中吸引的會員類型的人口統計時，您發現了什麼？

And then just also -- I think the comment on the third quarter was that the Medicare Advantage margin in '25 might step up modestly but still be below your long-term targets for Medicare Advantage. Is that still your thinking?

而且，我認為對第三季的評論是，25 年的醫療保險優勢計劃利潤率可能會小幅上升，但仍低於醫療保險優勢計劃的長期目標。您現在還是這樣想嗎？

Well, thank you, AJ. I have just a few comments. First, we feel very good about and confident in the enrollment guidance that we gave for Medicare Advantage. It did come in line with the expectations that we set, and we had very strong member retention we think is a huge positive for us.

好吧，謝謝你，AJ。我只是有幾點評論。首先，我們對為 Medicare Advantage 提供的登記指導感到非常滿意和有信心。它確實符合我們設定的期望，我們的會員保留率非常高，我們認為這對我們來說是一個巨大的利好。

So overall, I'll ask Felicia to maybe give you a little bit more detail about it but really good in terms of the positioning of product, and geography, and overall, and we do think that's where we'll end the year. So Felicia, maybe a little bit more guidance on that.

所以總的來說，我會請 Felicia 給你更詳細的信息，但在產品定位、地理定位和總體方面，這確實很好，我們確實認為這就是我們結束今年的時候。所以費莉西亞，也許在這方面需要更多的指導。

Good morning, AJ, and thank you for the question. As Gail said, we are very pleased with the outcome of our annual enrollment period. Performance was really aligned with our expectations, driven predominantly by strong member retention and really stability in our offerings amid significant disruptions in the market this year.

早安，AJ，謝謝你的提問。正如蓋爾所說，我們對年度招生的結果非常滿意。業績確實與我們的預期一致，這主要得益於在今年市場發生重大混亂的情況下，強大的會員保留率和產品真正穩定。

The enrollment trends that we saw in our core markets really reflect the value that seniors placed our balanced approach. And we were very focused on our local strategy to ensure that we were effectively capturing growth opportunities where they were most favorable for us.

我們在核心市場看到的入學趨勢確實反映了老年人對我們的平衡方法的重視。我們非常注重本地策略，以確保我們能夠有效地抓住最有利於我們的成長機會。

We are very pleased with the product and the geographic composition of our growth. We saw very strong HMO growth by design and less PPO growth in the markets that we were looking for that growth.

我們對產品和成長的地理分佈非常滿意。我們看到，在我們期待成長的市場中，HMO 成長非常強勁，而 PPO 成長則有所減少。

So with AEP results in hand right now, we are confident around our 2025 Medicare Advantage guidance of 7% to 9%, which from a member growth perspective, it's right in line with our expectations that we provided last year.

因此，根據目前掌握的 AEP 結果，我們對 2025 年 Medicare Advantage 7% 至 9% 的指導目標充滿信心，從會員成長的角度來看，這與我們去年提供的預期一致。

We are obviously going to continue to be very vigilant around how we manage growth throughout the rest of the year. As you said, there will be predominantly age-ins and some individuals that come in as a result of dual eligibility. But we are confident in the actions and strategies that we have to maintain growth within the guide that we provided. Thank you.

顯然，我們將繼續高度警惕如何在今年剩餘時間內管理成長。正如你所說，主要會有一些符合年齡要求的個人和一些因雙重資格而進入的個人。但我們對自己所採取的行動和策略充滿信心，我們能夠在所提供的指導範圍內保持成長。謝謝。

And then AJ, on your margin question, we are positioned well to achieve a margin stability in 2025 through many of the factors that Felicia mentioned, including disciplined cost management and a strong retention.

然後 AJ，關於您的利潤率問題，透過 Felicia 提到的許多因素，包括嚴格的成本管理和強大的保留率，我們有能力在 2025 年實現利潤率穩定。

Thank you, Mark. AJ and Lance, next question please.

謝謝你，馬克。AJ 和 Lance，請問下一個問題。

Lance Wilkes, Bernstein.

蘭斯威爾克斯、伯恩斯坦。

Great. Thanks so much. Could you talk a little bit about what you were seeing in terms of utilization? In particular, perhaps you could talk to what you're seeing in trends by product like MA and commercial. And how you're thinking about that in terms of your assumptions for '25? And if you can give any commentary on categories of medical cost trend as far as like inpatient, outpatient, et cetera. That would be great. Thanks a lot.

偉大的。非常感謝。您能否稍微談談您在利用率方面看到的情況？具體來說，也許您可以談談您所看到的 MA 和商業等產品的趨勢。那麼您如何根據對 25 年的假設來考慮這個問題呢？您能否對住院、門診等醫療費用趨勢類別發表一些評論？那太棒了。多謝。

Lance, thanks very much for the question this morning. Cost trend in the fourth quarter developed largely as we anticipated with stability, I would say, across our lines of business. Specifically, Medicaid, trends remained elevated. They were stable, particularly as we've called out in prior quarters in behavioral health and inpatient services. And we think it's primarily because of the ongoing impact of the membership mix changes following redeterminations has really stabilized at this point.

蘭斯，非常感謝您今天早上提出的問題。我想說，第四季的成本趨勢基本上符合我們的預期，而且我們所有業務線的成本都比較穩定。具體來說，醫療補助趨勢仍然高漲。它們很穩定，特別是正如我們在前幾個季度所呼籲的行為健康和住院服務。我們認為，這主要是因為重新確定後會員結構變化的持續影響目前已經真正穩定下來。

In Medicare, cost trend similarly in the fourth quarter were elevated. They were manageable. We saw notable drivers here, including some of the post-acute care services. Again, very consistent with prior expectations and the way that we've priced our bids for 2025.

在醫療保險方面，第四季的成本趨勢同樣上升。他們是可以管理的。我們在這裡看到了值得注意的驅動因素，包括一些急性後期護理服務。再次，這與先前的預期以及我們對 2025 年的定價方式非常一致。

On the commercial side, I would say, performance remains strong, in line with the disciplined pricing approach that we've adopted to date. And so as we think about 2025, we do expect these elevated trends really to persist in the first half of the year, particularly in Medicaid.

從商業方面來看，我想說，業績依然強勁，這與我們迄今為止所採用的嚴謹的定價方式一致。因此，當我們展望 2025 年時，我們確實預計這些上升趨勢將在今年上半年持續下去，尤其是在醫療補助領域。

On the Medicare side, they're similarly expected to remain stable at the current levels. And so I would say our outlook for '25 really incorporates these dynamics. We're taking a prudent approach to guidance to ensure again we deliver sustainable long-term value.

在醫療保險方面，預計同樣將保持穩定在目前水準。所以我想說，我們對 25 年的展望確實體現了這些動態。我們採取審慎的指導方式，以確保再次提供可持續的長期價值。

Thank you, Mark, and thanks for the question, Lance. And again, I'll just reiterate, I think what you're seeing from us is a very prudent approach in terms of very consistent to what we've shared on where utilization is. Next question, please.

謝謝你，馬克，也謝謝你的提問，蘭斯。我再重申一遍，我認為您從我們這裡看到的是一種非常謹慎的方法，與我們在利用率方面分享的內容非常一致。請回答下一個問題。

Stephen Baxter, Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

Hi, thanks. Just to follow up on that, you mentioned that Medicaid is an influencer of the higher year-over-year MLR that you're expecting in 2025. I think your previous expectations you discussed last quarter were for something more stable than that. And it sounds like potentially the conversation around 1/1 rates has been pretty constructive. I love to just get a better sense of what explicitly you're embedding for Medicaid full-year MLR change in this guidance. Thank you.

嗨，謝謝。為了跟進這一點，您提到醫療補助是影響 2025 年 MLR 年比上升的一個因素。我認為您上個季度討論過的預期是比這更穩定的。聽起來圍繞著 1/1 利率的討論可能相當有建設性。我希望能更了解您在本指南中明確嵌入的 Medicaid 全年 MLR 變化的內容。謝謝。

Stephen, thanks very much for the question. Maybe let me start with the fourth quarter Medicaid trend in a little bit more detail. So in the fourth quarter, Medicaid cost trends developed in line with the expectations we communicated during October.

史蒂芬，非常感謝您的提問。也許讓我先更詳細地介紹一下第四季的醫療補助趨勢。因此，在第四季度，醫療補助成本趨勢與我們十月傳達的預期一致。

So specifically, trends generally remain consistent with the elevated levels we observed in September. And again, that reflects just the stabilization of our membership base, given again, redeterminations materially completed.

因此具體來說，趨勢總體上與我們 9 月觀察到的高水準保持一致。再次，這反映了我們會員基礎的穩定，因為重新確定已經實質上完成。

As we look forward to 2025, we expect these higher-than-typical Medicaid cost trends, particularly as I mentioned a moment ago in behavioral health and inpatient care, really to persist into the first half of 2025. And why does that matter? Well, it matters because current rates have not yet fully caught up to these cost trends, and so we're maintaining a prudent stance on how quickly the Medicaid margins are going to rebound in 2025.

展望 2025 年，我們預期這些高於典型的醫療補助成本趨勢，特別是我剛才提到的行為健康和住院護理，將持續到 2025 年上半年。這為什麼重要？這很重要，因為目前的費率尚未完全趕上這些成本趨勢，因此我們對醫療補助利潤率在 2025 年的反彈速度持謹慎態度。

And this simply reflects both the elevated level of cost trends we expect to continue in the first half, but also the incremental rate adjustments that we're working on with our state partners. And so you could think about Medicaid as really being a tale of two halves, stabilization in the early part of the year, followed by improvement in the second half of the year as rate adjustments begin to more fully reflect the heightened cost pressures.

這不僅反映了我們預計上半年成本趨勢將繼續上升，也反映了我們正在與國家合作夥伴共同努力進行的增量費率調整。因此，你可以把醫療補助看作是一個由兩個部分組成的故事，年初趨於穩定，下半年則開始改善，因為費率調整開始更充分地反映出日益增加的成本壓力。

Thank you. Next question, please.

謝謝。請回答下一個問題。

Lisa Gill, JPMorgan.

摩根大通的麗莎吉爾 (Lisa Gill)。

Good morning. I just really want to understand two things. First would be the comments around the Part D redesign. Mark, can you talk about the specific impact to MLR? And then secondly, just understanding the performance in CarelonRx going into 2025, you talked about mid-teens growth. Can you talk about how much of that is organic? The investments that you are making when we think about the margin improvement that you are talking about for 2025?

早安.我只是確實想了解兩件事。首先是有關 D 部分重新設計的評論。馬克，你能談談對 MLR 的具體影響嗎？其次，只要了解 CarelonRx 在 2025 年的表現，您就會談到十幾歲的中期成長。你能說說其中有多少是有機的嗎？當我們考慮您所說的 2025 年利潤率提高時，您所做的投資是什麼？

Thank you Lisa, I am going to have Mark address the first part of your question and then I will ask Pete to talk about the growth which we are really pleased and excited about with the strategies and execution Carelon has. Mark, please?

謝謝你，麗莎，我將讓馬克回答你問題的第一部分，然後我將請皮特談談 Carelon 的增長情況，我們對 Carelon 的戰略和執行感到非常高興和興奮。請標記一下好嗎？

Lisa, thanks very much for the question this morning. So for '25, we're guiding to an MLR of that 89.1%, and that's approximately 60 bps higher than the prior year at the midpoint.

麗莎，非常感謝您今天早上提出的問題。因此，對於 25 年，我們預期 MLR 為 89.1%，比上年的中點高出約 60 個基點。

There are three primary factors that are driving the increase here. First is the impact of our strategic growth mix in Medicare, including the Part D changes, and second one is recent acquisitions. And then third is really a prudent view towards medical cost trends.

推動這一成長的主要因素有三。首先是我們的醫療保險策略成長組合的影響，包括 D 部分的變化，其次是最近的收購。第三是對醫療成本趨勢保持審慎的看法。

So specifically, the business mix changes are really driven by CareBridge running in the 20-ish basis point range, and that's expected to run at a higher MLR than our organic businesses as well as stronger relative growth in our Medicare businesses inclusive of, to your point, the changes in the Part D the benefit structure, which has increased the direct subsidy. In addition, the MLR guidance does reflect elevated but stable cost trends that you heard us talk about a couple of minutes ago because we're operating in a more dynamic cost environment than historical norms.

因此，具體來說，業務組合變化實際上是由CareBridge 在20 個基點範圍內運作所推動的，預計其MLR 將高於我們的有機業務，並且我們的醫療保險業務（包括您的）將實現更強勁的相對成長一點，D部分福利結構的變化，增加了直接補貼。此外，MLR 指導確實反映了您幾分鐘前聽到我們談論的較高但穩定的成本趨勢，因為我們在比歷史規範更具動​​態的成本環境中運作。

Pete, maybe share your thoughts on Carelon.

皮特，也許可以分享一下你對 Carelon 的看法。

Yeah, appreciate it. And thanks for the question. I'll talk broadly about Carelon, what we're really excited about what's going on in Carelon and the growth opportunities. We came off a very, very strong '24, as I think you saw in terms of our growth. We had another strong quarter of growth and very balanced with respect to internal versus external growth.

是的，非常感謝。感謝您的提問。我將廣泛地談論 Carelon，我們對 Carelon 的發展和成長機會感到非常興奮。從我們的成長情況來看，我們度過了非常非常強勁的 24 年。我們又度過了一個強勁成長的季度，內部成長和外部成長非常均衡。

We continue to expand a lot of our risk arrangements internally across oncology, across behavioral health, post-acute solutions. And then externally, last year, we have one of our best years ever in terms of external growth, doing about 4x in terms of revenue growth versus '23.

我們繼續在腫瘤學、行為健康、急性後解決方案等領域內部擴展許多風險安排。從外部來看，去年是我們外部成長最好的一年，營收成長約是23年的4倍。

And by the way, one of the other key points that we've talked about historically, we're seeing really nice penetration as it relates to the Blues. That momentum will continue into 2025. You'll see very significant growth in our services part of the business with over 50% growth.

順便說一句，我們在歷史上討論過的另一個關鍵點是，我們看到與藍調相關的滲透力非常好。這種勢頭將持續到 2025 年。您會看到我們服務業務部分實現了非常顯著的成長，增幅超過50%。

As Mark mentioned, we're excited about the addition of CareBridge, that certainly adds to it. But then importantly, even outside of CareBridge, our organic growth, both internal and external on the services side, is well above 20%. So very pleased with that.

正如馬克所提到的，我們對 CareBridge 的加入感到非常興奮，這無疑為我們的表現增添了助力。但重要的是，即使在 CareBridge 之外，我們服務的內部和外部有機成長都遠高於 20%。我對此非常高興。

I think you also referenced Rx, Lisa. And I feel very good about our story in Rx and how our growth story is resonating in the marketplace. Momentum really does continue to build. We're working very closely with Morgan and the commercial team.

我認為你也提到了 Rx，麗莎。我對我們在 Rx 的故事以及我們的成長故事在市場上的反應感到非常滿意。發展勢頭確實在繼續增強。我們正在與摩根和商業團隊密切合作。

And one of the things that I'll say that's really resonating in the marketplace and has actually enabled us to win some large accounts, upmarket and national account is this real focus on high-touch customer service and advocacy. We are really doubling down on the patient experience and making sure that they have a strong experience across both medical and pharmacy.

我要說的一件事確實在市場上引起了共鳴，並且實際上使我們贏得了一些大客戶、高端市場和全國客戶，那就是真正注重高接觸客戶服務和宣傳。我們確實加倍重視病患體驗，並確保他們在醫療和藥局方面都有豐富的體驗。

It's what we talk about in terms of whole health and we're really pleased about how that's playing out. And then importantly, we continue to do well in our sweet spot, mid-market and down market. So I think overall, a very strong story in terms of Carelon growth.

這就是我們所談論的整體健康問題，我們對目前的結果感到非常高興。重要的是，我們繼續在我們的最佳市場、中端市場和低端市場表現良好。因此我認為整體而言，Carelon 的發展非常強勁。

Yes. Thanks, Pete, and thanks for the question, Lisa. And just to punctuate maybe a couple of things. We're really excited about the momentum, both internally and externally in Carelon.

是的。謝謝，皮特，也謝謝你的提問，麗莎。也許只是想強調幾件事。我們對 Carelon 內部和外部的發展勢頭感到非常興奮。

And as you heard from Pete, a couple of things. One, deepening capabilities inside of Carelon, so we can advance our strategy around more whole health risk. And I can see that in the numbers that we're sharing and plus what happened in '24 and then external validation with additional clients. Both two areas that we've talked about strategically. So, thanks very much for your question. Next question, please.

正如您從 Pete 那裡聽到的，有幾件事。一是深化 Carelon 內部的能力，以便我們能夠圍繞更全面的健康風險來推進我們的策略。我可以從我們分享的數字以及 24 年發生的情況以及透過其他客戶的外部驗證中看到這一點。我們已經從戰略角度討論了這兩個領域。非常感謝您的提問。請回答下一個問題。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

Hi, good morning. I think there's still some confusion around your Medicare Advantage membership growth for 2025. So I was hoping you could to clear some of this up and tell us what your actual AEP growth is, how much of that accounts for the full year outlook.

嗨，早安。我認為您對 2025 年醫療保險優勢計劃 (Medicare Advantage) 會員增長情況仍然存在一些疑惑。所以我希望你能澄清一些問題並告訴我們你的實際 AEP 成長是多少，其中有多少佔全年前景。

I'll have Felicia share her thoughts on that.

我會讓費莉西亞分享她對此的想法。

So Andrew, thank you very much for that question. Our AEP growth is certainly very strong, and that reflects a lot of group membership growth that came in, a particular group account that, frankly, we're pleased with. That was a commercial account that we had a long-standing relationship with. So very familiar with a lot of the demographics and dynamics associated with that group.

所以安德魯，非常感謝你提出這個問題。我們的 AEP 成長確實非常強勁，這反映了大量團體會員的成長，坦白說，我們對此感到滿意。那是一個與我們有著長期合作關係的商業帳戶。因此非常熟悉該群體的許多人口統計和動態。

And then in terms of our Medicare -- individual Medicare Advantage growth, it's right in line with the expectations that we provided. So in total, we are right in the range that we left you with, which is the 7% to 9% growth, which we expect overall this year. And we'll continue to have in place actions to manage appropriately growth throughout the rest of the year around our Medicare Advantage business.

就我們的醫療保險—個人醫療保險優勢計劃的成長而言，它完全符合我們所提供的預期。因此，總體而言，我們的成長幅度正好在我們先前給出的範圍內，即 7% 到 9% 的成長，這也是我們預期今年的整體成長幅度。我們將繼續採取行動，在今年剩餘時間內適當管理醫療保險優勢業務的成長。

Yes. Thank you, Felicia and Andrew, just to be clear because I don't want any confusion. That 7% to 9%, we essentially don't expect significant growth, we expect minimal growth for the rest of the year, which -- with strong retention. So just to give you some sense of our confidence in that, that's how we're projecting that, aligned similarly to what we've seen, for example, in '24 just given the market positioning. Next question, please.

是的。謝謝你們，費莉西亞和安德魯，我只是想說清楚，因為我不想造成任何混淆。我們基本上不認為那 7% 到 9% 會有顯著的成長，我們預計今年剩餘時間的成長將很小，但保留率會很高。因此，只是為了讓您了解我們對此的信心，這就是我們的預測，與我們在 24 年看到的類似，只是給出了市場定位。請回答下一個問題。

Ryan Langston, TD Securities.

瑞安·蘭斯頓（Ryan Langston），道明證券。

Hi, thanks. I know you stepped back from the Blue Cross of Louisiana acquisition a little while ago, but I believe there's still a potential to revisit that deal. I guess is that true? And then just maybe more broadly on the environment. You closed Kroger Specialty, closed Paragon, you closed CareBridge. Maybe just remind us of your priority going forward into '25 and beyond on potential acquisition targets? Thank you.

嗨，謝謝。我知道您不久前放棄了對路易斯安那州藍十字的收購，但我相信仍然有可能重新審視這筆交易。我想這是真的嗎？然後可能更廣泛地談論環境問題。你關閉了 Kroger Specialty，關閉了 Paragon，關閉了 CareBridge。也許只是提醒我們，您在 25 年及以後的潛在收購目標上的優先事項是什麼？謝謝。

Yeah. Thanks for the question. We really don't comment on acquisitions or our posture on that. I mean we have a good partnership actually with Blue Cross Blue Shield Louisiana. We work with them closely in Medicaid and some of the duals in Medicare and a number of products in Carelon.

是的。謝謝你的提問。我們確實不對收購或我們對此的態度發表評論。我的意思是我們實際上與路易斯安那州藍十字藍盾有著良好的合作關係。我們與他們就醫療補助計劃 (Medicaid)、醫療保險 (Medicare) 中的一些雙重計劃以及 Carelon 中的多種產品展開密切合作。

So with many of our Blue partners, which you've heard us talk about, we continue to provide services because we have some really unique capabilities. Let me ask Pete to comment on your CareBridge question.

因此，對於您聽到我們談論的許多藍色合作夥伴，我們會繼續提供服務，因為我們擁有一些真正獨特的能力。讓我請皮特對您的 CareBridge 問題進行評論。

Yeah. No, thanks a lot. I think your question in terms of what we're interested in. I always like to talk about strategy in terms of framing where our interest reside. And again, we've talked about that the strategy overall of Carelon's to deliver whole health, we're really focused on affordability and empathy. And we face off with our health plan partners and really identify areas of complexity in healthcare and try to solve those with differentiated solutions and doing so at risk.

是的。不，非常感謝。我認為你的問題符合我們感興趣的內容。我總是喜歡從我們的興趣所在來談論戰略。我們再次討論 Carelon 提供全面健康服務的整體策略，我們真正注重的是可負擔性和同理心。我們與我們的健康計劃合作夥伴面對面，真正找出醫療保健中的複雜領域，並嘗試用差異化的解決方案來解決這些問題，儘管這樣做存在風險。

And you've seen that really play through in our transactions, be it on the pharmacy side or on the services side, and we'll continue down that path. So there are many areas of interest when you think about where specialty trend is, how that impacts the different lines of business. We continue to sort of evaluate that. We'll be opportunistic on the pharmacy side. We think there are additional ways to enhance the whole health experience.

而且您已經看到這在我們的交易中發揮了作用，無論是在藥房方面還是在服務方面，我們都會繼續沿著這條道路前進。因此，當您思考專業趨勢在哪裡以及它如何影響不同的業務線時，會發現有很多值得關注的領域。我們將繼續對此進行評估。我們將在藥房方面抓住機會。我們認為還有其他方法可以增強整體健康體驗。

And importantly, we think with what you're seeing in healthcare today, the fragmentation of data and the patient experience, and enabling a much better whole health experience, as Gail said before, we see a tremendous opportunity around technology and data and enhancing the overall experience. So those are areas that we're very interested in as we move forward.

重要的是，我們認為，鑑於當今醫療保健領域數據和患者體驗的碎片化，以及實現更好的整體健康體驗，正如蓋爾之前所說，我們看到了技術和數據方面的巨大機遇，並增強了整體體驗。因此，這些都是我們今後非常感興趣的領域。

Next question, please.

請回答下一個問題。

Justin Lake, Wolfe Research.

賈斯汀·萊克（Justin Lake），沃爾夫研究公司。

Thanks. Good morning. A question on the healthcare benefits business. First, hoping you can talk to your expected seasonality for 2025, including how Q1 should look versus the full year. And then on the health benefits 2025 op margin guidance, looks like it's down year-over-year. You've talked to Medicaid being flat, Medicare being flat. Is that coming in commercial? And maybe you can talk about what's driving that and the magnitude of it on the commercial side. Thanks.

謝謝。早安.關於醫療保健福利業務的問題。首先，希望您能談談您對 2025 年的預期季節性，包括第一季與全年相比的情況。然後，就健康福利 2025 年營業利潤率指引而言，看起來比去年同期有所下降。您已經談到醫療補助持平、醫療保險持平。這是商業版嗎？也許您可以談談推動這一現象的因素以及其在商業方面的影響程度。謝謝。

Justin, thanks very much for your question. Let me go ahead and start with the seasonality, and then I'll talk a little bit about operating margins, the health benefit level after that. For seasonality, as you heard during our prepared remarks this morning, we do expect adjusted EPS to be weighted more towards the first half of the year with slightly more than 60% of full-year earnings occurring in that period. And then within the first half, we anticipate a little bit more than half of those earnings to then show up in the first quarter.

賈斯汀，非常感謝您的提問。讓我先從季節性開始，然後再談一下營業利潤率，以及健康福利水準。至於季節性，正如您在我們今天早上的準備好的發言中所聽到的，我們確實預計調整後的每股收益將更多地集中在上半年，全年收益的60% 多一點將發生在這一時期。在上半年，我們預計略多於一半的收益將在第一季實現。

And that reflects two things. One is typical seasonal dynamics, and then two is sort of our evolving business mix. As I think about seasonal dynamics, if you can think about the commercial business here, typically contributing a larger share earnings in the first half of the year, and then with continued strong retention and disciplined pricing, we expect that's going to continue to be the same pattern in 2025.

這反映了兩件事。一是典型的季節性動態，二是我們不斷變化的業務組合。當我考慮季節性動態時，如果你能考慮這裡的商業業務，它通常會在上半年貢獻更大的份額收益，然後憑藉持續強勁的留存率和嚴格的定價，我們預計這將繼續成為2025年也將出現同樣的情況。

On Medicaid, margins are more back-end loaded, especially as rate updates from state partners take effect. That's our first-half, second-half story. And then, of course, we've also reflected the inflation reduction act Medicare Part D changes and the benefit of the leap year in the first quarter. So a lot going on with seasonality, but let me point to those early comments I made.

在醫療補助方面，利潤率更加後端化，特別是在州合作夥伴的費率更新生效之後。這就是我們的故事上半部和下半部。當然，我們也在第一季反映了通膨降低法案 Medicare Part D 的變化和閏年帶來的好處。季節性發生了很多變化，但讓我指出我之前所做的那些評論。

On the operating margin expectations, we do expect a 25 to 50 basis points decline year over year. And there are a couple of discrete impacts outside of core operating performance, but in line with our expectations, that's what I would call out for you. The first is that we're going to be cycling the nonrecurring expense benefits that we had in 2024.

對於營業利益率預期，我們確實預期將年減 25 至 50 個基點。除了核心營運績效之外，還有一些離散的影響，但符合我們的預期，這就是我要向您指出的。首先，我們將循環使用 2024 年的非經常性費用福利。

Second, we're going to get a little bit of membership mix impacts through the slightly stronger relative growth in our Medicare lines of business compared to commercial, inclusive of the Medicare Part D design change. And then I would make the point sort of excluding those discrete impacts the margins across the health benefits businesses would have been stable.

其次，與商業相比，我們的醫療保險業務線的相對增長略強，這將對會員結構產生一定影響，其中包括醫療保險 D 部分的設計變更。然後我想指出的是，排除這些離散影響後，健康福利業務的利潤率將會保持穩定。

Thank you. Next question, please.

謝謝。請回答下一個問題。

Josh Raskin, Nephron Research.

喬希‧拉斯金 (Josh Raskin)，腎元研究公司。

Hi, thanks. Good morning. Just within the 2025 guidance, can you speak to your expectations for commercial trend and what you priced for? And I just want to make sure I understand, are you still expecting margin improvement in commercial? I thought that was a previous expectation.

嗨，謝謝。早安.僅在 2025 年指導範圍內，您能談談您對商業趨勢的期望以及您的定價嗎？我只是想確保我理解正確，您是否仍期待商業利潤率的提高？我以為那是以前的期望。

And then just on the MA side, I know the CMS data got rescinded, but it looked like your growth was already above -- slightly above the midpoint of full year guidance. I heard not a lot of growth the rest of the year. Could you just help us with the actions you've taken on the distribution side and maybe why you've taken some of those actions, and if that's what's slowing the growth?

然後就在 MA 方面，我知道 CMS 數據被撤銷了，但看起來你的增長已經高於 - 略高於全年指導的中點。我聽說今年剩餘時間的成長幅度不會很大。您能否幫助我們介紹您在分銷方面採取的行動，以及為什麼採取這些行動，以及這些行動是否是導致成長放緩的原因？

Josh, thanks very much for your question. On '25 commercial trends, looking ahead, we really do anticipate commercial cost trends to stay above those historical averages. But most importantly, this is something that we've expected and we've accounted for in our pricing strategy.

喬希，非常感謝你的提問。關於'25商業趨勢，展望未來，我們確實預期商業成本趨勢將保持高於歷史平均。但最重要的是，這是我們預料到的，並且已經在我們的定價策略中考慮到了。

Morgan and team have taken a very disciplined approach between competitiveness and underwriting discipline to ensure that those are priced for. It's a hard market. It's a very rational market. We feel very good about our balance of pricing and our forward-looking view of trends here. So on the commercial side, certainly, retention is strong, pricing is strong, margins remain robust.

摩根和他的團隊在競爭力和承保紀律之間採取了非常嚴謹的方法，以確保價格合理。這是一個艱難的市場。這是一個非常理性的市場。我們對我們的定價平衡和對趨勢的前瞻性看法感到非常滿意。因此從商業方面來看，保留率肯定很高，定價很高，利潤率仍然很高。

Yeah. Thanks, Josh. I'll take the second part of your question, which is kind of our view. Part of this is, as you think about AEP, we expect the data to settle out over the next few months. So I think you'll have a better view of what AEP actually looked like.

是的。謝謝，喬希。我將回答你問題的第二部分，也是我們的觀點。部分原因是，當您考慮 AEP 時，我們預計數據將在未來幾個月內穩定下來。所以我認為您會更了解 AEP 的實際情況。

And then secondarily, just looking at our trajectory and our placement of our products in each of the businesses. And as you note, just duals and sort of that pace, that's why we feel very confident of the rest of the year growth.

其次，只需查看我們的發展軌跡以及我們產品在各個業務中的定位。正如您所說，只是雙倍的和那種速度，這就是我們對今年剩餘時間的增長非常有信心的原因。

We still expect strong retention, but we don't expect any significant growth of new sales, for example. But other than a normal cadence, and we saw that cadence in 2024 as well. Next question, please.

例如，我們仍然預期保留率會很高，但我們預計新銷售不會有任何顯著成長。但除了正常節奏之外，我們在 2024 年也看到了這種節奏。請回答下一個問題。

Dave Windley, Jefferies.

傑富瑞（Jefferies）的戴夫溫德利（Dave Windley）。

Thanks for taking my question. Good morning. Question on pricing, kind of a two-parter. The guidance in commercial for ASO revenue or fee revenue flat. Your membership, I think you're expecting up, is there no pricing there?

感謝您回答我的問題。早安.關於定價的問題，分為兩個部分。商業上對於ASO收入或費用收入的指導持平。您的會員資格，我想您已經預料到了，那裡沒有定價嗎？

And in Medicaid, I hear you saying kind of stable MLR, stable margin, as we move into the early part of 2025. I think 50% of the book reprices on Jan 1. And so I'm just curious about the benefit or lack thereof from that price to actually move you into an improving pattern in your Medicaid margins. So pricing on Medicaid and ASO. Thanks.

在醫療補助方面，我聽到您說隨著我們進入 2025 年初，MLR 和利潤率將趨於穩定。我認為 50% 的書籍將於 1 月 1 日重新定價。所以我只是好奇這個價格是否真的能讓您的醫療補助利潤率進入改善模式。因此，醫療補助和 ASO 的定價。謝謝。

Okay. We'll try to address -- there's a lot embedded in that question. Maybe Mark first, and then I'll ask some of the other colleagues here to join in on the rest of the answers. Mark?

好的。我們將盡力解答——這個問題包含很多內容。也許首先是馬克，然後我會請這裡的其他一些同事加入回答其餘問題。標記？

Dave, thanks very much for the question. The first one is relatively simple on the service fee revenues guide of approximately flat year over year. This is primarily because one of the main business drivers here as we're targeting a shift from fee-based to risk-based contracts.

戴夫，非常感謝您的提問。第一個相對簡單，服務費收入指引與去年同期大致持平。這主要是因為我們這裡的主要業務驅動力之一就是從基於費用的合約轉向基於風險的合約。

Meaning, within Carelon Services, we're expecting a portion of our new wins and contract expansions really to convert on those fee-based arrangements to risk-based arrangements. And so we'll record that premium rather than necessarily through the service fee line.

意思是，在 Carelon Services 內部，我們預計部分新勝利和合約擴展實際上會將基於費用的安排轉化為基於風險的安排。因此，我們將記錄該保費，而不一定透過服務費記錄。

Next will be Felicia to answer the other parts of your question.

接下來由 Felicia 來回答您問題的其他部分。

Yes. Dave, thank you for the question. Certainly, let me start by saying that we continue to be very focused on working tirelessly with our states partners to make sure that we are getting actuarially sound rates. When we take a look at our rating cycle, we have about 41% of our members tied to January, but then we have the rest of the rating year for the rest of our membership.

是的。戴夫，謝謝你的提問。當然，首先我要說的是，我們將繼續致力於與各州的合作夥伴不懈合作，以確保我們獲得精算合理的費率。當我們回顧我們的評級週期時，我們發現大約有 41％ 的會員與一月份相關，但其餘會員的評級則與全年剩餘時間相關。

At this point, we have visibility into about 70% of our premium on the Medicaid side. And as you heard Mark mention earlier, January came in, in line just with what we expected, insufficient but very constructive conversations and good work with our state partners. And then the July rates will be critical as well as we continue to close and narrow that gap, and expect to see strong improvement in the back half of the year in Medicaid.

目前，我們已經了解了醫療補助方面約 70% 的保費。正如您之前聽到馬克提到的，一月份正如我們預期的那樣，雖然與我們的州合作夥伴進行了不充分但非常有建設性的對話並開展了良好的合作。隨著我們繼續縮小差距，七月份的費率也將至關重要，我們預計今年下半年醫療補助率將出現強勁改善。

Next question, please.

請回答下一個問題。

Joanna Gajuk, Bank of America.

美國銀行的喬安娜‧加朱克 (Joanna Gajuk)。

Hi, good morning. Thanks so much for taking the question. So I was looking at your slides. And the slide that when you talk about the long-term CAGR targets, I noticed that you no longer seem to be targeting to get to your margin 6.5% - 7% by 2027.

嗨，早安。非常感謝您回答這個問題。所以我正在看你的幻燈片。當您在幻燈片中談到長期複合年增長率目標時，我注意到您似乎不再以 2027 年實現 6.5％ - 7％ 的利潤率作為目標。

So is that the way to read it? And also, I guess, if that's the case, when should we expect that to be achieved? And what would need to happen really for the margins to get to that target Thank you.

那麼，這是閱讀的方式嗎？而且我想，如果是這樣的話，我們什麼時候可以達成這個目標呢？那麼，要真正實現這一目標，利潤率需要怎麼做呢？

Joanna, great question and a very sharp eye. Let me maybe start by emphasizing, we remain committed to the long-term financial targets that we introduced at our 2023 Investor Day. We've not changed our target ranges or our expectations for either revenue growth or operating margin, and our goal is to deliver at least 12% average annual adjusted EPS growth.

喬安娜，這個問題問得非常好，而且觀察力很強。首先我想強調的是，我們仍然致力於實現我們在 2023 年投資者日提出的長期財務目標。我們沒有改變我們的目標範圍或對收入成長或營業利潤率的預期，我們的目標是實現平均年調整後每股收益成長至少 12%。

In other words, nothing has changed about our conviction in the significant embedded earnings power of our businesses. What has evolved is that the faster than projected and, I'd say, very positive growth that we've delivered across our Carelon businesses versus what we shared when we set those targets in 2023 has changed.

換句話說，我們對於自身業務龐大內含獲利能力的信念並沒有任何改變。實際情況是，與我們在 2023 年設定目標時所說的相比，我們在 Carelon 業務中實現的成長速度快於預期，而且可以說非常積極，但這種情況已經改變了。

And specifically, Carelon growth is exceeding those original expectations. And we're very pleased that the deliberate actions we've taken to enhance and deepen our risk-taking capabilities has led to an acceleration of this business.

具體來說，Carelon 的成長超出了最初的預期。我們非常高興，我們為增強和深化承擔風險的能力而採取的慎重行動已加速了這項業務的發展。

So putting it in numbers. With today's 2025 revenue guidance, we anticipate Carelon services to grow at over a 30% CAGR since 2022. And that's significantly above our original target range of high-teens to low 20s. And that's very positive for the earnings growth of Carelon, but it also shifts the near-term margin dynamics for those newer capabilities, right? Just given the normal time it's going to take for new deals to reach, for example, mature margin levels.

所以用數字來表達。根據今天的 2025 年收入指導，我們預計 Carelon 服務自 2022 年以來將以超過 30% 的複合年增長率增長。這大大高於我們最初的目標範圍（10 多歲到 20 多歲出頭）。這對 Carelon 的獲利成長非常有利，但也會改變這些新功能的短期利潤動態，對嗎？考慮到新交易達到成熟的保證金水準所需的正常時間。

So in other words, our earnings power remains strong, but the business mix and timing have changed. So I'd probably end here with, look, we remain confident in the embedded earnings call of the businesses. We'll provide a couple more details at our Investor Day later this year. But this is really representative of the change.

換句話說，我們的獲利能力依然強勁，但業務組合和時機已經改變了。因此，我可能想在這裡結束說，你看，我們仍然對企業的嵌入式獲利預測充滿信心。我們將在今年稍後的投資者日上提供更多詳細資訊。但這確實代表了改變。

Thank you. Next question, please.

謝謝。請回答下一個問題。

Erin Wright, Morgan Stanley.

摩根士丹利的艾琳·賴特。

Great. Thanks. A follow-up on Medicare Advantage. I wanted to hear your thoughts on the advanced rate notice and where it can go from here in terms of incorporating a catch-up period in the final rate notice. And just bigger picture in light of that and the broader political environment seems to be more supportive of MA, but how are you thinking about regulatory implications, I guess, across the rest of your business and mainly in Medicaid, where I guess there's a lot of questions and maybe there's no answer. But wanted to hear your initial thoughts. Thanks.

偉大的。謝謝。對醫療保險優勢計劃的後續行動。我想聽聽您對提前利率通知的看法，以及在最終利率通知中加入補繳期方面可以採取哪些措施。從更大的角度來看，更廣泛的政治環境似乎更支持 MA，但你如何看待監管影響，對你的其他業務，主要是醫療補助，我想這方面有很多影響問題，但也許沒有答案。但想聽聽你的初步想法。謝謝。

Again, a very fulsome question, Erin. We'll try to address that. Maybe directionally, we think it's positive. Obviously, it's preliminary, not final. I'll have Felicia share some more details on that, and we'll talk about sort of kind of how we're heading. Felicia?

這又是一個很詳細的問題，艾琳。我們將盡力解決這個問題。也許從方向上看，我們認為這是正面的。顯然，這只是初步結果，而非最終結果。我會讓費莉西亞分享更多有關這方面的細節，然後我們會討論一下我們的進展。費利西亞？

Sure, Erin. Thank you very much for that question. we all have to keep in mind that beneficiaries choose Medicare Advantage for the value that it provides and it delivers. In over 34 million people in this country, older adults and persons with disability, have proactively chosen MA. Rate stability really helps us to continue to be able to provide the benefits that deliver high-quality care that seniors value and depend on.

當然，艾琳。非常感謝您提出這個問題。我們都必須記住，受益人選擇醫療保險優勢計劃是因為其提供和實現的價值。在這個國家，有超過3400萬人，老年人和殘疾人，都主動選擇了MA。費率穩定確實有助於我們繼續提供老年人重視和依賴的高品質照護福利。

Regarding the advanced notice, after two consecutive years of cuts to MA program, we are very pleased to see the direction of the advanced MA rate notice that came out earlier this month. Now, while the base rate reflects progress, I think, towards more adequate funding in the program, we still believe that it's insufficient in light of the cost trends that we've seen over the past year.

關於提前通知，在連續兩年削減MA計畫後，我們很高興看到本月初發布的提前MA利率通知的方向。現在，雖然我認為基準利率反映了在該計劃中獲得更充足資金的進展，但根據過去一年的成本趨勢，我們仍然認為，基準利率是不夠的。

So we look forward to working very collaboratively with the new administration in terms of our proposed recommendations on changes in the advanced notice, particularly with respect to some of the reforms in the Part D risk model and other policies which we believe will improve the program long term. So we look forward to working with the administration over the next few weeks and months to make sure that the final notice advances a program that seniors in this country have certainly come to rely on.

因此，我們期待與新政府密切合作，就提前通知的變化提出建議，特別是關於 D 部分風險模型和其他政策的一些改革，我們認為這些改革將長期改善該計劃。因此，我們期待在未來幾週和幾個月內與政府合作，以確保最終通知能夠推進這個國家老年人所依賴的計劃。

And Erin, just briefly on your comments around sort of Medicaid and the environment there. Just a couple of things. I mean I think as you think about the deep expertise and the years that we've worked in this space, we have a long history across multiple administrations providing critical benefits to our members and deep expertise, particularly in working with the states.

艾琳，請您簡單談談您對醫療補助計劃及其環境的看法。僅舉幾例。我的意思是，當你想到我們在這個領域的深厚專業知識和工作年限時，我們擁有在多個政府部門為我們的成員提供重要利益的悠久歷史和深厚的專業知識，特別是在與各州合作方面。

What I'd say we're really looking forward to is a public private partnership where we can work with our states and the government to bring innovative programs that we think can really benefit these members and I think provide even better value.

我想說，我們真正期待的是公私合作夥伴關係，我們可以與各州和政府合作推出創新計劃，我們認為這些計劃可以真正使這些成員受益，我認為這些計劃甚至可以提供更好的價值。

So we're -- again, it's early. There are no firm proposals. A lot of different discussion. But I think we're approaching this in the public private partnership and also a long history of working across this for many, many years. Thank you. Next question, please.

所以我們—再說一次，現在還早。尚無確切提案。很多不同的討論。但我認為，我們正在透過公私合作夥伴關係來解決這個問題，並且我們已經在這個領域工作了很多年。謝謝。請回答下一個問題。

Sarah James, Cantor Fitzgerald.

莎拉詹姆斯 (Sarah James)，費茲傑拉領唱者。

This is Gabie on for the line for Sarah. Could you just speak a little bit more to the commercial cost trends you saw in the fourth quarter and overall for 2024, maybe more by product inpatient, outpatient? And then just reiterate what's assumed in guidance for how commercial cost trends evolve in '25?

我是加比 (Gabie)，接聽莎拉的電話。您能否再多談談您在第四季度以及整個 2024 年看到的商業成本趨勢，也許更多是按產品住院、門診劃分的？然後重申指導中對 25 年商業成本趨勢如何演變的假設？

Gabie, welcome. And I'm going to apologize in advance, this might be a little bit of a short answer. So I'd simply note that commercial performance remained strong in the fourth quarter, trends were elevated throughout the year, they were stable, and most importantly, they were priced for.

加比，歡迎光臨。我要提前道歉，這可能是個簡短的回答。因此，我只想指出，第四季度商業表現依然強勁，全年趨勢上升，並且穩定，最重要的是，它們的價格合理。

We see continued driver-of the elevated cost trend come from a couple of key categories, for example, some of the inpatient medical, a little bit of outpatient ER. But for the most part, developed exactly in line with what we expect.

我們看到成本上升趨勢的持續驅動因素來自幾個關鍵類別，例如部分住院醫療，少量門診急診室。但大部分內容的發展都完全符合我們的預期。

And I'd say the same for 2025. Our pricing initiatives are ongoing. We'll look to continue to expand margin via mix and penetration of some of the specialty products, but we feel very good about how we're positioned.

我對 2025 年也抱持著同樣的看法。我們的定價舉措仍在持續進行中。我們希望透過一些特色產品的混合和滲透來繼續擴大利潤，但我們對我們的定位感到非常滿意。

Thank you, Mark. And just reiterating, I mean, we feel very good that we priced. It's a hardened market in commercial and have seen really strong results across our commercial business. So thank you for that question. Next question, please.

謝謝你，馬克。我再次重申，我們對我們的定價感到非常滿意。商業市場已經變得十分強勁，我們的商業業務也取得了非常強勁的業績。感謝您的提問。請回答下一個問題。

George Hill, Deutsche Bank.

德意志銀行的喬治·希爾。

Yeah. Good morning guys and thanks for taking the questions. Kind of two parts here on the exchange business. I guess, number one is do you guys have an expectation for what happens to the enhanced subsidies as part of the upcoming political cycle?

是的。大家早安，感謝你們回答問題。這裡的交換業務分為兩部分。我想，第一個問題是，你們對於即將到來的政治週期中增加補貼會發生什麼變化有什麼預期嗎？

And then part two, Mark, is kind of a nuanced one. What percent of your exchange members have actually paid the January premiums relative to what you guys have experienced last year given that the government turned the income verification back on kind of expecting a change in like when people actually show up and pay the premiums there? Any color would be helpful.

然後第二部分，馬克，是有點微妙的。鑑於政府重新開啟收入核實，預計人們實際到場並繳納保費的時間會發生變化，相對於去年的情況，你們交易所有多少比例的會員實際繳納了 1 月份的保費？任何顏色都會有幫助。

Let me have Morgan address your first question and then Mark your second. So Morgan?

讓我讓摩根回答您的第一個問題，然後讓馬克回答您的第二個問題。那麼摩根？

So George, thanks for the question there. First of all, we're really pleased with the commercial ACA performance. That business has turned out to be quite a good one. And as you've noticed over the past several years, we've taken a very prudent methodical approach to getting into various markets and actually growing that slowly.

喬治，謝謝你的提問。首先，我們對商業 ACA 的表現非常滿意。事實證明那筆生意相當不錯。正如您在過去幾年中註意到的那樣，我們採取了非常審慎的方法進入各個市場並緩慢地發展。

It's one where we've seen the trends as they are they've been priced for. This year, we're particularly pleased with the fact that we've expanded into non-Blue geographies in three additional markets. So we really look at this as an overall white space.

我們已經看到了趨勢，並且已經為它們定價。今年，我們特別高興的是，我們已將業務擴展到另外三個市場的非藍色地區。因此我們確實將其視為一個整體的空白。

Certainly, there's the opportunity to have a reduction in the actual subsidies or elimination, which would certainly shrink the market at some sorts, if indeed that occurs. That said, we absolutely believe that this is a really, really solid market for us.

當然，有可能減少實際補貼或取消補貼，如果確實發生這種情況，這肯定會在某種程度上縮小市場。儘管如此，我們絕對相信這對我們來說是一個非常非常穩固的市場。

We like the business. It's a complementary business for us in taking risk, and it certainly created a promising white space for long-term growth as we continue to kind of create that harmonious connection between [Medi]Care, [Medi]Caid, and ACA. So it brings together both government and health benefits or commercial benefits. And I'll pass it to Mark to the balance of your question.

我們喜歡這個生意。對我們來說，這是一項在承擔風險方面具有補充作用的業務，而且隨著我們繼續在[Medi]Care、[Medi]Caid 和ACA 之間建立和諧的聯繫，它無疑為長期增長創造了一個有希望的空白空間。因此，它結合了政府和健康利益或商業利益。我會將你的問題的其餘部分轉交給馬克。

George, thanks. At this time, there's really no change in our effectuation rates being a little bit conservative in the assumptions. I'd say the effectuation has been very consistent with what we've observed in the prior years. And our guidance for membership growth that we released this morning, incorporates those assumptions.

喬治，謝謝。目前，我們的實現率其實沒有變化，只是假設有點保守。我想說，其效果與我們前幾年觀察到的情況非常一致。我們今天早上發布的會員成長指南就包含了這些假設。

And one thing about -- just in terms of where the Federal Government. Obviously, there's still a lot of discussions. There's no final policy. And I think one of the things to consider that -- there's a lot of flexibility that Congress has when considering an extension of a subsidy, so it doesn't have to be an all or nothing decision.

還有一件事——僅就聯邦政府而言。顯然，還有很多討論。還沒有最終政策。我認為需要考慮的事情之一是，國會在考慮延長補貼時具有很大的靈活性，因此不一定要做出全有或全無的決定。

Adjustments can include full extension or partial. So just as we go through this process, we're obviously sharing the value that these subsidies have for our members and the impact it has to them. Next question, please.

調整可以包括全部擴充或部分擴充。因此，當我們經歷這個過程時，我們顯然會分享這些補貼對我們的成員的價值及其對他們的影響。請回答下一個問題。

Scott Fidel, Stephens.

史考特菲德爾、史蒂芬斯。

Hi, thanks. Good morning. I wanted to just get a clarification and then a question. Just the clarification would be appreciate Mark's comments on the operating margin dynamics for Carelon by '27. I was hoping maybe, Mark, if you could also just elaborate on health benefits and whether those margin targets are still intact for '27 or have evolved? And then also I was just curious if you guys can give us the breakdown in the commercial risk enrollment growth guidance between commercial group and the exchanges. Thanks.

嗨，謝謝。早安.我只是想得到一個澄清，然後提出一個問題。只要澄清一下，就很感激馬克對 Carelon 27 年營業利潤率動態的評論。馬克，我希望您能詳細說明健康福利，以及這些利潤目標在 27 年是否仍然完好無損或已經發生了變化？另外，我很好奇你們是否可以給我們提供商業集團和交易所之間商業風險登記增長指導的細目。謝謝。

Thank you very much for the question. Scott, just on the health benefits margin. So again, maybe just to reiterate some of the importance from my prior commentary. So our long-term vision and margin objectives for health benefits business haven't changed. And we do remain confident in the earnings power that's embedded in these health businesses and the growth they continue to drive for Carelon.

非常感謝您的提問。斯科特，只是關於健康福利的邊際。所以，也許只是想重申我之前評論的一些重要性。因此，我們對健康福利業務的長期願景和利潤目標並沒有改變。我們對這些健康業務的盈利能力以及它們繼續推動 Carelon 的成長仍然充滿信心。

In terms of the change we made this quarter based in part on investor feedback was really to reflect faster than projected. And I spoke about this a minute ago, that the positive growth that we've delivered across the Carelon businesses.

就我們本季根據投資人回饋所做的改變而言，其反映速度確實比預期的要快。我剛才談到了這一點，我們 Carelon 業務實現了積極的成長。

So concurrent with that, we also want to stay prudent about the pace at which our evolving health benefits business mix and investments come together to support those long-term target margins. We'll provide more details at this year's investor conference about where we stand with that, and you'll hear more about the growth opportunities at that time.

因此，同時，我們也希望對不斷發展的健康福利業務組合和投資的步伐保持謹慎，以支持這些長期目標利潤率。我們將在今年的投資者會議上提供更多有關我們立場的詳細信息，屆時您也會聽到更多有關成長機會的信息。

Yes. Thanks, Mark. And again, I guess our key message is we believe that there's really strong embedded earnings power, and Carelon has really accelerated that as well. So that's really the message that we are trying to share today. Next question, please.

是的。謝謝，馬克。我想我們的關鍵訊息是，我們相信該公司擁有非常強大的內在獲利能力，而 Carelon 也確實加速了這一進程。這就是我們今天想要傳達的訊息。請回答下一個問題。

Michael Ha, Baird.

麥可·哈，貝爾德。

I wanted to revisit AJ's question and ask it in a bit different way. So regarding your '25 MA growth guide, healthy growth in line with expectations, averting the worst case high-growth scenarios that investors had. With that said, for the investors who may still push back and say, okay, Elevance only achieved this healthy growth level through aggressive plan suppression tactics, and that the company still mispriced the business.

我想重新審視 AJ 的問題並以稍微不同的方式提出。因此，關於您的 '25 MA 成長指南，健康成長符合預期，避免了投資者所面臨的最糟糕的高成長情景。話雖如此，但投資者可能仍會反駁說，好吧，Elevance 只是通過積極的計劃抑制策略才實現了這一健康的增長水平，而且該公司仍然對業務進行了錯誤定價。

Curious to hear your response to that. I know you're still very confident. But given this context, I'm trying to get a better sense of the level of conviction and confidence on MA margins this year. Thank you.

我很想聽聽您的回答。我知道你還是很有信心的。但考慮到這種背景，我試圖更了解今年對 MA 利潤率的信念和信心水平。謝謝。

Thank you for the question. I guess sort of just to level set kind of our view. I mean, obviously, we were very specific around wanting to target certain types of growth by marketplace, geography and product as well as continue our growth in our strong duals business.

感謝您的提問。我想這只是為了確定我們的觀點。我的意思是，顯然，我們非常具體地希望透過市場、地理和產品實現某些類型的成長，並繼續實現我們強大的雙重業務的成長。

So I guess I would reframe the answer, to your question as we had really good retention. And that in our individual Medicare Advantage book, I think, has positioned us quite well for sustainable long-term growth. So we feel all of this actually plays into our long-term strategy. We're being prudent around where Medicare is going as Mark shared in sort of our guide around trend, and want to make sure that we position that business the right way.

因此，我想我會重新回答你的問題，因為我們的保留率確實很好。我認為，在我們的個人醫療保險優勢計劃中，這一點為我們實現可持續的長期成長奠定了良好的基礎。因此我們認為所有這些實際上都符合我們的長期策略。正如馬克在我們的趨勢指南中分享的那樣，我們對醫療保險的發展方向持謹慎態度，並希望確保我們以正確的方式定位業務。

The other growth that we saw, which is also, I think, a significant positive is in our group growth. And that's from a large client that we have significant experience with and have worked with. And I think that is an inherent part of our strategy in group MA is to convert those members over. And we did that this year, and we're really pleased with.

我們看到的另一個成長，我認為也是一個顯著的正面因素，是我們集團的成長。這來自一位我們有著豐富經驗並曾與之合作過的大客戶。我認為這是我們 MA 集團策略的一個固有部分，就是將這些成員轉變過來。今年我們做到了這一點，我們對此感到非常高興。

And we saw some stronger growth because of the strength of the brand that we have with that customer. And again, the strong service and delivery, we've delivered this customer for many, many years. So I guess my positioning is we feel quite good about where we said we were going to guide for growth, where we are ending on growth. And it is the right mix of product and geography to match where our capabilities are. Next question, please.

而且，由於我們與該客戶之間的品牌實力，我們看到了更強勁的成長。再次強調，我們多年來一直為該客戶提供強大的服務和交付。所以我想我的定位是，我們對於我們所說的要引導成長的地方以及我們即將實現成長的地方感到非常滿意。這是與我們的能力相符的產品和地理位置的正確組合。請回答下一個問題。

Whit Mayo, Leerink Partners.

惠特·梅奧（Whit Mayo），Leerink Partners 合夥人。

Thanks. I just wanted to get a quick update on the performance of your Puerto Rico MA business. How did that perform last year versus your targets? And what are you thinking about growth in margins this year and whether or not that's driving any contribution to the views on stabilization overall MA margins. Thanks.

謝謝。我只是想快速了解您在波多黎各 MA 的業務表現。與你們的目標相比，去年的表現如何？您對今年利潤率的成長有何看法，這是否會對穩定整體 MA 利潤率產生影響。謝謝。

Well, Felicia should address that. Thank you.

好吧，費莉西亞應該會解決這個問題。謝謝。

So, good morning, Whit, and thank you so much for the question. As you know, as we headed into AEP of '24, we made some strategic decisions with respect to our Puerto Rico business, making significant reductions in our supplemental benefits to make sure that over time, we were balancing margin and membership. And I will say that the success of that was very solid.

早安，惠特，非常感謝你的提問。如您所知，當我們進入 24 年的 AEP 時，我們就波多黎各業務做出了一些策略決策，大幅削減了我們的補充福利，以確保隨著時間的推移，我們能夠平衡利潤和會員人數。我要說的是，這次行動取得了十分穩固的成功。

We demonstrated our ability to be able to get to a place we needed to stabilizing that environment. It worked very well in '24 and we continue that same strategy as we headed into 2025. So we feel very well about how we are strategically positioned in Puerto Rico and look forward to continuing to make sure that we deliver value to the residents of Puerto Rico in the MA program. So thank you very much for that question.

我們證明了我們有能力到達穩定環境所需的地方。這項策略在 2024 年發揮了很好的作用，我們將繼續推行同樣的策略，邁向 2025 年。因此，我們對自己在波多黎各的戰略地位感到非常滿意，並期待繼續確保我們在 MA 計劃中為波多黎各居民帶來價值。非常感謝您提出這個問題。

Thank you, Whit. And that will be our last question. I want to thank everyone for joining us on the line today and for your continued interest and support in Elevance Health. We entered '25 resolute in our efforts to make the healthcare system simple, affordable and accessible for our members. And we're confident that our actions will ensure meaningful impact in 2025 and position the business to return to our long-term growth algorithms over time. Thank you so much again for your interest in Elevance Health, and have a great rest of your week.

謝謝你，惠特。這是我們的最後一個問題。我要感謝今天與我們一起參與的所有人，以及你們對 Elevance Health 的持續關注和支持。進入2025年，我們堅定不移地努力為我們的會員提供簡單、實惠和可及的醫療保健系統。我們相信，我們的行動將確保在 2025 年產生有意義的影響，並使業務隨著時間的推移恢復到我們的長期成長演算法。再次感謝您對 Elevance Health 的關注，並祝您本週剩餘時間過得愉快。

Ladies and gentlemen, a recording of this conference will be available for replay after 11:00 AM today through February 23, 2025. You may access the replay system at any time by dialing (866) 405-7292, and international participants can dial (203) 369-0604. 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 之後至 2025 年 2 月 23 日提供重播。您可隨時撥打（866）405-7292存取重播系統，國際參與者可撥打（203）369-0604。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。