Elevance Health Inc (ELV) 2025 Q1 法說會逐字稿

Ladies and gentlemen, thank you for standing by and welcome to the Elevance Health first-quarter earnings conference call.

女士們、先生們，感謝你們的支持，歡迎參加 Elevance Health 第一季財報電話會議。

(Operator Instructions)

（操作員指示）

As a reminder, today's conference is being recorded.

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.

現在我想將會議交給公司管理階層。

Please go ahead.

請繼續。

Good morning and welcome to Elevance Health's first-quarter 2025 earnings call.

早安，歡迎參加 Elevance Health 2025 年第一季財報電話會議。

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, our CFO; Pete Haytaian, President of Carelon; Morgan Kendrick, President of our Commercial Health Benefits business; and Felicia Norwood, President of our Government Health Benefits business.

我叫 Nathan Rich，是投資人關係副總裁。今天早上參加收益電話會議的有總裁兼執行長 Gail Boudreaux；我們的財務長 Mark Kaye； Pete Haytaian，Carelon 總裁；我們的商業健康福利業務總裁 Morgan Kendrick；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 a discussion of our first quarter performance. Mark will then discuss our financial results and outlook in greater detail.

蓋爾將在電話會議開始時回顧我們在策略舉措方面取得的進展，並討論我們第一季的業績。然後馬克將更詳細地討論我們的財務表現和前景。

After our prepared remarks, the team will be available for Q&A.

在我們準備好發言後，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 forward-looking statements on this call. Listeners are cautioned that these statements are subject to certain risks and uncertainties, many of which are difficult to predict and generally beyond the control of Elevance Health. These risks and uncertainties can cause actual results to differ materially from our current expectations. We advise listeners to carefully review the risk factors discussed in today's press release and in our quarterly filings with the SEC.

在通話過程中，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 指標的對帳可在我們的網站 elevancehealth.com 上查閱。我們也將在此電話會議上做出前瞻性陳述。請聽眾注意，這些聲明存在一定的風險和不確定性，其中許多難以預測且通常超出 Elevance Health 的控制範圍。這些風險和不確定性可能導致實際結果與我們目前的預期有重大差異。我們建議聽眾仔細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。

I will now turn the call over to Gail.

現在我將電話轉給蓋爾。

Good morning and thank you for joining today's call. At Elevance Health, we began 2025 with focus, momentum, and a deep commitment to advancing our purpose to improve the health of humanity. Across our enterprise, this purpose is not an abstract mission.

早安，感謝您參加今天的電話會議。在 Elevance Health，我們以專注、動力和堅定的承諾開啟了 2025 年，以推進我們改善人類健康的目標。在我們的企業中，這個目的並不是一個抽象的使命。

It's what drives how we serve our members, support care providers, and partner with communities. In the first quarter, we've seen that commitment come to life in powerful ways. Let me begin by highlighting just a few examples of the difference we're making.

它推動著我們如何為會員提供服務、支持照護提供者以及與社區合作。在第一季度，我們看到了這項承諾以強有力的方式得以實現。首先，讓我重點介紹一下我們正在做出的貢獻的幾個例子。

We believe the healthcare experience should be simpler, more affordable, and more human. That's why we've made sustained investments to fundamentally transform how people experience their care. In Q1, our patient advocacy solutions supported over 6 million members, delivering personalized guidance to navigate benefits, manage chronic conditions, and access behavioral health services.

我們相信醫療保健體驗應該更簡單、更實惠、更人性化。這就是為什麼我們持續投資以從根本上改變人們的護理體驗。在第一季度，我們的患者權益解決方案為超過 600 萬名會員提供了支持，為他們提供個人化指導，幫助他們了解福利、管理慢性病並獲得行為健康服務。

With a 95% satisfaction rate, it's become a valuable differentiator, especially among employers seeking holistic, proactive care for their employees. We also continue to scale HealthOS, our digital platform that integrates clinical data and insights into provider workflows.

憑藉高達 95% 的滿意度，它已成為一項寶貴的差異化因素，特別是對於尋求為員工提供全面、主動關懷的雇主而言。我們還將繼續擴展 HealthOS，這是我們的數位平台，將臨床數據和見解整合到提供者的工作流程中。

It now supports more than 88,000 care providers and over 1,200 provider organizations, enabling real-time decision making and seamless prior authorizations when documentation is accurate and complete. And for high performing providers, we've gone a step further, eliminating prior authorization requirements on more than 400 outpatient procedures to reduce administrative friction and speed up access to care.

現在它支援超過 88,000 個護理提供者和超過 1,200 個提供者組織，在文件準確且完整的情況下實現即時決策和無縫的事先授權。對於高績效提供者，我們更進一步，取消了 400 多項門診手術的事先授權要求，以減少行政摩擦並加快獲得醫療服務的速度。

These efforts are helping us reduce complexity, rebuild trust, and create a more connected care experience for both members and care providers. Across every line of business, we're addressing the full spectrum of physical, behavioral, and social health to drive better outcomes and lower total cost of care.

這些努力正在幫助我們降低複雜性、重建信任並為會員和護理提供者創造更緊密的護理體驗。在每一個業務領域，我們都致力於解決身體、行為和社會健康等各個方面的問題，以取得更好的結果並降低整體護理成本。

We're expanding our value-based oncology care model to Medicare Advantage this year following success in commercial last year which reduced inpatient admissions and higher adherence to treatment protocols. These are the kind of outcomes that matter most to members and care teams alike.

繼去年商業化取得成功後，我們今年將把基於價值的腫瘤治療模式擴展到醫療保險優勢計劃，從而減少住院人數並提高治療方案的依從性。這些結果對會員和護理團隊來說都是最重要的。

Through Carelon Services, we continue to expand our external reach. In Q1, we launched new post acute and behavioral health contracts with health plan clients, validating our ability to deliver risk-based outcomes for complex populations and reinforcing Carelon's role as a scalable platform for whole person care.

透過 Carelon Services，我們不斷擴大我們的外部影響力。在第一季度，我們與健康計劃客戶推出了新的急性後和行為健康合同，驗證了我們為複雜人群提供基於風險的結果的能力，並加強了 Carelon 作為全人護理可擴展平台的作用。

We also completed the acquisition of CareBridge at the end of last year, further strengthening our capabilities in home and community-based services. By integrating these offerings into our Medicaid & Duals platforms, we're delivering high touch in-home support to individuals with complex needs, helping to avoid ER visits and institutional stays.

我們也在去年年底完成了對 CareBridge 的收購，進一步增強了我們在家庭和社區服務方面的能力。透過將這些服務整合到我們的 Medicaid & Duals 平台中，我們為有複雜需求的個人提供高接觸式上門支持，幫助他們避免急診就診和住院。

And as we scale our risk-based care model, we're leveraging Carelon's advanced data-driven capabilities to deepen collaboration with providers and close gaps in care. These value-based arrangements are not only improving quality, but have also driven nearly $100 in per member per month savings across medical and pharmacy, highlighting the impact of our whole health approach.

隨著我們擴大基於風險的護理模式，我們正在利用 Carelon 先進的數據驅動功能來深化與提供者的合作並縮小護理方面的差距。這些基於價值的安排不僅提高了質量，而且還使每位會員每月在醫療和藥房方面節省了近 100 美元，凸顯了我們的整體健康方法的影響。

Now turning to our first quarter results. We delivered performance in line with our expectations, reflecting consistent execution and disciplined operations despite an elevated trend environment. Across our businesses, we're staying focused on what we can control, delivering operational results, engaging proactively with partners, and advancing our long-term strategy.

現在來看看我們的第一季業績。我們的業績符合預期，儘管趨勢環境有所好轉，但我們仍堅持執行並嚴格運作。在我們的業務中，我們始終專注於我們能夠控制的事情，提供營運成果，積極與合作夥伴合作，並推動我們的長期策略。

In Medicaid, we continue to make progress on rate alignment with April adjustments coming in as expected and early discussions for the July cohort underway. These conversations reflect a shared understanding of the need to align reimbursement with the current level of acuity of our membership.

在醫療補助方面，我們在費率調整方面繼續取得進展，四月份的調整正如預期的那樣，七月份的早期討論正在進行中。這些對話反映了大家對需要將報銷與我們會員的當前敏銳度水準一致這一共同的理解。

At the same time, we're partnering with states to rethink care delivery. Our long-term care model continues to deliver better outcomes at lower cost by integrating home-based services, behavioral health and care coordination.

同時，我們正在與各州合作，重新思考醫療服務提供方式。我們的長期照護模式透過整合家庭服務、行為健康和照護協調，繼續以更低的成本提供更好的結果。

Our recent acquisition of Centers Plan for Healthy Living in New York will expand our whole health approach to deliver improved care for members and greater value for the state. In Medicare Advantage, performance was consistent with expectations, retention remains strong, and growth was targeted and disciplined, supporting both margin and membership sustainability.

我們最近收購了紐約健康生活中心計劃，這將擴大我們的整體健康方法，為會員提供更好的護理並為國家創造更大的價值。在醫療保險優勢計劃中，業績與預期一致，保留率依然強勁，成長有針對性且有紀律，支持利潤率和會員人數的可持續性。

We remain confident in the long-term outlook for MA. Stronger retention not only improves member satisfaction, it's associated with better care coordination, fewer inpatient stays, and lower overall Medicare spending.

我們對 MA 的長期前景仍然充滿信心。更高的留任率不僅可以提高會員滿意度，還可以改善護理協調、減少住院時間並降低整體醫療保險支出。

In commercial, we're seeing strong engagement with our integrated offerings. Employers increasingly value our differentiated approach, which brings together advocacy, behavioral health, pharmacy, and specialty care into a seamless experience.

在商業領域，我們的綜合產品獲得了廣泛的認可。雇主越來越重視我們的差異化方法，它將宣傳、行為健康、藥房和專業護理整合成無縫體驗。

We're encouraged by the momentum we have heading into the 2026 selling season. And while individual ACA effectuation rates have been lower, we still expect solid growth in 2025. Our expansion into three new states supports our broader strategy to build lifetime value through coordinated ACA and Medicaid coverage.

我們對 2026 年銷售旺季的強勁勢頭感到鼓舞。儘管個人 ACA 實施率較低，但我們仍預期 2025 年將穩健成長。我們向三個新州的擴張支持了我們更廣泛的策略，即透過協調的 ACA 和醫療補助覆蓋來建立終身價值。

Carelon continues to be a strategic growth engine for Elevance Health. In the first quarter, we significantly expanded our relationships with external payers, including Many Blues plans for solutions in post-acute, behavioral health, specialty care, and palliative, further validating Carelon's ability to deliver outcomes beyond our own membership.

Carelon 繼續成為 Elevance Health 的策略性成長引擎。在第一季度，我們大幅擴大了與外部付款人的關係，包括 Many Blues 計劃，該計劃旨在提供急性後、行為健康、專科護理和安寧療護方面的解決方案，進一步驗證了 Carelon 為我們自己的會員之外的人提供成果的能力。

These relationships underscore the strength of Carelon's operating model and its alignment with what clients are asking for -- solutions that drive outcomes, reduce cost, and simplify care. We're executing with consistency, advancing our strategy with discipline, and delivering measurable value across the enterprise.

這些關係凸顯了 Carelon 營運模式的優勢及其與客戶要求的一致性——推動成果、降低成本和簡化護理的解決方案。我們始終如一地執行，嚴格推進我們的策略，並在整個企業中提供可衡量的價值。

What sets Elevance Health apart is not just how we perform, but why we perform. Through a purpose-driven model that focuses on whole person health, supports our partners, and delivers outcomes that matter.

Elevance Health 的與眾不同之處不僅在於我們的表現如何，還在於我們為什麼表現如此。透過以目標為導向的模式，專注於整個人的健康，支持我們的合作夥伴，並提供重要的成果。

Before I turn it over to Mark, I want to thank our more than 100,000 associates. Their commitment and passion continues to define our culture, power our performance, and strengthen our impact. This quarter, Elevance Health was named once again to Fortune's 100 Best Companies to Work For, recognized as one of America's most innovative companies, and included in the JUST 100 by JUST Capital, reflecting both the values we uphold and the difference we strive to make every day.

在將權力移交給馬克之前，我想感謝我們十多萬名同事。他們的承諾和熱情繼續定義我們的文化，推動我們的表現，並增強我們的影響力。本季度，Elevance Health 再次被《財星》雜誌評為 100 家最適合工作的公司之一，被公認為美國最具創新精神的公司之一，並被 JUST Capital 列入 JUST 100 強，這反映了我們所秉持的價值觀以及我們每天努力實現的改變。

With that, I'll turn it over to our CFO, Mark Kaye to take you through the financial results and outlook.

接下來，我將把時間交給我們的財務長馬克凱伊 (Mark Kaye)，讓他向您介紹財務表現和前景。

Mark?

標記？

Thank you and good morning, everyone.

謝謝大家，早安。

As you just heard from Gail, we're encouraged by our strong start to 2025, delivering results that are aligned with the expectations we laid out at the beginning of the year. In the first quarter, and as we reported on our Form 8-K filing last week, GAAP diluted earnings per share was $9.61 and adjusted diluted earnings per share was $11.97, reflecting year over year growth of more than 10%, underscoring the resilience of our diversified business and disciplined execution across our strategic initiatives.

正如您剛才從蓋爾那裡聽到的，我們對 2025 年的強勁開局感到鼓舞，取得的成果與我們年初制定的預期一致。在第一季度，正如我們上週提交的 8-K 表格中所述，GAAP 稀釋每股收益為 9.61 美元，調整後稀釋每股收益為 11.97 美元，同比增長超過 10%，凸顯了我們多元化業務的韌性和各項戰略舉措的嚴格執行。

We ended the first quarter with 45.8 million medical members, up 99,000 from year end, driven primarily by targeted expansion and better than expected retention rates in Medicare Advantage. While our individual ACA membership grew approximately 11% sequentially, we anticipate a moderation in membership during the second quarter as effectuation rates on renewing members are tracking below our initial expectations.

第一季結束時，我們的醫療會員人數為 4580 萬，比年底增加了 99,000 人，這主要得益於有針對性的擴張以及醫療保險優勢計劃 (Medicare Advantage) 的保留率好於預期。雖然我們的個人 ACA 會員數量環比增長了約 11%，但我們預計第二季度會員數量將有所放緩，因為續約會員的實際生效率低於我們最初的預期。

Operating revenue in the quarter was $48.8 billion, an increase of over 15%, principally driven by higher premium yields in our health benefits segment, growth in our Medicare Advantage and individual ACA membership, and CarelonRx product revenue.

本季營業收入為 488 億美元，成長超過 15%，主要得益於健康福利部門的保費收益率提高、醫療保險優勢計劃和個人 ACA 會員人數的增長以及 CarelonRx 產品收入。

In addition, our revenue result reflects contributions from recent acquisitions, particularly in pharmacy services and home health, two areas critical to advancing our whole health strategy. These investments strengthen our ability to deliver more connected care, and we are actively integrating these assets across our health benefits and Carelon platforms to improve outcomes for members and accelerate our enterprise flywheel.

此外，我們的收入結果反映了最近收購的貢獻，特別是在藥房服務和家庭保健領域，這兩個領域對於推進我們的整體健康策略至關重要。這些投資增強了我們提供更互聯醫療服務的能力，我們正在積極整合這些資產到我們的健康福利和 Carelon 平台中，以改善會員的結果並加速我們的企業飛輪。

Our consolidated benefit expense ratio was 86.4%, an increase of 80 basis points year over year. The increase was due to higher cost trends in our Medicaid business, partially offset by out of period Medicaid premium taxes that had no material impact on operating gain.

我們的綜合福利費用率為86.4%，較去年同期增加80個基點。這一增長是由於我們的醫療補助業務成本趨勢上升，但部分被對營業收益沒有重大影響的非定期醫療補助保費稅所抵消。

The ratio also benefited from favorable seasonality in Medicare Part D, specifically related to the Inflation Reduction Act changes. Overall, utilization patterns in our health benefit segment remain elevated, but consistent with the assumptions embedded in our full year guidance.

該比率也受益於醫療保險 D 部分的有利季節性，具體與通貨膨脹削減法案的變化有關。總體而言，我們的健康福利部門的利用模式仍然很高，但與我們全年指導中的假設一致。

In our Medicare Advantage business, the first quarter developed in line with expectations that high costs trends would persist in 2025, and we have maintained a prudent posture in our outlook appropriate for this early stage of the year.

在我們的醫療保險優勢業務中，第一季的發展符合高成本趨勢將持續到 2025 年的預期，我們對今年年初的前景保持了審慎的態度。

The adjusted operating expense ratio stood at 10.7%, an improvement of 60 basis points, reflecting our commitment to disciplined expense management and thoughtful prioritization of strategic investments. Health benefits operating gain of $2.2 billion declined slightly on higher Medicaid costs, partly offset by operating efficiencies.

調整後的營業費用率為 10.7%，改善了 60 個基點，反映了我們對嚴格的費用管理和對策略性投資的深思熟慮的優先排序的承諾。由於醫療補助成本上升，健康福利營運收益 22 億美元略有下降，但營運效率的提高部分抵消了下降。

Carelon's operating gain of $1.1 billion grew 34% driven by growth in pharmacy volumes and the improved performance of deployed risk-based capabilities. Net investment income exceeded our expectations for the first quarter.

Carelon 的營業利潤為 11 億美元，增長了 34%，這得益於藥房數量的增長以及部署的基於風險的能力的績效的提高。第一季淨投資收益超出我們的預期。

The factors driving this outperformance were incorporated in our full year guidance, though the timing was earlier than anticipated. As such, we continue to expect our 2025 net investment income to align closely with our initial guidance.

儘管時間比預期的要早，但推動這一優異表現的因素已納入我們的全年指導中。因此，我們繼續預期 2025 年淨投資收益將與我們的初步指引緊密一致。

Turning to our balance sheet. We ended the quarter with a debt to capital ratio of approximately 41%, preserving flexibility for strategic investments and future capital deployment. Days in claims payable were 44 days as of March 31 when adjusted for the acquisition of CareBridge.

轉向我們的資產負債表。本季末，我們的債務資本比率約為 41%，為策略投資和未來資本部署保留了靈活性。經調整收購 CareBridge 後，截至 3 月 31 日，應付理賠天數為 44 天。

The increasing DCP of 0.5 days sequentially reflects our consistent and prudent approach to reserving. We continue to expect DCP to trend towards the low 40s over time. Operating cash flow totaled $1 billion and reflected timing-related items that negatively impacted working capital in the quarter.

DCP 連續增加 0.5 天，體現了我們一貫審慎的儲備方針。我們繼續預期 DCP 隨著時間的推移將趨向於 40 年代的低點。經營現金流總計 10 億美元，反映了與時間相關的項目對本季營運資金的負面影響。

Importantly, we expect these timing items to reverse as the year progresses with our outlook for operating cash flow of approximately $8 billion remaining unchanged. We continue to approach the pacing of share repurchases opportunistically.

重要的是，我們預計這些時間項目將隨著時間的推移而逆轉，我們對約 80 億美元經營現金流的預期將保持不變。我們將繼續適時地調整股票回購的節奏。

In the quarter, we repurchased 2.2 million shares of common stock for approximately $880 million, demonstrating our confidence in the intrinsic value of our shares. Overall, we are pleased with our start to the year and are reiterating our guidance for adjusted diluted earnings per share to be in the range of $34.15 to $34.85.

本季度，我們以約 8.8 億美元回購了 220 萬股普通股，顯示我們對股票內在價值充滿信心。總體而言，我們對今年的開局感到滿意，並重申調整後每股攤薄收益在 34.15 美元至 34.85 美元之間的預期。

Regarding earnings seasonality, we continue to expect more than 60% of adjusted earnings per share to be realized in the first half of the year.

關於獲利季節性，我們仍然預計上半年將實現超過 60% 的調整後每股盈餘。

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

接線員，請開始提問環節。

(Operator Instructions)

（操作員指示）

AJ Rice, UBS.

瑞銀的 AJ Rice。

Maybe just try to flush out some of the issues that have been raised regarding Medicare Advantage. I know it's not as large a business for you as it is for some others, but certainly, there's been some discussion about Group MA.

也許只是嘗試解決有關醫療保險優勢計劃所提出的一些問題。我知道對你們來說這不像對其他人來說那麼大的業務，但確實，已經對 Group MA 進行了一些討論。

Are you seeing anything unusual there? There's concern about the IRA impact. How is that shaping up so far relative to the changes and how you've incorporated them in their outlook? And then I know you said you've got an elevated trend that seems to be in the individual market tracking your expectations. Is -- do you feel like you got a good read on it or do we really need to get to the second quarter before we have full visibility on how that's all trending?

你在那裡看到什麼不尋常的東西了嗎？人們擔心愛爾蘭共和軍的影響。相對於這些變化，目前進展如何？您如何將這些變化融入他們的展望中？然後我知道您說過，您發現了一種上升趨勢，似乎個人市場正在追蹤您的預期。您是否覺得您對此有了很好的了解，或者我們是否真的需要進入第二季度才能完全了解所有趨勢？

Thanks for the very comprehensive first question there. Anticipating we're likely to get a couple of questions on trend during the time together this morning, let me start from a Broad perspective. Medicare costs overall remain elevated but manageable to start the year, very consistent with our fourth quarter experience and very much in line with our expectations for the first quarter.

感謝您提出非常全面的第一個問題。預計我們今天早上在一起討論時可能會問到幾個有關趨勢的問題，讓我從廣泛的角度開始。整體而言，醫療保險成本在年初仍然較高，但在可控範圍內，這與我們第四季的經驗非常一致，也與我們對第一季的預期非常一致。

Effectively, nothing has materially changed with respect to our prior commentary. In the first quarter, we did see flu and respiratory illnesses cause slightly higher utilizations. Those costs moderated as the quarter came to a close, very much as you'd expect for seasonal conditions.

實際上，我們先前的評論並沒有任何實質的改變。在第一季度，我們確實看到流感和呼吸道疾病導致利用率略有上升。隨著本季的結束，這些成本有所緩和，這與人們對季節性情況的預期非常一致。

We are also very closely tracking weekly claims data, prior authorizations, and provider level interactions to identify emerging patterns quickly. And that's going to enable us to detect shifts and respond accordingly. But based on the most recent data review that we've conducted by our teams, we remain comfortable with the trend environment and the cost trajectory we've seen here to date.

我們也密切追蹤每週的索賠資料、事先授權和提供者層級的互動，以便快速識別新出現的模式。這將使我們能夠檢測到變化並做出相應的反應。但根據我們團隊進行的最新數據審查，我們對迄今為止所看到的趨勢環境和成本軌跡仍然感到滿意。

And sort of just reiterating what Mark said, I think we feel very much aligned with our expectations to start the year. So again, I appreciate the question and next question, please.

我只是重申了馬克所說的話，我認為我們的感覺與我們對今年年初的期望非常一致。再次感謝您的提問，請再提一個問題。

Lance Wilkes, Bernstein.

蘭斯威爾克斯、伯恩斯坦。

Could you talk a little bit about the Carelon Services really strong growth? And in particular, could you talk to cross sales into the Anthem book of business and how that's progressing? And then maybe if you could quantify or give us more details on sales into the Blues and other plans there.

您能否簡單談談 Carelon Services 的強勁成長？特別是，您能否談談交叉銷售進入 Anthem 業務的情況以及進展如何？然後，也許您可以量化或向我們提供有關藍軍銷售情況和其他計劃的更多細節。

And I guess as part of that if you want to talk a little bit about specialty pharmacy ramping into CarelonRx as well and how far along you are in that process, that would be great.

我想，如果您願意談談專科藥房進軍 CarelonRx 的情況以及您在過程中的進展情況，那就太好了。

A number of questions there. We'll try. I'll ask Pete Haytaian to address those, but appreciate the recognition of the very strong results that we've seen in both internal and external growth with Carelon Services and CarelonRx. So Pete?

這裡有很多問題。我們會盡力。我會請 Pete Haytaian 來解決這些問題，但同時也感謝大家對我們在 Carelon Services 和 CarelonRx 的內部和外部成長方面所取得的強勁業績的認可。那麼皮特？

Great question. Like Gail said, we're really pleased with the momentum we're seeing on the services side in Carelon. I think you saw it in the quarter, we had over 60% growth. We continue to track to the 50% -- at least 50% for the year.

好問題。正如蓋爾所說，我們對卡雷隆服務業的發展動能感到非常高興。我想您在本季度已經看到了這一點，我們的成長率超過了 60%。我們將繼續追蹤 50%——至少全年 50%。

And to your point, we're seeing really nice balanced growth internally and externally. To speak first internally, you asked about that. We're seeing really nice expansion. You heard it in the prepared remarks around products like total cost of care for oncology which we've been expanding last year into our commercial business now, into Medicare this year.

正如您所說，我們看到內部和外部都實現了非常好的平衡成長。先從內部來講，你問了這個問題。我們看到了非常好的擴張。您在腫瘤治療總成本等產品的準備好的發言中聽到了這一點，去年我們已將其擴展到我們的商業業務中，今年又擴展到醫療保險中。

So we're seeing that proliferate across the portfolio as well as in Medicaid in areas like behavioral health where we continue to expand our seriously mentally ill offering as well as other offerings. And then externally, we came off a really strong year in '24 as you know and heard around Carelon Services growth.

因此，我們看到這種服務在整個投資組合以及醫療補助計劃中不斷擴展，尤其是在行為健康等領域，我們將繼續擴大針對嚴重精神病患者的服務以及其他服務。從外部來看，正如您所知和聽到的有關 Carelon Services 成長的情況，我們在 2024 年取得了非常強勁的成績。

As it relates to this year, we feel very confident in the growth that we're seeing this year in 2025 across Carelon Services. And again, we're seeing diversity in what we're selling across all our offerings, across PAS, across our specialty care services business, across behavioral health.

就今年而言，我們對 2025 年 Carelon Services 的成長充滿信心。而且，我們看到，我們所銷售的所有產品、PAS、專業護理服務業務、行為健康領域的產品都呈現出多樣性。

And then of course, with the addition of CareBridge, which we're really excited about. So we will see in 2025 the most significant external growth across the Carelon Services portfolio. As it relates to CarelonRx, again, I'm very confident and happy about performance as it relates to our strategy there, continuing to follow through as it relates to SpecialtyRx and our migration in that business.

當然，還有 CareBridge 的加入，我們對此感到非常興奮。因此，我們將在 2025 年看到 Carelon Services 產品組合實現最顯著的外部成長。至於 CarelonRx，我對它的表現非常有信心和高興，因為它與我們在那裡的策略有關，並將繼續貫徹與 SpecialtyRx 和我們在該業務中的遷移相關的策略。

And as you know, we started with acquiring BioPlus and then Kroger Specialty Pharmacy. And so we're being very thoughtful about how we manage that, very thoughtful around the patient and the provider experience.

如您所知，我們首先收購了 BioPlus，然後收購了 Kroger Specialty Pharmacy。因此，我們非常認真地考慮如何管理這個問題，並且非常重視患者和提供者的體驗。

And we'll continue to migrate scripts both for Elevance as well as Kroger over the next year or so in addition to the work that we're doing around Paragon and our infusion businesses. So overall, very, very pleased across the portfolio in Carelon.

除了我們正在進行的 Paragon 和輸液業務工作之外，我們還將在未來一年左右繼續為 Elevance 和 Kroger 遷移腳本。總體而言，我對 Carelon 的投資組合非常滿意。

Thank you, Pete. And next question, please.

謝謝你，皮特。請問下一個問題。

Stephen Baxter, Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

Thanks for the color on the exchanges. I was hoping if you could expand a little bit maybe quantitatively on kind of how different the effectuation rate is actually coming in. I guess how much of a membership step down you're expecting when we get to the second quarter?

感謝您對交流的關注。我希望您能稍微擴展一下，從數量上說明實際效果率的差異。我猜當我們進入第二季時，您預計會員人數會減少多少？

And how much, if at all, are these dynamics impacting? How you're thinking about exchange profitability for the year inside your guidance?

這些動態的影響有多大（如果有的話）？您如何看待今年的交易所獲利能力？

We've been very pleased with our sustained growth in the individual ACA market. And we expect 2025 to be another year of growth likely at or above market levels. Our member effectuation rates, which are essentially the proportion of all members who have paid their premiums, are indeed tracking a little bit lighter than our initial expectations.

我們對個人 ACA 市場的持續成長感到非常高興。我們預計 2025 年將是另一個成長年，可能達到或超過市場水準。我們的會員生效率，本質上是所有已支付保費的會員的比例，確實比我們最初的預期要低一些。

And this is really due in part to a surge in passive renewals among people transitioning from Medicaid who are now paying premiums in 2025. Given the 90 day grace period has now ended, we do project membership attrition in the mid single digit percent range in early Q2, after which we'll anticipate our membership or ACA membership base will stabilize for 2025.

這在一定程度上是由於從醫療補助計劃過渡到現在支付 2025 年保費的人群的被動續保數量激增。鑑於 90 天的寬限期現已結束，我們預計第二季初的會員流失率將達到個位數的中等水平，之後我們預計我們的會員人數或 ACA 會員基礎將在 2025 年保持穩定。

And importantly, these revised membership assumptions are factored into our reaffirmed 2025 EPS guidance. And so you could think about commercial risk-based membership really ending the year in the range of 4.9 million to 5 million members.

重要的是，這些修訂後的會員假設已納入我們重申的 2025 年每股盈餘指引中。因此，你可以想像到今年年底基於商業風險的會員人數實際上將在 490 萬至 500 萬之間。

Thanks, Mark. Next question, please.

謝謝，馬克。請回答下一個問題。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

It looks like today's MLR finished better than what was implied from your comments at our March conference. Can you help us understand what developed favorably in the back half of March to drive that better MLR performance and how is that shaping your view on trend for the balance of the year?

看起來今天的 MLR 表現比您在我們三月會議上的評論中所暗示的要好。您能否幫助我們了解 3 月下半月哪些有利因素推動了 MLR 表現的改善，以及這對您對今年剩餘趨勢的看法有何影響？

As expected, our Medicare Part D medical cost ratio in the quarter ended up where we expected. And the primary drivers here really come from both the IRA as well as a premium tax that we incurred that was larger than anticipated specifically on the premium tax related to one of our larger Medicaid states, and that premium tax had the dual effect of both lowering current period benefit expense ratio and increasing the current period operating expense ratio.

正如預期的那樣，本季我們的 Medicare Part D 醫療成本比率最終達到了我們的預期。這裡的主要驅動力實際上來自於 IRA 以及我們所承擔的保費稅，該稅比預期的要大，特別是與我們較大的醫療補助州之一相關的保費稅，而保費稅具有降低當期福利費用率和增加當期運營費用率的雙重效果。

But importantly, with no material impact on overall operating earnings. And this adjustment effectively accounts for the majority of that positive variance that you're seeing between our reported benefit expense ratio and the updated analyst consensus estimates.

但重要的是，這對整體營業收入沒有實質影響。這種調整實際上解釋了我們所報告的福利費用率與最新的分析師一致估計值之間的大部分正差異。

Thanks, Mark. Next question, please.

謝謝，馬克。請回答下一個問題。

Lisa Gill, JPMorgan.

摩根大通的麗莎吉爾。

I appreciate the comments around Medicare elevated but manageable. Can you maybe just talk about new members versus existing members and how those new members came on when we think about risk coding?

我很欣賞有關醫療保險的那些高尚但可控的評論。當我們考慮風險編碼時，您能否談談新成員與現有成員的區別，以及這些新成員是如何加入的？

And then just lastly, Mark, can you help us understand on Part D and the changes on IRA, what the specific impact was to medical cost trend or MLR in the first quarter?

最後，馬克，您能否幫助我們了解 D 部分和 IRA 的變化，以及其對第一季醫療成本趨勢或 MLR 的具體影響？

Let me maybe start firstly with the Part D piece. We've received a lot of questions from investors on this topic in the last little while. So let me take maybe a moment just to first provide some additional context about the Part D Inflation Reduction Act changes, and then I'll get to your specific question.

我首先從 D 部分開始。最近一段時間，我們收到了很多投資者關於這個​​主題的提問。因此，請允許我花一點時間首先提供一些有關《D 部分通貨膨脹削減法案》變化的額外背景信息，然後我再回答您的具體問題。

There are really two key factors at play here in 2025. First is the lower $2,000 member maximum out of pocket cap, which really accelerates when beneficiaries reach their cost sharing limit, and that effectively shifts more liability onto the health plans early in the year.

2025 年實際上有兩個關鍵因素在起作用。首先是較低的 2,000 美元會員最高自付上限，當受益人達到其成本分攤限額時，這一上限才會真正加速，這實際上會在年初將更多的責任轉移到健康計劃上。

Second is the offset from the enhanced CMS direct subsidies that replace some of that cost burden that members and plan sponsors carried in prior years. And when taken together, these changes effectively reverse the usual quarterly seasonality pattern for Part D.

第二是抵銷增強的 CMS 直接補貼，以取代會員和計劃發起人前幾年承擔的部分成本負擔。綜合起來，這些變化有效地扭轉了 D 部分通常的季度季節性模式。

And that results in stronger financial performance in the earlier quarters and lower margins in the later quarters. And although it's still early, we are seeing this new seasonality pattern play out from both a pricing and a forecasting perspective.

這導致前幾季的財務業績表現更強勁，而後幾季的利潤率下降。儘管現在還為時過早，但從定價和預測的角度來看，這種新的季節性模式正在發揮作用。

And so to your question, you could think about Part D seasonality now much more closely resembling that of a broader medical benefits business with a much steeper slope as more members enter into that catastrophic phase of coverage as the year progresses.

因此，對於您的問題，您可以認為 D 部分的季節性現在更類似於更廣泛的醫療福利業務，並且隨著時間的推移，隨著越來越多的成員進入災難性的承保階段，其斜率會更加陡峭。

And then briefly just on Medicare Advantage membership, we are carefully managing the new volume and we are delivering targeted growth across specific populations, products, and geography.

然後簡要介紹醫療保險優勢會員資格，我們正在謹慎管理新的會員數量，並針對特定人群、產品和地區實現有針對性的增長。

And I guess I would just reiterate in terms of your membership, we feel really good about where we grew the products, where we grew and the geography. So in terms of the strategy that we laid out last year and shared with you, we feel that that's playing out and feel this is very consistent with the expectations we set.

我想我只想重申一下，就你們的會員資格而言，我們對我們的產品發展地點、發展地點和地理位置感到非常滿意。因此，就我們去年制定並與您分享的策略而言，我們認為該策略正在發揮作用，並且與我們設定的期望非常一致。

So thank you and next questions, please.

謝謝您，請問下一個問題。

Ann Hynes, Mizuho Securities.

瑞穗證券的安‧海因斯 (Ann Hynes)。

Earlier in the conference call, you cited that Medicare trends were in line with your expectations. Can you actually remind us what is embedded in guidance, meaning are you assuming 2024 trends growing high single digits or mid single digits? Any clarification, I think would be very helpful.

在電話會議早些時候，您提到醫療保險趨勢符合您的預期。您能否提醒我們指導中包含的內容，這意味著您是否假設 2024 年的趨勢成長率為高個位數或中個位數？我認為任何澄清都會非常有幫助。

I think we feel pretty comfortable that trends have emerged consistent with the expectations that we're managing. And maybe if I take this question from a slightly different angle thinking through the margin perspective, we really do feel good about our positioning in Medicare, having seen the composition of our membership.

我認為，我們感到相當舒服，因為趨勢的出現與我們所管理的預期一致。也許如果我從稍微不同的角度，從利潤的角度來思考這個問題，那麼在看到我們的會員組成後，我們確實對我們在醫療保險中的定位感到滿意。

And importantly, the results to start the year. Just as a reminder, we do expect to see stable margins in 2025. And that's going to come through strong retention rates, disciplined cost management, and importantly, the improved recognition of that member acuity following the elevated utilization trends that we've seen in recent years.

重要的是，這是新年伊始的成果。提醒一下，我們確實預期 2025 年的利潤率將保持穩定。這將透過強大的保留率、嚴格的成本管理以及更重要的是，隨著近年來利用率上升趨勢的出現，對會員敏銳度的認識不斷提高來實現。

Next question, please.

請回答下一個問題。

Ryan Langston, TD Cowen.

瑞安·蘭斯頓（Ryan Langston），TD Cowen。

You mentioned flu and respiratory was affecting the quarter. Sorry if I missed it, but can you just give us a sense on how much of the specific impact that was on the first quarter MLR and if those respiratory trends were different between your service lines or patient populations?

您提到流感和呼吸道疾病正在影響本季。抱歉，如果我錯過了，但您能否告訴我們這對第一季 MLR 的具體影響有多大，以及您的服務線或患者群體之間的呼吸趨勢是否不同？

We entered the year of modeling in influenza and influenza-like season to follow the pre-COVID norms, which are somewhat higher than what we observed during the pandemic era. And despite those prudent assumptions, first quarter flu-driven costs came in modestly above our own expectations.

我們進入了流感和流感樣季節建模的一年，以遵循 COVID 之前的規範，這些規範略高於我們在大流行時期觀察到的規範。儘管做出了這些謹慎的假設，但第一季流感引發的成本仍略高於我們的預期。

And importantly, here, the severity of those flu cases was in line with our assumptions. And given the recent decrease in flu incidence rates, we don't anticipate any outsized impacts in the second quarter. So for the first quarter, to your question, you can think about the impact of the benefit expense ratios between 15 basis points and 20 basis points.

重要的是，這些流感病例的嚴重程度與我們的假設一致。鑑於近期流感發生率的下降，我們預計第二季度不會產生任何過大的影響。因此，對於第一季度，對於您的問題，您可以考慮福利費用率在 15 個基點到 20 個基點之間的影響。

Thank you, Mark. Next question, please.

謝謝你，馬克。請回答下一個問題。

Erin Wright, Morgan Stanley.

摩根士丹利的艾琳·賴特。

Appreciate the detail on the EPS cadence, and there's a lot of moving pieces with the Medicaid state rate dynamics and how that progresses over the course of the year has anything changed on that front, but you also have respiratory that you just called out, Part D seasonality.

感謝您提供有關 EPS 節奏的詳細信息，並且醫療補助州費率動態中有很多變動因素，以及它在一年中如何發展，在這方面有什麼變化，但您也有剛才提到的呼吸系統疾病，即 D 部分季節性。

I guess what is -- where does that leave us for MLR in the second quarter? And anything else to call out that we should be aware of as we're thinking about the upcoming quarter?

我想問的是——第二季的 MLR 表現如何？當我們考慮下一季時，還有什麼其他需要注意的嗎？

We are pleased with our results in the first quarter with I'd say seasonality consistent with what we anticipated in the January guidance. A couple of key factors to call out here. First, our first quarter benefit expense ratio did benefit from that favorable workday calendar that effectively pulled forward some earnings into the first quarter.

我們對第一季的業績感到滿意，我認為季節性與我們在一月份的指引中預期的一致。這裡需要指出幾個關鍵因素。首先，我們的第一季福利費用率確實受益於有利的工作日日曆，這有效地將部分收益提前到第一季。

Second, as you noted, there was the Part D benefit design changes, and that has notably shifted that earnings cadence of our Medicare drug plans. And we'll expect that Part D seasonality going forward to more closely resemble our medical benefits business I mentioned earlier.

其次，正如您所說，D 部分福利設計發生了變化，這顯著改變了我們的醫療保險藥品計劃的獲利節奏。我們預計 D 部分的季節性將更類似於我之前提到的醫療福利業務。

And then finally, we are seeing a more front loaded earnings contribution, thanks to our shift in membership mix, namely lower Medicaid membership and then higher ACA growth. And all of this gets back to our point of continuing to expect more than 60% of earnings to be realized in the first half of the year.

最後，由於會員結構的變化，即醫療補助會員人數減少，ACA 會員人數增加，我們看到了更多的前期收益貢獻。所有這些都回到了我們的觀點，即繼續預期上半年將實現 60% 以上的收益。

And sort of just to reiterate based on the number of questions sort of on our expectations, I guess I would say we came into the year very respectful of the environment and had planned and are seeing an elevated season. But feel that we've accounted for that and feel quite frankly that we're just going to continue to monitor the situation, but as Mark has shared, feel comfortable in the ranges and the reiteration of our guidance.

根據對我們的期望提出的問題數量，我只是想重申一下，我想說，我們今年非常尊重環境，並且已經做好了計劃，並且看到了一個增長的季節。但感覺我們已經考慮到了這一點，坦白說，我們只是將繼續監測情況，但正如馬克所分享的，我們對範圍和指導的重申感到滿意。

Next question, please.

請回答下一個問題。

Ben Hendrix, RBC Capital Markets.

加拿大皇家銀行資本市場 (RBC Capital Markets) 的 Ben Hendrix。

I was getting a lot of questions about visibility into the remainder of the year, and I appreciate your comments about MA new members and your ability to detect trends sooner. But I was wondering if you could specifically talk about your new member engagement strategy.

我收到了很多關於今年剩餘時間前景的問題，我很感謝您對 MA 新成員的評論以及您更早發現趨勢的能力。但我想知道您是否可以具體談談您的新會員參與策略。

How many of those new members you've actually reached out to and engaged and kind of how you're thinking about that translating to primary care activity and outpatient referrals later down the road?

您實際上聯繫了多少新成員並與他們互動，您認為這將如何轉化為以後的初級保健活動和門診轉診？

I'm going to ask Felicia Norwood, who leads our Government business to address that.

我將請主管政府事務的費利西亞·諾伍德 (Felicia Norwood) 來解決這個問題。

I mean certainly, as soon as members come into Elevance Health, we are very focused on making sure that we engage those members early. A very dedicated focus around getting individuals to have their annual wellness visits, expediting care early on, and making sure we understand what their health risk assessments look like so that we are able to be very focused on the type of care that they need and the care coordination that comes from our clinical team.

我的意思是，當然，一旦會員加入 Elevance Health，我們就會非常注重確保儘早與這些會員互動。我們非常注重讓個人進行年度健康檢查，儘早加快護理，並確保我們了解他們的健康風險評估情況，以便我們能夠非常專注於他們需要的護理類型以及來自我們臨床團隊的護理協調。

Previously, we would have waited longer on some of those. We've accelerated a lot of those to make sure that we are doing complete and accurate capturing of those individuals and their health conditions, all with the expectation that we do everything that we can to maintain quality and make sure that those individuals have a very strong experience with us.

以前，我們會等待更長時間才能得到其中一些。我們已經加快了許多步伐，以確保我們能夠完整準確地掌握這些人及其健康狀況，所有這些都是為了盡一切努力保持質量，並確保這些人與我們擁有非常豐富的體驗。

So we're very focused on making sure that individuals get the care they need, being able to get them to see their physicians early and establishing a plan of care early into our relationship with them going forward.

因此，我們非常注重確保個人得到他們需要的護理，能夠讓他們儘早去看醫生，並在與他們建立關係的早期制定護理計劃。

And just a few other things that I would like to reiterate about our membership. One, if you think about our product mix, it's heavily HMO. And we've also been moving much more aggressively into value-based care, where our physicians are much more actively engaged with their patients earlier in the year.

關於我們的會員資格，我還想重申幾件事。首先，如果你考慮我們的產品組合，你會發現其中大部分是 HMO。我們也一直在更積極地轉向基於價值的醫療服務，我們的醫生在今年早些時候就更加積極地與患者互動。

And specifically, increasing our upside downside risk percentage of that. So if we look at our Medicare book, we feel very good about the active engagement and the more accurate capture of our clinical conditions across the board.

具體來說，就是增加我們的上行下行風險百分比。因此，如果我們看一下我們的醫療保險帳簿，我們會對積極參與和全面更準確地捕捉我們的臨床狀況感到非常高興。

And again, as we shared, I think in some of our comments, we feel good about the disciplined strategy that we executed this year around growth and geographies and specifically, on our product types. So overall, we feel that that's playing to the expectations that we laid out and they're going to continue to manage it and continue to engage our patients to ensure that they get the right care and that we align them appropriately with our value-based providers.

再次，正如我們所分享的，我認為在我們的一些評論中，我們對今年圍繞增長和地域，特別是我們的產品類型執行的嚴謹戰略感到滿意。因此，總的來說，我們認為這符合我們提出的期望，他們將繼續管理它並繼續與我們的患者互動，以確保他們得到正確的護理，並確保我們適當地將他們與我們基於價值的提供者結合起來。

But thank you very much for the question and next question, please.

非常感謝您提出這個問題，請再提一個問題。

Josh Raskin, Nephron Research.

Josh Raskin，腎元研究公司。

If you think about your MA bid strategy in the coming years, how important is the lifetime value of the member and the opportunity to penetrate that member with additional say Carelon Services and which Carelon Services specifically benefit most from that growth in MA?

如果您考慮未來幾年的 MA 競標策略，那麼會員的終身價值和透過額外的 Carelon 服務滲透該會員的機會有多重要，以及哪些 Carelon 服務具體從 MA 的成長中受益最多？

I'm going to ask Felicia first to just address our overall Medicare strategy and then Pete to comment a little bit about how we're embedding both the Carelon Services but also, as I mentioned a minute ago, our value-based care.

我將首先請 Felicia 談談我們的整體醫療保險策略，然後請 Pete 稍微評論一下我們如何嵌入 Carelon 服務，以及我剛才提到的基於價值的護理。

So Felicia, first and then Pete.

首先是 Felicia，然後是 Pete。

I mean we absolutely want to make sure that we have members for life. At the end of the day, we want to be a lifetime trusted partner and really value the relationship that we have with our members. Members choose Medicare Advantage because of the value that it brings, and we think that value is significant relative to fee for service.

我的意思是，我們絕對希望確保我們擁有終身會員。歸根究底，我們希望成為終身值得信賴的合作夥伴，並真正重視與會員之間的關係。會員選擇 Medicare Advantage 是因為它帶來的價值，我們認為相對於服務費而言，這種價值更為重要。

If we think about our bid strategy for 2026, it's certainly still early. But I can assure you that it will be a very thoughtful and disciplined one that's very much focused on stability and sustainability in our Medicare Advantage program and making sure that we are leveraging and engaging our Carelon partners and making sure that those individuals receive the highest quality care, particularly for those with complex conditions.

如果我們考慮 2026 年的申辦策略，現在肯定還為時過早。但我可以向你們保證，這將是一次非常深思熟慮和嚴謹的決策，我們將重點關注醫療保險優勢計劃的穩定性和可持續性，並確保我們利用和吸引我們的 Carelon 合作夥伴，並確保這些人獲得最高品質的護理，特別是對於那些病情複雜的人。

Pete?

皮特？

I think it's a really great question, Josh. I appreciate it very much. We're trying to be very targeted around what we do. And as Felicia said, we face off with our health plan partners in this case, to your question, Felicia and the government programs team identify those areas of complexity and high cost and how we can effectively build clinical and engagement strategies around them.

我認為這是一個非常好的問題，喬希。我非常感激。我們努力使我們所做的事情非常有針對性。正如費利西亞所說，在這種情況下，我們與我們的健康計劃合作夥伴對峙，對於您的問題，費利西亞和政府專案團隊確定了那些複雜且成本高的領域，以及我們如何有效地圍繞它們制定臨床和參與策略。

If you look at our portfolio of offerings, we're being very, very intentional about that. So starting off on our value-based care strategy and how we're approaching that through Mosaic. You've heard us talk a lot about post acute care and what we're doing through our PAS offerings. Most recently, with CareBridge, and I think a real differentiated way to manage care in the home, highly scalable, I think in a capital efficient way.

如果你看一下我們的產品組合，你會發現我們對此非常非常用心。因此，首先介紹我們的基於價值的護理策略，以及我們如何透過 Mosaic 來實現這一目標。您已經聽我們談論了很多有關急性後期護理以及我們透過 PAS 產品進行的工作。最近，我又推出了 CareBridge，我認為這是一種真正差異化的居家照護管理方式，具有高度可擴展性，而且我認為是一種資本高效的方式。

And then services at the end of life and in some cases, in the most complex periods of members around palliative care. On the pharmacy side, you look at the areas that we're very focused in on around SpecialtyRx, et cetera.

然後是臨終關懷服務，在某些情況下，是在成員最複雜的時期提供安寧療護。在藥房方面，我們重點關注 SpecialtyRx 等領域。

So we're being very thoughtful around Government programs business, around Medicare specifically and trying to touch members in the moments that matter in these areas of real high cost complexity in healthcare and it's really what powers the flywheel that we talk about in the company.

因此，我們對政府專案業務，特別是醫療保險業務非常認真，並試圖在醫療保健領域這些真正高成本複雜領域的重要時刻接觸會員，這才是我們在公司中談論的飛輪的真正動力。

Next question, please.

請回答下一個問題。

Sarah James, Cantor Fitzgerald.

莎拉詹姆斯，費茲傑拉領唱者。

I wanted to go back to the RAF score availability because I think it's an important point and likely knowable at this time. So one of your peers saw a lower portion of new members on boarding with RAF scores than normal.

我想回到 RAF 分數可用性問題，因為我認為這是一個重要點，並且此時很可能是可以知道的。因此，您的一位同事發現，新成員中擁有 RAF 分數的比例低於正常水平。

How did the portion of new members that onboarded with existing RAF scores compare to historical average for Elevance? And can you give us some context of what the typical step up is of what portion new members have RAF scores typically versus year two when they're renewing with you? What portion have RAF scores?

與 Elevance 的歷史平均值相比，擁有現有 RAF 分數的新會員比例如何？您能否向我們介紹一下，新成員與您續約時，與第二年相比，皇家空軍分數的典型提升幅度是多少？哪些部分有 RAF 分數？

So risk adjustment remains a critical component of how we ensure that member benefits are aligned with their healthcare needs. And over the past couple of years, we've navigated two consecutive years of reimbursement changes to the program, including shifts in the underlying risk model.

因此，風險調整仍然是我們確保會員福利與其醫療保健需求一致的關鍵組成部分。在過去的幾年裡，我們連續兩年對該計劃的報銷進行了修改，包括底層風險模型的轉變。

And while the base -- the recent base rate release was more reflective of actual trend, it doesn't fully restore the impact of prior underfunding. And you can think about us as remaining disciplined in how we approach benefit design and coding.

儘管最近公佈的基準利率更能反映實際趨勢，但它並不能完全恢復先前資金不足的影響。您可以認為我們在福利設計和編碼方面始終保持著嚴謹的態度。

And our focus on accurately documenting member conditions better ensures we can support their clinical needs. And ultimately, we do see risk adjustment that's helping to ensure seniors receive the comprehensive care they deserve while also supporting a sustainable, stable marketplace for the long term.

我們專注於準確記錄會員狀況，以更好地確保我們能夠滿足他們的臨床需求。最終，我們確實看到風險調整有助於確保老年人獲得應有的全面護理，同時也支持長期可持續、穩定的市場。

And I would just say our members are aligned with the expectations we set. So thank you for the question.

我只想說我們的成員與我們設定的期望一致。謝謝你的提問。

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究公司。

Can you tell us how Medicaid MLR margin trended from Q4 last year to Q1 this year? Just flat, up, down? And then does your guidance still anticipate Medicaid margins being flat year over year in 2025 before improving in 2026?

您能告訴我們從去年第四季到今年第一季度，醫療補助 MLR 利潤率的趨勢如何嗎？只是平的、向上的、向下的？那麼，您的指導意見是否仍預期醫療補助利潤率將在 2025 年與去年持平，然後在 2026 年有所改善？

Maybe at a very high level, the benefit expense ratio did decrease sequentially more from the fourth quarter of last year to the first quarter of this year than is typical. And you could think about that really as being driven by a workday dynamics in the first quarter and Medicare Part D seasonality changes.

也許處於非常高的水平，從去年第四季到今年第一季度，福利費用率確實比典型情況下降得更多。你可以認為這實際上是由第一季的工作日動態和醫療保險 D 部分的季節性變化所驅動的。

On Medicaid, I would say trends remain elevated but decelerated as expected during the first quarter. And that reflects the stable membership levels and utilization patterns and this really aligns with our broader view that recovering Medicaid margins is likely to be a tale of two halves.

關於醫療補助，我想說趨勢仍然保持高位，但在第一季如預期的那樣有所放緩。這反映了穩定的會員水準和利用模式，這與我們的更廣泛的觀點一致，即恢復醫療補助利潤可能是一個兩半的故事。

We're going to see stabilization early in the year and then improvements materializing in the latter half of the year as rate updates continue to come in.

我們將在年初看到穩定，然後隨著利率更新的不斷推出，在下半年將出現改善。

Thank you. Next question, please.

謝謝。請回答下一個問題。

Joanna Gajuk, Bank of America Securities.

美國銀行證券的喬安娜‧加朱克 (Joanna Gajuk)。

Actually, to follow up on this last comment in terms of Medicaid rate outlook. Like you say, you expect some improvements that can have. So any update you might have? I mean I understand that July rate update right will be important here but any indications there? And also when will you know those July rate updates?

實際上，要就醫療補助費率前景來跟進這最後一條評論。就像您說的，您期待能夠取得一些改進。那麼您可能有任何更新嗎？我的意思是，我明白 7 月的利率更新在這裡很重要，但有什麼跡象嗎？另外您什麼時候能知道七月的利率更新？

Thanks for the question. Felicia?

謝謝你的提問。費利西亞？

Our Medicaid team is in constant communication with our state partners, advocating for actuarially sound rates that adequately account for the elevated acuity and cost trend that we certainly experienced late last year.

我們的醫療補助團隊與我們的州合作夥伴保持著持續的溝通，倡導精算合理的費率，以充分考慮到我們去年年底所經歷的敏銳度和成本上升趨勢。

Today, our January and April rate renewals were in line with our expectations and really reflect progress towards bringing rates back to a level that will prospectively cover cost trends. When we think about July, our July renewals represent about one-third of our membership, and early discussions with our states are underway, but it's far too soon to comment around where we are because those discussions have really just commenced.

今天，我們一月和四月的費率更新符合我們的預期，並真正反映了將費率恢復到預期覆蓋成本趨勢的水平的進展。當我們想到七月時，我們七月份的續約人數約占我們會員人數的三分之一，並且與各州的早期討論正在進行中，但現在評論我們的進展還為時過早，因為這些討論才剛剛開始。

I will say that we will continue to provide regular updates to our state partners and work very closely with them to make sure that our go-forward rates align with the level of trend we're experiencing in our Medicaid book.

我想說的是，我們將繼續定期向我們的州合作夥伴提供最新信息，並與他們密切合作，以確保我們的前進率與我們在醫療補助書中經歷的趨勢水平保持一致。

And as we said, I think they've been very constructive discussions with our state to align rates to the acuity of the population.

正如我們所說，我認為他們與我們的州進行了非常建設性的討論，以使費率與民眾的敏銳度保持一致。

Next question, please.

請回答下一個問題。

George Hill, Deutsche Bank.

德意志銀行的喬治·希爾。

This is probably one for Mark and for Pete is I have a question about V28. And I guess could you talk about the -- your expected impact from the V28 risk model change this year kind of as it relates to last year? And what I'm really trying to focus on is, is this kind of a lapping effect as it relates to the implementation of the risk model or a stacking effect? And I don't know if it's too early to think about like what happens as we move from '25 into '26.

這可能是針對 Mark 和 Pete 的一個問題，我對 V28 有疑問。我想您能否談談今年 V28 風險模型變化與去年相比預計產生的影響？我真正想關注的是，這種與風險模型實施相關的重疊效應還是堆疊效應？我不知道現在考慮從 25 年到 26 年會發生什麼是否為時過早。

I'll get started here. The V28 risk adjustment model has introduced changes to the way that the Medicare Advantage plans obviously receive funding based on members' clinical and demographic profiles. And these modifications obviously affect how we document and report chronic conditions, factors that really ultimately help align planned payments with the healthcare needs of our members.

我就從這裡開始。V28 風險調整模型改變了醫療保險優勢計劃根據會員的臨床和人口統計資料獲得資金的方式。這些修改顯然會影響我們記錄和報告慢性病的方式，這些因素最終有助於使計劃支付與我們會員的醫療保健需求保持一致。

That said, these changes were anticipated and incorporated into our 2025 planning and pricing. And we're going to continue to take a disciplined approach to benefit design and remain focused on driving that value through strong member engagement and effective care coordination.

也就是說，這些變化是可以預見的，並納入我們的 2025 年規劃和定價中。我們將繼續採取嚴謹的方法進行福利設計，並繼續專注於透過強大的會員參與和有效的護理協調來推動這一價值。

And over time, we really believe our operational execution and our diversified portfolio position put us in a good place to navigate this transition.

隨著時間的推移，我們確實相信我們的營運執行和多元化投資組合地位將使我們處於有利地位來應對這一轉變。

Thank you. Next question, please.

謝謝。請回答下一個問題。

Whit Mayo, Leerink Partners.

惠特·梅奧 (Whit Mayo)，Leerink Partners。

Just wanted to follow up on Group MA. I don't think I heard you directly comment on this, but are you seeing any different trends with care activity or utilization patterns versus individual MA, not versus your expectations per se, but just anything different about group MA?

只是想跟進 MA 集團的情況。我認為我沒有聽到您直接對此發表評論，但是您是否看到護理活動或利用模式與個人 MA 有任何不同趨勢，而不是與您的預期本身不同，而是團體 MA 有什麼不同？

The utilization patterns that we observed in the first quarter do not indicate any meaningful acceleration in cost trend for our group MA business. And just to remind you, that represents about 15% of our total Medicare Advantage enrollment.

我們在第一季觀察到的利用模式並未顯示我們的集團 MA 業務的成本趨勢有任何顯著加速。需要提醒您的是，這約占我們醫療保險優勢計劃總登記人數的 15%。

And as a reminder, our MA growth this year does include meaningful contribution from really one large group MA account, and so retention across our book remains strong. We'll also continue to approach this segment with discipline, ensuring that the offerings are sustainable and aligned with our long-term margin objectives.

提醒一下，我們今年的 MA 成長確實包括來自一個大型集團 MA 帳戶的有意義的貢獻，因此我們整個帳簿的保留率仍然很高。我們也將繼續嚴格對待這一領域，確保產品可持續並符合我們的長期利潤目標。

So I'd say while trends are elevated, it's early in the year for completion factors to fully mature, but we've not seen changes in utilization patterns from what we expected.

因此我想說，雖然趨勢有所提升，但完成因素在年初才完全成熟，但我們並沒有看到利用模式發生預期的變化。

And I think we have one last question in the queue.

我想我們還有最後一個問題。

Michael Ha, Baird.

麥可·哈，貝爾德。

Regarding Part D, I just wanted to double click into it a bit more. Based on the emerging Part D claims data you're seeing year to date, I was wondering if you could discuss the utilization, what percent of your MA Part D members are already through their maximum out of pocket limits?

關於 D 部分，我只是想再多點一下。根據您今年迄今為止看到的新興 D 部分索賠數據，我想知道您是否可以討論一下利用率，有多少百分比的 MA D 部分成員已經達到了他們的最高自付限額？

How does that compare to your expectations? Basically, how much clarity do you have on the new normal of utilization behavior? And I guess the fear is if there was going to be higher than expected Part D utilization levels and it doesn't materialize until the back half of this year, then plans may end up missing it in their June bid.

這與您的期望相比如何？基本上，您對利用行為的新常態有多少了解？我想令人擔心的是，如果 D 部分的利用率高於預期，而直到今年下半年才實現，那麼計劃最終可能會在 6 月的競標中失敗。

So is there any way at all that you could help us sort of assuage those concerns?

那麼，您有什麼辦法可以幫助我們緩解這些擔憂嗎？

Perhaps the best place for me to start is to say that we are comfortable with the mix of our Medicare Advantage membership that we've attracted this year. We always balance benefit design against risk management and price discipline so that ultimately, we remain confident that our MA membership mix is aligned with a sustainable high quality risk pool.

也許對我來說最好的開始是說我們對今年吸引的醫療保險優勢會員的組合感到滿意。我們始終在福利設計與風險管理和價格紀律之間取得平衡，以便最終我們仍然相信我們的 MA 會員組合與可持續的高品質風險池保持一致。

With respect to Part D, we've also not observed a substantial variation to our plan this year. And any higher utilization that we might hypothetically see would of course Michael, as you know, be balanced by risk corridors, rebates, and other contractual offsets, and that's the way I would think about this.

關於 D 部分，我們也沒有發現今年的計畫有實質變化。當然，正如你所知，我們可能假設看到的任何更高的利用率都會透過風險走廊、回扣和其他合約抵消來平衡，這就是我對此的看法。

That was the last question.

這是最後一個問題。

I just want to reaffirm a few things. One, that we are pleased with the start of the year. We're remaining disciplined. We're respectful of the environment, and you'll continue to see that from us for the course of this year.

我只是想重申幾件事。一是我們對今年的開始感到滿意。我們將繼續保持紀律。我們尊重環境，今年您將繼續看到我們這樣做。

And I also want to thank everyone on the line for your questions today and your interest in Elevance Health. We're pleased, as I said, with the strong start to the year and we're confident that our actions are going to have and make meaningful impact and make healthcare simple, affordable, and accessible for our members, communities, and care partners.

我還要感謝今天在線上的各位提問以及對 Elevance Health 的關注。正如我所說，我們對今年的良好開局感到高興，我們相信我們的行動將產生有意義的影響，並使我們的會員、社區和護理夥伴能夠輕鬆、負擔得起、方便地享受醫療保健。

We look forward to updating you on our progress in the quarters ahead. Have a great rest of the week.

我們期待在未來幾季向您通報我們的進展。祝本週剩餘時間過得愉快。

Thank you again for joining us.

再次感謝您的參與。

Ladies and gentlemen, a recording of this conference will be available for replay after 11:00 AM today through May 22, 2025. You may access the replay system at any time by dialing 800-396-1242, and international participants can dial 203-369-3272.

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 5 月 22 日提供重播。您可以隨時撥打 800-396-1242 存取重播系統，國際參與者可以撥打 203-369-3272。

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

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