Elevance Health Inc (ELV) 2026 Q2 法說會逐字稿

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

各位女士、先生，感謝您稍候並歡迎參加 Elevance Health 2026 年第二季財報電話會議。（接線員指示）提醒您，今天的會議將被錄音。

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

現在我想把會議交給公司管理團隊。請開始。

Good morning, and welcome to Elevance Health second-quarter 2026 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; Felicia Norwood, our Chief Health Benefits Officer; Morgan Kendrick, President of our Commercial Health Benefits Business; and Aimee Dailey, President of our Government Health Benefits Business.

早安，歡迎參加 Elevance Health 2026 年第二季財報電話會議。我是投資人關係副總裁 Nathan Rich。與我們一同出席本次財報電話會議的有：總裁暨執行長 Gail Boudreaux；財務長 Mark Kaye；健康福利長 Felicia Norwood；商業健康福利事業總裁 Morgan Kendrick；以及政府健康福利事業總裁 Aimee Dailey。

Gail will begin with a review of our second quarter results, the progress we have made against our strategic priorities, and targeted investments designed to strengthen the enterprise over time. Mark will then discuss our financial performance and outlook in greater detail.

Gail 將先回顧我們第二季的業績、在策略優先事項上的進展，以及為了長期強化企業而進行的重點投資。接著 Mark 將更詳細說明我們的財務表現與展望。

After our prepared remarks, the team will be available for a question-and-answer session. 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.

在我們的準備講稿之後，團隊將開放問答。在本次電話會議中，我們將提及若干非 GAAP 財務衡量指標。這些非 GAAP 指標與最直接可比的 GAAP 指標之調節表，已公布於我們的網站 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 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.

我們也將在本次電話會議中作出前瞻性陳述。提醒聽眾注意，這些陳述受若干風險與不確定性影響，其中許多難以預測，且通常超出 Elevance Health 的控制範圍。這些風險與不確定性可能導致實際結果與我們目前的預期出現重大差異；我們建議聽眾仔細閱讀今日新聞稿以及我們向美國證券交易委員會（SEC）提交之季度申報文件中所討論的風險因素。

I will now turn the call over to Gail.

現在我把電話交給 Gail。

Good morning and thank you for joining us. Elevance Health delivered second quarter results ahead of our outlook, reflecting favorable benefit expense performance, disciplined execution, and the actions we are taking to manage healthcare costs more effectively across the enterprise.

早安，感謝各位加入我們。Elevance Health 第二季業績優於我們的展望，反映出有利的福利費用表現、嚴謹的執行力，以及我們為在全企業更有效管理醫療成本所採取的行動。

Today, we are raising our 2026 adjusted diluted earnings per share guidance to at least $27, and we remain confident in our ability to return to at least 12% adjusted EPS growth in 2027 off our ending 2026 earnings baseline. Importantly, our confidence is not based on a single line of business or a single quarter. We are seeing progress across the breadth of our portfolio.

今天，我們將 2026 年調整後稀釋每股盈餘（EPS）指引上調至至少 27 美元；同時，我們仍有信心在 2026 年期末盈餘基礎上，於 2027 年回到至少 12% 的調整後 EPS 成長。重要的是，我們的信心並非建立在單一業務線或單一季度之上。我們正看到整體投資組合各面向的進展。

Medicare Advantage reflects the deliberate actions we took to improve performance. Our commercial and individual ACA businesses are developing as anticipated, and Carelon and our AI-enabled capabilities are becoming more meaningful contributors. We remain focused on disciplined management of the Medicaid business as the operating environment remains dynamic.

Medicare Advantage 反映出我們為改善表現而採取的審慎行動。我們的商業與個人 ACA 業務按預期發展，而 Carelon 以及我們以 AI 驅動的能力正成為更具意義的貢獻來源。在營運環境仍具動態變化之際，我們仍專注於以紀律方式管理 Medicaid 業務。

The broader enterprise is performing against the framework we laid out. And the targeted investments underway are designed to strengthen the durability of that performance. Healthcare should be easier to navigate and more responsive to the people it serves. Consumers expect more from the healthcare system, greater transparency, better connectivity, and more personalized support that meets their needs. And we share that expectation.

更廣泛的企業整體表現符合我們所提出的架構。而目前進行中的重點投資，旨在強化該表現的持久性。醫療照護應更容易被理解與使用，並對其服務對象更具回應性。消費者對醫療體系有更高期待：更高透明度、更佳連結性，以及更符合其需求的個人化支持。我們也認同這樣的期待。

At Elevance Health, trust is earned through every interaction. To be our members' lifetime trusted health partner, we must continue to make healthcare simpler, more personal, and more affordable. That's why we're accelerating investments in capabilities that directly support our strategy. These capabilities are tied to the operating levers that drive performance, earlier detection of medical cost trends, more precise clinical intervention, a simpler member experience, and better provider connectivity.

在 Elevance Health，信任是透過每一次互動所建立。要成為會員一生信賴的健康夥伴，我們必須持續讓醫療照護更簡單、更個人化且更可負擔。因此，我們正加速投資於能直接支持我們策略的能力建設。這些能力與驅動績效的營運槓桿相連結，包括更早偵測醫療成本趨勢、更精準的臨床介入、更簡化的會員體驗，以及更好的醫療服務提供者連結。

Let me share a few examples. First, we are managing medical cost trends with greater speed and precision. In a dynamic environment, we're improving our ability to detect cost pressures earlier and respond quickly with targeted action plans across our clinical, network payment integrity, and operating teams. In many cases, we've compressed months of work into days. These capabilities are already helping us identify emerging cost drivers more quickly and deploy more focused interventions across the enterprise.

我分享幾個例子。第一，我們正以更快速度與更高精準度管理醫療成本趨勢。在動態環境中，我們提升更早辨識成本壓力的能力，並能透過臨床、網路支付完整性（payment integrity）與營運團隊，快速以具針對性的行動計畫回應。在許多情況下，我們把原本需要數月的工作壓縮到數天內完成。這些能力已在協助我們更快辨識新出現的成本驅動因素，並在全企業部署更聚焦的介入措施。

Second, we're improving how members access care and support. Through Sydney Health, Concierge care and proactive member engagement. We're using data, digital tools, and dedicated care teams to help members navigate benefits, schedule care, manage conditions, and close gaps in care. The result is a more proactive, seamless, and personal experience.

第二，我們正在改善會員取得照護與支持的方式。透過 Sydney Health、禮賓式照護（Concierge care）以及主動式會員互動。我們運用資料、數位工具與專責照護團隊，協助會員理解福利、安排就醫、管理病況並補足照護缺口。其結果是更主動、更無縫且更個人化的體驗。

Third. We're expanding Carelon's value-based solutions to address complex and fast-growing areas of healthcare spend. CareBridge extends Carelon's whole health model into the home, where better coordination can improve outcomes and lower costs. CareBridge can generate medical savings in the mid-teens for these members, and we're expanding it to new markets.

第三。我們正擴大 Carelon 的價值導向解決方案，以因應醫療支出中複雜且快速成長的領域。CareBridge 將 Carelon 的全人健康模式延伸至居家場景，在那裡更好的協調可改善結果並降低成本。對這些會員而言，CareBridge 可帶來約中十位數百分比的醫療節省，我們也正將其擴展至新市場。

Finally, we're reducing friction for care providers and members. With Health OS, we collaborate with providers earlier in the care journey to review care plans, reduce delays, and support better clinical decisions. In health systems where these workflows have been deployed, we've seen significant reduction in avoidable denials, documentation requests, and administrative friction.

最後，我們正在降低醫療服務提供者與會員的摩擦。透過 Health OS，我們在照護旅程的更早階段與提供者合作，審視照護計畫、減少延誤，並支持更佳的臨床決策。在已部署這些工作流程的醫療體系中，我們看到可避免的拒付、文件補件要求與行政摩擦顯著降低。

Together, these investments strengthen our ability to manage trend and improve the experience from members and care providers. They're directly tied to the areas that matter most to long-term performance; earlier trend detection, more precise intervention, and a scalable operating model.

綜合而言，這些投資強化了我們管理趨勢的能力，並改善會員與醫療服務提供者的體驗。它們與長期績效最關鍵的領域直接相連：更早的趨勢偵測、更精準的介入，以及可擴展的營運模式。

Turning now to our performance by line of business, let me start with Medicaid. Because I know it's an important area of focus for investors. The Medicaid environment continues to be dynamic, and we're managing it with discipline. Second-quarter performance supports our full-year framework, reflecting stronger-than-expected rate updates, membership and acuity that remain broadly aligned with our assumptions and targeted actions against known areas of elevated trend.

接下來談各業務線的表現，我先從 Medicaid 開始。因為我知道這是投資人關注的重要領域。Medicaid 的環境仍持續動態變化，而我們以紀律方式加以管理。第二季表現支持我們的全年架構，反映出高於預期的費率更新、會員數與病況嚴重度（acuity）整體仍大致符合我們的假設，以及針對已知趨勢偏高領域所採取的重點行動。

Based on what we see today, our Medicaid operating margin outlook remains appropriately prudent and unchanged from our prior guidance. Our outlook reflects a balanced view of the second half; an elevated trend environment, improving rate alignment, acuity that remains broadly consistent with our expectations, and the growing impact of the actions we are taking to manage healthcare costs.

基於我們目前所見，Medicaid 的營業利益率展望仍維持適度審慎，且與先前指引一致。我們的展望對下半年採取平衡觀點：趨勢環境仍偏高、費率對齊改善、病況嚴重度整體仍與我們預期大致一致，以及我們為管理醫療成本所採取行動的影響正逐步擴大。

We continue to see 2026 as the trough year for our Medicaid margin, with improvement over time supported by better rate alignment and the maturation of our care management actions. Medicaid remains an important part of our portfolio, and we are managing it with clear strategic and financial discipline. We regularly assess each market based on strategic fit, operational requirements, and the ability to generate an appropriate return on capital. We recently reached a mutual agreement with the District of Columbia to exit the DC Medicaid market.

我們仍認為 2026 年將是 Medicaid 利益率的谷底年度，隨時間推進，改善將由更佳的費率對齊以及照護管理行動的成熟所支撐。Medicaid 仍是我們投資組合的重要部分，我們以清晰的策略與財務紀律加以管理。我們會依據策略契合度、營運要求，以及創造適當資本報酬的能力，定期評估各市場。我們近期與哥倫比亞特區達成共同協議，將退出 DC 的 Medicaid 市場。

As we continue our assessment, we expect to exit additional Medicaid markets over the next 12 to 18 months, where we do not see a path to sustainable performance. These are targeted portfolio actions. And they do not change our commitment to serving Medicaid members in markets where we can deliver value for states, members, and shareholders.

在持續評估的同時，我們預期未來 12 至 18 個月內，將退出更多我們看不到可持續績效路徑的 Medicaid 市場。這些是有針對性的投資組合調整行動。且不會改變我們在能為州政府、會員與股東創造價值的市場中，服務 Medicaid 會員的承諾。

In Medicare Advantage, we are seeing clear evidence that the deliberate actions we took to reposition the portfolio are translating into stronger performance. Disciplined plan design, a more focused mix of D-SNP and HMO products. Favorable claims experience and the growing impact of our care management programs support our path to at least a 2% operating margin this year.

在 Medicare Advantage（聯邦醫療保險優勢計畫）方面，我們看到明確證據顯示，我們為重新定位投資組合而採取的審慎行動，正轉化為更強勁的表現。嚴謹的計畫設計、更聚焦的 D-SNP 與 HMO 產品組合。有利的理賠經驗，以及我們照護管理計畫日益擴大的影響力，支持我們今年達成至少 2% 營運利潤率的路徑。

Our 2027 bids were developed with the same discipline, reflecting a prudent view of cost trend, continued focus on margin improvement, and stability in the benefits that members value most. We will continue to manage this business with focus on delivering long-term value for seniors and sustainable performance for the enterprise.

我們的 2027 年投標亦以同樣的紀律制定，反映對成本趨勢的審慎看法、持續聚焦利潤率改善，以及維持會員最重視之福利的穩定性。我們將持續以專注的方式經營此業務，為長者提供長期價值，並為企業帶來可持續的績效。

In the individual ACA business, performance is developing broadly consistent with how we priced and planned the year. Member retention has been encouraging, and the composition of the risk pool remains broadly aligned with our assumptions. As expected, the higher mix of bronze plans creates more [pranced] seasonality, and we are not extrapolating early-year favorability. As we prepare for 2027, our focus remains on offering value for consumers while improving the long-term financial sustainability of this business.

在個人 ACA（平價醫療法案）業務方面，績效發展大致符合我們對年度定價與規劃的預期。會員留存令人鼓舞，風險池的組成也大致與我們的假設一致。如預期，由於青銅計畫占比較高，季節性更為明顯，我們不會將年初的有利表現外推。在準備 2027 年之際，我們的重點仍是為消費者提供價值，同時提升此業務長期的財務可持續性。

In commercial, the market is focused on affordability and experience, and that aligns directly with our differentiated offerings. Employers are looking for solutions that lower health care costs, simplify navigation, and better support their employees. Our integrated medical and pharmacy model is resonating, and we're seeing strong demand for our patient advocacy, behavioral health, and digital engagement capabilities.

在商業保險方面，市場聚焦於可負擔性與體驗，這與我們具差異化的產品供給直接一致。雇主正在尋找能降低醫療成本、簡化就醫導航並更好支持員工的解決方案。我們整合式的醫療與藥局（藥品）模式正獲得市場共鳴，我們也看到對病患倡議、行為健康與數位互動能力的強勁需求。

Turning to Carelon. Performance remains in line with our expectations, and we're focused on scaling solutions that improve outcomes for members with complex and chronic needs. Behavioral health is a clear example. When members need additional support, our programs help identify those needs earlier, connect them to appropriate care, and coordinate services more effectively. Through stronger member engagement and fewer adverse events, these programs have delivered 10% cost savings on average.

接著談 Carelon。績效仍符合我們的預期，我們正專注於擴大可改善具複雜與慢性需求會員之結果的解決方案規模。行為健康就是一個明確例子。當會員需要額外支持時，我們的計畫可更早辨識需求、將其連結至適當照護，並更有效地協調服務。透過更強的會員參與與更少的不良事件，這些計畫平均帶來 10% 的成本節省。

As we expand these capabilities across new populations and external client relationships, Carelon is becoming an increasingly important and durable driver of enterprise growth over time.

隨著我們將這些能力擴展至新的族群與外部客戶關係，Carelon 正逐步成為推動企業長期成長愈發重要且具韌性的動能。

In summary, our second quarter performance gives us increased confidence in the year. We're raising our earnings guidance. Managing the business with discipline. Scaling Carelon's value-based capabilities. And investing in the areas that matter most to our future financial performance.

總結而言，我們第二季的表現讓我們對今年更具信心。我們上調獲利指引。以紀律管理業務。擴大 Carelon 的價值導向能力。並投資於對我們未來財務表現最關鍵的領域。

Before closing, I want to thank our associates. The progress we are making is a direct reflection of their focus, discipline, and commitment to the people we serve.

在結束之前，我想感謝我們的同仁。我們所取得的進展，直接反映了他們的專注、紀律，以及對我們所服務人群的承諾。

With that, I'll turn the call over to Mark to review our second-quarter financial results and outlook in greater detail.

接下來，我將把電話會議交給 Mark，由他更詳細地回顧我們第二季的財務結果與展望。

Thank you, Gail, and good morning, everyone. Elevance Health reported second-quarter adjusted diluted earnings per share of $7.45, which exceeded our outlook. The strength in our operating performance reflected favorable benefit expense performance in Medicare Advantage and Individual ACA. Disciplined expense management and continued execution against our care management initiatives. We continue to make targeted investments in the capabilities that support our long-term growth.

謝謝你，Gail，各位早安。Elevance Health 公布第二季調整後稀釋每股盈餘為 7.45 美元，優於我們的展望。我們營運表現的強勁，反映 Medicare Advantage 與個人 ACA 的福利費用表現有利。嚴謹的費用管理，以及持續落實我們的照護管理措施。我們持續進行具針對性的投資，以強化支持長期成長的能力。

In the quarter, we also recorded a net below-the-line benefit of $0.80 per share, primarily related to valuation adjustments within net investment income. Importantly, we intend to use this non-recurring benefit to fund one-time investments in the second half of the year that advance the capabilities Gail discussed. These investments are focused on medical cost management, member engagement, provider connectivity, and Carelon's integrated capabilities. They are intended to strengthen our operating model and improve the consistency of our performance over time.

本季我們也認列每股 0.80 美元的稅後（below-the-line）淨收益，主要與淨投資收益中的估值調整有關。重要的是，我們計畫運用這項非經常性收益，在下半年資助一次性投資，以推進 Gail 所提到的能力建置。這些投資聚焦於醫療成本管理、會員互動、醫療服務提供者連結，以及 Carelon 的整合式能力。其目的在於強化我們的營運模式，並隨時間提升績效表現的一致性。

Our second-quarter operating results support raising our full-year 2026 adjusted diluted earnings per share guidance to at least $27, while preserving appropriate prudence in our outlook. Similarly, we now view at least $26 as the appropriate earnings baseline for modeling purposes, and we remain confident in returning to at least 12% adjusted EPS growth in 2027 of those higher earnings baseline.

我們第二季的營運結果支持我們將 2026 全年調整後稀釋每股盈餘指引上調至至少 27 美元，同時在展望中保留適當的審慎性。同樣地，基於建模目的，我們現在認為至少 26 美元是適當的獲利基準，且我們仍有信心在 2027 年於此較高的獲利基準之上，回到至少 12% 的調整後 EPS 成長。

Now turning to our second quarter results. We ended the quarter with 44.9 million medical members. As expected, the sequential change was primarily driven by a known fee-based customer transition and attrition in our individual ACA and Medicaid businesses.

接著說明我們第二季的結果。本季末我們的醫療會員數為 4,490 萬人。如預期，序列變動主要由一項已知的按費用計價（fee-based）客戶轉換，以及我們個人 ACA 與 Medicaid 業務的會員流失所驅動。

Operating revenue totaled $49.8 billion, an increase of 0.8% year-over-year, driven by higher premium yields and product revenue, partly offset by lower health plan membership. In Medicaid, second-quarter performance supports the full-year margin framework we laid out earlier this year. Cost drivers remain elevated and concentrated in the categories we have discussed previously, including behavioral health, specialty pharmacy, outpatient surgery, and emergency department utilization.

營運收入合計 498 億美元，年增 0.8%，主要由較高的保費收益率與產品收入帶動，但部分被健康保險計畫會員數下降所抵銷。在 Medicaid 方面，第二季表現支持我們今年稍早提出的全年利潤率架構。成本驅動因素仍處於高位，且集中在我們先前討論過的類別，包括行為健康、專科藥局、門診手術，以及急診使用率。

Our outlook assumes this operating environment persists through the balance of the year. Rate updates received during the quarter were higher than anticipated, and membership and acuity remain broadly aligned with our expectations. We are also acting directly on the cost drivers we are seeing through clinical oversight, enhanced payment integrity, earlier interventions in behavioral health, and network management.

我們的展望假設此營運環境將持續至今年剩餘期間。本季收到的費率更新高於預期，而會員數與病情嚴重度（acuity）仍大致符合我們的預期。我們也正透過臨床監督、強化支付完整性、更早介入行為健康，以及網絡管理，直接因應所見的成本驅動因素。

Taken together, our full-year Medicaid operating margin outlook of approximately negative 1.75% remains appropriately prudent based on what we see today. We view 2026 as a track for Medicaid margins with improvement over time as rates incorporate more recent experience and our care management actions mature.

綜合而言，基於我們目前所見，我們對全年 Medicaid 營運利潤率約為負 1.75% 的展望仍屬適當審慎。我們將 2026 年視為 Medicaid 利潤率的過渡年份，隨著費率納入較近期的經驗，以及我們的照護管理措施逐步成熟，利潤率將隨時間改善。

In Medicare Advantage, results were stronger than expected and were a contributor to our outperformance in the quarter. The intentional portfolio actions we took for 2026 are translating to improved performance. Disciplined plan design, a more focused product mix, favorable client experience, and our capabilities all support our path to an operating margin of at least 2% this year.

在 Medicare Advantage 方面，結果優於預期，並促成我們本季的超預期表現。我們為 2026 年所採取的有意識投資組合調整，正轉化為改善的績效。嚴謹的計畫設計、更聚焦的產品組合、有利的客戶體驗，以及我們的能力建置，共同支持我們今年達成至少 2% 營運利潤率的路徑。

Our 2027 bid submissions placed an emphasis on plans where we can deliver sustainable value for seniors. Particularly dual eligible members, and appropriate returns for the enterprise.

我們的 2027 年投標提交，強調聚焦於我們能為長者提供可持續價值的計畫。特別是同時符合兩項資格（dual eligible）的會員，以及為企業帶來適當的回報。

In our Individual ACA business, favorability in the quarter reflected the more pronounced seasonality associated with our higher mix of bronze plans, which is contemplated in our outlook. We have now incorporated the final 2025 CMS risk adjustment results, which were favorable to our prior estimate. We are prudently re-establishing the majority of the prior year favorability in our current year risk adjustment accrual, given current market dynamics, member mix, and claims experience that is still maturing.

在我們的個人 ACA 業務中，本季的有利表現反映了因青銅計畫占比較高而帶來更明顯的季節性，這已納入我們的展望之中。我們現已納入 2025 年 CMS 風險調整的最終結果，該結果較我們先前估計更為有利。鑑於目前的市場動態、會員組合，以及仍在成熟中的理賠經驗，我們正以審慎方式，在本年度風險調整應計中重新建立前一年度有利因素的大部分。

Member retention remains modestly ahead of our expectations, and we now expect to end 2026 with at least 1 million individual ACA members. Commercial group performance was in line with our expectations, with cost trend remaining elevated, but consistent with the pricing approach we have taken. We have applied the same discipline to the 2027 selling season.

會員留存仍略優於我們的預期，我們目前預期 2026 年底個人 ACA 會員數至少達到 100 萬人。商業團體業務表現符合我們的預期，成本趨勢仍處於高位，但與我們採取的定價方法一致。我們也以同樣的紀律應用於 2027 年的銷售季。

Turning to Carelon, performance remains consistent with the outlook we provided at the beginning of the year. In CarelonRx, we are pleased with early progress in the 2027 selling season. Reflecting demand for our integrated medical and pharmacy offering. In Carelon Services, near-term earnings reflect ongoing investment in the platform and the scaling of newer, risk-based programs, which naturally take time to mature. The capabilities we are building are directly aligned with the operating priorities Gail discussed.

談到 Carelon，其表現仍與我們在年初提供的展望一致。在 CarelonRx 方面，我們對 2027 年銷售季的早期進展感到滿意。這反映出市場對我們整合式醫療與藥局服務方案的需求。在 Carelon Services 方面，短期獲利反映了我們對平台的持續投資，以及較新的風險型方案的規模化推進；這些方案自然需要時間成熟。我們正在打造的能力，與 Gail 所談到的營運優先事項直接一致。

Now moving to the balance sheet and operating cash flow. Days in claims payable were 45.4 days as of June 30, an increase of 2.9 days year-over-year. Operating cash flow totaled $1.9 billion in the quarter, driven by our strong operating performance. Second quarter cash flow also benefited from the timing of the state Medicaid pass-through payment received in the quarter that was remitted in July.

接著談資產負債表與營運現金流。截至 6 月 30 日，應付理賠天數為 45.4 天，較去年同期增加 2.9 天。本季營運現金流合計 19 億美元，主要由我們強勁的營運表現所帶動。第二季現金流亦受惠於州 Medicaid 轉付（pass-through）款項的時點：該款項於本季收到，並於 7 月匯出。

Additionally, we made an initial remittance to CMS of $342 million in the second quarter related to the matter discussed last quarter, and our estimate of the potential total financial exposure remains unchanged. As of July 9, we completed all steps required by CMS and have subsequently received written confirmation from CMS that sanctions will not be imposed and the matter is closed. We are pleased to have reached this resolution and look forward to offering our Medicare Advantage plans to beneficiaries without interruption. Based on the strengths of our operating performance and our outlook for the remainder of the year, we are raising our full-year operating cash flow to at least $6 billion.

此外，我們在第二季就上季所討論事項向 CMS 進行了 3.42 億美元的首次匯繳，而我們對潛在總財務曝險的估計維持不變。截至 7 月 9 日，我們已完成 CMS 要求的所有步驟，並隨後收到 CMS 的書面確認，表示不會施加制裁且此事已結案。我們很高興達成此一解決方案，並期待能不中斷地向受益人提供我們的 Medicare Advantage 計畫。基於我們營運表現的優勢以及對今年剩餘期間的展望，我們將全年營運現金流上調至至少 60 億美元。

Turning now to our revised outlook. We view our updated 2026 adjusted diluted earnings per share guidance of at least $27 as prudent and appropriate, supported by current operating trends. Beyond our EPS outlook, the principal operating elements of our full-year framework remain unchanged, though we now expect our adjusted operating expense ratio to be in the upper half of our full-year guidance range.

接著談我們修訂後的展望。我們認為，將 2026 年調整後稀釋每股盈餘（EPS）指引更新為至少 27 美元，是審慎且適切的，並受到目前營運趨勢的支持。除 EPS 展望外，我們全年架構中的主要營運要素維持不變，但我們現在預期調整後營運費用率將落在全年指引區間的上半部。

With respect to seasonality, we expect third quarter adjusted EPS to represent approximately 17% of our revised full-year guidance. Our confidence in returning to at least 12% adjusted EPS growth in 2027 of our ending 2026 earnings baseline is supported by multiple levers, including continued execution in health benefits, growth in Carelon, operating efficiency and disciplined capital deployment.

就季節性而言，我們預期第三季調整後 EPS 約占修訂後全年指引的 17%。我們對於在 2027 年、以 2026 年期末盈餘為基準回到至少 12% 的調整後 EPS 成長充滿信心，這將由多項槓桿支撐，包括健康福利業務的持續執行、Carelon 的成長、營運效率提升，以及有紀律的資本配置。

With that, operator, please open the line for questions.

以上，接線員，請開放提問。

(Operator Instructions)

(接線員指示)

AJ Rice, UBS.

AJ Rice，UBS。

Hi, everybody, and thanks for the comments. Maybe just to drill down a little bit on your Medicaid comments, if possible. It sounds like the rate updates are coming in more favorable. When you think about the trajectory over the course of the year, that 1.75% negative margin. Is the back half more favorable than the front half? Is there an expectation on where you'll exit the year?

大家好，謝謝你們的說明。如果可以的話，我想就你們對 Medicaid 的評論再深入一點。聽起來費率更新更為有利。當你們看全年走勢時，那個 -1.75% 的負利潤率。下半年會比上半年更有利嗎？你們預期年底會以什麼水準收官？

And then if you could just provide a little color more on your thinking about exiting markets, I know you probably don't want to mention the states, but can you give us a sense of overall sizing, maybe of how much we're talking about there? And is this in any way driven by future things like work requirements or is it basically driven by just current discussions with states and where you feel you're landing.

另外，若你們能再多分享一些對退出市場的想法；我知道你們可能不想提州別，但能否讓我們了解整體規模，大概是在談多少？而這是否在任何程度上是由未來因素（例如工作要求）所驅動，還是基本上只是由目前與各州的討論，以及你們認為最終落點所驅動？

Thanks for the question, AJ. It might be helpful to sort of first frame kind of the overall quarter and how we're expecting the year, because I think that's important. Then I'll ask Mark to comment more specifically on your Medicaid questions, which I think are very important.

謝謝你的問題，AJ。我想先從整體季度表現以及我們對全年預期的框架來說明，因為我認為這很重要。接著我會請 Mark 更具體回應你關於 Medicaid 的問題，我認為那些問題非常重要。

As you take a look back at just what we've reported, we're very pleased with the performance we've seen through June, and second-quarter results exceeded our outlook. And I do think they very much focused on the disciplined execution. Given that, as you know, we've raised our guidance to at least $27 while maintaining, I think, which is important, a prudent view of the second half.

回顧我們剛公布的結果，我們對截至 6 月的表現非常滿意，第二季結果超出我們的展望。我也確實認為，這很大程度上反映了有紀律的執行。因此，如你所知，我們將指引上調至至少 27 美元，同時我認為也很重要的是，我們仍對下半年保持審慎看法。

And again, thinking about our overall performance, the second quarter was broad-based. We saw favorable performance in Medicare Advantage and individual ACA and continued disciplined execution in commercial, with also ongoing progress against Carelon, which is scaling quite nicely and seeing some good benefits from the actions we've taken to manage medical costs. Specifically to Medicaid, as I shared and Mark shared in his comments, it remains dynamic, and we are managing that business with discipline.

再談整體表現，第二季的良好表現是全面性的。我們在 Medicare Advantage 與個人 ACA 業務看到有利表現，商業保險也持續有紀律地執行；同時 Carelon 也持續推進、規模化相當順利，並從我們為管理醫療成本所採取的行動中看到一些良好效益。就 Medicaid 而言，如我與 Mark 在評論中所分享的，該業務仍具動態性，我們正以紀律來管理這項業務。

What's important to think about is that original full-year framework is still intact from what we see today, and it's supported by stronger-than-expected rates, membership and acuity that are broadly aligned with our assumptions, and very specific focused actions around the known cost pressures, which really haven't changed over the course of this quarter or last year.

重要的是要理解，從我們目前所見，原先的全年框架仍然完整，並受到幾項因素支持：費率優於預期、會員數與病況嚴重度（acuity）大致符合我們的假設，以及針對已知成本壓力所採取的非常具體且聚焦的行動；而這些成本壓力在本季或去年以來其實並沒有改變。

And importantly, we're seeing those begin to mature the actions we're taking, and I think that's important too. But again, we want to remain prudent given the dynamic environment that we're in. I also just want to comment briefly on the investments we're making on the non-recurring below-the-line favorability we saw. These are targeted investments, and they're very focused on long-term performance acceleration, so strengthening medical cost management, the provider connectivity work, and improving operating efficiency.

而且重要的是，我們看到所採取的行動開始成熟並產生效果，我認為這也很重要。但同樣地，鑑於我們所處的動態環境，我們希望保持審慎。我也想簡短談一下我們針對這次看到的一次性、非經常性稅前以下（below-the-line）有利因素所進行的投資。這些是具針對性的投資，並非常聚焦於長期績效加速，包括強化醫療成本管理、提升與醫療提供者的連結性（provider connectivity）工作，以及改善營運效率。

I think it's really important for everyone to understand these are one-time and non-recurring investments that will not go on beyond '26 for these. We found it was important because it wasn't part of our recurring earnings. So taken together, we see a lot of confidence in 2026 and quite frankly, a lot of confidence now in these emerging areas to return to our at least 12% adjusted EPS.

我認為讓大家理解這點非常重要：這些是一次性、非經常性的投資，對於這些項目而言，不會在 2026 年之後持續。我們認為這樣做很重要，因為它並不屬於我們的經常性獲利。綜合來看，我們對 2026 年很有信心，坦白說，對這些正在成形的新興領域也更有信心，能回到至少 12% 的調整後 EPS。

With that, I'll ask Mark to comment more specifically on your Medicaid questions so that we can round out the totality of what you asked.

接著我會請 Mark 更具體回應你關於 Medicaid 的問題，讓我們把你提到的問題完整回答。

AJ, appreciating you may get a couple of Medicaid questions on the call today. Just to answer yours specifically, we do expect the second-half Medicaid margin profile to improve from the second quarter, and that's going to be supported by that favorable July 1 rate activity, as well as our continued execution against the cost pressures that we've been discussing.

AJ，我理解你今天在電話會議上可能會收到幾個 Medicaid 相關問題。就你這個問題的具體回答，我們確實預期下半年 Medicaid 的利潤率輪廓會較第二季改善，這將由 7 月 1 日較有利的費率動態所支撐，同時也包括我們持續針對先前討論過的成本壓力執行相關措施。

Thank you. Next question, please.

謝謝。請進行下一個問題。

Justin Lake, Wolfe Research.

Justin Lake，Wolfe Research。

Thanks. Good morning. Maybe I'll just follow-up on AJ's question here in a couple of ways on Medicaid. First, maybe -- is there anything you can give us in terms of order of magnitude on some of the exits you talked about maybe versus that $57 billion kind of Medicaid run rate on revenue. How do we think about those exits in terms of sizing?

謝謝。早安。我想就 AJ 的 Medicaid 問題用幾個角度追問一下。首先，關於你們提到的一些退出，能否就量級提供一些資訊，例如相對於 Medicaid 約 570 億美元的營收年化水準。我們該如何從規模角度看待這些退出？

And then you talked about acuity being in line with your expectations in Medicaid. And I find that interesting just because you had one of the more conservative assumptions on acuity impact the trend this year, I think it was in the 2% to 3% range. So I'm curious, as Medicaid lives keep attriting, are you seeing the acuity of those members, the utilization continuing to tick higher, meaning the healthier members that keep attriting. Is it kind of in line with that 2% to 3%? Thanks.

然後你提到在醫療補助（Medicaid）方面，病情嚴重度（acuity）與你們的預期一致。我覺得這點很有意思，因為你們今年對病情嚴重度對趨勢的影響採用了較為保守的假設，我記得大約是在 2% 到 3% 的區間。所以我想請教，隨著 Medicaid 參保人數持續流失，你們是否看到這些會員的病情嚴重度、使用量（utilization）持續走高，也就是較健康的會員持續流失所致。這是否大致符合那個 2% 到 3% 的範圍？謝謝。

Justin, good morning, and thank you for the questions there. Let me go ahead and start off by saying that Medicaid cost trend in the second quarter developed broadly in line with the framework that we expected. Costs remain elevated, but the drivers are identifiable and they're actionable. And they're primarily in the categories that we spoke about in the scripted remarks here, behavioral health, including ADA therapy, emergency department utilization, outpatient surgery, and specialty pharmacy.

Justin，早安，也謝謝你的提問。我先說明一下，第二季 Medicaid 的成本趨勢整體上與我們預期的框架大致一致。成本仍然偏高，但驅動因素是可辨識的，而且是可採取行動處理的。主要集中在我們在事先準備的講稿中提到的類別：行為健康（behavioral health，包含 ADA 治療）、急診使用、門診手術，以及專科藥局（specialty pharmacy）。

Importantly, I would say we are not seeing a new stepwise acuity reset. Membership and acuity remain broadly aligned with our assumptions. And the incremental pressure is increasingly coming from utilization among members who remain in the program. And that distinction is really important because it gives us very clear operating levers.

重要的是，我會說我們沒有看到新的階梯式病情嚴重度重置（stepwise acuity reset）。會員數與病情嚴重度大致仍與我們的假設一致。而新增的壓力愈來愈多來自仍留在計畫中的會員之使用量。這個區分非常重要，因為它讓我們有非常清楚的營運槓桿可以運用。

From an outlook perspective, the second quarter really reinforced our confidence in the full-year Medicaid framework. The July rate activity was constructive. It was also modestly favorable to our expectations. And that shows that the rate environment is moving in the right direction as states incorporate more recent experience.

從展望角度來看，第二季確實強化了我們對全年 Medicaid 框架的信心。7 月的費率動態（rate activity）是正面的。而且也略優於我們的預期。這顯示隨著各州納入較近期的經驗數據，費率環境正朝正確方向發展。

And at the same time, we are staying quite prudent. Specifically, we are not assuming a material improvement in Medicaid trend in the back half of the year. And so the way I'd summarize it is as follows, elevated but understood trend improving rate alignment, targeted cost actions underway, and a full-year margin outlook that we believe is appropriately prudent.

同時，我們仍維持相當審慎。具體而言，我們並未假設今年下半年 Medicaid 趨勢會有實質改善。因此我會這樣總結：趨勢偏高但可理解、費率對齊度正在改善、針對性的成本行動正在推進，以及我們認為已適度審慎的全年利潤率展望。

Thank you. Next question please.

謝謝。請下一題。

Stephen Baxter, Wells Fargo.

Stephen Baxter，富國銀行（Wells Fargo）。

Yeah. Hi. Thank you. I know it's still pretty early in the year for the exchanges and you aren't carrying the favorability that you've discussed largely forward at this stage. But, it would be great to try to understand as you got a better perspective on where risk adjustment is coming in for the first half, like how do we think about where first half performance was versus your expectations? How are you thinking about your risk adjustment position in 2026?

是的。嗨。謝謝。我知道對交易所（exchanges）來說今年還算早期，而且你們目前也沒有把你們討論過的有利因素（favorability）在此階段大幅延伸到後續。不過，如果能理解你們對上半年風險調整（risk adjustment）落點有了更清楚的視角後，我們該如何看待上半年表現相對於你們預期的差異，會很有幫助。你們如何看待 2026 年的風險調整部位？

And I know you're reestablishing most of the 2025 risk adjustment favorability that you saw in the quarter, but any sense of what did actually flow through the results in the quarter would actually be helpful.

我也知道你們正在把本季看到的 2025 年風險調整有利因素大多重新建立回去，但如果能分享一下本季實際有多少反映在結果中，也會很有幫助。

Steve, thanks very much for the question. I think the way I'd frame this is that the final 2025 risk adjustment results were quite favorable relative to our prior estimate, and that's reinforced our confidence in our estimation and reserving process. And you're able to get a sense of the magnitude of that simply by looking at our disclosures in the earnings release in terms of the sequential move quarter over quarter in reported ACA revenue.

Steve，非常感謝你的問題。我會這樣說明：2025 年最終的風險調整結果相較於我們先前的估計相當有利，這也強化了我們對估計與提存（reserving）流程的信心。你也可以透過我們在財報新聞稿中的揭露，觀察已申報的 ACA 收入在季度間（quarter over quarter）的連續變動，來感受其幅度。

At the same time, we are not extrapolating that favorability into 2026. Now, from our perspective, the ACA market is still developing. Member mix has changed meaningfully. And obviously, the shift towards bronze plans has implications for both premium yield and risk adjustment. So, as we move into the second-half of the year, we are reestablishing much of that 2025 favorability in our 2026 risk adjustment accrual. And again, I call that really intentional prudence.

同時，我們不會把這樣的有利因素外推到 2026 年。就我們的觀點，ACA 市場仍在發展中。會員結構（member mix）已出現顯著變化。而且，向青銅計畫（bronze plans）轉移，對保費收益率（premium yield）與風險調整都有影響。因此，隨著我們進入下半年，我們會在 2026 年的風險調整應計（accrual）中，重新建立 2025 年多數的有利因素。我再次強調，這是刻意的審慎作法。

Thank you. Next question, please.

謝謝。請下一題。

Ann Hynez, Mizuho Securities.

Ann Hynez，瑞穗證券（Mizuho Securities）。

Great. Thank you. Can you remind us in all your divisions. What your trend actually was for Medicaid, ACA, and MA in guidance and what Q2 actually came, the final results were. Thank you.

很好。謝謝。可以請你提醒我們，在你們所有事業部門中，指引（guidance）裡 Medicaid、ACA 與 MA 的趨勢（trend）分別是多少，以及第二季實際出來的最終結果是多少嗎？

I very much appreciate the question this morning. And maybe let me take that really from the perspective of Medicaid to start. And I'm going to combine your question a little bit with what Justin asked earlier, just around utilization and acuity, specific in Medicaid, as I think a little bit more color here would be helpful to put out.

非常感謝你今天早上的問題。也許我先從 Medicaid 的角度來回答。我也會把你的問題和 Justin 先前問的、關於 Medicaid 的使用量與病情嚴重度的問題稍微合併一起回答，因為我想補充一些細節會更有幫助。

So I would say both utilization and acuity, especially Medicaid, do remain part of that equation, but that persistent pressure now is increasingly driven more by utilization among members who remain in the program. And, obviously we saw during the post-PHE unwinding, the largest issue was really that acuity reset of lower cost that members really exited the program.

所以我會說，使用量與病情嚴重度，特別是在 Medicaid，仍然是這個方程式的一部分；但目前持續的壓力愈來愈多是由仍留在計畫中的會員之使用量所驅動。而且很明顯地，在 PHE（公共衛生緊急狀態）結束後的退場（unwinding）期間，最大的問題其實是較低成本的會員退出計畫所造成的那次病情嚴重度重置。

And I would say that dynamic hasn't disappeared, but it really is moderating. We are seeing members leave Medicaid today who are still lower costs than those that are staying, but that gap has really significantly narrowed, and that's really important to us as we think about our trends and outlook for the remainder of the year.

我會說那個動態並沒有消失，但確實正在趨緩。我們目前仍看到離開 Medicaid 的會員，其成本仍低於留下來的會員，但這個差距已明顯縮小；這對我們在思考今年剩餘期間的趨勢與展望時非常重要。

And then in terms of ACA, I would simply say here that trend was very much in line to slightly favorable for the second quarter. That's supported by those favorable volume and timing dynamics. I'd simply note here that we don't view the quarter as a change in the earnings profile for the year, and that favorability reflected that more bronze plan orientation as well as that better early membership coming in. Thank you.

至於 ACA，我只想簡單說，第二季的趨勢非常符合預期，甚至略為有利。這受到那些有利的量（volume）與時點（timing）動態所支持。我也想補充，我們不認為這一季代表全年獲利輪廓（earnings profile）出現改變；這些有利因素反映了更偏向青銅計畫的取向，以及較佳的早期會員加入情況。謝謝。

Thank you, Mark. Next question please.

謝謝你，Mark。請下一題。

Andrew Mok, Barclays.

Andrew Mok，巴克萊（Barclays）。

Hi, good morning. I wanted to follow-up on the seasonal favorability. You called out $0.25 of favorability this quarter, which grew sequentially from $0.15 in the first quarter. I understand that you're not taking credit for that in guidance, but can you help us understand why this increased sequentially when you presumably had better visibility into underlying membership and benefit design?

嗨，早安。我想追問一下季節性有利因素（seasonal favorability）。你提到本季有每股 0.25 美元的有利因素，較第一季的每股 0.15 美元呈現連續增加。我理解你們沒有在指引中把這點算作功勞，但你能否協助我們理解，為什麼在你們理應對底層會員結構與給付設計有更好能見度的情況下，這個數字會連續上升？

And then relatedly, is there anything you're seeing that suggests that this first half upside would reverse in the back half of the year or is that just a conservative stance on your end? Thanks.

另外相關地，你們是否看到任何跡象顯示上半年這個上行（upside）會在下半年反轉，還是這只是你們採取較保守立場？謝謝。

Andrew, thanks very much for the question. Let me go ahead and start here by reiterating sort of a comment from Gail earlier that the quarter really reflected very solid execution, reflected a diversified set of earnings contributors and the financial flexibility to now invest in further capabilities that are going to make our performance more durable over time.

Andrew，非常感謝你的問題。我先從重申 Gail 先前的一點開始：本季確實反映了非常扎實的執行力，反映了多元化的獲利貢獻來源，以及如今具備的財務彈性，得以進一步投資於能讓我們長期表現更具持續性的能力。

In the quarter, we had about $0.50 of the operating outperformance. And I would say that was about equally split between Medicare Advantage and the individual ACA.

在本季，我們的營運表現超出預期約 0.50 美元。我會說這大致平均分布在 Medicare Advantage 與個人 ACA 之間。

In Medicare Advantage, that favorability primarily reflected the deliberate portfolio actions we took for 2026, our favorable membership mix, better claims experience, and those actions were really intentional, right? We prioritized sustainable economics, and we're delivering on what we committed to do.

在 Medicare Advantage 方面，這項有利表現主要反映了我們為 2026 年所採取的審慎投組行動、我們有利的會員結構組合、更佳的理賠經驗；而且這些行動確實是有意為之，對吧？我們優先考量可持續的經濟性，並且正在兌現我們承諾要做的事。

In the individual ACA, to your question, the favorability really reflected two factors: first, we saw more pronounced seasonality, to your point, from a higher mix of bronze plans, that was about equal in magnitude to what we saw in the first quarter. And secondly, we did see that final ACA 2025 risk adjustment results come through favorable to our estimate. We have reestablished the vast majority of that. And so as we think about the outlook for the full year, this is really about us being prudent for the second-half rather than anything else.

在個人 ACA 方面，回到你的問題，這項有利表現主要反映兩個因素：第一，正如你所指出的，由於青銅級（bronze）方案占比更高，我們看到更明顯的季節性，其幅度大致與第一季所見相當。第二，我們確實看到 ACA 2025 年最終風險調整結果出爐，較我們的估計更為有利。我們已經把其中絕大部分重新建立回來。因此，當我們思考全年展望時，這主要是我們對下半年保持審慎，而不是其他因素。

Yeah. Thanks, Mark. And I guess I would just like to reiterate Mark's comment given the last several questions. One, around there are no surprises. Our outlook remains prudent, as Mark said, and in explaining each of the lines of business. So we feel very much aligned, but we wanted to make sure in this environment that we do remain prudent.

是的。謝謝，Mark。鑑於剛才幾個問題，我想再重申 Mark 的評論。第一，沒有任何意外。如 Mark 所說，我們的展望仍然保持審慎，並且已就各條業務線加以說明。所以我們覺得彼此非常一致，但在這樣的環境下，我們也希望確保自己確實維持審慎。

Next question, please.

請下一題。

Lance Wilkes, Bernstein.

Bernstein 的 Lance Wilkes。

Great. Could you talk a little bit about the bidding posture you've got in ACA and MA for '27 as far as your orientation towards growth versus further margin recovery? And maybe if you can just give a clarification on the Medicaid exits. As far as criteria, are you looking at particular types of programs, blue states or maybe your market share position in states that would be important criteria for determining which ones would be more likely to be subject to exit.

很好。能否談談你們在 ACA 與 MA 針對 2027 年的投標姿態（bidding posture），就成長導向與進一步修復利潤率之間，你們的取向如何？另外也請你們釐清一下 Medicaid 的退出。就判準而言，你們是在看特定類型的計畫、偏藍州（blue states），或是你們在各州的市占地位是否會是重要判準，用以決定哪些市場更可能退出？

Great. Well, thanks, Lance. I'm going to have Felicia to address the ACA question and then Aimee Dailey, who leads government business, to talk about the market exits in Medicaid. So, Felicia?

很好。謝謝你，Lance。我會請 Felicia 回答 ACA 的問題，然後請負責政府業務的 Aimee Dailey 談談 Medicaid 的市場退出。那麼，Felicia？

Good morning, and thank you for the question, Lance. As we think about ACA for 2027, I think we are taking a very consistent posture with what we had in 2026. So we are going to be very focused on making sure that we are achieving the sustainable margin through very disciplined market-specific pricing that will reflect the cost trend and certainly the evolving morbidity.

早安，謝謝你的提問，Lance。談到 2027 年的 ACA，我認為我們採取的姿態會與 2026 年非常一致。因此，我們將非常專注於透過高度紀律、以市場為基礎的定價，確保達成可持續的利潤率，該定價將反映成本趨勢，當然也會反映不斷演變的疾病負擔（morbidity）。

When you look at our prioritization, obviously having planned options that are going to drive that sustainable performance becomes very important for us. So we've been very pleased with how we've seen the marketplace shift in terms of bronze plans. We think that it's going to be very important for our strategy as we drive sustainable margins going forward. And I do think the expectation for us is to continue to prioritize affordable plan options that are going to continue to drive sustainable performance for the enterprise.

從我們的優先事項來看，顯然，規劃能夠推動可持續表現的方案選項，對我們而言非常重要。因此，我們對於市場在青銅級（bronze）方案方面的轉變感到非常滿意。我們認為，當我們推動未來可持續利潤率時，這將對我們的策略非常重要。而我也確實認為，我們的預期是持續優先提供可負擔的方案選項，以持續推動企業的可持續表現。

In terms of Medicaid exits, I will say this. Medicaid remains as Gail said, a very core part of our diversified portfolio, but we are going to be very disciplined around where we participate. We made a mutual decision with DC to exit. And we feel good about that decision, and we will make sure that there is continuity of care for our members as we go through this transition.

至於 Medicaid 的退出，我會這麼說。如 Gail 所說，Medicaid 仍然是我們多元化投組中非常核心的一部分，但我們會非常有紀律地決定在哪些地方參與。我們與華盛頓特區（DC）做出共同決定退出。我們對這個決定感到放心，並且在過渡期間，我們會確保會員照護的連續性。

But if we take a look at our overall portfolio, we regularly assess all of the markets that we participate in. And as a result of this, we will plan to exit additional markets where the economics don't support sustainable performance. At the end of the day, Medicaid participation has to make strategic and financial sit for us within our diversified portfolio. So where we have alignment with duals, our Carelon strategy, and a sustainable operating framework, we remain committed. And where those conditions aren't present, we're going to take the disciplined action that we need to.

但如果我們檢視整體投組，我們會定期評估所有我們參與的市場。因此，我們計畫退出更多在經濟性上無法支持可持續表現的市場。歸根結底，Medicaid 的參與必須在我們多元化投組中，對我們具有策略與財務上的契合度。所以，在我們與雙重資格（duals）、我們的 Carelon 策略，以及可持續的營運架構相一致之處，我們仍然承諾投入。而在不具備這些條件的地方，我們將採取所需的紀律性行動。

Bottom line, we are very committed to supporting members in states where we can deliver sustainable value going forward, and we'll continue to work very closely with our state partners.

總而言之，我們非常致力於在我們能夠持續提供價值的州支持會員，並且會持續與各州合作夥伴密切合作。

Thanks, Felicia. I know Felicia was very comprehensive, but maybe just some comments from Aimee as well.

謝謝，Felicia。我知道 Felicia 已經非常全面了，但也許也請 Aimee 補充幾點。

Yeah, I will just reiterate that Medicaid remains a core part of our diversified portfolio. We continue to be committed to the program and the members we serve. Our participation has to make strategic and financial sense, as Felicia said, but we will remain committed in this market and we'll evaluate it with discipline.

好的，我只想重申，Medicaid 仍然是我們多元化投組的核心部分。我們持續致力於該計畫以及我們所服務的會員。如 Felicia 所說，我們的參與必須在策略與財務上合理，但我們會在這個市場保持承諾，並以紀律方式加以評估。

Thank you. Next question please.

謝謝。請下一題。

Lisa Gill, JPMorgan.

JPMorgan 的 Lisa Gill。

Thanks very much. Good morning. I appreciate the comments on your investments, one-time, non-reoccurring, but can you help me understand how that's going to play into the growth rate going into next year? What kind of operational leverage you can get? And more specifically, are these investments in technology and people? How do I think about the specific investments that you are making, and again what the return will be as we get into '27?

非常感謝。早安。我理解你們提到的投資是一次性、非經常性的，但你能否幫我理解，這將如何影響明年進入時的成長率？你們能取得什麼樣的營運槓桿？更具體地說，這些投資是投入在科技與人員嗎？我該如何看待你們正在進行的具體投資，以及同樣地，當我們進入 2027 年時，回報會是什麼？

Thanks, Lisa, and thanks for the question. So I think, again, going back to reframing, the investments as I said are one-time and non-recurring. So those, the investment costs sit in '26, will not reoccur until '27. And also, we are looking at these as long-term durable capabilities. Some are technology, but honestly they're all driven based on improving the capabilities that we have inside of the business.

謝謝，Lisa，也謝謝你的問題。我想，再次回到重新框架的說法：如我所說，這些投資是一次性且非經常性的。因此，這些投資成本會落在 2026 年，不會在 2027 年再次發生。此外，我們也把這些視為長期、耐久的能力建置。其中有些是科技，但坦白說，它們全部都是以提升我們企業內部既有能力為出發點所驅動。

So as we think about that operating impact, it's really an enabler of all of the key capabilities we talked about. They're aimed at the levers that matter most to our long-term performance. So strengthening medical costs, in my opening comments, I talked about moving from months of identification to days and hours. And again, we're using this to strengthen our data and our insight capabilities and then take actions faster on medical cost management.

因此，當我們思考其營運面的影響時，它其實是我們談到的所有關鍵能力的促成因素。它們瞄準的是對我們長期表現最重要的槓桿。例如強化醫療成本管理：在我開場的評論中，我提到要把辨識時間從以月計縮短到以天、以小時計。同樣地，我們正利用這些投資來強化我們的資料與洞察能力，並更快採取行動來管理醫療成本。

It's also about simplifying the member experience, improving provider connectivity and enhancing our claims accuracy and driving greater operational efficiency. We feel very confident in returning to our adjusted at least 12% earnings growth next year. And I think these are the kinds of things that give us that confidence because it gives us the leverage that we're talking about. So just a couple of things to make this real.

這也關乎簡化會員體驗、改善與醫療服務提供者的連結、提升理賠準確性，並推動更高的營運效率。我們對於明年回到至少 12% 的調整後盈餘成長非常有信心。我認為，正是這類事情讓我們有這樣的信心，因為它帶來我們所談的槓桿效益。所以我再舉幾個例子，讓它更具體。

For members, what we're looking at, we've shared Sydney Health touches about 22 million members now. That means fewer handoffs, better navigation, more proactive support. Concierge Care and proactive member engagement helps us support members upfront faster because the data is now all centralized and members can navigate much more easily.

就會員而言，我們所看到的是，我們已與各位分享，Sydney Health 現在已觸及約 2,200 萬名會員。這代表交接更少、導覽更好、支援更具前瞻性。禮賓式照護（Concierge Care）與主動式會員互動，能幫助我們更快在前端支援會員，因為資料如今已全面集中，會員也能更容易地進行導覽。

Medical cost management is really about investments in analytics and AI-enabled tools that again allow us to identify those pressures earlier, but more importantly, allow us to implement clinical oversight, payment integrity, changes in our network, those kind of interventions. Does take time to mature, but we need the data, we need the infrastructure in place this year, and we expect to see that next year. And it's not just going to be in our cost structure, our expense cost structure, we expect to see it in our medical cost structure. That's what these investments in medical management are about.

醫療成本管理，實際上就是投資於分析與 AI 賦能工具，讓我們能再次更早辨識這些壓力，但更重要的是，讓我們能夠落實臨床監督、支付完整性（payment integrity）、網路調整等各類介入措施。這些需要時間成熟，但我們今年必須把資料與基礎設施建置到位，並預期明年會看到成效。而且不只會反映在我們的成本結構、費用成本結構上，我們也預期會反映在我們的醫療成本結構上。這就是這些醫療管理投資的目的。

And then I'll just conclude on two things. On provider connectivity, we've shared with you Health OS and the related tools. Those really are about reducing the documentation requests. Improving prior authorization, getting us to 80% real-time, improving payment accuracy and reducing friction. Those are all, I think, really important components of what we're doing.

接著我用兩點作結。在提供者連結性方面，我們已與各位分享 Health OS 及相關工具。這些確實是為了減少文件請求。改善事前授權（prior authorization），讓我們達到 80% 即時處理，提升支付準確性並降低摩擦。我認為這些都是我們正在做的事情中非常重要的組成部分。

And finally, Carelon, which is an important strategic asset for us, scaling those value-based solutions in the complex areas of spending. CareBridge has been very successful for us. We're looking to continue to accelerate the deployment of CareBridge. Behavioral health and oncology are two other areas.

最後是 Carelon，這是我們重要的策略性資產，能在支出較複雜的領域擴大那些以價值為基礎的解決方案。CareBridge 對我們而言非常成功。我們希望持續加速 CareBridge 的部署。行為健康與腫瘤學是另外兩個領域。

So we expect those benefits to be embedded and built over time. But I think the objective is straightforward. Use this non-recurring opportunity to accelerate capabilities that manage how we manage costs and simplify our experience for our long-term goals. So thanks very much for the question.

因此我們預期這些效益會隨時間逐步內嵌並建立起來。但我認為目標很明確。運用這個一次性的機會，加速能夠管理成本、並為我們長期目標簡化體驗的能力。非常感謝你的提問。

Next question, please.

請下一題。

Kevin Fischbeck, Bank of America.

美國銀行（Bank of America）的 Kevin Fischbeck。

Great, thanks. I just I'm having a little difficulty reconciling some of the commentary that you've made on the Medicaid side. You talked a lot about the volatility of things there, but I guess when we think about how you've talked about things, you said rates are coming in better, and it seems like everything else is coming in line, but you haven't improved your outlook for margins. So why isn't there a lift if rates are coming in better? And then if rates are coming in better, why are we talking more about exiting potential states today than we have a couple of years ago? It seems like it's the opposite of an improving rate outlook. Thanks.

好的，謝謝。我在調和你們對 Medicaid 端的一些評論時有點困難。你們談了很多那邊的波動性，但我想，當我們回想你們對情況的描述時，你們說費率進來得更好，而且看起來其他一切也都逐步到位，但你們並沒有上調對利潤率的展望。所以如果費率進來得更好，為什麼沒有帶來提振？另外，如果費率進來得更好，為什麼我們今天談到可能退出某些州的情況，比兩年前更多？這看起來與費率展望改善的方向相反。謝謝。

Good morning, and really appreciate the question, the opportunity to talk through this a little bit more. Let me start off by saying that our second-half Medicaid trend outlook is very consistent with our first half experience, and in a sense, quite prudent. And there are three important points I wanted to make here.

早安，也非常感謝這個問題，讓我們有機會再更深入說明。我先說明，我們對下半年 Medicaid 趨勢的展望，與上半年經驗非常一致，某種程度上也相當審慎。我想在這裡提出三個重點。

First, the July rate activity was favorable. And as we've mentioned earlier, that does confirm that the rate environment is moving in the right direction. Though the full-year benefit is obviously naturally moderated by the timing and the portion of the book that's affected.

第一，7 月的費率動態是有利的。如同我們先前提到的，這也確認費率環境正朝正確方向發展。不過，全年的效益顯然會因生效時點以及受影響的業務組合比例而自然被稀釋。

Second, membership and acuity are broadly aligned with the assumptions embedded in our initial outlook, and that's encouraging.

第二，會員數與病情嚴重度（acuity）大致與我們初始展望中所內嵌的假設一致，這令人鼓舞。

And third, we continue to see elevated utilization, but in the categories we've been discussing. And that pressure is increasingly driven by those identifiable utilization patterns, which allows us to respond more effectively. When we think about the rate update as of July 1, you could think about it still being in that mid-single-digit percent range, but maybe towards the upper end of mid-single-digits as opposed to the lower end when we originally started the year, and that should give you enough for modeling purposes.

第三，我們仍看到偏高的使用量，但主要集中在我們一直在討論的類別。而這些壓力愈來愈多是由可辨識的使用型態所驅動，這讓我們能更有效地回應。當我們看 7 月 1 日的費率更新，你可以把它視為仍在中個位數百分比區間，但可能更接近中個位數的上緣，而不是我們年初時的下緣；就建模而言，這應該足夠。

Yeah, and Kevin, specifically to your question around exits for markets, as Felicia shared, we're taking a portfolio look at all of our states, quite frankly. We did this in Medicare last year. We made, I think very disciplined decisions around long-term profitability as well as long-term fit for the company. We've been doing the same thing in Medicaid and have made those same kind of decisions. So it's not just about what 2026 or 2027 look like, this is really about the long-term sustainability of those markets, how they align to our dual footprint and some of the other considerations we have.

是的，Kevin，針對你特別問到的市場退出問題，如 Felicia 所分享的，我們坦白說正在以投資組合的角度檢視我們所有州的業務。我們去年在 Medicare 就做過這件事。我認為我們針對長期獲利能力以及與公司長期契合度，做出了非常嚴謹的決策。我們在 Medicaid 也在做同樣的事，並做出同類型的決定。所以這不只是關於 2026 或 2027 會是什麼樣子，而是關於這些市場的長期可持續性、它們如何與我們的雙重足跡（dual footprint）對齊，以及我們的其他考量。

So we actually feel that this is the right time to be very disciplined about these actions and look at where the long-term trajectory is for the places that we want to participate. So thanks very much for the question and the opportunity to explain that more.

因此我們其實認為，現在正是以高度紀律來推動這些行動、並檢視我們希望參與之地點的長期軌跡的適當時機。非常感謝你的提問，也謝謝你給我們機會更進一步說明。

Next question, please.

請下一題。

Scott Fidel, Goldman Sachs.

高盛（Goldman Sachs）的 Scott Fidel。

Hi, thanks. Good morning. Sorry, I'm going to tick on the Medicaid topic as well. But I thought it might be helpful just maybe looking out, two to three years and you talked about how you continue to view 2026 as the trough year for Medicaid. Clearly, you're not going to sort of continue to sort of sustain a negative 1.75%, and we'll look to change on that.

嗨，謝謝。早安。抱歉，我也要接續 Medicaid 的話題。但我想也許有幫助的是，把視野拉到未來兩到三年；你們談到仍然把 2026 視為 Medicaid 的谷底年度。很明顯，你們不會一直維持負 1.75%，而是會尋求改變。

What I'm curious about, though, is how you would frame the sort of the macro around Medicaid, as we look out to what's a pretty substantial package of regulations that will be coming from the OBBBA with the SDP reform and work requirements and the 1115 waivers moving budget neutral, I mean, that could all have implications for funding for Medicaid, but then also you're talking about these proactive initiatives you're doing, including activity markets and clearly doing what you can from the company level.

不過我好奇的是，當我們展望未來時，你們會如何界定 Medicaid 的宏觀面：OBBBA 將推出一套相當龐大的監管方案，包含 SDP 改革與工作要求，以及 1115 豁免轉為預算中立；我的意思是，這些都可能影響 Medicaid 的資金來源。同時你們也在談公司層面正在做的主動式措施，包括活躍市場（activity markets），顯然也在盡一切努力改善利潤率表現。

So, I guess, Mark, Felicia, how would you frame that in terms of thinking about Medicaid as withdrawal, but trying to reconcile that with the headwinds at the sector level, at the macro level, but then the company having sort of doing all it can to improve the margin performance?

所以我想問，Mark、Felicia，你們會如何在思考 Medicaid 作為一種「退場／收縮」的同時，去調和產業層面、宏觀層面的逆風，以及公司又在盡其所能改善利潤率表現這兩者？

Yeah, thanks for the question. I will ask both Mark and Felicia's comments on that. But I guess you mentioned a lot of very specific discrete things. I mean, our overall framing is that many -- those are manageable things within the framework that we've laid out and the experience we've had to date. And quite frankly, the maturation of what we're seeing on rates aligning, as well as our actions aligning and then being very disciplined in our portfolio. But let me turn it over to Mark first, and then I'll have Felicia to comment as well.

好的，謝謝你的問題。我會請 Mark 和 Felicia 都對此發表看法。不過你提到了很多非常具體、離散的事項。我們整體的框架是：在我們已提出的架構與迄今的經驗之下，許多——這些都是可管理的事項。坦白說，隨著我們看到費率對齊的成熟度提升、我們的行動也逐步對齊，並且在投資組合上保持高度紀律。但我先把問題交給 Mark，接著也請 Felicia 補充。

Thanks very much. I think this is a very interesting question and certainly one that we've been exploring internally for a while now is how is the macro environment changing and how are we expecting things to ultimately develop over time. And maybe let me cover one specific area, given the specificity of your questions, Scott. Let me talk a little bit about 2027 One Big Beautiful Bill Act implications in acuity, and then we can go from there.

非常感謝。我認為這是一個非常有意思的問題，而且我們內部確實已經探討了一段時間：宏觀環境正在如何變化，以及我們預期事情最終會如何隨時間發展。也許鑑於你問題的具體性，Scott，我先聚焦一個特定面向。我先談談 2027 年《One Big Beautiful Bill Act》對醫療嚴重度（acuity）的影響，然後我們再接著討論。

So if I think about 2027, you know, we do expect to continue to see some incremental acuity pressure as those eligibility dynamics continue. And that's really going to include specifically that One Big Beautiful Act related community engagements and the verification requirements. But importantly, from our perspective, we don't view that as a broad-based reset, anything comparable to the post-PHE unwind. And that's really significant because I would say that means the acuity shift to a large degree is behind us.

所以如果我思考 2027 年，你知道，我們確實預期隨著那些資格認定動態持續，我們仍會看到一些額外的醫療嚴重度壓力。而這主要會特別包含與《One Big Beautiful Act》相關的社區接觸（community engagements）以及驗證要求。但重要的是，從我們的角度來看，我們不把這視為全面性的重置，或任何可與 PHE 結束後的解綁（unwind）相提並論的情況。這點非常關鍵，因為我會說這意味著醫療嚴重度的轉移在很大程度上已經在我們身後了。

And so as you think about those macro factors, OBBBA is important, but it's not something that's going to be a defining moment, at least as we see 2027 at this point.

因此，當你思考那些宏觀因素時，OBBBA 很重要，但至少就我們目前對 2027 年的看法而言，它不會是一個決定性的時刻。

Yeah. The other thing I will say is that when we take a look at 2027 and the work requirements that we're going to be working on. When we look at the interim final rule, it doesn't give us much pause or concern. I think the things that we see there are things that we anticipated, and we believe that the changes will be very phased, state-specific, and they will be very manageable.

是的。我另外要說的是，當我們檢視 2027 年以及我們將要推動的工作要求（work requirements）時，我們看了臨時最終規則（interim final rule），並沒有讓我們感到太多停頓或擔憂。我認為我們在那裡看到的內容是我們原本就預期會出現的，而且我們相信這些變更會是非常分階段、因州而異，並且是非常可管理的。

The rule sets a framework, but states continue to have significant flexibility as they work through this process. So as we step back and think about what this means overall, we are going to be working closely with our state partners to make sure that what we are doing is helping our members manage what can be the operational complexity that goes along with work requirements.

該規則建立了一個框架，但各州在推進這個流程時仍保有相當大的彈性。因此，當我們退一步思考這整體代表什麼時，我們將與各州合作夥伴密切合作，確保我們所做的事情能協助會員因應與工作要求相關、可能出現的營運複雜性。

But in terms of the overall impact, we think that these will be very manageable in the framework of the broader Medicaid environment and certainly are very much unlike what happened during the redetermination process. The members that are going to be impacted are only the Medicaid expansion members and some waiver members. That represents roughly 20% of our overall book.

但就整體影響而言，我們認為在更廣泛的 Medicaid 環境框架下，這些都是非常可管理的，且當然與重新認定（redetermination）流程期間發生的情況非常不同。會受到影響的會員僅限於 Medicaid 擴張（expansion）會員以及部分豁免（waiver）會員。這約占我們整體業務組合（book）的 20%。

But we take a look at this in the context that this will be a very phased implementation process with a lot of collaboration between us, our state partners, and our members. So, thank you for the question.

但我們是在這樣的脈絡下看待：這將是一個非常分階段的導入流程，且我們、各州合作夥伴與會員之間會有大量協作。所以，謝謝你的提問。

Thank you, Felicia and Mark. And just, I think it's helpful to take a Zoom out for a moment because I know there's a lot of interest in Medicaid. Hopefully, we've been able to answer your questions. But I think as you think about the overall company again, our confidence in '27 is really about the broad enterprise and the breadth of our portfolio and the operating actions we've taken.

謝謝你，Felicia 和 Mark。我想稍微拉遠一點看會很有幫助，因為我知道大家對 Medicaid 很感興趣。希望我們已經能回答你的問題。但我認為當你再回到整體公司來看，我們對 2027 年的信心其實來自於整體企業面，以及我們投資組合的廣度與我們採取的營運行動。

So it's not dependent on any single line of business, quite frankly, and that's what gives us so much confidence and really does reflect the diversity of the contributions across health benefits, Carelon, the efficiency and capital deployment.

坦白說，它並不依賴任何單一業務線，而這正是讓我們如此有信心的原因，也確實反映了健康福利（health benefits）、Carelon、效率提升與資本配置等各方面貢獻的多元性。

And again, I just want to remind people, we have several very visible drivers, and we're showing that already in 2026. Commercial is performing quite well with pricing discipline. We feel very good about MA, benefiting from the actions we took as well as the positioning we have for 2027. And the individual ACA is developing consistently, and as you heard from Mark and others, we've been very prudent in how we've thought about that business to ensure that it performs as planned.

再提醒大家一次，我們有幾個非常明確可見的驅動因素，而且我們在 2026 年就已經展現出來。商業保險（Commercial）在定價紀律下表現相當好。我們對 MA（Medicare Advantage）也感到非常樂觀，受惠於我們採取的行動以及我們為 2027 年所做的定位。而個人 ACA（Affordable Care Act）業務也在穩健發展；正如你從 Mark 和其他人那裡聽到的，我們在思考這項業務時一直非常審慎，以確保其能如計畫般表現。

Medicaid does remain an important part of our broader framework, but we continue to view it, '26 is a trough. And we do see the improvement supported by the rate alignment and the maturation of the actions that we've taken this year. And again, I want to emphasize that we are being prudent because we want those actions to mature before we take full credit for them.

Medicaid 仍然是我們更廣泛框架中的重要部分，但我們仍然認為 2026 年是谷底（trough）。我們確實看到改善，並且有費率對齊（rate alignment）以及我們今年採取行動逐步成熟所帶來的支撐。再次強調，我們保持審慎，因為我們希望這些行動先成熟，再把它們的效益完全反映進來。

So our broad earnings path, quite frankly, is not dependent on any outsized improvement in any single business. So that's why we see it as manageable. And again, accelerating investments, as I shared before. So thank you very much for the question. Appreciate the focus.

因此，坦白說，我們整體獲利路徑並不依賴任何單一業務出現過度顯著的改善。這也是為什麼我們認為它是可管理的。另外，如我先前分享的，我們也在加速投資。非常感謝你的提問。也感謝你聚焦在這些重點上。

Next question, please.

下一個問題，請。

Dave Windley, Jefferies.

Jefferies 的 Dave Windley。

Hi. Thanks for taking my question. I wanted to ask a question still on kind of utilization, but the shape of your experience in the first half, I think Elevance did not call out quite as much flu and weather in the first quarter as some of your peers did. And I wondered if what we're hearing from you on 2Q is perhaps a reflection of bounce-back activity more so than maybe you might have anticipated from 1Q. And again, I'm suggesting maybe flu weather-related in retrospect.

嗨。謝謝讓我提問。我想問的問題仍然有點關於利用率（utilization），但更聚焦在你們上半年經驗的形狀；我認為 Elevance 在第一季並沒有像一些同業那樣特別提到流感與天氣的影響。我想知道，我們從你們對第二季（2Q）的說法中聽到的，是否更像是相較於第一季（1Q）你們原先預期更明顯的反彈活動（bounce-back activity）。我再次提出這個假設：回頭看可能與流感、天氣相關。

And then if I could ask, on the non-recurrence of the investments, Gail, I want to make sure I understand, does that mean the dollars come out next year, i.e. $0.80 worth of EPS comes back to the bottomline next year or you just don't grow those investments next year and they fall into the baseline? I want to make sure I understand that. Thank you.

另外如果我可以再問一個，關於投資不再重複（non-recurrence）的部分，Gail，我想確認我理解正確：這是否表示明年這些金額會退出，也就是每股盈餘（EPS）約 0.80 美元明年會回到淨利（bottom line）；還是說你們只是明年不再增加這些投資，然後它們會納入基準（baseline）？我想確保我理解正確。謝謝。

Sure. We'll clarify. I'll have Mark go through the numbers with you.

當然。我們會釐清。我請 Mark 跟你把數字說明一下。

I appreciate the two questions. Let me maybe take the first one. I'll focus again on Medicaid here, just given it's the topic for the call. We did not see second quarter really as an acceleration in Medicaid cost trend beyond our expectations. And the way I'd probably frame this is the second quarter cost trend was consistent with our first quarter experience when adjusting for blue activity and the prior development from the first quarter. In other words, core utilization is consistent.

謝謝你這兩個問題。我先回答第一個。我會再次聚焦在 Medicaid，因為這是本次電話會議的主題。我們並沒有看到第二季 Medicaid 的成本趨勢超出我們預期而加速。我大概會這樣表述：在調整了 blue activity（藍色活動）以及第一季的先前發展（prior development）之後，第二季的成本趨勢與我們第一季的經驗一致。換句話說，核心利用率是一致的。

On the investment spend here, the 2026 outlook from the first quarter already included approximately $0.75 of EPS tied to those targeted investment spending that we spoke about at the beginning of the year. Those investments should be viewed as part of the ongoing run rate of the business, and that will support areas like AI adoption and workforce enablement, Carelon scaling, et cetera.

至於投資支出，第一季所提供的 2026 年展望已經包含了約 0.75 美元的 EPS，這與我們在年初提到的那些目標性投資支出相關。這些投資應被視為業務持續性運行率（run rate）的一部分，並將支持例如 AI 導入與人力賦能（workforce enablement）、Carelon 規模化等領域，等等。

In addition, as we've spoken about this morning, we now expect to deploy approximately $0.80 of net below-the-line favorability from the second quarter into one-time accelerated investments in the second half. You should not see that $0.80 of net below-the-line favorability as a recurring part. Those are one-time for this year, not part of 2027.

此外，正如我們今天早上所談到的，我們現在預期會把第二季約 0.80 美元的淨「線下」（below-the-line）有利因素，投入到下半年一次性的加速投資中。你不應將這 0.80 美元的淨線下有利因素視為會重複發生的一部分。這些是今年的一次性項目，不會納入 2027 年。

And as a reminder, our jumping-off point for the adjusted 12% growth is the $26 that we shared.

另外提醒一下，我們用於調整後 12% 成長的起點，是我們先前分享的 26 美元。

Next question, please.

下一個問題，謝謝。

Ryan Langston, TD Cowen.

Ryan Langston，TD Cowen。

Thanks. So, based on some of the commentary from the hospitals, surgical volumes appear to be broadly lower in the second quarter versus last year. In the prepared remarks, you mentioned outpatient surgery is a continued source of cost pressure. So, I'm wondering if that pressure is related more towards higher volumes or higher acuity procedures. And is there any risk that you see of any catch-up from those procedures in the back half of the year? Thank you.

謝謝。所以，根據一些醫院方面的評論，第二季的手術量相較去年似乎整體偏低。在準備好的發言中，你提到門診手術仍是成本壓力的來源。所以我想請教，這個壓力比較是來自更高的量，還是更高病情嚴重度（acuity）的手術？另外，你是否看到今年下半年這些手術有任何補做（catch-up）的風險？謝謝。

We would say that outpatient surgery is not a universal trend driver for us, but it doesn't matter in certain lines of business. For example, Medicaid outpatient surgery trend is more utilization-driven. Local group is more unit cost mix-driven. In Medicare and individual ACA, we are seeing moderately, actually lower surgery trends.

我們會說，門診手術對我們而言並不是一個普遍性的趨勢驅動因素，但在某些業務線上確實會有影響。例如，Medicaid 的門診手術趨勢更偏向由使用量所驅動。本地團體（local group）則更偏向由單位成本組合所驅動。在 Medicare 與個人 ACA 方面，我們看到的是中度、其實是較低的手術趨勢。

On ACA, we do look at utilization per member, and we did expect per member utilization to be higher because we priced for that higher expected morbidity. And so overall, I would say that, again, not really a universal trend driver for us relative to the other categories we've called out. Thank you.

在 ACA 方面，我們會看每位會員的使用量，而我們確實預期每位會員使用量會更高，因為我們在定價時已反映較高的預期罹病程度（morbidity）。因此整體而言，我會說，再次強調，相較於我們點出的其他類別，這並不是我們的普遍性趨勢驅動因素。謝謝。

Next question, please.

下一個問題，謝謝。

Elizabeth Anderson, Evercore ISI.

Elizabeth Anderson，Evercore ISI。

Hi, guys. Good morning. You talked a lot about the prudence of the outlook in terms of margins and your expectations for the year, which makes sense given the volatility in many of the business lines. Can you talk about any change in, like, prudence regarding your reserve posturing for the quarter -- starting in the second quarter for any of your businesses?

嗨，各位。早安。你們談了很多關於展望在利潤率以及今年預期上的審慎性，考量到許多業務線的波動性，這很合理。你們能否談談本季在準備金配置（reserve posturing）的審慎程度是否有任何改變——從第二季開始，在你們任何業務上是否有變化？

I appreciate the question. We remain confident in our reserving levels and that the reserving posture we have maintained is consistent and prudent. Both relative to our membership base and claims inventory and claims experience, but also consistent and prudent relative to prior practice here. We ended the quarter with a days in claims payable, as you saw in our published results of 45.4 days, and that is up 2.9 days year-over-year. And so we feel good in the reserving posture as we ended the second quarter. Thank you.

謝謝你的提問。我們對目前的準備金水準仍然有信心，也認為我們維持的準備金配置是一致且審慎的。這不僅相對於我們的會員基礎、理賠存量與理賠經驗而言是如此，也與過去在這裡的作法一致且審慎。本季結束時，我們的應付理賠天數（days in claims payable）如你在已公布的結果中所見為 45.4 天，年增 2.9 天。因此，我們對第二季結束時的準備金配置感到安心。謝謝。

Erin Wright, Morgan Stanley.

Erin Wright，Morgan Stanley。

Great. Thanks. I know there's a lot of questions on Medicaid, so I'll ask something a little bit different. But I want to dig in a little bit more in terms of what you're seeing across Medicare Advantage in terms of just underlying utilization trends. There just seems to be a narrative out there that underlying utilization trends are more favorable here.

好的。謝謝。我知道大家對 Medicaid 有很多問題，所以我問一個稍微不同的。但我想更深入了解你們在 Medicare Advantage 方面看到的基本使用量趨勢。外界似乎有一種說法，認為這裡的基本使用量趨勢更有利。

And what are your expectations that that continues? And you talked about your bid process already on that front, but just curious how you're thinking about that going forward? And then I know it's really early to even remotely talk about [STARS], but if I throw that out there just in the context of the evolution in this administration, how you think about STARS, generally speaking. Thanks.

你們預期這種情況會持續嗎？你們也提到已經在那方面進行投標流程，但我想了解你們接下來如何思考？另外我知道現在談 [STARS] 還非常早，但如果我把它放在這一屆政府政策演變的脈絡下，你們整體上如何看待 STARS？謝謝。

Sure. Why don't I have Aimee Dailey comment on Medicare?

當然。不如我請 Aimee Dailey 來談談 Medicare？

Sure. So, appreciate all the questions there, and I'll try and cover as many as I can. Maybe I'll start more broadly at our bid approach. Our bid approach in 2027 was very consistent with the discipline strategy we've been executing over the past several years. And while we're encouraged by the final rate notice, which I know is a few months past now, we do continue to believe underlining medical cost trend is still outpacing program funding.

好的。謝謝這些問題，我會盡量涵蓋多一些。也許我先從我們的投標策略更宏觀地談起。我們在 2027 年的投標策略，與過去幾年一直在執行的紀律性策略非常一致。雖然我們對最終費率公告感到鼓舞（我知道那已是幾個月前的事），但我們仍然認為，基礎醫療成本趨勢仍在超過計畫資金的增幅。

So, we submitted our bids with a prudent view of trend and a continued focus on sustainable margin improvement. The actions we took in '26 are performing as we expected, and I know we've talked about the favorability just in the second quarter, ahead of our expectations, which reflect the deliberate portfolio actions we took, a favorable membership mix and better claims experience. And so we remain on track to achieve at least 2% margin for Medicare Advantage this year, and that gives us a fair amount of confidence that the strategy is working and has informed how we approach our '27 bids.

因此，我們以審慎的趨勢觀點提交投標，並持續聚焦於可持續的利潤率改善。我們在 '26 年採取的行動表現符合預期；我們也談到第二季的有利表現優於預期，這反映了我們刻意進行的投資組合行動、有利的會員組合，以及更好的理賠經驗。因此，我們仍按計畫在今年達成 Medicare Advantage 至少 2% 的利潤率，這讓我們相當有信心策略正在奏效，也影響了我們對 '27 年投標的做法。

And maybe take a minute then to go to STARS. It's really still early to comment on the next payment year, and so I wouldn't want to get ahead of the CMS process. But as you know, STARS remains one of our core enterprise priorities. We've made significant investments that we believe will continue to improve performance over time. We've enhanced our CAHPS infrastructure with AI-powered personalized member engagement, omnichannel outreach, and rewards programs, and we've also invested in clinical data on interoperability, strengthening provider engagement, and expanding programs focusing on closing gaps in care, which is obviously very important.

接著我再花點時間談 STARS。現在評論下一個給付年度仍然太早，所以我不想超前 CMS 的流程。但如你所知，STARS 仍是我們企業層級的核心優先事項之一。我們已投入大量資源，我們相信這些投資將隨時間持續改善表現。我們以 AI 驅動的個人化會員互動、全通路觸達，以及獎勵方案，強化了 CAHPS 基礎建設；同時也在臨床資料互通性上投資、強化與提供者的互動，並擴大聚焦於縮小照護缺口的方案，這顯然非常重要。

So while we're not prepared or should not be making predictions about payment year '28 in the future, we feel really good about the trajectory of the business. And we view STARS as a multi-year journey and are executing against that discipline roadmap. Thank you.

因此，雖然我們尚未準備好、也不應該對未來的 '28 給付年度做出預測，但我們對業務的發展軌跡感到非常樂觀。我們將 STARS 視為一段多年期的旅程，並正依照那份具紀律的路線圖執行。謝謝。

Thank you, Aimee. Next question, please.

謝謝你，Aimee。下一個問題，謝謝。

Jason Cassorla, Guggenheim Securities.

Jason Cassorla，Guggenheim Securities。

Great. Thanks. Good morning. Maybe just wanted to ask on commercial. You're still tracking to the high end of ASO or fee-based enrollment guidance. You're fairly in line with the employer group risk enrollment expectation. Just is there anything fundamental worth noting about what you're seeing on the commercial enrollment front?

好的。謝謝。早安。我想問一下商業保險（commercial）。你們仍在追蹤 ASO 或按費用計價（fee-based）投保人數指引的高端。你們也大致符合雇主團體風險型投保人數的預期。在商業投保人數方面，你們看到的情況是否有任何值得特別指出的根本性變化？

And then with trend expected to remain elevated, I guess, how are you balancing pricing versus kind of the trend vendor opportunity for commercial books? And then lastly, if I could tack on, you've talked about the integrated model resonating. I guess, is there any way you can help frame for us the runway you have for the integrated model opportunity? Thanks.

另外，在趨勢預期仍將維持高檔的情況下，我想請教你們如何在定價與商業保單在趨勢/供應商（trend vendor）機會之間取得平衡？最後，如果我可以再加問一題，你們提到整合式模式（integrated model）正在引起共鳴。你們是否能協助我們界定一下，整合式模式機會的成長跑道（runway）還有多長？謝謝。

Let me ask Morgan Kendrick to address on your questions.

我請 Morgan Kendrick 來回應你的問題。

Get off of mute here for a minute. No, sorry about that. I want to just address your conversation around the market in general. And as I think about it, you probably can see the bulk of the business fee-based are self-funded on the commercial side, which consists of both local market activity as well as national accounts, both of which are performing incredibly well right now.

我先解除靜音一下。不，抱歉。我想先回應你對整體市場的討論。就我來看，你大概也看得出來，商業端按費用計價的業務大多是自籌資金（self-funded），其中包含本地市場業務以及全國型客戶（national accounts），而這兩者目前的表現都非常好。

I think about our persistency rate and our sale rate based on opportunity, and it's climbing from prior years, which tells me the market is -- our assets are resonating with the market nonetheless. And the market is maniacally focused on affordability and simplicity, and that's exactly what the organization is focused on as well.

我在思考我們的續保率以及基於商機的銷售率，這些指標相較於前幾年正在攀升，這告訴我市場——我們的資產仍然在市場上引起共鳴。而市場正以近乎狂熱的程度聚焦在可負擔性與簡單性上，這也正是本組織同樣聚焦的方向。

We see that continuing. I think it's going to be a big driver for us continually right now. What I think is really an interesting new fact that's coming through is when we think about 2026 was a record year in our national account business. Our pipeline came back almost just as large this year for the '27 businesses we had in '26. And people vote with their feet as you certainly know, oddly or not oddly, interestingly, one of our big opportunities this year was customers that left us two or three years ago in the middle of their contract with an alternative payer have moved back to Anthem.

我們看到這種趨勢仍在延續。我認為這在目前會持續成為我們的一大驅動力。我覺得一個非常有意思、正在浮現的新事實是：當我們回顧2026年，我們的全國帳戶業務創下了紀錄年。而今年，我們的業務管線幾乎又回到與2026年相同規模，對應的是我們在2026年拿下的2027年業務。而且你也很清楚，人們會用腳投票；不論奇怪與否、也或許不奇怪，但很有意思的是，我們今年的一個重大機會來源，是那些在兩、三年前、在與替代付款方合約期間中途離開我們的客戶，如今又回到Anthem。

So that's something that says and speaks loudly, in my opinion, about the quality of the assets, how the whole organization works together to make healthcare more affordable and easier to navigate for our consumers.

所以在我看來，這件事非常有力地說明了我們資產的品質，以及整個組織如何協同運作，讓醫療照護對消費者而言更可負擔、也更容易理解與使用。

And then just briefly on the pricing, we are pricing to our forward view of medical cost trends with the discipline needed to support sustainable margins over time.

另外簡要談一下定價：我們是依據對醫療成本趨勢的前瞻性判斷來定價，並以必要的紀律來支撐長期可持續的利潤率。

Thank you. Couple of key takeaways. Hopefully, you heard on commercial one, affordability and experience really matter, very disciplined pricing, really strong fee-based growth we've seen with our assets resonating. And we continue to consolidate clients, and we continue to win back clients, which I think is a really strong forward view of how the market views us.

謝謝。幾個重點結論。希望大家在商業保險這一塊有聽到：可負擔性與體驗真的很重要；定價非常有紀律；我們看到以費用為基礎的成長非常強勁，因為我們的資產正在引起共鳴。而且我們持續整併客戶，也持續贏回客戶；我認為這非常有力地反映了市場如何看待我們的前景。

We have time for one more question.

我們還有時間再問一題。

George Hill, Deutsche Bank.

George Hill，德意志銀行。

Hey, good morning, guys, and thanks for squeezing me in. Mark, a simple question, and I just want to zoom out. You started to talk about kind of the outlook for '27 broadly. I thought, could you just quickly address kind of like where your early expectations and the puts and takes are for '27 foot against the long-term growth algorithm? I imagine you guys will lose less money in Medicaid next year, which will be a good thing, and they will continue to grow commercial probably flattish, Carelon's up cap deployment will be somewhere. We'd love if you could whatever you can take kind of broadly sketching out the '27 outlook versus the ultimate income growth outdoor. Thank you.

各位早安，謝謝讓我插個問題。Mark，一個簡單的問題，我想把視角拉遠一點。你剛開始談到對2027年的整體展望。我想請你能否快速說明一下，你們對2027年的初步預期，以及相對於長期成長算法（long-term growth algorithm）有哪些利多與利空因素？我猜想你們明年在Medicaid的虧損會減少一些，這會是好事；商業保險可能持續成長但大致持平；Carelon的上限（cap）部署會落在某個水準。我們很希望你能就你能分享的範圍，概略勾勒一下2027年的展望，相對於最終的獲利成長目標。謝謝。

George, thanks very much for the last question here. I was really hoping to get a one on Carelon, but let me talk a little bit about financials for a second here. So our confidence in 2027, as Gail mentioned earlier, is really based on the breadth and the durability of our earnings base. It's not based on any one single line of business or one recovery assumption. And as we look toward next year, we do expect to enter '27 with pretty good visibility across the major drivers of the business.

George，非常感謝你作為最後一題。我其實很希望能收到一題關於Carelon的問題，但我先談一下財務面。如同Gail先前提到的，我們對2027年的信心，主要來自我們獲利基礎的廣度與耐久性。這並不是建立在任何單一業務線或單一復甦假設之上。而當我們展望明年時，我們確實預期在進入2027年時，對於業務的主要驅動因素會有相當不錯的能見度。

So on Medicaid, certainly, our base case is not that the business remains flat. We do expect performance to improve, especially as rates increasingly reflect cost experience and as our care management actions mature. In Medicare Advantage, certainly, the portfolio actions we took for 2026, they're showing through, mix is developing favorably, and you heard from Aimee, sort of the discipline and intentionality with which they approach the 2027 bid cycle, so we do feel confident there.

就Medicaid而言，當然，我們的基本情境並不是業務維持持平不變。我們確實預期績效會改善，特別是當費率愈來愈能反映成本經驗、以及我們的照護管理措施逐步成熟之後。在Medicare Advantage方面，當然，我們為2026年所採取的投資組合行動已開始反映出效果，組合結構正朝有利方向發展；你也聽到Aimee提到，他們以何等的紀律與目的性來面對2027年的投標循環，因此我們對此也很有信心。

You heard from Morgan on Commercial Group, very strong outlook for sales. And certainly on the individual ACA, you should have confidence that we are pricing and positioning our book of business as consistently for 2027 and as strongly for 2027 as we've done for 2026.

你也聽到Morgan談到商業團體保險（Commercial Group），銷售展望非常強勁。而在個人ACA方面，你也應該有信心：我們在2027年的定價與業務布局，會像我們在2026年所做的一樣一致，並且同樣強而有力。

And then finally, just on a capital deployment, this obviously remains an important contributor to EPS growth over time, and we are executing our capital management very effectively. So key point here, just in closing, our path to at least 12% adjusted EPS growth in 2027, broad-based, balanced, and grounded in execution across our businesses. Thank you.

最後談一下資本部署：很明顯，這仍是長期EPS成長的重要貢獻來源，而我們正在非常有效地執行資本管理。所以在此收尾的重點是：我們在2027年達成至少12%調整後EPS成長的路徑，是廣泛分布、均衡配置，並且建立在各項業務的執行力之上。謝謝。

Thank you, Mark, and thank you to everyone who joined us on the call today. We're pleased with the strong second-quarter performance, and we're encouraged by the progress we're making across Elevance Health. We're raising our '26 adjusted EPS guidance, managing the business with discipline, and accelerating targeted investments in medical cost management, member experience, provider connectivity, operating efficiency, and Carelon's integrated capabilities. We're confident in the path ahead and committed to creating long-term value for our members, customers, partners, and shareholders.

謝謝你，Mark，也謝謝今天加入電話會議的各位。我們對第二季的強勁表現感到滿意，也對我們在Elevance Health各方面取得的進展感到鼓舞。我們上調了2026年調整後EPS指引，以紀律管理業務，並加速在醫療成本管理、會員體驗、醫療服務提供者連結、營運效率，以及Carelon整合式能力上的重點投資。我們對前方道路充滿信心，並致力於為會員、客戶、合作夥伴與股東創造長期價值。

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

感謝各位對Elevance Health的關注，祝各位本週剩餘時間愉快。

Ladies and gentlemen, a recording of this conference will be available for replay after 11:00 AM today through August 14, 2026. You may access the replay system at any time by dialing 800-391-9853 and international participants can dial 203-369-3269. This concludes our conference for today.

各位女士、先生，本次會議的錄音將於今日上午11:00之後提供重播，並可重播至2026年8月14日。您可於任何時間撥打800-391-9853進入重播系統，國際與會者可撥打203-369-3269。本日會議到此結束。

Thank you for your participation and for using Verizon Conferencing. You may now disconnect.

感謝您的參與並使用Verizon Conferencing。您現在可以掛線。