Elevance Health Inc (ELV) 2025 Q4 法說會逐字稿

Ladies and gentleman, thank you for standing by and welcome to the Elevance Health fourth quarter conference call. (Operator Instructions) As a reminder, today's conference is being recorded.

女士們、先生們，感謝各位的耐心等待，歡迎參加 Elevance Health 第四季電話會議。（操作說明）提醒各位，今天的會議正在錄音。

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

現在我將把會議交給公司管理階層。請繼續。

Good morning and welcome to Elevance Health's fourth quarter 2025 earnings conference call. My name is Nathan Rich, Vice President of Investor Relations. With us 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.

早安，歡迎參加 Elevance Health 2025 年第四季財報電話會議。我是投資者關係副總裁內森·里奇。出席本次財報電話會議的有：總裁兼執行長 Gail Boudreaux；財務長 Mark Kaye；Carelon 總裁 Pete Haytaian；商業健康福利業務總裁 Morgan Kendrick；以及政府健康福利業務總裁 Felicia Norwood。

Gail will begin the call with a discussion of our 4th quarter performance, our 2026 guidance and the progress we continue to make on our strategic priorities. Mark will then discuss our financial results and outlook in greater detail. After our prepared remarks. The team will be available for Q&A. During the call, we will reference certain non-GAAP financial measures. Reconciliations of these non-GAAP measures to the most directly comparable GAAP measures are available on our website, elevancehealth.com.

Gail 將在電話會議上首先討論我們第四季度的業績、2026 年的業績指引以及我們在策略重點方面持續取得的進展。接下來，馬克將更詳細地討論我們的財務表現和展望。在我們發言完畢之後。團隊成員將接受問答環節。在電話會議中，我們將提及一些非GAAP財務指標。這些非GAAP指標與最直接可比較的GAAP指標的調節表可在我們的網站elevancehealth.com上查閱。

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.

我們也將在本次電話會議上發表一些前瞻性聲明。聽眾請注意，這些聲明存在一定的風險和不確定性，其中許多風險和不確定性難以預測，並且通常超出 Elevance Health 的控制範圍。

These risks and uncertainties may 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.

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.

現在我將把電話交給蓋爾。

Good morning and thank you for joining us today. Affordability remains the central challenge in healthcare. At Elevance Health, our focus is on improving outcomes, making care easier to access and navigate, and managing costs responsibly.

早安，感謝各位今天收看我們的節目。醫療保健領域面臨的核心挑戰仍然是費用可負擔性。在 Elevance Health，我們的重點是改善治療效果，讓患者更容易獲得和使用醫療服務，並負責任地控製成本。

Our commitment to whole person health shapes how we deliver on our strategy by strengthening care coordination, reducing unnecessary complexity, and creating a simpler experience for those we serve.

我們致力於全人健康，並透過加強護理協調、減少不必要的複雜性以及為我們服務的對象創造更簡單的體驗，來實踐我們的策略。

Before I go through the business, there are three points I want to underscore. First, 2026 is a year of execution and repositioning. And the outlook we provided today reflects prudent, achievable assumptions grounded in pricing discipline, operational rigor, and targeted investments.

在詳細介紹業務之前，我想強調三點。首先，2026 年是執行和重新定位之年。我們今天提供的展望反映了審慎、可實現的假設，這些假設是基於定價紀律、營運嚴謹性和有針對性的投資。

Second, even in a dynamic environment, we are acting decisively in the areas within our control to strengthen margins, reduce volatility, and improve the consistency of our performance.

其次，即使在動態的環境中，我們也在可控範圍內採取果斷行動，以增強利潤率、降低波動性並提高績效的穩定性。

And third, as those actions take hold, we expect to return to at least 12% adjusted EPS growth in 2027, off our ending 2026 earnings baseline, supported by the earnings power of our diversified platform.

第三，隨著這些措施的實施，我們預計到 2027 年，調整後每股盈餘成長率將至少恢復到 12%，以 2026 年底的獲利基準為基準，這得益於我們多元化平台的獲利能力。

Consistent with that approach, we are establishing 2026 adjusted diluted earnings per share guidance of at least $25.50. As you consider the year over year comparison, it's important to remember that our 2025 results included approximately $3.75 per share of favorable non-recurring items.

基於此，我們設定了2026年調整後稀釋每股盈餘至少為25.50美元的預期。在進行同比比較時，需要注意的是，我們2025年的表現包含了約3.75美元的有利非經常性專案收益。

Let me walk through how we are positioning the portfolio. In Medicaid, we continue to see our rates lag elevated acuity and utilization, and we are working urgently with state partners on both rate actions and program design changes that support the long-term sustainability of the Medicaid program.

讓我來詳細介紹一下我們是如何建立投資組合的。在醫療補助計劃中，我們持續看到我們的費率落後於病情嚴重程度和使用率的上升，我們正在與州合作夥伴緊急合作，採取費率措施和項目設計變更，以支持醫療補助計劃的長期可持續性。

We continue to view 2026 as a trough year. We expect our Medicated operating margin to be approximately -1.75%, with improvement over time as rates incorporate more current experience and our actions take hold. We are also preparing for new eligibility and community engagement requirements under recently enacted federal legislation, the One Big Beautiful Bill Act. As these changes are phased in by states. We expect Medicaid membership may decline, and the acuity of the population may shift over time. And we have reflected that in our planning assumptions.

我們仍然認為2026年是低谷年。我們預計藥物業務的營業利潤率約為 -1.75%，隨著費率納入更多當前經驗以及我們的措施生效，利潤率將隨著時間的推移而改善。我們也在為最近頒布的聯邦立法《一個美好的大法案》中規定的新的資格和社區參與要求做準備。各州將分階段實施這些變更。我們預計醫療補助計劃的參保人數可能會下降，而且隨著時間的推移，參保人群的病情嚴重程度可能會改變。我們在規劃假設中也考慮到了這一點。

We believe this is manageable within the context of our diversified enterprise and long-term growth strategy, and we're approaching these changes constructively with state partners, with a focus on continuity of care and program stability.

我們認為，在我們多元化的企業和長期成長策略的背景下，這是可以控制的，我們正在與州合作夥伴以建設性的方式應對這些變化，重點是護理的連續性和專案的穩定性。

Turning to Medicare, our execution during the annual election period was aligned with our emphasis on delivering greater value for members and strengthening our performance, while maintaining stable share in markets that are core to our long-term growth. We expect Medicare Advantage membership to decline in the high-teens percentage range in 2026, reflecting deliberate portfolio actions and stability in our dual eligible membership.

就醫療保險而言，我們在年度選舉期間的執行情況與我們致力於為會員提供更大價值和加強業績的重點相一致，同時在對我們長期成長至關重要的市場中保持穩定的份額。我們預計 2026 年 Medicare Advantage 會員人數將下降 10% 以上，這反映了我們精心策劃的投資組合策略以及我們雙重資格會員人數的穩定性。

The actions we've taken and the composition of our membership should support meaningful margin improvement in 2026. In the Individual ACA market, we've repositioned our plans with discipline to reflect higher costs observed this year, and the expiration of enhanced subsidies, while maintaining value and access for consumers.

我們採取的行動和我們的成員組成應該能夠支持2026年利潤率的顯著提高。在個人 ACA 市場，我們已根據今年觀察到的較高成本和增強補貼的到期情況，有條不紊地調整了我們的計劃，同時保持了消費者的價值和可及性。

Our commercial business continues to have healthy momentum, particularly in national accounts, supported by a productive selling season, favorable client retention, and new opportunities to expand our reach to the second blue bid process.

我們的商業業務持續保持良好的發展勢頭，尤其是在全國性客戶方面，這得益於高效的銷售季、良好的客戶留存率以及將我們的業務拓展到第二輪藍色投標流程的新機遇。

We remain disciplined in our pricing and focused on delivering sustainable margins while helping employers address affordability through whole health solutions that integrate a member's medical, pharmacy, and behavioral health needs. Our integrated approach continues to resonate in the market, and we are pleased that 40 employers over the past five years have selected our Anthem affiliated plans as their sole carrier.

我們在定價方面保持嚴謹，專注於提供可持續的利潤，同時透過整合會員的醫療、藥房和行為健康需求的整體健康解決方案，幫助雇主解決負擔能力問題。我們的一體化方案在市場上持續獲得認可，我們很高興在過去五年中，有 40 家雇主選擇我們 Anthem 旗下的保險計劃作為其唯一的承保機構。

And finally, Carelon is increasingly recognized as a differentiated platform in the market, with growing demand for its solutions in managing high cost, complex areas of healthcare. Near-term growth will be moderated by lower health plan membership, most pronounced in CarelonRx, while Carelon Services is less impacted by membership dynamics, reflecting its broad mix of external relationships and value-based arrangements.

最後，Carelon 越來越被市場認可為一個差異化的平台，其解決方案在管理高成本、複雜的醫療保健領域的需求不斷增長。短期成長將受到健康計畫會員人數減少的抑制，CarelonRx 的情況最為明顯，而 Carelon Services 受會員動態的影響較小，這反映了其廣泛的外部關係和基於價值的安排。

As our business mix evolves, and we make targeted investments to strengthen the foundation, we are also refining certain long-term margin expectations to reflect a more prudent view of the forward environment. Our long-term enterprise margin target is 5% to 6%. For Health Benefits, Carelon and CarelonRx, we are targeting mid-single-digit margins with our Carelon Services target unchanged.

隨著我們的業務組合不斷演變，我們也進行了有針對性的投資來加強基礎，同時我們也在調整一些長期利潤率預期，以反映對未來環境更加審慎的看法。我們的長期企業利潤率目標是 5% 到 6%。對於健康福利、Carelon 和 CarelonRx，我們的目標是實現中等個位數的利潤率，而 Carelon Services 的目標保持不變。

These updates are intended to provide a clearer, more durable framework for evaluating performance, and they do not change our focus on disciplined execution, durable earnings growth, and strong cash generation.

這些更新旨在為評估業績提供更清晰、更持久的框架，並且不會改變我們對嚴謹執行、持續獲利成長和強勁現金流的關注。

Stepping back, we view 2026 as a year of execution and repositioning. Across Medicaid, Medicare Advantage, and ACA, the dynamics we've described reflect a combination of policy-driven changes and deliberate portfolio and pricing actions designed to strengthen performance consistency. And we are aligning our cost structure and operating priorities accordingly. That's why we believe we have a clear line of sight to improve performance as we move through this year and into 2027.

從長遠來看，我們認為 2026 年是執行和重新定位之年。在醫療補助計劃、醫療保險優勢計劃和《平價醫療法案》中，我們所描述的動態反映了政策驅動的變化以及旨在加強績效一致性的精心策劃的投資組合和定價行動的結合。我們正在據此調整成本結構和營運重點。正因如此，我們相信，在今年以及邁向 2027 年的過程中，我們有清晰的路徑來提高業績。

Now let me turn to the actions we have underway. We are strengthening our ability to anticipate emerging utilization trends and improve care coordination by leveraging actionable data and advanced analytics. These capabilities help us identify trends earlier and address inefficiencies in the system, while supporting timely access to appropriate high-quality care.

現在讓我來談談我們正在採取的行動。我們正在利用可操作的數據和高級分析來增強預測新興利用趨勢和改善護理協調的能力。這些能力有助於我們及早發現趨勢並解決系統中的低效率問題，同時支持及時獲得適當的高品質照護。

In Medicaid, we're strengthening our analytics to identify outlier utilization and billing patterns in high cost substance use disorder treatment settings, while maintaining access to clinically appropriate care. These insights are enabling targeted actions, including provider education, claims review enhancements, and payment accuracy and compliance initiatives where appropriate, consistent with program requirements and clinical guidelines.

在醫療補助計劃中，我們正在加強分析，以識別高成本藥物濫用障礙治療機構中異常的使用和計費模式，同時保持獲得臨床適當護理的機會。這些見解有助於採取有針對性的行動，包括對供應商進行教育、改進理賠審查，以及在適當情況下採取支付準確性和合規性舉措，這些都符合專案要求和臨床指南。

We're able to execute with confidence because we've built and are scaling capabilities that improve outcomes and reduce costs in complex areas of healthcare. In 2026, we will further strengthen specialty pharmacy management, advance behavioral health support, and expand care management programs for members with elevated care needs. Established programs in oncology and serious mental illness are delivering savings for our health plans in the face of heightened utilization trend.

我們能夠充滿信心地執行任務，是因為我們已經建立並正在擴展相關能力，從而在複雜的醫療保健領域改善結果並降低成本。2026年，我們將進一步加強專科藥局管理，推動行為健康支持，並擴大對有較高照護需求會員的護理管理計畫。面對醫療資源利用率不斷上升的趨勢，腫瘤科和嚴重精神疾病領域的成熟計畫正在為我們的健康計畫節省開支。

Our patient advocacy programs now serve over 7 million members, up nearly 20% from last year. Through proactive, tailored support, we help members navigate the system with greater confidence, remove points of friction, and close gaps in care, especially for individuals with greater care needs, where early engagement can materially improve outcomes and reduce downstream costs. And we remain deeply committed to improving the experience of care providers.

我們的病患權益倡議計畫目前服務超過 700 萬名會員，比去年成長了近 20%。透過積極主動、量身定制的支持，我們幫助會員更有信心地使用系統，消除摩擦點，並彌合護理方面的差距，特別是對於護理需求較高的個人而言，早期介入可以顯著改善結果並降低後續成本。我們始終致力於改善醫護人員的體驗。

We remain on track to exceed our commitment that 80% of prior authorization decisions will be made in real time in 2027, particularly for routine approved services, supporting faster access to care and reducing administrative burden for care providers. Through our Health OS platform, we're enabling real-time data exchange that aligns information across the system, streamlines interactions with care providers, and makes it easier to deliver care.

我們仍有望超額完成我們的承諾，即到 2027 年，80% 的事先授權決定將實時做出，特別是對於常規批准的服務，這將有助於更快地獲得醫療服務，並減輕醫療服務提供者的行政負擔。透過我們的 Health OS 平台，我們實現了即時數據交換，從而協調了整個系統的信息，簡化了與護理人員的互動，並使提供護理變得更加容易。

In summary, while the environment we operate in continues to evolve, our strategic direction remains clear. We are entering 2026 with prudent planning assumptions, focused execution, and targeted investments to unlock the embedded earnings power of our diversified platform. And based on the actions underway this year, we remain confident in our long-term algorithm and our expectation to return to at least 12% adjusted EPS growth in 2027.

總之，儘管我們所處的環境不斷變化，但我們的策略方向依然明確。我們以審慎的規劃假設、專注的執行和有針對性的投資進入 2026 年，以釋放我們多元化平台蘊含的獲利能力。根據今年正在採取的行動，我們仍然對我們的長期演算法充滿信心，並預期到 2027 年調整後每股收益成長率將至少恢復到 12%。

Before closing, I want to thank our associates for their unwavering commitment to our purpose throughout 2025. In the face of a challenging year for our industry, our teams operated with integrity, compassion, and a deep sense of responsibility to the people and communities we serve. Their dedication is the foundation of our performance today and the progress we are building for the future, and I am deeply grateful for the impact they continue to make across Elevance Health.

在結束演講之前，我要感謝我們的同事在 2025 年裡對我們目標的堅定不移的承諾。面對業界面臨的挑戰，我們的團隊秉持誠信、同情心和對我們所服務的人民和社區的強烈責任感來開展工作。他們的奉獻精神是我們今天成就和為未來發展奠定基礎的基石，我由衷感謝他們持續為 Elevance Health 做出的貢獻。

With that, I'll turn the call over to Mark for a more detailed review of our financial results and outlook.

接下來，我將把電話交給馬克，讓他更詳細地回顧我們的財務表現和展望。

Thank you, Gail, and good morning. Elevance Health reported adjusted diluted earnings per share of $3.33 for the fourth quarter and $30.29 for the full year. Relative to our guidance, fourth quarter results benefited from greater tax favorability than anticipated, increasing the full year contribution from non-recurring items to $3.75 per share.

謝謝你，蓋爾，早安。Elevance Health公佈第四季度調整後稀釋每股收益為3.33美元，全年調整後稀釋每股收益為30.29美元。與我們的預期相比，第四季業績受益於比預期更大的稅收優惠，使全年非經常性項目貢獻增加至每股 3.75 美元。

Solid underlying performance in the quarter enabled us to advance a portion of the investments we had planned for 2026 and to support our workforce as we enter the year. Throughout 2025, we remained focused on aligning pricing to elevated cost trends, refining our product portfolio, and investing selectively in capabilities that differentiate our model and support sustainable growth.

本季穩健的基本面表現使我們能夠推進部分原計劃於 2026 年進行的投資，並在新的一年伊始為我們的員工隊伍提供支援。2025 年全年，我們將繼續專注於調整定價以適應不斷上漲的成本趨勢，完善我們的產品組合，並有選擇地投資於能夠使我們的模式脫穎而出並支持可持續增長的能力。

We ended the year with 45.2 million members, a decrease of approximately 500,000 year over year, principally reflecting a decline in Medicaid membership due to continued eligibility reverifications.

年底會員人數為 4,520 萬，比前一年減少了約 50 萬，主要原因是由於持續的資格重新核實導致醫療補助計劃會員人數下降。

Operating revenue for the quarter totaled $49.3 billion, an increase of 10% from the prior year, driven by premium rate adjustments in recognition of higher cost trends and acquisitions completed in the past year. Our consolidated benefit expense ratio was 93.5% for the quarter and 90% for the full year, in line with our guidance.

本季營業收入總計 493 億美元，比上年增長 10%，主要得益於保費調整以反映成本上升趨勢以及上一年完成的收購。本季綜合福利支出率為 93.5%，全年綜合福利支出率為 90%，與我們的預期一致。

Cost trend development was consistent with our expectations across major lines of business. Our adjusted operating expense ratio is 10.8% for the fourth quarter and 10.5% for the full year. We are managing the enterprise with discipline while making targeted investments to support our long-term performance.

各主要業務線的成本趨勢發展與我們的預期一致。我們第四季的調整後營業費用率為 10.8%，全年的調整後營業費用率為 10.5%。我們以嚴謹的管理方式經營企業，同時進行有針對性的投資，以支持我們的長期績效。

During the quarter, we pulled forward one quarter of the approximately $1 per share of incremental investments that we had anticipated in 2026. Our Medicaid operating margin ended the year slightly favorable to the outlook provided last quarter. We are encouraged by the initial results of our targeted efforts to better coordinate care and support high-quality, low-cost treatment pathways.

本季度，我們提前完成了原計劃在 2026 年進行的每股約 1 美元的增量投資的四分之一。我們的醫療補助營運利潤率年底略好於上季給予的預期。我們為更好地協調護理和支持高品質、低成本的治療途徑而採取的有針對性措施取得了初步成果，這令我們感到鼓舞。

While the benefit of these actions will build over the course of the year, we continue to expect cost trend to be in the mid-single-digit percent range in 2026, with rates lagging this level of trend. As such, we anticipate our Medicaid operating margin for 2026 to be approximately -1.75% in line with what we shared last quarter.

雖然這些措施的益處將在一年內逐漸顯現，但我們仍然預計到 2026 年成本趨勢將保持在個位數百分比的中等水平，而費率將落後於此趨勢水平。因此，我們預計 2026 年的 Medicaid 營運利潤率約為 -1.75%，與我們上個季度公佈的數據一致。

Medicare cost trend in the quarter was consistent with our expectations. For 2026, we made deliberate changes to our plan offerings and intentionally exited select geographies, prioritizing plans that deliver value to members while producing sustainable financial performance. As you heard from Gail, we now expect Medicare Advantage membership to decline in the high-teens percentage range in 2026 while achieving meaningful margin improvement.

本季醫療保險成本趨勢與我們的預期一致。2026 年，我們對計劃產品進行了有意識的調整，並有意退出部分地區，優先考慮能夠為會員帶來價值並產生可持續財務業績的計劃。正如蓋爾所說，我們現在預計到 2026 年，Medicare Advantage 會員人數將下降 10% 以上，同時實現顯著的利潤率提升。

We've also repositioned our Individual ACA business for higher expected morbidity following the expiration of enhanced subsidies. Similarly, our commercial group risk membership reflects our focus on margin stability and discipline pricing.

隨著額外補貼到期，預計發病率將上升，我們也重新調整了個人 ACA 業務的策略。同樣，我們的商業團體風險成員資格反映了我們對利潤穩定性和定價紀律的重視。

Carelon continues to experience strong customer demand for its solutions. However, near-term growth will be moderated by lower health plan membership. The guidance provided today reflects the impact of our anticipated membership headwinds, as well as investments we plan to make as we scale our dispensing and home health assets.

Carelon 的解決方案持續受到客戶的強勁需求。然而，由於醫療保險計劃投保人數減少，短期內成長將會放緩。今天提供的指導意見反映了我們預期會員人數下降的影響，以及隨著我們擴大藥品分發和家庭健康資產規模，我們計劃進行的投資。

Operating cash flow was $4.3 billion for the year, or approximately 0.8 times GAAP net income. Cash flow in December was negatively impacted by the timing of certain Medicaid-related payments, which were subsequently received in early January. Incorporating these items, we expect our 2026 operating cash flow to be at least $5.5 billion. Days in claims payable was 41.3 days, a decrease of 0.1 days sequentially. For 2026, we expect days in claims payable to remain in the low 40s range consistent with our long-term target.

該年度經營現金流為 43 億美元，約為 GAAP 淨收入的 0.8 倍。12 月的現金流量受到某些與醫療補助相關的付款時間的不利影響，這些款項隨後在 1 月初收到。將這些項目納入考量後，我們預計 2026 年的經營現金流至少為 55 億美元。應付賠款天數為 41.3 天，比上一季減少了 0.1 天。預計 2026 年應付賠款天數將維持在 40 天左右，與我們的長期目標一致。

In the fourth quarter, we repurchased 1.4 million shares for $470 million, bringing fully repurchases to $2.6 billion. Combined with dividends paid during the year, we returned $4.1 billion of capital to shareholders.

第四季度，我們以 4.7 億美元的價格回購了 140 萬股股票，使全部回購金額達到 26 億美元。加上本年度支付的股息，我們向股東返還了 41 億美元的資本。

Turning to our outlook, we are establishing guidance for adjusted diluted earnings per share to be at least $25.50 in 2026. We anticipate operating revenue to decline in the low single-digit percent range in 2026, driven by a low double-digit percentage decline in risk-based membership, partly offset by higher premium yields and growth in Carelon.

展望未來，我們預計 2026 年調整後稀釋每股收益至少為 25.50 美元。我們預計 2026 年營業收入將下降個位數百分比，主要原因是風險型會員人數下降兩位數百分比，但部分會被更高的保費收益率和 Carelon 的成長所抵消。

Our consolidated medical loss ratio is expected to be 90.2% plus or minus 50 basis points, reflecting a prudent view of cost trend and shifting acuity in Medicaid. Our adjusted operating expense ratio is expected to be 10.6% plus or minus 50 basis points as we maintain operational discipline while investing to scale Carelon, embed AI enabled and digital capabilities, and simplify the member experience.

我們綜合醫療損失率預計為 90.2%，上下浮動 50 個基點，這反映了對醫療補助計劃成本趨勢和病情嚴重程度變化的審慎看法。我們調整後的營運費用率預計為 10.6% 上下浮動 50 個基點，因為我們在保持營運紀律的同時，投資擴大 Carelon 的規模，嵌入人工智慧和數位化能力，並簡化會員體驗。

Our capital deployment plans remain aligned to our long-term framework, and we plan to allocate approximately $2.3 billion towards share repurchases in 2026. Regarding earnings seasonality, we expect to earn approximately two-third of our adjusted EPS in the first half of 2026, with 65% of that coming in the first quarter.

我們的資本部署計畫與我們的長期框架保持一致，我們計劃在 2026 年撥出約 23 億美元用於股票回購。關於獲利季節性，我們預計 2026 年上半年將實現調整後每股收益的約三分之二，其中 65% 將在第一季實現。

Based on the actions underway this year, we are reaffirming our long-term algorithm of at least 12% adjusted earnings per share growth annually on average over time, and we expect to return to at least that level of growth in 2027 off our ending 2026 earnings baseline.

根據今年的進展情況，我們重申了我們的長期演算法，即平均每年至少實現 12% 的調整後每股收益成長，並且我們預計在 2027 年，根據我們 2026 年底的收益基準，我們將恢復到至少這一增長水平。

Finally, a long-term earnings growth algorithm is supported by multiple levers. Robust revenue growth, operating margin expansion driven by operational execution and technology integration, and our commitment to disciplined capital allocation.

最後，長期獲利成長演算法由多種槓桿支撐。強勁的收入成長、營運執行和技術整合推動的營業利潤率擴張，以及我們對嚴格資本配置的承諾。

As our business evolves, we are recalibrating our long-term margin targets for the enterprise, as well as for each segment to reflect our current portfolio and how we expect it to evolve in the future, both across and within segments.

隨著業務的發展，我們正在重新調整企業以及各個業務部門的長期利潤率目標，以反映我們目前的業務組合以及我們預期其未來在各個業務部門之間和內部的發展趨勢。

Importantly, the revision to our health benefits target margin is reflective of the revenue mix we have today while maintaining our targets by line of business. These adjustments are intended to provide a clear and durable framework for evaluating performance, but do not change our conviction in the embedded earnings power of our diversified platform.

重要的是，我們對健康福利目標利潤率的調整反映了我們目前的收入結構，同時維持了我們各業務線的目標。這些調整旨在為評估績效提供一個清晰持久的框架，但不會改變我們對多元化平台內在獲利能力的信念。

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

請接線生開通提問通道。

(Operator Instructions)

（操作說明）

AJ Rice, UBS.

AJ Rice，瑞銀集團。

Hi everybody. Thanks for the question. I wonder, when you think about the cost trend across the major lines of businesses, I think the industry would say and I think you guys would say that it was elevated in 2025 across commercial, Medicaid, Medicare and exchanges.

大家好。謝謝你的提問。我想知道，當你考慮各主要業務線的成本趨勢時，我認為業內人士會說，你們也會說，到 2025 年，商業保險、醫療補助、醫療保險和交易所的成本都會上升。

I know Mark is saying that you have a mid-single-digit cost trend assumption in Medicaid, I believe in the '26 guidance. But I wondered if I could just get you to comment on are you assuming sort of a similar cost trend in '26 in your embedded guidance to what you experienced in '25? Or is there any place you're assuming it gets worse or better?

我知道馬克的意思是，醫療補助計劃的成本趨勢假設為個位數中段，我相信 2026 年的指導意見。但我很想知道，您在製定業績指引時是否假設 2026 年的成本趨勢與 2025 年的情況類似？或者你認為在哪些地方情況會變得更糟或更好？

A.J., good morning and thank you very much for that question. Briefly, I would say the fourth quarter medical cost performance across the health benefits segment came in generally in line to slightly better than our expectations. We did see some modest variations by line of business, and so we've carried that forward into our planning for 2026.

A.J.，早安，非常感謝你的提問。簡而言之，我認為第四季度健康福利領域的醫療成本表現總體上符合預期，或略優於預期。我們發現不同業務線之間存在一些細微的差異，因此我們將這些差異延續到了 2026 年的規劃中。

To your question, in commercial, within large group, we do expect cost patterns and margins to be largely consistent with what we saw in 2025, meaning an elevated but stable trend environment with some pockets of high utilization.

關於您的問題，在商業領域，在大集團內部，我們預計成本模式和利潤率將與 2025 年的情況基本一致，這意味著趨勢環境將保持較高但穩定，並伴隨一些高利用率的領域。

In ACA, we again expect accelerating cost trends, especially as the expiration of the enhanced premium subsidies affects the risk pool. We do expect to see some healthier members exit. We do expect the remaining population to become more acute.

在《平價醫療法案》(ACA) 中，我們再次預期成本趨勢將加速成長，尤其是在增強保費補貼到期影響風險池的情況下。我們預期一些健康狀況較好的成員會退出。我們預期剩餘人口的病情會更加嚴重。

In Medicaid, we expect cost pressure to remain pressured again in 2026 at roughly twice the historical average, and that's going to reflect elevated utilization. It's going to reflect continued misalignment between rates and member acuity. That said, I would say, after two years of fairly unprecedented trend, we do expect some moderation versus 2025. So you could think about cost trend here moving into that mid-single-digit range, per your question.

在醫療補助方面，我們預計到 2026 年成本壓力將再次持續，約為歷史平均值的兩倍，這將反映出更高的利用率。這將反映出費率與會員病情嚴重程度之間持續存在的不匹配。也就是說，在經歷了兩年前所未有的趨勢之後，我們預計到 2025 年將有所緩和。所以，根據你的問題，你可以考慮這裡的成本趨勢正在朝向個位數中段的區間發展。

And then finally, in Medicare, we anticipate higher reported cost trend in 2026 but that's going to be largely driven by our membership mix, including a greater emphasis on D-SNP. So overall, I'd say we're continuing to monitor trends very closely. We're comfortable with how we ended 2025, and we're very confident that our outlook for 2026 is prudent and appropriate.

最後，在醫療保險方面，我們預計 2026 年報告的成本趨勢會更高，但這主要受我們的會員組成驅動，包括更加重視 D-SNP。總的來說，我認為我們將繼續密切關注各種趨勢。我們對 2025 年的收官表現感到滿意，並且非常有信心，我們對 2026 年的展望是審慎而恰當的。

Thank you, Mark. Next question, please.

謝謝你，馬克。下一個問題。

Andrew Mok, Barclays.

Andrew Mok，巴克萊銀行。

Hi, good morning. Your 2026 membership declines generally came in larger than expected, especially on the Medicare side. Can you walk us through what played out during AEP that prompted the negative revisions and help us understand the components of membership declines within commercial risk between ACA and employer group? Thanks.

您好，早安。2026 年會員人數的下降幅度普遍大於預期，尤其是在醫療保險方面。您能否詳細介紹一下 AEP 期間發生了什麼，導致出現了負面修訂，並幫助我們了解 ACA 和雇主團體之間商業風險中會員人數下降的構成要素？謝謝。

Thank you for the question. I'm going to have Felicia Norwood start and then maybe Mark talk a little bit about the second part.

謝謝你的提問。我打算先讓菲莉西亞·諾伍德開始，然後馬克可能會稍微談談第二部分。

Good morning Andrew, and thank you for the question. Our enrollment during AEP and the member composition is really aligned with our focus on margin. As you know, we took very deliberate steps to reposition our business to deliver sustainable value for our members and move the business towards our margin objectives.

安德魯，早安，謝謝你的提問。我們在 AEP 期間的招生情況和成員組成與我們對利潤率的關注非常契合。如您所知，我們採取了非常審慎的措施來重新定位我們的業務，以便為我們的會員提供可持續的價值，並推動業務朝著我們的利潤目標邁進。

So while our outlook for our membership is going to be in the high-teens percentage range, and this is below our expectations, we're really pleased with how members reacted to our emphasis on D-SNP as well as our HMO products as we go forward.

因此，雖然我們對會員人數的預期將達到十幾個百分點，低於我們的預期，但我們對會員們對我們重視 D-SNP 以及 HMO 產品所作出的反應感到非常滿意。

From a profitability perspective, I will say the mix of the lives that we lost was very consistent with our strategy. A majority of the attrition occurred in PPO products and in HMO products in geographies where we didn't offer a comparable alternative and where we were intentionally disciplined in repositioning our product vis-a-vis the broader market.

從獲利角度來看，我認為我們失去的生命類型與我們的策略非常吻合。大部分流失發生在 PPO 產品和 HMO 產品中，尤其是在我們沒有提供類似替代方案的地區，並且我們有意地對產品相對於更廣泛市場的定位進行了嚴格調整。

The outcome that we've seen in January AEP reflects deliberate choices. The products and the members that we exited were less aligned with our long-term objectives, particularly as we continue to focus on our D-SNP products.

1月AEP的選舉結果反映了深思熟慮的選擇。我們退出的產品和成員與我們的長期目標不太契合，尤其是在我們繼續專注於 D-SNP 產品的情況下。

Importantly, and I think this is critical, we are positioned to deliver meaningful Medicare margin improvement to at least 2% in 2026, which is a meaningful step up year-over-year. So very pleased at how things turned out, higher membership losses, but very consistent with the expectations.

重要的是，我認為這一點至關重要，我們有能力在 2026 年將 Medicare 利潤率提高至少 2%，這是一個顯著的同比增長。對結果非常滿意，雖然會員流失率較高，但這完全符合預期。

And then I'll turn it over to Mark for the rest of the responses.

然後我會把剩下的回答交給馬克。

And Andrew, on your question on the employer group risk membership, we are expecting to end 2026 down in the high single-digit percent range, and the short answer here is it's just a strong focus on margin discipline.

安德魯，關於你提出的雇主團體風險成員資格問題，我們預計到 2026 年底將下降個位數百分比，簡而言之，這只是對利潤率紀律的嚴格把控。

Some of the expected decline is really driven by deliberate pricing decisions that we've made. Maybe more specifically in a subset of accounts, including, some of the lower or negative margin of public sector business that we had. And, we really did make a conscious decision to hold the line on pricing and not pursue business that returns below our margin thresholds.

部分預期中的下跌其實是由我們做出的有意定價決策所造成的。或許更具體地說，是在部分帳戶中，包括我們一些利潤較低或為負利潤的公共部門業務。而且，我們確實經過深思熟慮，決定堅持價格底線，不去追求利潤率低於我們門檻的業務。

So thank you for the question. And I think the headline there again is this played out in a very disciplined way against the pricing expectations we set. And I think we feel very good about where we're coming into 2026.

謝謝你的提問。我認為，關鍵在於，這次的定價策略非常有條不紊，符合我們設定的價格預期。我認為我們對2026年的前景非常樂觀。

Next question, please.

下一個問題。

Justin Lake, Wolfe Research

賈斯汀·萊克，沃爾夫研究公司

Thanks, good morning. Wanted to ask about margins in the Health Benefits business for '26. So you mentioned Medicaid margins of minus 1.75%. I appreciate the help there. And you did say that margins were a little better than expected, I think, Mark, in the fourth quarter. Can you expand on the drivers of that in terms of pricing and cost as you go into 2026? And then any color on where guidance assumption sits for margins for the exchanges on Medicare Advantage would be helpful as well. Thank you.

謝謝，早安。想諮詢一下2026年健康福利業務的利潤率。所以你提到了 Medicaid 的利潤率為 -1.75%。非常感謝您的幫忙。馬克，我記得你說過第四季的利潤率比預期略好一些。展望 2026 年，您能否詳細說明影響價格和成本的因素？此外，如果能提供關於醫療保險優勢計劃交易所利潤率指導假設的任何信息，也將很有幫助。謝謝。

Justin, thanks very much for the question. I thought a good place for me maybe to start here is really to talk about how we ended the year from a margin perspective. And then I'll give a little bit of color in 2026. So overall, Health Benefits margin is very much in line with our outlook and our expectation.

賈斯汀，非常感謝你的提問。我認為，或許我應該先談談我們從利潤率的角度是如何結束這一年的。然後，我會在 2026 年增添一些色彩。因此，整體而言，健康福利利潤率與我們的預期和展望非常吻合。

On Medicaid, margins were pressured in the fourth quarter, but they did track slightly better than our outlook that we gave in October. And that really reflected two things, one, we had some favorable prior period development come through, and we also had some modest retroactive rates. And if you exclude those two items, Medicaid margins, completely in line with expectations. They still reflected that elevated utilization. They still reflected that ongoing reverification-driven, risk-pool deterioration and the misalignment of our rates and acuity.

第四季度，醫療補助業務的利潤率受到壓力，但略好於我們在 10 月給出的預期。這其實反映了兩件事，一是之前的一些有利發展，二是之前的一些追溯性利率也比較溫和。如果排除這兩個因素，醫療補助利潤率完全符合預期。它們仍然反映出較高的利用率。它們仍然反映了持續的重新核實驅動的風險池惡化以及我們的費率和敏銳度的不匹配。

On Medicare fourth quarter margins, inclusive of the IRA driven Part D seasonality were largely in line with our expectations. They reflected the prudent assumptions that were embedded in our 2025 bids and overall guidance.

Medicare 第四季利潤率（包括 IRA 驅動的 D 部分季節性因素）基本上符合我們的預期。這些反映了我們在 2025 年投標和整體指導中體現的審慎假設。

And then in the commercial large group, cost patterns and margins, I would say, were again largely consistent with our expectations. On the ACA side, a smidgen better than our prudent outlook. Cost trends were significantly above historical levels, but again, very much in line with what we were expecting.

然後，在大型商業集團中，成本模式和利潤率，我認為，也基本上符合我們的預期。從ACA的角度來看，情況比我們謹慎的預期略好。成本趨勢明顯高於歷史水平，但與我們的預期非常吻合。

And so as we think about 2026, the guidance that we put out this morning really incorporates that framework, and that really means that continued pressure in Medicaid offset by improvement in Medicare Advantage, as you heard Felicia talk about, and then better performance in the Individual ACA space.

因此，當我們展望 2026 年時，我們今天早上發布的指導意見確實包含了這個框架，這意味著，正如你聽到 Felicia 所談到的，Medicaid 的持續壓力將被 Medicare Advantage 的改善所抵消，然後在個人 ACA 領域取得更好的表現。

And then lastly, you had a quick question on flu. So maybe let me go ahead and cover that here. We did see a meaningful uptick in influenza-like activity in December that did have a modest adverse impact on the fourth quarter benefit expense ratio. And we have carried some of that experience into our 2026 planning. So specifically, we are expecting first quarter headwind of about 20 basis points for flu. That's already embedded in that outlook.

最後，你還問了一個關於流感的簡短問題。所以，或許我應該在這裡詳細介紹一下。12 月我們確實看到流感樣活動顯著增加，這對第四季度的福利支出率產生了輕微的不利影響。我們將其中一些經驗運用到了 2026 年的規劃中。具體來說，我們預計流感將為第一季帶來約 20 個基點的不利影響。這種觀點已經根深蒂固了。

Thank you. Next question, please.

謝謝。下一個問題。

Lance Wilkes, Bernstein.

蘭斯威爾克斯，伯恩斯坦。

Great. In the Medicaid business, could you talk a little bit about rate outlook for 2026? And then could you help frame for us how we should be thinking about this on a go-forward basis with respect to, obviously, you've given the trend estimate. But how should we be looking at kind of rate expectations, what states are doing as far as program changes? And then what are the opportunities and the achievable objectives for medical management? Thanks.

偉大的。在醫療補助業務方面，您能否談談 2026 年的費率前景？那麼，您能否幫助我們建立一個框架，讓我們了解在您給出的趨勢估計的基礎上，我們應該如何看待這個問題？但是，我們應該如何看待利率預期，以及各州在專案調整上採取了哪些措施？那麼，醫療管理方面有哪些機會和可實現的目標呢？謝謝。

Felicia?

菲利西亞？

Good morning, Lance, and thank you for the question. We are contemplating a composite rate increase in 2026 in the mid-single-digit percent range net of certain known risk corridor impacts. I will say the final rates that we've received from states for January, and as you know, January represents about one-third of our Medicaid premium, those rates were in line with our expectations. But for these states, the rates, while modestly above the historical levels, will still lack trend in 2026 given the ongoing membership attrition and the shifting risk pools we continue to see as a result of some ongoing state reverification activity.

早安，蘭斯，謝謝你的提問。我們正在考慮在 2026 年進行一次綜合利率上調，上調幅度在個位數百分比範圍內，扣除某些已知的風險走廊影響後。我要說的是，我們從各州收到的 1 月份的最終費率，正如您所知，1 月份的費率約占我們 Medicaid 保費的三分之一，這些費率符合我們的預期。但對於這些州而言，儘管其比率略高於歷史水平，但鑑於持續的會員流失以及由於一些州正在進行的重新核實活動而導致的風險池不斷變化，到 2026 年，這些比率仍將缺乏趨勢。

You mentioned program changes. I will say the rate discussions today are increasingly tied to broader program changes and benefit designs that states are more receptive to consideration. And I think that's very important as we think about trying to maintain long-term sustainability and the adjustments that need to be made in states around budget challenges that we're going to see in 2026.

您提到了程序變更。我想說，如今的費率討論越來越與更廣泛的項目變革和福利設計聯繫在一起，而各州也更願意考慮這些變革和設計。我認為這一點非常重要，因為我們正在考慮如何維持長期的可持續性，以及各州在 2026 年將面臨的預算挑戰方面需要做出的調整。

We are always engaged in constructive conversations with our state partners, and we're also taking actions ourselves to help control what states are seeing in terms of their Medicaid budgets by doing all of the things that states expect. That's tightening our cost management, increasingly focused on those high trend drivers that you heard earlier around behavioral health, ABA and other services. And certainly very much engaged in program integrity activities to make sure that the program reflects soundness as we look at ongoing issues in the program.

我們始終與各州合作夥伴進行建設性對話，同時我們也採取實際行動，透過做各州期望的一切事情，來幫助控制各州在醫療補助預算方面所面臨的情況。這意味著我們將收緊成本管理，越來越關注您之前聽到的那些關於行為健康、ABA 和其他服務的高趨勢驅動因素。當然，我們也積極參與專案完整性活動，以確保專案在處理專案中出現的問題時，能夠體現出健全性。

So good constructive conversations with rates, a continued lag, though, in terms of the trend. But I would say we continue to be very engaged in having a program that's long-term sustainable in our Medicaid program.

因此，與利率方面進行了良好的建設性對話，但就趨勢而言，仍然存在滯後。但我認為，我們將繼續致力於打造一個能夠長期可持續發展的醫療補助計劃。

Thank you. Next question, please.

謝謝。下一個問題。

Josh Raskin, Nephron Research.

Josh Raskin，腎單位研究。

Hi, thanks. Maybe just big picture, if you could give us a little bit more details and speak to what gives you that confidence to confirm the long-term EPS growth target of 12% plus starting in 2027 in light of the trends that you've seen in the past two years.

您好，謝謝。或許從宏觀角度來看，如果您能提供更多細節，並說明是什麼讓您有信心確認從 2027 年開始的長期 EPS 成長目標達到 12% 以上（考慮到您在過去兩年中看到的趨勢），那就太好了。

Is there something specific in Medicare or Medicaid or the commercial markets that suggest an opportunity to start growing earnings in '27? Or are you seeing something in Carelon side that maybe leads to a stronger acceleration of growth there? And lastly, I assume this includes your view of the 2027 MA rates post the prelim notice.

醫療保險、醫療補助或商業市場是否存在某些特殊情況，預示著 2027 年將有機會開始成長收益？或者，您是否在 Carelon 方面看到了某些可能導致其成長速度更快的因素？最後，我假設這包括您對初步通知發布後 2027 年 MA 利率的看法。

Yeah. Thank you for the question, Josh. I think it helps, as we frame '27 let's start with '26. We guided to an adjusted diluted EPS of at least $25.50. And again, as I shared, we see that outlook as prudent and achievable, and it's based on actions that are already underway to reposition our business and improve margins across the enterprise.

是的。謝謝你的提問，喬希。我認為這樣做會有幫助，在展望 2027 年時，讓我們從 2026 年開始。我們預計調整後攤薄每股收益至少為 25.50 美元。正如我之前所說，我們認為這項預期是審慎且可實現的，並且是基於我們正在採取的措施，這些措施旨在重新定位我們的業務並提高整個企業的利潤率。

So if I step back, '25 was about strengthening the foundation. We tightened pricing discipline. We improved our execution and we advanced our affordability through Carelon. And as you just heard from Mark, the fundamentals came in where we expected them to. And I think that work matters as we think about the next few years because it gives us a very clear line of sight and a lot of confidence in the outlook that we're laying.

所以，如果我回顧一下，2025 年的主題是鞏固基礎。我們加強了價格管控。我們透過 Carelon 提高了執行效率，並提升了產品的可負擔性。正如馬克剛才所說，基本面的表現符合我們的預期。我認為這項工作對於我們展望未來幾年至關重要，因為它讓我們對我們正在建立的前景有了非常清晰的認識和極大的信心。

So my headline for '26 is all about execution. The fundamentals are there. Looking to '27, we have confidence in at least 12% adjusted EPS growth coming off of our '26 ending baseline. And again, that's because it's driven by the same fundamentals that we saw at the end of '25 and into '26. Again, over the past two years, we've made very specific portfolio targeted decisions.

所以我對 2026 年的標題是「執行力」。基本要素都具備了。展望 2027 年，我們有信心在 2026 年底基準的基礎上，實現至少 12% 的調整後每股收益成長。再一次，這是因為它的基本面與我們在 2025 年末和 2026 年初看到的相同。同樣，在過去的兩年裡，我們針對投資組合做出了非常具體的決策。

Our pricing has hardened and our operating decisions are designed to protect our earnings base and position the enterprise for durable growth. That leverages the unique capabilities. And I think our diversified platform, we're going to start to see come through.

我們的定價策略已經趨於成熟，我們的營運決策旨在保護我們的獲利基礎，並使企業實現永續成長。這是利用了其獨特的功能。我認為我們多元化的平台將會開始發揮作用。

And there's three points I just want to underscore. First, the key earnings levers are already in motion. So that puts us in place for '25 and '26. Again, pricing care management and the portfolio, we feel, are positioned.

我只想強調三點。首先，關鍵的獲利槓桿已經開始發揮作用。這樣我們就為 2025 年和 2026 年做好了準備。再次強調，我們認為，護理管理和產品組合的定價已經到位。

Second, our '26 outlook is intentionally prudent so as those actions mature, we can capture more operating leverage, and that sets up a clear step-up into 2027.

其次，我們對 2026 年的展望是有意採取謹慎的態度，以便隨著這些措施的成熟，​​我們可以獲得更多的經營槓桿，從而為 2027 年的明顯進步奠定基礎。

And third, and I think this is really important to your question. The path isn't predicated on a single assumption. It's built on multiple independent levers and disciplined execution across Commercial, Medicare, Carelon and Medicaid. And that's why we have the confidence both in the '27 and our long-term earnings algorithm. And that confidence is behind our outlook in 2026 and the growth in '27. So hopefully, that provides some clarity.

第三，我認為這對你的問題至關重要。這條道路並非基於單一假設。它建立在多個獨立槓桿和商業保險、聯邦醫療保險、卡雷隆保險和醫療補助計劃的嚴格執行之上。也因為如此，我們對 2027 年的預測以及我們的長期獲利演算法都充滿信心。而這種信心正是我們對 2026 年的展望以及對 2027 年成長的支撐。希望這能有所幫助。

Thank you for the question. Next question, please.

謝謝你的提問。下一個問題。

Lisa Gill, JPMorgan.

Lisa Gill，摩根大通。

Thanks very much and good morning. I want to go back to Mark's comments on the investments that were pulled forward. Mark, I want to make sure that I heard you correctly. You said it was roughly $1 of investments but $0.25 was pulled forward. So should I think that $0.75 is still embedded in your guidance for 2026? And can you talk about specifically what buckets those investments are in? And how do we think about how it flows through the model?

非常感謝，早安。我想回到馬克對提前進行的投資項目的評論。馬克，我想確認一下我是否聽清楚了。你說投資金額大約是 1 美元，但預付了 0.25 美元。那麼，我是否應該認為 0.75 美元仍然包含在你們對 2026 年的預期之中？您能否具體談談這些投資屬於哪些類別？那麼，我們該如何看待它在模型中的流動呢？

Lisa, good morning and thanks very much for the question. Maybe let me do a little bit of a broader framing and then I'll get specifically to your question. So our results this morning do include $3.75 of discrete noncore items embedded in our outlook. And that is, to your point, $0.75 more favorable than what we contemplated in our October call.

麗莎，早安，非常感謝你的提問。或許我可以先從更廣的角度來闡述一下，然後再具體回答你的問題。因此，我們今天早上公佈的結果中包含了3.75美元的非核心項目，這些項目已納入我們的展望中。正如您所說，這比我們在 10 月的電話會議中設想的要有利 0.75 美元。

So what changed versus prior expectations? Well, that incremental favorability, that was driven entirely by strategic tax items that came in better than expected as we finalized results particularly in the fourth quarter. And importantly, I want to emphasize this point here. Underlying operating performance came in as expected, meaning medical cost trends, operating execution, they're consistent with our outlook.

與先前的預期相比，有哪些變化？嗯，這種增量利好完全是由策略性稅收項目推動的，這些項目在我們最終確定業績時，尤其是在第四季度，表現好於預期。而且，我在這裡要強調一點，這一點非常重要。基本營運績效符合預期，這意味著醫療成本趨勢、營運執行情況均與我們的預期一致。

So given that our performance in those tax-related benefits, we made two intentional decisions. One, we pulled forward a $0.25 of the approximately $1 of incremental investments that we had previously planned for 2026. And two, we deployed an additional $0.25 towards retention and targeted workforce investments here. And so it gives us a lot of confidence as we set the baseline for 2026.

鑑於我們在稅收優惠方面的表現，我們做出了兩個有意的決定。第一，我們提前投入了先前計劃在 2026 年投入的約 1 美元增量投資中的 0.25 美元。其次，我們還額外投入了 0.25 美元用於員工留任和有針對性的勞動力投資。因此，這讓我們在設定 2026 年基準時充滿信心。

Thank you. Next question, please.

謝謝。下一個問題。

Ann Hynes, Mizuho Securities.

安海恩斯，瑞穗證券。

Great, thank you. Good morning. Great. I know in your long-term guidance, you're lowering the margin profile of each segment. Within the health care benefits segment, can you let us know what changed for your long-term targets for Medicaid, Medicare and commercial? And then on Carelon, it looks like you're lowering the Rx part of it. Is that just driven by membership losses? Or is there anything else that's lowering of that target? Thanks.

太好了，謝謝。早安.偉大的。我知道在您的長期業績指引中，您正在降低各個業務板塊的利潤率。在醫療保健福利領域，您能否告知我們您在醫療補助、醫療保險和商業保險方面的長期目標發生了哪些變化？然後，在 Carelon 上，看起來你正在降低 Rx 部分的含量。這僅僅是因為會員流失造成的嗎？或者還有其他因素導致該目標降低嗎？謝謝。

Ann, good morning. So most important here, we have not changed the underlying margin expectations for any line of business within Health Benefits, and that continues to reflect the risk that we assume and the value that we deliver for employers and the government programs that we support.

安，早安。因此，最重要的是，我們沒有改變健康福利業務線的基本利潤預期，這繼續反映了我們承擔的風險以及我們為雇主和我們支持的政府項目創造的價值。

What has changed is how we calibrate the Health Benefits segment margin to the portfolio we are operating today, applying the same line of business margin framework that we've always used. So as we worked through an elevated cost trend environment, I would say commercial growth had been more measured than we originally anticipated, also as we prioritized disciplined pricing and margin integrity over volume.

改變的是我們如何根據我們目前營運的業務組合來調整健康福利部門的利潤率，我們仍然沿用我們一直以來使用的業務線利潤率框架。因此，在成本上升的環境下，我認為商業成長比我們最初預期的要謹慎得多，因為我們優先考慮的是嚴格的定價和利潤率，而不是銷售量。

At the same time, the composition within commercial, that's also evolved. So individual ACA now represents a larger share of the segment relative to group commercial, and that obviously carries a different margin profile.

同時，商業廣告的組成也在不斷發展。因此，個人 ACA 目前在該細分市場中所佔份額相對於團體商業保險更大，這顯然具有不同的利潤率特徵。

And so when you reflect these dynamics through the existing line of business margin ranges, the result is that mid-single-digit Health Benefits segment margin expectation. And so the key point here, look, this is not about a change in strategy or change in underwriting discipline or pricing. This is just a recalibration to better reflect the mix of our business today and a prudent view of the operating environment.

因此，當你將這些動態反映在現有的業務線利潤率範圍內時，結果就是健康福利部門的利潤率預期為個位數中段。所以關鍵在於，這並非是策略、核保紀律或定價方面的改變。這只是為了更好地反映我們目前的業務組合以及對經營環境的審慎考量而進行的重新調整。

And why don't we have Pete talk a little bit about Carelon?

我們為什麼不讓皮特談談卡雷隆呢？

Okay. No, thanks a lot for the question, Ann. So you asked about the Rx margins longer term. And yes, we are adjusting them. It's a positive story around really growth and diversification of our portfolio. As we talked about, we're seeing a lot of growth in Rx. And in fact, just to reflect on what happened this past year headed into 2026, it was our best growth year ever.

好的。不，非常感謝你的提問，安。所以你問的是處方藥的長期利潤率。是的，我們正在進行調整。這是一個關於我們投資組合真正成長和多元化的積極故事。正如我們剛才討論的，我們看到處方藥領域正在蓬勃發展。事實上，回顧過去一年到 2026 年的發展歷程，這是我們有史以來成長最好的一年。

And part of that is the composition of the business that we're growing through. And we're starting to see a lot more large upmarket jumbo accounts flowing through our business. So that's one factor, and that comes with a different margin profile.

而這其中一部分原因在於我們所發展的業務組成。我們開始看到越來越多的高端大客戶透過我們的業務進行交易。所以這是其中一個因素，而這又會帶來不同的利潤率。

In addition, we continue to build out our specialty business. That's going really well both internally and externally. And again, that comes with a bit of a lower margin profile. And you've heard Gail and Mark talk about the investments that we're making in that regard.

此外，我們也將繼續拓展我們的特色業務。這件事無論從內部或外部來看，進展都非常順利。而且，這也意味著利潤率會略低一些。你們也聽蓋爾和馬克談過我們在這方面進行的投資。

And then finally, I would say, longer term, we're very mindful and respectful of what's going on from a policy perspective. And I think we're being very prudent in this regard as we think about the longer-term profile of the Rx business. Thanks for that question.

最後，我想說，從長遠來看，我們非常關注並尊重政策層面正在發生的事情。我認為，在考慮處方藥業務的長期發展前景時，我們在這方面做得非常謹慎。謝謝你的提問。

Thank you. Next question, please.

謝謝。下一個問題。

Ryan Langston, TD Cowen.

Ryan Langston，TD Cowen。

Hi, good morning. This is Christian Borgmeyer on for Ryan Langston. Can you share where you began the year in terms of ACA membership after the annual enrollment period? Data on sign-ups nationally came in higher than we expected given the expiring subsidies, but I know there's some attrition typically in the first quarter. I know it's early in the year, but any notable changes in utilization patterns from this line of business in January? Thanks.

您好，早安。這裡是克里斯蒂安·博格邁爾，替瑞安·蘭斯頓為您報道。能否分享一下在年度註冊期間結束後，您年初的ACA會員資格狀況？考慮到補助即將到期，全國註冊人數數據高於我們的預期，但我知道第一季通常會有一些流失。我知道現在還只是年初，但1月該業務線的使用率模式是否有任何顯著變化？謝謝。

Christian, good morning and thank you very much for the question. On the Individual ACA, we are guiding towards at least 900,000 members at year-end 2026. And that outlook really reflects two drivers here, first, the expiration of the enhanced premium tax credits, which we expect is going to pressure retention and increase lapse activity, and second, intentional exits that we've made as part of our repositioning of the book for a more sustainable profile.

克里斯蒂安，早安，非常感謝你的提問。在個人ACA方面，我們預計到2026年底會員人數至少達到90萬人。這種前景實際上反映了兩個驅動因素，首先是增強型保費稅收抵免的到期，我們預計這將對續保率造成壓力並增加退保活動，其次是我們為了使業務結構更加可持續而進行的有意退出。

Importantly, coming out of open enrollment, membership is up approximately 10%, and that's helped in part by some of the modest growth that we've seen in markets we first entered in 2025, which offsets some of the intentional attrition that we expected in our core Blue states. Overall, I'd say trends through open enrollment are largely in line with what we've seen in the broader market.

重要的是，在開放註冊期結束後，會員人數增加了約 10%，這部分得益於我們在 2025 年首次進入的市場中看到的適度增長，這抵消了我們在核心藍州預期的一些有意流失。總的來說，我認為開放註冊期間的趨勢與我們在更廣泛的市場中看到的趨勢基本一致。

The key swing factor, and I think this gets to the heart of your question, is really now effectuation rates. And that's going to come down to member premium payments and lapse behavior. And that typically is going to become much clearer through early April as members work through that normal billing cycle over the next few months.

關鍵的搖擺因素，我認為這才是你問題的核心，就是效應率。而這最終將取決於會員的保費繳交狀況和續費行為。通常情況下，到四月初，隨著會員們在接下來的幾個月完成正常的帳單週期，這種情況會變得更加明朗。

Thank you. Next question, please.

謝謝。下一個問題。

Scott Fidel, Goldman Sachs.

Scott Fidel，高盛集團。

Oh hi, thanks, good morning. Just interested if you can provide us with an update on capital deployment priorities for 2026. And in particular, maybe just sort of touch on the M&A priorities in terms of, one, just appetite for doing transactions this year just given a dynamic backdrop.

哦，你好，謝謝，早安。我們想了解您能否提供一下2026年資本部署重點的最新情況。特別是，或許可以稍微談談併購方面的優先事項，一方面是鑑於當前動態的背景，今年進行交易的意願。

And then two, looking over the last several years, certainly, you've had a lot of activity on the M&A side on Carelon Services, and in particular, acquiring risk-based platforms to integrate into that. Just interested if that remains a priority at this point or whether you're more focused on integration of those assets you've acquired over the last several years. Thanks.

其次，回顧過去幾年，Carelon Services 在併購方面確實有很多活動，特別是收購基於風險的平台並將其整合到自身業務中。我只是想知道，目前這是否仍然是優先事項，還是你們更專注於整合過去幾年收購的資產。謝謝。

Thank you very much for the question. I'd say in the near term, our capital allocation is going to reflect a more conservative posture. Our priority here, look, is to maintain balance sheet strength and strong credit profile, fund targeted investments that accelerate margin stabilization and Carelon's continued growth and then to remain opportunistic around share repurchases, especially where we see compelling value.

非常感謝您的提問。我認為，短期內，我們的資本配置將體現出更保守的姿態。我們目前的首要任務是保持資產負債表的穩健性和良好的信用狀況，為有針對性的投資提供資金，以加速利潤率穩定和Carelon的持續增長，然後保持對股票回購的機會，尤其是在我們看到具有吸引力的價值時。

Over the longer term, the capital allocation framework is unchanged. We remain completely committed to a balanced approach that supports our long-term growth algorithm, including reinvestment back into the business, disciplined M&A focused on some of the integration or integrated capabilities that have strengthened our competitive position and then, of course, consistent capital return back to shareholders through dividends and share repurchases.

長遠來看，資本配置框架不會改變。我們始終致力於採取平衡的策略，以支持我們的長期成長演算法，包括將資金再投資於業務，有條不紊地進行併購，重點關註一些能夠增強我們競爭地位的整合或整合能力，當然，還有透過分紅和股票回購向股東持續提供資本回報。

On M&A specifically, our near-term priority is really focused on that integration execution, really fully scaling and realizing the value from recent acquisitions. And so at least in the first half of 2026, you should expect a lower level of M&A activity and a much greater relative emphasis on opportunistic share repurchases.

具體到併購方面，我們近期的重點是真正集中精力執行整合，真正全面擴大規模，並實現近期收購的價值。因此，至少在 2026 年上半年，預計併購活動水準將有所下降，而機會主義股票回購將相對更加重要。

Thank you. Next question, please.

謝謝。下一個問題。

Kevin Fischbeck, Bank of America.

凱文‧菲施貝克，美國銀行。

Great, thanks. I wanted to follow up kind of on this margin commentary and the changes that you're doing there. I guess maybe putting in the framework of just the changes that you've had in the enrollment across the different businesses. I definitely applaud when managed care companies exit markets that aren't profitable, low margin. I think it's 100% the right thing to do.

太好了，謝謝。我想就您提到的邊注和您正在進行的更改做一些後續說明。我想或許應該把你們各個業務部門招生方面所發生的變化納入框架考量。我絕對讚賞醫療管理公司退出那些不獲利、利潤率低的市場。我認為這百分之百是正確的做法。

But given that the membership numbers have been lower than we would have thought, I guess, across most of the products, is there anything that we should be reading into as far as where you are strategically or competitively in these markets? The magnitude is more than we would have expected and it's a broad-based, across-the-board dynamics.

但鑑於大多數產品的會員數量都低於我們的預期，我想，這是否暗示了您在這些市場的策略或競爭地位方面存在一些問題？其影響程度超出了我們的預期，而且是廣泛而全面的動態變化。

So just trying to understand there's something we should be reading into this and why like this business mix that you're now forecasting is different than the business mix you thought a few years ago when you provided your previous margin assumptions. Thanks.

所以，我只是想弄清楚，這其中是否有什麼值得我們解讀的地方，以及為什麼你現在預測的業務組合與你幾年前提供之前的利潤率假設時所設想的業務組合有所不同。謝謝。

Yeah. Thanks for the question. I guess I would simply say the headline is no, this is a very disciplined approach in each of the businesses. And let me just touch on them. In the commercial business, we made very specific decisions around the ACA and feel very good about the sustainability of where the platform and the membership is coming out. And as you heard from Mark a few minutes ago, I think we positioned ourselves well for sustainable business there.

是的。謝謝你的提問。我想簡單地說，結論是“不”，這是每個企業都非常自律的做法。讓我簡單談談它們。在商業領域，我們圍繞著 ACA 做出了非常具體的決定，並且對平台和會員的可持續性感到非常滿意。正如你幾分鐘前從馬克那裡聽到的，我認為我們已經為在那裡的可持續業務做好了充分的準備。

On the broader commercial risk-based business, we actually had quite high retention amongst our commercial business but made some very conscious pricing decisions around public sector accounts that have been below profitability. So again, this is a repositioning of the portfolio ready for growth. On the ASO, we had a very strong national account selling season with great retention.

在更廣泛的商業風險業務方面，我們的商業客戶留存率其實相當高，但我們對盈利能力低於預期的公共部門客戶做出了一些非常謹慎的定價決策。所以，這又是為了成長而進行的投資組合重新調整。在應用程式商店優化 (ASO) 方面，我們取得了非常強勁的全國客戶銷售季，客戶留存率也很高。

I think Medicaid represents really just the redetermination impacts, but we continue to grow and have won accounts in some of the more complex populations. So again, feel good there. And I feel very good about the positioning in Medicare Advantage. We came into this. We are very clear what we needed to do.

我認為 Medicaid 實際上只代表了重新評估的影響，但我們仍在不斷發展壯大，並在一些更複雜的人群中贏得了客戶。所以，再次祝你一切順利。我對在聯邦醫療保險優勢計劃中的定位感到非常滿意。我們捲入了這件事。我們非常清楚自己需要做什麼。

As you heard, we believe we have improved our margin and, again, our sustainability. So I actually would say where we are entering '26 quite strongly positioned for future growth in a very sustainable, strong margin position. So thanks for the question.

正如你們所聽到的，我們相信我們已經提高了利潤率，並且再次提高了我們的永續發展能力。所以，我認為我們進入 2026 年時已經處於非常強勁的領先地位，未來成長前景光明，利潤率也非常穩定。謝謝你的提問。

Next question, please.

下一個問題。

Erin Wright, Morgan Stanley.

艾琳·賴特，摩根士丹利。

Great, thanks. So clearly, the industry was somewhat caught off guard with the MA rate notice this week. And just can you remind us of just your response? I think we know that to some extent, but your just ability to mitigate this on top of the cuts that you're making this year as well. I assume you'll continue to take a disciplined approach here.

太好了，謝謝。顯然，本週MA的費率通知讓業界有些措手不及。您能否提醒我們一下您的回覆？我想我們對此有所了解，但你能否在今年削減開支的同時，進一步緩解這個問題？我想你在這裡會繼續採取嚴謹的態度。

And just your thoughts on what this means for the industry, for the MA market as a whole and from a policy perspective and what we could see going forward. And just do you think also more specifically, some of the risk adjustment changes being made, are you more or less exposed relative to the industry on that front? Thanks.

您認為這對產業、對整個 MA 市場意味著什麼？從政策角度來看，我們未來可能會看到什麼？更具體地說，您認為針對某些風險調整措施的調整，與業界相比，您在這方面面臨的風險是更大還是更小？謝謝。

Yeah. Well, thank you for the question, Erin. And I'll start with just your sort of between the lines question, which is we will continue to take a very disciplined approach and positioning of our Medicare book. But I think it's important to start off by first framing the implications of the advance notice. Medicare Advantage is a critically important program for seniors, and it brings together, as we've said, affordable coverage, coordinated care and supplemental benefits that members rely on to stay healthy and independent.

是的。謝謝你的提問，艾琳。我先回答你提出的這個言外之意的問題，那就是我們將繼續採取非常嚴謹的態度來管理我們的醫療保險業務。但我認為，首先要先明確提前通知的影響。Medicare Advantage 對老年人來說是一項至關重要的計劃，正如我們所說，它將價格合理的保險、協調的護理和補充福利結合在一起，會員們依靠這些來保持健康和獨立。

We are still going through the details. We just got them of the advance notice. But at a high level, the advance notice is effectively flat, which you've all reported on. And quite frankly, it just doesn't keep pace with the current medical fasting utilization trends, and that does create real pressure on benefit stability and affordability for seniors.

我們仍在核實細節。我們剛剛提前通知了他們。但從整體來看，提前通知的情況基本上持平，這一點你們都已經報道過了。坦白說，它根本跟不上當前醫療斷食的使用趨勢，這確實給老年人的福利穩定性和負擔能力帶來了真正的壓力。

For MA to remain strong, the program needs to be stable and sustainable, and stability gets underlined when payment rates don't keep pace with the utilization and cost trends, especially as the member needs grow more and more complex. So we're going to continue to advocate, obviously, because if funding consistently lags the reality on the ground, the levers that we have are benefits, networks, premiums and exiting geographies. And quite frankly, that's not good for seniors and I don't think it's good for the program. And we do believe, we see more than 55% of seniors selecting this program. So it's very popular.

要使醫療保險優勢計劃保持強勁勢頭，該計劃需要保持穩定和可持續，而當支付率跟不上利用率和成本趨勢時，穩定性就顯得尤為重要，尤其是在成員需求變得越來越複雜的情況下。所以，我們顯然會繼續倡導，因為如果資金持續落後於實際情況，我們所能採取的措施就是福利、人脈、保費和退出地理市場。坦白說，這對老年人來說不好，我認為這對專案本身也不好。我們相信，超過 55% 的高年級學生會選擇這個計畫。所以它非常受歡迎。

We're also supportive of the measures that protect the integrity of the risk adjustment program. And if you think back, risk adjustment exists for a reason. It's to ensure that plans are paid appropriately for the health status of the members they serve. So as we look ahead, we're going to continue to work with CMS on two things that have to go together.

我們也支持保護風險調整計畫完整性的措施。仔細想想，風險調整機制的存在是有原因的。這是為了確保醫療保險計劃能夠根據其服務對象（會員）的健康狀況獲得適當的付款。展望未來，我們將繼續與 CMS 合作，推進兩件必須同時進行的事情。

One is the appropriate funding that reflects the actual utilization and cost trends to support program stability, and two, if changes to that risk adjustment framework are proposed, they need to be accurate and predictable and trusted to avoid disruption, I think, in negatively impacting seniors. So our priority is, again, work with CMS and also protect seniors' access and affordability because we know the very popular program that delivers significant value for seniors. So thanks very much for the question.

第一，要提供適當的資金，以反映實際利用率和成本趨勢，從而支持專案的穩定性；第二，如果提議對風險調整框架進行更改，這些更改需要準確、可預測且值得信賴，以避免對老年人造成負面影響。因此，我們的首要任務仍然是與 CMS 合作，並保護老年人獲得醫療服務的機會和負擔能力，因為我們知道這項非常受歡迎的計劃能為老年人帶來巨大的價值。非常感謝您的提問。

Next question, please.

下一個問題。

Ben Hendrix, RBC Capital Markets.

Ben Hendrix，加拿大皇家銀行資本市場。

Great, thank you very much. I just wanted to go back quickly to the Carelon margin discussion. You noted expansion of risk-based solutions in Carelon Services through 2025. I was wondering if you could remind us of the new services under product lines where you're taking risk, and to what degree could that expansion provide an offset to the shifting margin dynamics you mentioned in CarelonRx. Thanks.

太好了，非常感謝。我只想快速回到 Carelon 利潤率的討論。您提到 Carelon Services 將在 2025 年前擴展基於風險的解決方案。我想請您提醒我們一下，您在哪些產品線下承擔了風險，以及這種擴張能在多大程度上抵消您在 CarelonRx 中提到的利潤率動態變化。謝謝。

I'll have Pete address your question. Thank you.

我會讓皮特來回答你的問題。謝謝。

No, thanks for that question. I think it's important to step back and just talk about how we address risk and Carelon because I think it's very important strategically. We're very intentional and disciplined about how we do that and take on risk. We, as you noted, have a diverse set of services and products and offerings. And importantly, in the infrastructure of Carelon, we're very disciplined around cost of care and managing trend across all these relationships.

不，謝謝你的提問。我認為重要的是退後一步，談談我們如何應對風險以及 Carelon，因為我認為這在策略上非常重要。我們在做事和承擔風險方面都非常謹慎和自律。正如您所指出的，我們擁有種類繁多的服務和產品。更重要的是，在 Carelon 的基礎設施中，我們對護理成本和管理所有這些關係中的趨勢都非常嚴格。

I'd also say that we have a good mix of fee-based business as well as risk business. And then when you break down our risk portfolio, we approach it in a very different way, in a diverse way, where we're taking risk on a category of service basis in some cases as well as on a whole health risk basis.

我還想說，我們的收費業務和風險管理業務組合得很好。然後，當我們細分我們的風險組合時，我們採取了一種非常不同的、多樣化的方法，在某些情況下，我們按服務類別承擔風險，而在某些情況下，我們則按整體健康風險承擔風險。

And again, we built in appropriate protections with risk corridors and discipline in terms of how we approach that. So I do think from an enterprise perspective, the way we approach that is very important in protecting our growth and our margin profile.

此外，我們也建立了適當的保護措施，包括風險走廊和紀律，以規範我們處理風險的方式。所以我認為，從企業的角度來看，我們處理這個問題的方式對於保護我們的成長和利潤率至關重要。

In terms of the services in which we deploy risk because you asked that as well, it varies. In most of our product offerings, we are assuming risk, like I said, sometimes on a category of care basis or on a whole risk basis. In some instances, we're on a fee basis. But we're excited about the proliferation of that and our advancement of whole health going forward.

至於我們部署風險的服務，正如您所問，情況各不相同。正如我所說，在我們的大多數產品中，我們都會承擔風險，有時是按護理類別承擔風險，有時是按整體風險承擔風險。在某些情況下，我們會收取費用。但我們對這種理念的普及以及未來整體健康的發展感到興奮。

When you think about our new offerings like SMI, when you think about what we're doing around oncology, when you think about what's happening with CareBridge, these are all risk offerings that are deploying a lot of value from a cost of care and quality perspective for the enterprise.

當你想到我們的新產品，例如 SMI，當你想到我們在腫瘤學領域所做的工作，當你想到 CareBridge 的發展，這些都是風險管理產品，它們從醫療成本和品質的角度為企業創造了巨大的價值。

Yeah. Thanks, Pete. And the only thing I'd say is we have a very strong external growth pipeline, which I think validates what Pete is saying. Again, we're looking at serving the more complex populations based on the experience we have in our own health plan. So a lot of those programs around oncology, severe mental illness, orthopedics really give us a growth opportunity. So thank you for the question.

是的。謝謝你，皮特。我唯一想說的是，我們擁有非常強大的外部成長管道，我認為這證實了皮特所說的。同樣，我們正在根據我們自身健康計劃的經驗，考慮如何為更複雜的人群提供服務。因此，腫瘤學、嚴重精神疾病、骨科等許多計畫都為我們提供了發展機會。謝謝你的提問。

Next question, please.

下一個問題。

Dave Windley, Jefferies.

戴夫溫德利，傑富瑞集團。

Hi, thanks for taking my question. I wanted to ask on the Medicaid membership expected decline. Is that all same store? Or does that contemplate an exit of a state or an end of a contract? I'm thinking about Georgia. And then the 9% in total is a little bit higher than we were expecting your 125 basis points, I think, of margin pressure in Medicaid is consistent with what you had said before. And so I wanted to try to reconcile those that, that additional membership decline doesn't further disrupt the margin. Thank you.

您好，感謝您回答我的問題。我想詢問一下關於醫療補助計劃成員人數預期下降的問題。都是同一家店嗎？或者，這是否意味著退出某個國家或終止某項合約？我在想喬治亞州。總共 9% 比我們預期的要高一些，我認為您之前所說的 Medicaid 利潤率壓力為 125 個基點是一致的。因此，我想嘗試調和這些因素，即會員人數的進一步下降不會進一步擾亂利潤率。謝謝。

Morning, Dave, and thank you for the question. You're right. We've guided to Medicaid membership decline around 750,000 members for 2026. And this really reflects really same-store, so a continuation of the challenges that we've seen across states as some states have really implemented more stringent eligibility reverification requirements. And that has happened, it happened consistently in 2025.

早安，戴夫，謝謝你的提問。你說得對。我們預測，到 2026 年，醫療補助計劃的會員人數將減少約 75 萬人。這確實反映了同店經營的現狀，也延續了我們在各州看到的挑戰，因為一些州確實實施了更嚴格的資格重新核實要求。而這種情況確實發生了，在 2025 年持續發生。

And we thought it was very important to be prudent as we took a look at 2026 to maintain that same posture. We're continuing to work closely with our states, but certain eligibility requirements as well as program changes will lead to some of those reductions in 2026

我們認為，展望 2026 年，保持謹慎非常重要，這樣才能維持同樣的姿態。我們正繼續與各州密切合作，但某些資格要求以及專案變更將導致部分資金在2026年減少。

And then, Dave, how that carries in forward into our margin guidance of approximately negative 1.75% for the year is really grounded in three core assumptions. Number one, cost trend is going to remain elevated. We have planned for medical cost trend in that mid-single-digit percent range, still materially above historical norms.

那麼，戴夫，這如何影響我們全年約負 1.75% 的利潤率預期，實際上是基於三個核心假設。第一，成本趨勢將持續高點。我們已將醫療成本趨勢預測在個位數百分比的範圍內，但仍遠高於歷史平均值。

And number two, rates, as we discussed early on the call, are going to improve. But they will still lag trends. And you can think about that as roughly one-third of those Medicaid premiums reset in January.

第二，正如我們在電話會議早期討論的那樣，利率將會改善。但它們仍會落後於趨勢。你可以理解為，大約三分之一的醫療補助保費將在 1 月重置。

And then third, we're not relying on rates alone. We are using all the levers we control, title medical and pharmacy cost management, expanded BH interventions, et cetera. And so taken together, we think our outlook for Medicaid margin is prudent for 2026.

第三，我們並非只依賴利率。我們正在利用我們所能控制的一切手段，包括醫療和藥房成本管理、擴大行為健康幹預等等。綜上所述，我們認為 2026 年 Medicaid 利潤率的預測是謹慎的。

Thank you. Next question, please.

謝謝。下一個問題。

Sarah James, Cantor Fitzgerald.

莎拉詹姆斯，坎托費茲傑拉。

Thank you. Commercial risk guidance is down about 700,000 lives while ACA is growing. Can you quantify how much of that decline reflects pricing actions on those government accounts versus employers shifting preference to ASO? And in your long-term Health Benefits margin guidance, does the mix change assume further commercial risk attrition or mainly the impact of the actions taken this year?

謝謝。商業風險指引導致約 70 萬人死亡，而《平價醫療法案》(ACA) 的受惠人數卻在增加。你能量化一下，這種下降有多少是由於政府帳戶的價格調整造成的，又有多少是由於雇主轉向ASO（應用商店優化）造成的嗎？在您對長期健康福利利潤率的預測中，這種結構變化是假設商業風險進一步下降，還是主要取決於今年採取的措施的影響？

Thanks very much for the question. Maybe just a moment here to clarify. So on the individual ACA, we are guiding to at least 900,000 members at year-end 2026, and it's important to put that in the context of obviously where we ended 2025. For the employer group risk-based membership, we do expect to decline year-over-year in the high single-digit percent range. We spoke a little bit about that earlier, and that's primarily because we're prioritizing margins.

非常感謝您的提問。或許需要花一點時間澄清一下。因此，就個人ACA而言，我們預計到2026年底會員人數至少達到90 萬人，而且顯然需要將其與我們2025年底的情況聯繫起來考慮。對於雇主團體基於風險的會員資格，我們預計其同比降幅將達到較高的個位數百分比。我們之前稍微談到過這一點，這主要是因為我們優先考慮利潤率。

And then finally, in ASO, we are expecting a pretty good season. I'm actually going to ask Morgan to help here because he deserves a lot of credit for our success in how we're guiding 2026.

最後，在ASO方面，我們預計本賽季會有一個相當不錯的成績。我其實打算請摩根幫忙，因為在指導 2026 年發展方面，他功不可沒。

Thanks, Mark, and thanks, Sarah. Regarding the ASO business, National accounts, and Gail mentioned too earlier, is just a spectacular year, which I think sort of speaks to the health of the assets across the entire enterprise when you look at it. And a couple of things were sort of driving that, Gail mentioned at the beginning of the conference today around second Blue bid, where this is the first year that we've had the opportunity for employers in competing geographies against us could actually quote with our organization if they wanted.

謝謝馬克，也謝謝莎拉。關於 ASO 業務、全國客戶以及前面提到的 Gail，今年的業績非常出色，我認為這從某種程度上反映了整個企業資產的健康狀況。蓋爾在今天的會議開始時提到，有幾件事促成了這一結果，那就是第二次藍色競標。今年是我們第一次有機會讓與我們競爭地區的雇主，如果他們願意的話，可以向我們的組織報價。

So when we think about how it came together, we had about 11 bids in the second Blue category for 2026, Won 9 of them. And the tee-up of the actual pipeline, 2027 looks strong and also '28 as we sit here. So whether we're talking to local markets or the national markets, the self-funded business has done quite well.

所以當我們回顧整個過程時，我們收到了 2026 年第二類藍色類別的大約 11 個投標，贏得了其中 9 個投標。就目前來看，該管道的實際開工日期是 2027 年，2028 年也很有希望。所以，無論我們談論的是本地市場還是全國市場，自籌資金的企業都做得相當不錯。

We expect it to continue to. And with that, as you also heard from Pete earlier, the pull-through with the CarelonRx has been really, really strong and notably in the upmarket where it had not been formerly. So we're pleased with it and, look forward to continued success.

我們預計這種情況還會持續下去。正如你之前從皮特那裡聽到的那樣，CarelonRx 的銷售情況非常非常強勁，尤其是在高端市場，而此前它並沒有進入高端市場。我們對此感到滿意，並期待繼續取得成功。

Thank you. Next question, please.

謝謝。下一個問題。

Jason Cassorla, Guggenheim.

傑森·卡索拉，古根漢。

Great, thanks. Good morning. Maybe just a question on aggregate Carelon. It looks like for '26, revenue is growing across both Rx and Services, margins are generally holding in for both despite the enrollment losses for your Health Benefits business. Maybe can you just help unpack or bifurcate CarelonRx and Services revenue and margin impacts, specifically coming from the Health Benefits enrollment losses versus perhaps the growth in margin maturation you're seeing from external clients would be helpful. Thanks.

太好了，謝謝。早安.也許只是想問一下關於Carelon聚合的問題。看起來 2026 年，處方藥和服務業務的收入都在增長，儘管健康福利業務的參保人數有所下降，但兩者的利潤率總體上都保持穩定。您能否幫忙分析 CarelonRx 和 Services 的收入和利潤率影響，特別是健康福利註冊損失帶來的影響，以及您從外部客戶看到的利潤率成長和成熟度提升的影響，這將很有幫助。謝謝。

Right. I'll let Pete address that. Thanks.

正確的。這個問題就讓皮特來回答吧。謝謝。

Yeah. No, thanks for that question. Let's step back and just talk about first setting up Carelon for 2026 of what we came off of in 2025, which was very, very strong. I think you saw that come through. We had almost 60% growth on the services side, and on the pharmacy side over 20% growth.

是的。不，謝謝你的提問。讓我們先回顧一下，先來談談我們如何在 2025 年的基礎上，為 2026 年做好準備，而 2025 年的業績非常非常強勁。我想你已經感受到這一點了。我們在服務方面實現了近 60% 的成長，在藥局方面實現了超過 20% 的成長。

And we're very encouraged in terms of what we're selling, a diversity of services, a growing portfolio of solutions. We launched CareBridge last year on the Rx side. As I noted before, we're selling upmarket to a much greater degree.

我們對自己銷售的產品感到非常鼓舞，我們提供多樣化的服務，並不斷拓展解決方案組合。我們去年在處方藥領域推出了 CareBridge。正如我之前提到的，我們的產品更大程度上向高端市場銷售。

And importantly, that momentum is continuing into 2026, with respect to your question, external sales. In fact, I'll emphasize this. We had the best year both in Services as well as Rx in terms of external growth. And when I mentioned external growth on the pharmacy side, that's the integrated ASO growth going forward.

更重要的是，就你提出的外部銷售問題而言，這種勢頭將持續到 2026 年。事實上，我要強調這一點。就外部成長而言，我們在服務業和處方藥業務方面都取得了最好的一年。當我提到藥局方面的外部成長時，指的是未來整合應用程式商店優化 (ASO) 的成長。

As you noted, those tailwinds are being offset by affiliated membership attrition. And when you think about services, we also had one large external client, which we had planned for, that went from a risk basis to a fee basis. But that was the largest driver in terms of headwinds overall.

正如您所指出的，這些利多因素正被附屬會員的流失所抵消。說到服務方面，我們還有一個大型外部客戶，我們之前已經為此做好了計劃，從按風險收費轉變為按服務收費。但就整體而言，這是最大的不利因素。

If you step back, though, and you take out that internal membership headwind, our overall growth would have been on the services side high teens, low 20s, and on the Rx side, in the low double-digit range, so consistent with what we've guided to longer term. And I would think of that as a mid-single-digit sort of op gain impact on the affiliated membership.

不過，如果退後一步，排除內部會員成長的不利因素，我們的整體成長在服務方面將達到十幾到二十幾個百分點，在處方藥方面將達到兩位數低點，這與我們對長期發展的預期一致。我認為這對附屬會員的營運收益影響大概在個位數左右。

Thank you, Pete. I think we have time for one last question.

謝謝你，皮特。我想我們還有時間問最後一個問題。

George Hill, Deutsche Bank.

喬治·希爾，德意志銀行。

Hey, good morning guys, and really appreciate you sneaking me in at the end. Mark, the topic where I'm getting the most questions is can you just contextualize a little bit more what does the ending baseline mean? You talked about earnings for fiscal '26 being front-end loaded. Should we kind of be thinking about that last period run rate as the baseline for 12% growth? And then maybe talk about any visibility to any onetime items in '26 and whether or not that will be included or excluded from the baseline. Thank you.

嘿，各位早安，非常感謝你們最後讓我插話。馬克，我收到的問題最多的是，你能否再詳細解釋一下「結束基線」的含義？你提到2026財年的收益主要集中在前期。我們是否應該將上一期的成長率視為 12% 成長率的基準？然後或許可以討論一下 '26 年任何一次性項目的可見性，以及這些項目是否會被納入或排除在基線之外。謝謝。

George, thanks very much for the question. This is really a good one to conclude on. So let me try to bring it together, the key themes and messages that we've delivered on the call today. So we have established the 2026 EPS guidance of at least $25.50, anchored in what I consider very prudent, achievable assumptions supported by actions that we have already taken underway to reposition our business and improve margins across the enterprise.

喬治，非常感謝你的提問。這是一個非常好的結尾。那麼，讓我試著總結一下我們今天在電話會議上提出的關鍵主題和資訊。因此，我們制定了 2026 年每股收益至少為 25.50 美元的預期，這一預期基於我認為非常謹慎、可實現的假設，並得到了我們已經採取的行動的支持，這些行動旨在重新定位我們的業務並提高整個企業的利潤率。

And at a high level, you could think about the EPS bridge to $25.50 is really being driven by a few key building blocks, stable performance in commercial fully insured and continued strength in commercial fee base, continued progress towards sustainable performance in ACA, Medicaid margins compressing to approximately negative 1.75% consistent with our view that 2026 is the trough year, more than 100 basis points of operating margin improvement in Medicare Advantage to at least 2%, low single-digit operating gain growth in Carelon where external momentum is partially masked by those affiliated health benefit membership declines, and then below the line, a meaningful step down reflecting the non-recurrence of the 2025 investment income and a return to a more normalized tax rate. So putting all of that together, again, the guidance of $25.50, prudent, achievable assumptions.

從宏觀層面來看，每股盈餘 (EPS) 達到 25.50 美元的目標實際上是由幾個關鍵因素驅動的：商業全險業務的穩定表現和商業收費基礎的持續強勁；《平價醫療法案》(ACA) 實現可持續業績的持續進展；醫療補助 (Medicaid) 利潤率收窄至約 -1.75%，這與我們醫療補助 (的營業利潤率提高 100 多個基點，至少達到 2%；Carelon 的營業收益增長較低，但其外部增長勢頭部分被附屬健康福利會員人數的下降所掩蓋；此外，由於 2025 年投資收益不再重現以及稅率回歸正常水平，每股收益將出現顯著下降。綜上所述，25.50 美元的指導價是審慎且可實現的假設。

Okay. Thank you, operator, and thank you to everyone on the line. As we close, Elevance Health is entering this year with a clear strategy and a strong sense of purpose. We're focused on improving affordability, simplifying health care and applying our capabilities in ways that drive better access outcomes and experiences for members and care providers and stronger health for the communities we serve.

好的。謝謝接線員，也謝謝所有線上用戶。在結束之際，Elevance Health 帶著清晰的策略和強烈的使命感邁入了新的一年。我們致力於提高醫療服務的可負擔性，簡化醫療保健流程，並運用我們的能力，為會員和醫療服務提供者帶來更好的醫療服務獲取結果和體驗，並增強我們所服務社區的健康水平。

While the operating environment remains dynamic, our diversified platform and differentiated whole health approach give us confidence in the path ahead, and the actions we've taken position the enterprise to drive sustainable earnings growth over the long term.

儘管經營環境依然瞬息萬變，但我們多元化的平台和差異化的整體健康理念讓我們對未來的道路充滿信心，我們採取的行動也使企業能夠在長期內實現可持續的盈利增長。

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

再次感謝您對 Elevance Health 的持續關注，並祝您本週餘下的時間愉快。謝謝。

Ladies and gentlemen, a recording of this conference will be available for replay after 11:00 AM today through February 28, 2026. You may access the replay system at any time by dialing (888) 566 0046 and international participants can dial (203) 369 3677. This concludes our conference for today. Thank you.

女士們、先生們，本次會議的錄影將於今天上午 11:00 後至 2026 年 2 月 28 日期間提​​供重播。您可以隨時撥打 (888) 566 0046 存取重播系統，國際參與者可以撥打 (203) 369 3677。今天的會議到此結束。謝謝。