Elevance Health Inc (ELV) 2026 Q3 法說會逐字稿

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

各位女士、先生，感謝您耐心等候，歡迎參加 Elevance Health 2026 年第三季財報電話會議。(接線員指示) 提醒各位，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.

現在我想把電話會議交給公司管理團隊。請開始。

Good morning, and welcome to Elevance Health's third quarter 2026 earnings conference call. My name is Nathan Rich, Vice President of Investor Relations. With us today on the earnings call are Gail Boudreaux, President and CEO; Mark Kaye, our CFO; and Felicia Norwood, our Chief Health Benefits Officer; and Morgan Kendrick, President of our Commercial Health Benefits business.

各位早安，歡迎參加 Elevance Health 2026 年第三季財報電話會議。我是投資人關係副總裁 Nathan Rich。今天與會的還有總裁暨執行長 Gail Boudreaux；財務長 Mark Kaye；健康福利長 Felicia Norwood；以及商業健康福利事業總裁 Morgan Kendrick。

Gail will highlight our third quarter performance and discuss the progress we're making on our strategic priorities. Mark will then discuss our financial results and the drivers supporting our earnings outlook in greater detail. After our prepared remarks, the team will be available for a question-and-answer session.

Gail 將重點說明我們第三季的表現，並分享我們在策略優先事項上的進展。接著 Mark 將更詳細說明我們的財務結果，以及支撐我們獲利展望的驅動因素。在準備好的發言之後，團隊將開放問答。

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. 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.

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。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，這些陳述受到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。

These risks and uncertainties may cause actual results to differ materially from our current expectations, and 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 strong third quarter results with Medicaid, Medicare Advantage and individual ACA each contributing to our better-than-expected performance. These results reflect focused execution across the enterprise. They support a higher earnings outlook for 2026 and increase our confidence in the sustainability of our performance entering 2027.

各位早安，感謝各位加入。Elevance Health 第三季交出強勁成果，Medicaid、Medicare Advantage 以及個人 ACA 業務均對我們優於預期的表現有所貢獻。這些成果反映了全企業聚焦執行的成效。它們支持我們上調 2026 年獲利展望，並提升我們對於在邁入 2027 年時維持表現可持續性的信心。

We are revising our 2026 adjusted diluted earnings per share guidance to at least $29, reflecting operating outperformance as well as favorable nonoperating items. More importantly, we're raising our 2026 earnings baseline to at least $26.75. That increase reflects better underlying results and greater confidence in the durability of that performance. From this higher baseline, we remain confident in our ability to deliver at least 12% adjusted diluted earnings per share growth in 2027.

我們將 2026 年調整後稀釋每股盈餘（EPS）指引修訂為至少 29 美元，反映營運表現優於預期以及有利的非營運項目。更重要的是，我們將 2026 年獲利基準上調至至少 26.75 美元。此一提升反映更佳的基本面結果，以及對該表現耐久性的更高信心。在此更高的基準之上，我們仍有信心在 2027 年實現至少 12% 的調整後稀釋每股盈餘成長。

We expect that growth to be driven by continued margin improvement in health benefits, broader adoption of Carelon value-based solutions and greater operating efficiency across the enterprise. We are bringing together the scale and local presence of our health benefits business with Carelon's clinical and operational expertise to improve outcomes and make care more affordable. As we extend these solutions across our health plans into external clients, we expect to improve medical cost management, increase operating leverage and deliver greater value for those we serve.

我們預期該成長將由健康福利業務持續的利潤率改善、Carelon 價值導向解決方案更廣泛的採用，以及全企業更高的營運效率所驅動。我們正把健康福利業務的規模與在地布局，與 Carelon 的臨床與營運專業結合，以改善結果並讓照護更可負擔。隨著我們將這些解決方案從自有健康計畫延伸至外部客戶，我們預期能改善醫療成本管理、提升營運槓桿，並為我們服務的對象創造更大價值。

We are already seeing measurable results. Carelon's risk-based oncology solution connects treatment planning with personalized support throughout a member's cancer journey through earlier identification of risks and more coordinated intervention, our cancer care engagement program has reduced avoidable inpatient emissions by 15% in the commercial market.

我們已經看到可衡量的成果。Carelon 的風險承擔型腫瘤解決方案，透過更早辨識風險與更協調的介入，將治療規劃與在會員癌症旅程中的個人化支持連結起來；我們的癌症照護參與計畫已使商業市場中可避免的住院排放量降低 15%。

Our Elevate medical cost management platform is helping our teams identify emerging cost drivers earlier and translate those insights into targeted action. This year, the platform has identified more than $300 million in anticipated savings. We are encouraged by these results and see significant opportunity as we deploy these capabilities more broadly across the enterprise.

我們的 Elevate 醫療成本管理平台正協助團隊更早辨識新出現的成本驅動因素，並將洞見轉化為具針對性的行動。今年以來，該平台已辨識出超過 3 億美元的預期節省金額。我們對這些成果感到鼓舞，並在將這些能力更廣泛部署至全企業時，看見顯著的機會。

Now let me turn to our performance by line of business. In Medicaid, third quarter performance was ahead of our outlook, primarily reflecting the benefit of recent rate actions. We are now tracking slightly ahead of our prior full year margin guidance. We remain focused on the drivers within our control. We are expanding evidence-based clinical oversight in behavioral health, strengthening care management and advancing targeted network actions while preserving access to appropriate care.

接下來我將按業務線說明我們的表現。在 Medicaid 方面，第三季表現優於我們的展望，主要反映近期費率調整帶來的效益。我們目前的追蹤結果略高於先前的全年利潤率指引。我們仍專注於可控的驅動因素。我們正在擴大以實證為基礎的行為健康臨床監督、強化照護管理，並推進具針對性的網絡行動，同時維持對適當照護的可近性。

Looking to 2027, we expect Medicaid margins to improve as rates become better aligned with cost trends and the actions we are taking continue to gain traction. In Medicare Advantage, we have repositioned our portfolio around the products and markets where we can deliver sustainable value for members. These deliberate actions together with improved medical cost performance and continued execution are delivering the results we expected and positioning the business for more sustainable growth over time.

展望 2027 年，我們預期 Medicaid 利潤率將改善，因為費率將與成本趨勢更為一致，且我們採取的行動將持續發揮成效。在 Medicare Advantage 方面，我們已將產品組合重新定位於我們能為會員提供可持續價值的產品與市場。這些審慎的行動，加上醫療成本表現改善與持續的執行力，正帶來我們預期的成果，並使該業務在時間推移下具備更可持續的成長定位。

We are carrying that same discipline into the 2027 annual election period with an emphasis on HMO plans and serving dual-eligible members. Our plan designs prioritize stability in the benefits members tell you most and reflect a measured view of cost trends. This approach supports further margin improvement in 2027 and as we advance toward our long-term operating margin target.

我們也以同樣的紀律投入 2027 年年度選擇期，重點放在 HMO 計畫以及服務雙重資格（dual-eligible）會員。我們的計畫設計優先確保會員最重視的福利之穩定性，並反映對成本趨勢的審慎評估。此一作法支持 2027 年進一步的利潤率改善，並推動我們朝長期營運利潤率目標邁進。

We recently received our 2027 Star ratings and are pleased that approximately half of our Medicare Advantage members will be enrolled in plans rated 4 stars or higher. We again achieved an enterprise-wide average of 4 stars in a competitive and dynamic environment. Our Stars performance remains a multiyear priority, and we continue to invest in member experience, clinical quality and care provider engagement to improve on these results.

我們近期收到 2027 年星級評等（Star ratings），很高興約有一半的 Medicare Advantage 會員將加入評等為 4 星或以上的計畫。在競爭激烈且快速變動的環境中，我們再次達成全企業平均 4 星的成績。星級表現仍是我們跨年度的優先事項；我們持續投資於會員體驗、臨床品質與照護提供者參與，以在此基礎上進一步改善成果。

In Commercial, we maintained a consistent and disciplined approach to the 2027 selling season. That approach reflects prudent pricing, the value of our integrated medical and pharmacy offering and our unwavering focus on affordability. We continue to see strong demand for our Anthem balance funded product and the differentiation created by our patient advocacy programs. These capabilities are increasing member engagement, strengthening clinical support and supporting disciplined cost management.

在商業業務方面，我們在 2027 年銷售季維持一致且有紀律的作法。此作法反映審慎的定價、我們整合醫療與藥局的產品價值，以及我們對可負擔性的堅定聚焦。我們持續看到市場對 Anthem balance funded 產品的強勁需求，以及由病患倡議計畫所創造的差異化。這些能力正提升會員參與度、強化臨床支持，並支撐有紀律的成本管理。

Turning to Carelon. We are pleased with its strong performance in the quarter. We're bringing together pharmacy, behavioral health and home-based care to create more integrated solutions that address a broader set of client needs. Our focus remains on deepening adoption across our health plans, expanding external client relationships and delivering measurable value. As a result, Carelon is becoming an increasingly important contributor to both affordability and enterprise earnings growth.

接著談 Carelon。我們對其本季的強勁表現感到滿意。我們正整合藥局、行為健康與居家照護，以打造更整合的解決方案，滿足更廣泛的客戶需求。我們的重點仍在於深化在自有健康計畫中的採用、擴大外部客戶關係，並交付可衡量的價值。因此，Carelon 正成為提升可負擔性與推動企業獲利成長愈來愈重要的貢獻者。

In summary, execution is strengthening across the enterprise. We are raising our 2026 guidance, increasing our earnings baseline and entering 2027 with greater momentum and visibility, we see a clear path to delivering at least 12% adjusted earnings per share growth in 2027, supported by continued margin improvement in health benefits, ongoing expansion of Carelon and greater operating efficiency across the enterprise.

總結來說，全企業的執行力正在增強。我們上調 2026 年指引、提高獲利基準，並以更強的動能與更高的能見度邁入 2027 年；我們清楚看到在 2027 年實現至少 12% 調整後每股盈餘成長的路徑，其支撐因素包括健康福利業務持續的利潤率改善、Carelon 的持續擴張，以及全企業更高的營運效率。

Beyond 2027, we believe the actions we are taking today position us to drive sustainable, long-term earnings growth. Before closing, I want to thank our associates. Their commitment, expertise and execution are central to our progress and to the difference we make for the people we serve.

展望 2027 年之後，我們相信今日所採取的行動，將使我們具備推動可持續、長期獲利成長的定位。在結束之前，我想感謝我們的同仁。他們的投入、專業與執行力，是我們進展的核心，也是我們為所服務的人們帶來改變的關鍵。

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

那麼，我將把電話交給 Mark，請他更詳細地回顧我們第三季的財務結果與展望。

Thank you, Gail, and good morning, everyone. Third quarter adjusted diluted earnings per share of $6.99 exceeded our outlook. Improved operating performance across the enterprise supports both our increased 2026 earnings guidance and a higher earnings baseline as we enter 2027. Results were driven by approximately $0.50 per share of operating outperformance, favorable benefit expense performance in the quarter reflected a recent Medicaid rate actions disciplined execution in Medicare Advantage and improved claims experience in our individual ACA business.

謝謝你，Gail，各位早安。第三季調整後稀釋每股盈餘為 6.99 美元，優於我們的展望。全企業營運表現改善，支撐我們上調 2026 年盈餘指引，並在邁入 2027 年時建立更高的盈餘基準。本季結果主要來自約每股 0.50 美元的營運超預期表現；此外，本季福利費用表現有利，反映近期 Medicaid 費率調整、Medicare Advantage 的紀律性執行，以及我們個人 ACA 業務理賠經驗改善。

We also recorded a net nonoperating benefit of $1.85 per share primarily related to valuation adjustments within investment income, partly offset by certain state tax items. Based on these results, we are raising our 2026 adjusted diluted earnings per share guidance to at least $29. Our earnings baseline increases by $0.75 to at least $26.75, reflecting third quarter operating outperformance and an improved full year outlook for individual ACA.

我們亦認列每股 1.85 美元的淨非營運利益，主要與投資收益中的估值調整相關，部分被若干州稅項目所抵銷。基於這些結果，我們將 2026 年調整後稀釋每股盈餘指引上調至至少 29 美元。我們的盈餘基準上調 0.75 美元至至少 26.75 美元，反映第三季營運超預期表現，以及個人 ACA 全年展望改善。

Looking ahead to next year, we remain confident in delivering at least 12% adjusted EPS growth in 2027 from this higher baseline. We expect broad-based operating improvement across our diversified portfolio with multiple earnings drivers supporting our outlook.

展望明年，我們仍有信心在此較高基準之上，於 2027 年達成至少 12% 的調整後 EPS 成長。我們預期多元化投資組合將出現廣泛的營運改善，並由多項盈餘驅動因素支撐我們的展望。

Let me now review our third quarter results in greater detail. We ended the quarter with approximately 44.9 million medical members, growth in our commercial fee-based membership offset anticipated attrition in our Medicaid business. Operating revenue increased just under 1% to $50.4 billion, driven by higher premium yields, Carelon Rx product revenue and service fees, which helped offset lower health plan membership.

接下來我將更詳細回顧第三季結果。本季末我們約有 4,490 萬名醫療會員；商業按費用計價（fee-based）會員成長，抵銷了 Medicaid 業務預期的流失。營運收入增加不到 1% 至 504 億美元，主要由較高的保費收益率、Carelon Rx 產品收入與服務費帶動，協助抵銷健康計畫會員數下降的影響。

Our consolidated benefit expense ratio was 90.6%, an improvement of 70 basis points. Medicaid, Medicare Advantage and individual ACA each delivered results favorable to our outlook. Our adjusted operating expense ratio increased 90 basis points to 11.3%. This quarter, we again made targeted onetime investments in member experience, medical cost management and Carelon's value-based solutions. We also funded actions to support growth in our dual eligible business and initiatives that enhance quality, including Stars.

合併福利費用率為 90.6%，改善 70 個基點。Medicaid、Medicare Advantage 與個人 ACA 的表現皆優於我們的展望。調整後營運費用率上升 90 個基點至 11.3%。本季我們再次針對會員體驗、醫療成本管理以及 Carelon 的價值導向解決方案進行有針對性的一次性投資。我們也投入資金支持雙重資格（dual eligible）業務成長，以及提升品質（包括 Stars 評等）的各項措施。

In Medicaid, cost trends remained elevated, but relatively stable compared with the second quarter. Our results in the quarter benefited from recent rate actions, and we now expect our full year operating margin to be slightly ahead of our prior outlook. We are encouraged by the progress in rate alignment and continue to take targeted action on the medical cost drivers within our control. We continue to view 2026 as the trough for our Medicaid margin and expect improvement in 2027.

在 Medicaid 方面，成本趨勢仍然偏高，但相較第二季相對穩定。本季結果受惠於近期費率調整，我們目前預期全年營運利潤率將略高於先前展望。我們對費率對齊的進展感到鼓舞，並持續就我們可控的醫療成本驅動因素採取有針對性的行動。我們仍認為 2026 年將是 Medicaid 利潤率的谷底，並預期 2027 年將改善。

In Medicare Advantage, the product and geographic actions we took for 2026, along with the quality of our retained membership mix support a full year operating margin of at least 2%. Our planned positioning for 2027 provides enhanced value for members while continuing to advance the business towards our target margin range. In individual ACA, we now expect a modestly higher full year operating margin as claims continue to develop favorably.

在 Medicare Advantage 方面，我們為 2026 年採取的產品與地理區域調整，加上保留會員組合的品質，支撐全年營運利潤率至少達 2%。我們對 2027 年的規劃定位將在持續推進業務朝目標利潤率區間邁進的同時，為會員提供更高價值。在個人 ACA 方面，隨著理賠持續朝有利方向發展，我們目前預期全年營運利潤率將小幅提高。

The seasonal increase in plan paid costs associated with a higher produce mix emerged more slowly than expected, and we have incorporated that experience into our risk adjustment position. Enrollment also remains ahead of expectations, reflecting the value our plans deliver and we now expect to end the year with at least 1.2 million members. For 2027, we will maintain our prudent approach to sustain this improved performance.

與較高的產品組合相關、由計畫支付成本的季節性上升，出現速度較預期慢；我們已將該經驗納入風險調整（risk adjustment）部位。投保人數亦持續高於預期，反映我們計畫所提供的價值；我們目前預期年底會員數至少達 120 萬。對於 2027 年，我們將維持審慎作法，以延續這項改善後的表現。

In Commercial group, cost trend remains consistent with our pricing assumptions. Importantly, we maintained that pricing discipline through the 2027 selling season and continue to prioritize client retention and profitable growth.

在商業團體（Commercial group）方面，成本趨勢仍與我們的定價假設一致。重要的是，我們在 2027 年銷售季期間維持了定價紀律，並持續優先著重客戶留存與獲利性成長。

Turning to Carelon. We are building a connected clinical platform to intervene across more of the care journey and assume risks that can improve outcomes and lower costs. We are encouraged by our sales momentum and the breadth of our pipeline. Our integrated offerings create opportunities to serve larger clients more effectively and as programs launch and mature, we expect Carelon's contribution to enterprise earnings to grow.

接著談 Carelon。我們正在打造一個互聯的臨床平台，以便在更多照護旅程環節介入，並承擔可改善結果、降低成本的風險。我們對銷售動能與管線廣度感到鼓舞。我們的整合式產品提供了更有效服務大型客戶的機會；隨著各項方案啟動並成熟，我們預期 Carelon 對企業整體盈餘的貢獻將成長。

Now moving to the balance sheet and operating cash flow. Days in claims payable were 44.9 days as of September 30. The an increase of 3.5 days year-over-year. Operating cash flow totaled $1.3 billion in the quarter, and we are raising our full year operating cash flow guidance to at least $6.5 billion.

現在轉到資產負債表與營運現金流。截至 9 月 30 日，理賠應付天數為 44.9 天。較去年同期增加 3.5 天。本季營運現金流合計 13 億美元，我們將全年營運現金流指引上調至至少 65 億美元。

Turning to our revised outlook. We now expect adjusted diluted earnings per share of at least $29 in 2026. Our revised guidance reflects third quarter outperformance and a strengthened ACA outlook partially offset by a nonrecurring discrete tax item we expect to recognize in the fourth quarter.

接著說明我們修訂後的展望。我們目前預期 2026 年調整後稀釋每股盈餘至少為 29 美元。修訂後指引反映第三季超預期表現與 ACA 展望走強，但部分被我們預期在第四季認列的一項一次性離散稅務項目所抵銷。

For 2027, we continue to expect at least 12% adjusted diluted earnings per share growth from our ending 2026 earnings baseline. We remain focused on managing medical costs using technology to increase productivity and allocating capital with discipline. Together, these efforts will improve operating performance and strengthen the long-term earnings potential of the enterprise.

對於 2027 年，我們仍預期在 2026 年期末盈餘基準之上，調整後稀釋每股盈餘至少成長 12%。我們仍專注於透過科技提升生產力以管理醫療成本，並以紀律方式配置資本。這些努力將共同改善營運表現，並強化企業長期盈餘潛力。

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

那麼，接線員，請開放提問。

(Operator Instructions)

(接線員指示)

AJ Rice, UBS.

UBS 的 AJ Rice。

Thanks. Hi, everybody. Maybe just a high-level first question. When you think about bridging to your 12% earnings growth next year, I wonder if we could flesh out a little more of what's underlying that. Is it -- you said you think you could get -- this is the bottom in Medicaid margin. Is it dependent upon Medicaid margin improvement next year?

謝謝。各位好。也許先問一個較高層次的問題。當你們思考明年 12% 盈餘成長的銜接時，我想我們是否可以更具體說明其背後的驅動因素。是否——你們提到你們認為 Medicaid 利潤率已到谷底。這是否取決於明年 Medicaid 利潤率的改善？

And maybe any comment on the underlying cost trends assumed across the major business lines. Is that similar to '26? Or are you assuming any improvement when you talk about 12% earnings growth?

另外，能否談談主要業務線所假設的基礎成本趨勢？這與 2026 年相近嗎？或者在談到 12% 盈餘成長時，你們是否假設會有任何改善？

Well, great. Thank you, AJ, for the question. I think it's probably helpful to frame our results and our outlook and give you a sense of what gives us confidence. And I guess I would start with -- our confidence first is stronger because we're entering '27 from a much higher earnings baseline and with stronger operating confidence and performance across the enterprise. As we shared, we remain confident in delivering at least the 12% adjusted EPS growth off the '27 higher ending baseline of '26 of $26.75.

好的，非常好。謝謝你，AJ，提出問題。我認為從框架化我們的結果與展望來說明、並讓你了解我們信心來源，可能會有幫助。我想我會先從——我們的信心之所以更強，首先是因為我們以更高的盈餘基準進入 2027 年，且全企業的營運信心與表現更為強勁。如同我們分享的，我們仍有信心在 2026 年較高的期末盈餘基準 26.75 美元之上，達成 2027 年至少 12% 的調整後 EPS 成長。

In terms of your question, we really -- we see a clear path through continued health benefit margin improvement, continued growth in our Carelon based solutions and a greater operating efficiency across our enterprise. But I think to your question, importantly, we're not relying on any single business marketer assumption, and that's really what gives us the confidence in both the outlook and the durability.

就你的問題而言，我們確實——我們看到一條清晰路徑：透過健康福利利潤率持續改善、Carelon 的價值導向解決方案持續成長，以及全企業更高的營運效率。但我認為回到你的問題，重要的是，我們並不依賴任何單一業務市場或假設；這正是我們對展望與其持久性具備信心的原因。

So thank you for the question. Next question, please.

所以謝謝你的提問。下一題，請。

Andrew Mok, Barclays.

Andrew Mok，巴克萊。

Hi, good morning. You attributed the Medicaid outperformance in the quarter primarily to better Medicaid rates, but Medicaid wasn't mentioned as a driver of year-over-year MLR improvement in the press release. So first, can you help us understand whether Medicaid MLR was up, down or flat versus 3Q '25? And second, are the better rates generally captured in prospective rates? Or is there a big out-of-period element that you would need to continue to fight for?

嗨，早安。你們將本季 Medicaid 的優於預期表現主要歸因於更好的 Medicaid 費率，但新聞稿中並未將 Medicaid 提及為年對年 MLR 改善的驅動因素。所以第一，能否協助我們了解 Medicaid 的 MLR 相較於 2025 年第三季是上升、下降還是持平？第二，較佳的費率通常是否已反映在前瞻性（prospective）費率中？或者是否存在很大的跨期（out-of-period）因素，需要你們持續去爭取？

Great. I'll have Mark address your question.

很好。我請 Mark 來回答你的問題。

Andrew, thanks very much for the question this morning. The third quarter MLR was 90.6%, and that was favorable to our expectations. The favorability was driven by each of our businesses, so Medicaid, Medicare and ACA all performed favorably versus what we expected.

Andrew，非常感謝你今天早上的提問。第三季的 MLR 為 90.6%，這比我們的預期更有利。這項有利因素來自我們各個業務，因此 Medicaid、Medicare 與 ACA 的表現都優於我們的預期。

Maybe just a little bit of detail on each. So on Medicaid, performance was better than expected, and that was primarily because of recent rate actions. The July 1 update did provide greater support to the second half margins, especially as states incorporated more recent cost experience but importantly, the underlying cost trend here remains elevated and broadly stable.

我或許補充一些各項的細節。在 Medicaid 方面，表現優於預期，主要是因為近期的費率調整。7 月 1 日的更新確實為下半年利潤率提供了更大的支撐，特別是各州納入了較近期的成本經驗；但重要的是，這裡的基礎成本趨勢仍然偏高且整體穩定。

On the Medicare Advantage side, also performance better than expected, that reflected the favorable mix of business we retained following our 2026 product and geographic actions. And then obviously, a disciplined plan design and execution on our medical cost management further supported that result. And then briefly on the individual ACA side, we did benefit from continued strength in membership and a slower-than-expected seasonal increase in some of the plan-paid costs associated with our higher brand mix.

在 Medicare Advantage 方面，表現也優於預期，反映了我們在 2026 年產品與地理區域調整後所保留下來業務的有利組合。此外，嚴謹的方案設計，以及我們在醫療成本管理上的執行力，也進一步支撐了這個結果。再簡要談一下個人 ACA 方面，我們確實受惠於會員人數持續強勁，以及與我們較高品牌組合相關、由計畫支付的部分成本，其季節性上升幅度低於預期。

Yes. And thanks, Mark. And I think, Andrew, the most important point is that Medicaid is moving from stabilization to improvement, and we are seeing better rate alignment, but we're also executing on actions that are within our control and feel the business is performing, and we have much greater visibility.

是的，謝謝你，Mark。我想，Andrew，最重要的一點是 Medicaid 正從「穩定」走向「改善」，我們看到更好的費率對齊；同時我們也在執行我們可控範圍內的行動，並認為業務表現良好，而且我們的能見度高了許多。

Next question please.

下一題請。

Justin Lake, Wolfe Research.

Justin Lake，Wolfe Research。

Thanks. Good morning. I wanted to stay on the topic of Medicaid. I appreciate the comments on 2027 improvement. And I think we all understand and appreciate that rates are getting better, like you said, reflect the higher cost trend that's been out there for a few years. But specifically, I think the question is the impact of work requirements and some of the other rollouts in 2027.

謝謝。早安。我想延續 Medicaid 這個主題。我很感謝你們對 2027 年改善的評論。我想我們都理解並認同，如你所說，費率正在變好，反映過去幾年一直存在的較高成本趨勢。但更具體地說，我想問的是 2027 年工作要求（work requirements）以及其他一些推行措施的影響。

Is there anything you could share with us on your early views on work requirements in terms of potentially how you think it's going to affect membership on a year-over-year basis and maybe the impact of -- on cost trend or acuity and any early rate actions that states are taking. Are you seeing states actually put something in rates for '27 in the back half of this year for oral apartments? Or are they saying, we'll look at it later after it rolls out? Thank you.

你們是否能分享一些早期看法：就工作要求而言，你們認為它可能會如何影響會員人數的年對年變化，以及對成本趨勢或病情嚴重度（acuity）的影響？另外，各州是否已在採取任何早期的費率行動？你們是否看到各州在今年下半年就把 2027 年的費率中納入一些內容，針對口腔（oral）……公寓（apartments）？還是他們說，等推行之後再來看？謝謝。

Thanks, Justin. I'll ask Felicia and then maybe Mark to address your questions because there was quite a bit there, Felicia?

謝謝，Justin。我會請 Felicia，然後也許再請 Mark 來回答你的問題，因為你提到的內容不少。Felicia？

Good morning, Justin. And thank you for the question. certainly, when we take a look at the work requirements, as you know, states are still working to develop plans for implementation around the work requirement, so we are staying close to those decisions. And those state decisions around their verification methods, whether they use self-attestation and other implementation timing is certainly going to impact what we see in terms of the overall changes in the Medicaid population.

早安，Justin。謝謝你的提問。當然，談到工作要求時，如你所知，各州仍在制定圍繞工作要求的實施計畫，因此我們會密切關注這些決策。各州在驗證方法上的決定（例如是否採用自我聲明 self-attestation）以及其他實施時程，確實會影響我們所看到的 Medicaid 整體人口變化。

From a rate perspective, I will tell you that states are obviously beginning to work on '27 rates, and we expect them to incorporate more of that cost trend that we're experiencing into those rates. Some of those states have included the kind of work requirements into those assumptions, but that varies state by state. So as we take a look at the potential acuity impact, that's going to be more visibility we have there as we move throughout the end of 2027 because we are still pretty early in the 2027 rate cycle.

從費率角度來看，我可以告訴你，各州顯然已開始著手 2027 年費率，我們預期他們會把我們正在經歷的更多成本趨勢納入這些費率中。其中一些州已將工作要求這類因素納入其假設，但各州情況不一。因此，當我們評估對病情嚴重度（acuity）的潛在影響時，隨著我們走到 2027 年底，能見度會更高，因為我們目前仍處於 2027 年費率循環的相對早期階段。

So as we look at where we are today, we are encouraged by what we're seeing in our 2027 rates and certainly the use of the updated requirements around work requirements in that rate perspective. but look to wait to hear how states ultimately implement those community engagement requirements as we go forward.

就我們目前所處的位置而言，我們對 2027 年費率所看到的情況感到鼓舞，當然也包括在費率觀點中對工作要求相關更新要求的採用。但我們也會等待，隨著後續推進，聽取各州最終將如何落實這些社區參與（community engagement）要求。

And then very briefly, Justin, just to add on to Felicia here, we are planning for incremental acuity pressure from some of those rate changes that Felicia, membership changes that Felicia spoke about here, and we do expect Medicaid margins to improve in 2027.

另外非常簡短補充一下，Justin，承接 Felicia 的說法，我們正在為她提到的部分費率變動、會員變動所帶來的額外病情嚴重度壓力做規劃，而我們也預期 Medicaid 利潤率在 2027 年會改善。

Next question please.

下一題請。

Stephen Baxter, Wells Fargo.

Stephen Baxter，富國銀行。

Thanks. Another follow-up on Medicaid. I mean we came away from the second quarter call thinking that your full year rate outlook probably came in about 100 basis points better than your initial guidance. I think the commentary was low end of mid-single digits to upper end of mid-single digits. And I think now you're only talking about Medicaid margin outlook that's slightly ahead of previous and maybe that's, I don't know, 25 basis points better or something in that general vicinity.

謝謝。再追問一題 Medicaid。我們從第二季電話會議的感受是，你們對全年費率的展望大概比最初指引好約 100 個基點。我記得當時的評論是從「中個位數的低端」到「中個位數的高端」。但我想現在你們談到的 Medicaid 利潤率展望只是略優於先前，可能只是好個 25 個基點左右或類似幅度。

I guess when we think about the difference between the improved rates and the improved margin, I guess what are the key kind of blocks that we should think about there? I guess how much of that is maybe cost or acuity above initial expectations? And how much of it I guess, would potentially be incremental investment that you've made? And how to think about whether that investment is part of the baseline are more opportunistic in 2026?

所以當我們思考「費率改善」與「利潤率改善」之間的差異時，我想問關鍵的拆解項目應該怎麼看？其中有多少可能是成本或病情嚴重度高於最初預期？又有多少可能是你們做了額外投資？以及該如何看待這些投資：它是基準的一部分，還是 2026 年較偏機會型的投入？

Stephen thanks very much for the questions this morning. Maybe let me just briefly start with the third quarter improvement. As we mentioned a moment ago, our July 1 rate actions that we received did deliver a sequential margin uplift that we expected while the underlying cost train did remain broadly elevated, but stable and very consistent with what we saw in the second quarter. It's worth knowing we're not looking to provide a specific try to think about the fourth quarter margin outlook. We expect to continue to see normal fourth quarter seasonality.

Stephen，非常感謝你今天早上的提問。我先簡要談一下第三季的改善。如我們剛才提到的，我們在 7 月 1 日取得的費率調整，確實帶來了我們預期的序列性利潤率提升；同時，基礎成本趨勢仍然整體偏高，但穩定，且與我們在第二季看到的情況非常一致。值得一提的是，我們不打算提供一個具體的……來協助思考第四季的利潤率展望。我們預期仍會看到正常的第四季季節性。

And the rate actions are really supporting better half or better second half margins relative to what we saw in the first half. And that's what gives us a much stronger sense for a starting point for 2027 than what we necessarily anticipated midyear Importantly, I don't care, there is a lot of work still to do. Rates are certainly not fully caught up with the underlying costs.

而這些費率調整確實在支撐下半年、也就是第二季之後的利潤率，相較於上半年更好。這也是為什麼我們對 2027 年的起點有更強的把握，較我們年中原先所預期的更好。重要的是，我不在乎——仍然還有很多工作要做。費率當然還沒有完全追上基礎成本。

And our focus here is really on closing that gap and then executing against our targeted medical cost actions. And the progress that we're making on those priorities really reinforces our view here that 2026 is the trust for Medicaid margins and that we will expect improvement again in 2027.

而我們在這裡的重點，確實是要縮小那個差距，並且依照我們鎖定的醫療成本行動來執行。我們在這些優先事項上所取得的進展，也再次強化了我們的看法：2026 年將是 Medicaid 利潤率的谷底，而我們預期 2027 年會再度改善。

Thanks, Mark. And I guess I would just like to reinforce a couple of things because it is both our recent rate actions were an important contributor to third quarter performance. And -- but the progress that we're seeing isn't solely dependent on rates as Mark shared. We've also been executing against a number of operating initiatives that are very much focused on medical cost management, care coordination network performance.

謝謝你，Mark。我想我只想再強調幾點，因為我們近期的調價行動確實是第三季表現的重要貢獻因素。不過——如 Mark 所分享的——我們看到的進展並不僅僅依賴費率。我們也在推動多項營運計畫，重點聚焦在醫療成本管理、照護協調與網絡績效。

And so I think the way we're thinking about the business is simple. We need appropriate rates. We need disciplined execution, and we're making progress on both fronts. And that's why our confidence in margin improvement has increased.

所以我認為我們對這項業務的思考方式很簡單。我們需要合適的費率。我們需要有紀律的執行，而我們在這兩方面都在取得進展。這也是為什麼我們對利潤率改善的信心提高了。

Thank you for the question. Next question.

謝謝你的提問。下一題。

Lisa Gill, JPMorgan.

Lisa Gill，摩根大通（JPMorgan）。

Thanks very much. Good morning. I want to switch over to Carelon for a minute. When I look at the quarter, Carelon Rx came in better than what our expectations were. You highlighted that part of this is due to product revenue. Can you just talk about what you're seeing on the Carelon Rx side -- is this specialty infusion, how you're thinking about that business?

非常感謝。早安。我想先切換到 Carelon 談一下。當我看這一季時，Carelon Rx 的表現優於我們的預期。你們提到其中一部分是來自產品營收。能否談談你們在 Carelon Rx 端看到的情況——這是專科輸注（specialty infusion）嗎？你們如何看待這塊業務？

And then dove tailing into that, as we think about '27, Gail, you made a comment about integrated medical and pharmacy for '27 in the sales -- selling season. Can you maybe just talk about what your expectations are on the pharmacy side as we go into '27?

接著延伸到這點，當我們思考 2027 年時，Gail，你提到在 2027 年的銷售季（selling season）會有整合式醫療與藥局（integrated medical and pharmacy）。你能否談談我們進入 2027 年時，你對藥局端的預期？

Lisa, thanks very much for the question, and I really appreciate an opportunity to talk about Carelon. So Carelon, from an earnings perspective, especially in Rx side, had a very strong quarter. We were up at 10.8% on an operating gain basis. Operating margin was 5.3% for the quarter. And that margin performance really reflected very solid underlying PDM execution as well as improved performance in our dispensing assets.

Lisa，非常感謝你的提問，也很感謝有機會談談 Carelon。就獲利角度而言，Carelon——特別是 Rx 端——本季表現非常強勁。以營運獲利（operating gain）計算，我們成長了 10.8%。本季營業利益率為 5.3%。而這樣的利潤率表現，確實反映了非常扎實的 PDM 執行力，以及我們配藥資產（dispensing assets）績效的改善。

And I think it's really important because it ties back to our strategy here in Carelon Rx, which is very much centered on integrated medical and pharmacy management and on controlling those levers that matter the most to total cost of care.

我認為這點非常重要，因為它回扣到我們在 Carelon Rx 的策略：核心在於整合式的醫療與藥事管理，並掌控那些對整體照護成本（total cost of care）影響最大的槓桿。

What we have seen is as we integrate medical and pharmacy, our members are benefiting by saving up to $100 per member per month and we see membrane integrated plans also experience about 30% or more fewer emergency room visits. So we feel very strongly about the Carelon Rx model. We're differentiated as we combine at pharmacy scale with that medical integration, we feel very supportive of how the quarter progressed.

我們看到的是，當我們把醫療與藥局整合後，我們的會員可受益於每位會員每月（PMPM）最多節省 100 美元；而我們也看到，採用整合方案的會員，其急診就診次數也會減少約 30% 或更多。因此我們對 Carelon Rx 模式非常有信心。我們的差異化在於：在具備藥局規模的同時，結合醫療整合；我們也對本季的進展感到非常振奮。

Thanks, Mark. And to your question, I think Mark answered it. We're very encouraged by the selling season and very encouraged by the integration between our medical and pharmacy clients. And as he shared, we're seeing almost $100 PMPM savings advantage for those clients, and I think that's what's really resonating in the marketplace.

謝謝你，Mark。針對你的問題，我想 Mark 已經回答了。我們對銷售季的表現非常受到鼓舞，也對我們醫療與藥局客戶之間的整合非常受到鼓舞。如他所分享的，我們看到這些客戶幾乎有每位會員每月接近 100 美元的節省優勢，我認為這正是市場上最有共鳴的地方。

Next question, please.

請下一題。

Lance Wilkes, Bernstein.

Lance Wilkes，Bernstein。

Great, thanks. Could you talk a little bit about the '27 selling season, in particular, interested in Carelon services? And how much of the outlook and growth might come from internal shifts of contracts as opposed to external.

很好，謝謝。你能談談 2027 年的銷售季嗎？我特別對 Carelon 服務（Carelon services）有興趣。以及展望與成長中，有多少可能來自合約在內部的轉移，而不是外部新增？

And then maybe related to '27, if you could talk a little on from employers second blue bid? And if you want to make a comment about Jeff Park getting appointed over in Carelon, that would be interesting, too.

另外也許與 2027 年相關，如果你能談談雇主端的 second blue bid 也可以。如果你也願意評論一下 Jeff Park 被任命到 Carelon 的事情，那也會很有意思。

Okay. Great. Why don't we ask Mark to talk about Carelon, and then I'd love to have Morgan to talk a little bit about our commercial selling season, which is going quite well. So Mark, please.

好的。很好。不如我們請 Mark 先談談 Carelon，然後我也想請 Morgan 談一下我們商業端的銷售季，目前進展相當順利。所以 Mark，請。

Lance. It's been a little bit since we've had the opportunity to talk about Carelon services on an earnings call. So maybe let me start a little bit with our strategy here as differentiation, and I'll get to your specific question here. So we're very confident in the broad growth trajectory of the Services business as we head into 2027.

Lance。我們有一段時間沒有在財報電話會議上談到 Carelon 服務了。所以我先從我們在這裡的策略與差異化談起，然後再回答你的具體問題。展望 2027 年，我們對服務業務（Services business）整體的成長軌跡非常有信心。

Our growth model is pretty straightforward. We've got to improve value internally and then we've got to scale externally -- and our affiliated health plans really give us that opportunity to refine our clinical model to demonstrate their financial impact before we bring those capabilities to external customers. And we've got a number of differentiators in how we connect those capabilities. Examples here could be Health OS and some of our connected clinical data, they really have helped us build a much more complete view of the member.

我們的成長模式相當直接。我們必須先在內部提升價值，然後再向外部擴張規模——而我們關係企業的健康計畫（affiliated health plans）確實給了我們機會：在把能力帶給外部客戶之前，先精煉我們的臨床模型，並展示其財務影響。而我們在串聯這些能力的方式上，也有多項差異化優勢。例如 Health OS 以及部分互聯的臨床資料，確實幫助我們建立對會員更完整的視圖。

And then we have AI-enabled workflows that help translate that information into earlier support through our risk-based programs, including, for example, care in the home. And objective here is really solidly focused on coordination across settings with a much greater accountability for outcomes and total cost of care.

此外，我們也有 AI 賦能的工作流程，能把這些資訊轉化為透過我們的風險型（risk-based）方案更早期的支持，例如居家照護（care in the home）。而我們的目標，確實是聚焦在跨場域的協調，並對結果與整體照護成本（total cost of care）承擔更高的責任。

In terms of the 2027 external selling season, I'd say it's progressing very well on the services side. We've already secured a number of new wins across key businesses. Including behavioral health, clinical care services as well as specialty and post-acute. We've also seen very good retention. We've exceeded 90% across the majority of our product and clinical risk solutions and that gives us a very durable base on which to add new business. And finally, I'd add here, the pipeline remains pretty broad. And so we feel very good about going into next year.

就 2027 年外部銷售季而言，我會說在服務端的進展非常順利。我們已在多個關鍵業務上拿下若干新的勝案。包括行為健康（behavioral health）、臨床照護服務，以及專科與急性後期（post-acute）。我們也看到非常好的續約表現。在我們多數產品與臨床風險解決方案上，續約率已超過 90%，這提供了非常穩固的基礎，讓我們能在其上新增業務。最後我也要補充，我們的商機管線（pipeline）仍相當廣泛。因此我們對進入明年感到非常樂觀。

Morgan?

Morgan？

Yes. Thanks for the question. A couple of things there. I want to touch on the 2027 cycle, first of all, has come together quite nicely, as Mark indicated, we started with a pipeline of over 1 million members in the RFP and we've had meaningful wins this cycle for 1/1/27. Notably, several large jumbo employers have moved back to Anthem after moving away for 12 months. it's been quite nice to see that. And of course, it has the full suite of the Carelon solutions as well as part of it. So nonetheless, feeling really strong about it.

是的。謝謝你的提問。這裡有幾點。我先談 2027 年的周期：如 Mark 所說，整體進展相當不錯；我們一開始在 RFP 中的管線超過 100 萬名會員，而在這個周期中，我們針對 1/1/27 取得了具意義的勝案。特別值得一提的是，有幾家大型超大型（jumbo）雇主在離開 12 個月後又回到 Anthem。看到這點相當令人欣慰。當然，這其中也包含 Carelon 解決方案的完整套組以及其中一部分。總之，我們對此感覺非常強勁。

As we think, too, about the second blue bid. Second blue bid is part of that $1 million, that $1.70 million number that we had upfront. So we've done quite well there. And so we're not winning every one of them, but the market is keeping the benefits of the settlement with the Blues and having different solutions available for them.

另外，談到 second blue bid。Second blue bid 是我們一開始提到的那個 100 萬、170 萬（1.70 million）數字的一部分。所以我們在那方面做得相當好。因此我們並不是每一案都贏，但市場正在保留與 Blues 和解所帶來的利益，並且讓他們有不同的解決方案可供選擇。

At the end of the day, I'll tell you the market is myopically focused on affordability and simply, and that's precisely what we're doing as well. So we're having a very solid season, 2028 is starting off strong. and we look forward to continued success in the commercial space.

歸根結底，我會告訴你，市場以短視的方式聚焦在可負擔性上，而這也正是我們正在做的事情。因此，我們這一季表現非常穩健，2028 年開局強勁。我們也期待在商業領域持續取得成功。

And Lance, to your final question, we are pleased to welcome Jeff Park as President of Carelon. As you saw from his background, he brings the significant amount of experience building and scaling health services and pharmacy businesses and importantly, has a proven track record of execution, which is a key focus for us.

另外，Lance，針對你最後一個問題，我們很高興歡迎 Jeff Park 出任 Carelon 總裁。如你從他的背景所見，他在建立並擴展健康服務與藥局業務方面擁有豐富經驗；更重要的是，他具備經過驗證的執行紀錄，而這正是我們的重點關注。

We see this. We've built a strong team inside of Carelon already, and this appointment continues to help us position for the next level of growth. So we're excited about having him join the team. And as you heard from us, we have a lot of excitement about Carelon and the ongoing contribution and growing contribution it's going to make to our earnings as we move forward.

我們確實看到了這一點。我們已在 Carelon 內部建立了一支強大的團隊，而這項任命將持續協助我們為下一階段的成長做好布局。因此，我們很期待他加入團隊。正如你們所聽到的，我們對 Carelon 充滿期待，並且隨著我們向前推進，它將對我們的獲利帶來持續且日益增加的貢獻。

So thank you for the question. Next question, please.

謝謝你的提問。請進行下一個問題。

Scott Fidel, Goldman Sachs.

Scott Fidel，高盛。

Good morning. I wanted to maybe stick on the commercial group market and just ask about the underwriting environment? And specifically, if you could talk about maybe what your current view on medical cost trend is for '26 and then how you're pricing for '27? I know you talked about continuing to be disciplined. Just curious on whether you're sort of pricing for a stable view on trend or some further acceleration?

早安。我想把焦點放在商業團體市場，請教一下承保環境如何？特別是，能否談談你們目前對 2026 年醫療成本趨勢的看法，以及你們如何為 2027 年定價？我知道你們提到會持續保持紀律。我只是好奇，你們的定價是假設趨勢維持穩定，還是會有進一步加速？

And then just maybe touch on some of the key underlying drivers and obviously with IDR, in particular being topical.

另外，也請談談一些關鍵的底層驅動因素，當然 IDR 尤其是目前的焦點。

Scott, good morning. So commercial group cost trend remains elevated, relatively stable and most importantly, in line with our pricing assumptions. And specifically, we priced 2026 and 2027 for a low double-digit cost trained environment. And we have a plan really built around stability year-over-year. And that includes incorporating the impact of the independent dispute resolution process. We certainly recognize the emerging pressure in mid-2025 and we incorporated that experience into our claims base and our forward train discussions that we used to price this year and next year. And importantly, our own IDR experience has remained very consistent with those assumptions.

Scott，早安。商業團體的成本趨勢仍然偏高、相對穩定，更重要的是，與我們的定價假設一致。具體而言，我們對 2026 與 2027 的定價，是以低雙位數的成本趨勢環境為基礎。我們的規劃確實是以年度之間的穩定性為核心。其中也包含納入獨立爭議解決（IDR）流程的影響。我們確實注意到 2025 年年中出現的壓力，並已將該經驗納入我們的理賠基礎與前瞻趨勢討論，用以支撐今年與明年的定價。而且很重要的是，我們自身的 IDR 經驗一直與這些假設非常一致。

If I stay back just for a moment here, IDR is obviously an industry-wide affordability issue -- and its impact varies meaningfully by geography, by funding arrangement as well as provider and network mix. And within our business, the pressure has been much more pronounced in our ASO block than in fully insured. And those differences obviously are together with those differences together with how each carrier ultimately prices its business means that other experiences could be different from our own.

我再補充一下，IDR 顯然是全產業的可負擔性議題——其影響會因地理區域、資金安排，以及提供者與網路組合而有顯著差異。在我們的業務中，壓力在 ASO（僅行政服務）業務區塊上比在全保（fully insured）更為明顯。而這些差異，再加上各家保險公司最終如何為其業務定價，意味著其他公司的經驗可能會與我們不同。

The final comment I'll make here is we have a very good and broad access to the Blues network into the blue card claims data. And that gives us great visibility into emerging patents -- and we're using those insights to strengthen both the claims review and dispute validity around IDR but more importantly, to price our products to ensure that we are ahead of any trend and the curve for 2027.

最後我想說的是，我們能非常充分且廣泛地存取 Blues 網路以及 Blue Card 的理賠資料。這讓我們對新出現的模式有很高的能見度——我們正運用這些洞見來強化 IDR 相關的理賠審查與爭議有效性判定，但更重要的是，用於產品定價，以確保我們在 2027 年能走在任何趨勢之前、領先曲線。

Next question, please.

請進行下一個問題。

Kevin Fischbeck, Bank of America.

Kevin Fischbeck，美國銀行。

Great, thanks. Maybe just going back to Medicaid. Obviously, you're looking for improvement in 2027 margins. Can you just remind us how long you think it might take for you to get back to target margins and kind of what the biggest variables are maybe outside of just the impact of our requirements?

很好，謝謝。我想回到 Medicaid。顯然你們希望 2027 年的利潤率改善。能否提醒我們，你們認為大概需要多久才能回到目標利潤率？以及除了（合規）要求影響之外，最大的變數可能是什麼？

We continue to expect Medicaid margins to improve in 2027. And as we've spoken about, that's going to be supported by better rate alignment and a growing contribution from our medical cost actions. States are increasingly incorporating more recent cost experience into their rates, and we're encouraged by the momentum that we see on that side.

我們仍預期 Medicaid 的利潤率會在 2027 年改善。正如我們先前談到的，這將由更好的費率對齊，以及我們醫療成本行動帶來的貢獻增加所支撐。各州正愈來愈多地把較近期的成本經驗納入其費率中，我們也對在這方面看到的動能感到鼓舞。

Rate discussions remain ongoing. States are also in the early stages of assessing how H1 is going to affect membership and acuity, and we spoke a little bit earlier to that. And most importantly, we are engaging proactively with the state partners to advocate in advance full rates that reflect the expected cost of caring for members who remain in the program.

費率討論仍在進行中。各州也正處於早期階段，評估 H1 將如何影響會員數與病情嚴重度（acuity），我們稍早也略有提到。最重要的是，我們正主動與州政府夥伴合作，提前倡議取得能反映預期照護成本的完整費率，以照顧仍留在計畫中的會員。

Over time, to your question, we continue to view 2% to 4% as the appropriate margin target for Medicaid. And the pace of recovery here is particularly going to depend on how quickly rates align with the underlying cost of care. And in addition, as we've discussed, Medicaid cost trend remains elevated, but really importantly, stable. And we'll certainly share more detail on the path to improvement in 2027 on our January earnings call. Thank you.

就你的問題而言，從長期來看，我們仍認為 2% 到 4% 是 Medicaid 合適的目標利潤率。而復甦的速度，將特別取決於費率與底層照護成本對齊的速度。此外，如我們所討論，Medicaid 的成本趨勢仍偏高，但非常重要的是，它是穩定的。我們會在 1 月的財報電話會議上，分享更多關於 2027 年改善路徑的細節。謝謝。

Erin Wright, Morgan Stanley.

Erin Wright，摩根士丹利。

Great, thanks. So in terms of what's embedded for 2027 earnings and your expectations, how are you thinking about the capital deployment or what's embedded on that front from a share buyback standpoint. And somewhat of a similar question and follow-up to some other Carelon questions. Just considering what you were in teeing kind of with the recent hire as well.

很好，謝謝。就 2027 年獲利所內含的內容與你們的預期而言，你們如何看待資本配置？或是在股份回購方面，這一塊目前內含了什麼假設？另外，算是與其他關於 Carelon 的問題相似的追問。也請結合近期的人事任命，談談你們的思考。

I guess, should we interpret this as you lean more into specialty and specialty pharmacy. Are there areas that you feel like you need to invest in or areas like you would have like to have greater scale or presence? Just curious on that front.

我想問的是，我們是否應將此解讀為你們會更著力於專科與專科藥局？是否有你們覺得需要投資的領域，或是希望擁有更大規模或更強存在感的領域？想了解你們在這方面的看法。

Erin, I appreciate the question. There are a couple of different topics there. So let me give a little bit of color. We'll certainly provide more detail in January on the underlying assumptions for 2027 and -- but certainly, on the capital deployment and operating efficiency side, in the near term, our posture is going to be very disciplined or intentionally disciplined. We're looking to really maintain that balance sheet strength. We're looking to fund targeted investments that support margin enhancement in Carelon growth, and we will remain opportunistic on share repurchases.

Erin，謝謝你的提問。你提到的其實有幾個不同主題。我先補充一些背景。我們當然會在 1 月提供更多關於 2027 年底層假設的細節——但就資本配置與營運效率而言，短期內我們的立場會非常有紀律，或說是刻意保持紀律。我們希望維持資產負債表的強度。我們也希望為能支持利潤率提升與 Carelon 成長的精準投資提供資金，同時在股份回購上保持機會主義。

Importantly, over the long term, our capital framework is really unchanged. We're looking to, again, reinvest back into the business, pursue a disciplined M&A focused on integrated capabilities and then return capital to shareholders through either dividends or share repurchases. And alongside that will definitely evaluate selective M&A opportunistically as it becomes available in the market.

重要的是，從長期來看，我們的資本框架基本上沒有改變。我們希望再次把資本再投資回業務、推動以整合式能力為重點且具紀律的併購，並透過股利或股份回購把資本回饋給股東。同時，我們也會在市場出現機會時，機會性地評估選擇性的併購。

And related to that, I thought I'd spend just a minute on specialty because it is central to kill on Rx because it effectively brings that medical and pharmacy management together around patients with the complex needs and our expanding our dispensing capabilities gives us opportunity to connect clinical support more closely with pricing and some of the site of care decisions.

另外，相關地我想花一點時間談談專科（specialty），因為它是 Rx 的核心，因為它能有效把醫療與藥事管理圍繞著有複雜需求的病患整合在一起；而我們擴大配藥（dispensing）能力，讓我們有機會把臨床支持更緊密地連結到定價，以及部分照護場域（site of care）的決策上。

And that basically gives us a direct role in improving the patient's experience. And the one point I want to cite here is that this year, we've launched our Oncology Center of Excellence within BioPlus, and that is strengthening the support that we've provided to patients and their treating physicians and we're seeing solid improvements in turnaround times in medication adherence and most importantly, the measures of quality and service that we provide to our members. Thank you.

而這基本上讓我們能夠直接扮演改善病患體驗的角色。我想在此引用的一點是，今年我們在 BioPlus 內部推出了腫瘤卓越中心（Oncology Center of Excellence），這正在強化我們對病患及其主治醫師所提供的支援；我們也看到用藥依從性相關的處理週期時間（turnaround times）出現扎實改善，最重要的是，我們為會員提供的品質與服務指標也有所提升。謝謝。

Next question, please.

下一個問題，請。

George Hill, Deutsche Bank.

George Hill，德意志銀行。

Yeah. Good morning, guys, and thanks for taking my question. Mark, I was going to ask about commercial expectations for 2027. I guess a couple of quick points. Is the expectation that IDR continues to weigh on results next year?

是的。各位早安，謝謝讓我提問。Mark，我想問一下你們對 2027 年商業保險的預期。我想先快速問兩點。你們是否預期 IDR 明年仍會對業績造成壓力？

And given what you're seeing in trends, are you guys pricing for margin expansion or margin kind of maintenance for next year? And then kind of like the subquestion here is like the expectation for ACA margins given the performance there this year?

另外，根據你們看到的趨勢，你們明年的定價是以毛利率擴張為目標，還是以毛利率大致維持為目標？再延伸一個子問題：鑑於今年 ACA 的表現，你們對 ACA 毛利率的預期是什麼？

So George, let me start just with IDR because I think broadly, I think it's an important policy topic, quite frankly, and as we shared before, we have been on top of IDR and a leader in advocating for change around the administrative processes for several years. So you heard we've incorporated into our assumptions, but honestly strongly believe that it does need to be changed. And our concern is not it's with whether the IDA process is operating as intended. We strongly support the consumer protections that it provides.

George，我先從 IDR 談起，因為我認為整體而言，坦白說這是一個重要的政策議題；而且如同我們先前分享的，我們多年來一直密切關注 IDR，並在倡議行政流程改革方面扮演領導角色。所以你也聽到我們已把它納入假設之中，但我們也確實堅信它需要被改變。我們的疑慮不在於——而是在於 IDA 流程是否如原本設計般運作。我們強烈支持其所提供的消費者保護。

But remember, it was designed as a backstop for resolving a relatively limited number of eligibility payments. And we're seeing significant process disputes, including claim eligibility awards, in many cases, way in excess of what is reasonable. And those outcomes really do suggest that the process is not consistently achieving the purpose.

但請記得，它原本是設計作為解決相對有限數量資格付款爭議的「最後防線」。然而我們看到大量流程爭議，包括理賠資格裁決（claim eligibility awards），在許多情況下遠遠超出合理範圍。而這些結果確實顯示，該流程並未一貫達成其目的。

And I think you also have to think about this, it is beyond health plans. These excessive awards and administrative burdens ultimately cost the entire health care system. And that's why we are taking steps to limit the impact of it as well as advocate both for regulatory and legislative changes to this process because we are seeing it come through in higher consumer costs.

而且你也必須想到，這影響的不只是健康保險計畫。這些過高的裁決金額與行政負擔，最終會讓整個醫療體系付出成本。因此我們一方面採取措施以降低其影響，另一方面也倡議透過監管與立法來改革這個流程，因為我們看到它正以更高的消費者成本形式反映出來。

And by the way, at a time when health care affordability remains the most important issue facing all of us. We believe that we need to resolve this and actually get a fix. So just quickly, I think it's important, our position is pretty straightforward. We support the consumer protections and the nose price deck, but we also know that we need this to strengthen the eligibility controls and improve the administration of this to ensure that there are not excess awards. Again, we've dedicated significant resources to help change this role.

順帶一提，在醫療可負擔性仍是我們所有人面臨的最重要議題之際。我們認為必須解決這個問題並真正完成修正。所以簡單說，我認為這點很重要：我們的立場相當明確。我們支持消費者保護以及「無意外帳單」（No Surprises）價格架構，但我們也知道需要強化資格控管並改善其行政管理，以確保不會出現過度裁決。再次強調，我們已投入大量資源來推動這項改革。

With that, let me have Mark answer the more specific questions that you asked.

接下來，我請 Mark 回答你提出的更具體問題。

You asked the two additional ones in terms of commercial large group fully insured, we're really looking for a plan that is built around stability in year -- sorry, stability in year-over-year. Margins are stable. On the ACA side, we feel pretty good about where the 2027 rates have landed.

你另外問到兩點：就商業大型團體全險（fully insured）而言，我們主要尋求的是一個以年度間穩定性為核心的方案——抱歉，是以年對年穩定性為核心。毛利率維持穩定。至於 ACA 方面，我們對 2027 年費率落點感到相當有信心。

We believe they position us to build on this year's progress and our approach to the ACA market really remains very disciplined and very market-specific, meaning the rates that we filed and that have been approved really reflect our forward view of medical cost trend and morbidity together with any risk adjustment or local benefits or network dynamics that obviously incorporated into that assessment.

我們相信這些費率能讓我們在今年進展的基礎上持續推進；而我們對 ACA 市場的做法仍然非常嚴謹、且高度因地制宜——也就是說，我們所申報並獲核准的費率，確實反映了我們對醫療成本趨勢與疾病負擔（morbidity）的前瞻看法，再加上任何風險調整、在地給付或網路（network）動態等因素，這些都已納入評估。

The last comment I'll make here is that we do expect the risk pool to take more than one renewal cycle to normalize following the expiration of those enhanced subsidies.

我最後想補充的是：在那些加碼補貼到期之後，我們確實預期風險池需要不只一個續保週期才能恢復正常化。

Next question, please.

下一個問題，請。

Ann Hynes, Mizuho Securities.

Ann Hynes，瑞穗證券。

Great. Thank you so much. Maybe we come to you on the ACA, just comment on overall better performance. And with the Wakely data okay versus what you expected in Q2 -- and can you remind us how the disenrollment impacts market acuity, meaning are all the levers that we're seeing in bronze? And if so, how does that help risk adjuster in the gold population? Thanks.

太好了。非常感謝。也許我們回到 ACA，請你們評論一下整體表現變得更好的原因。另外，Wakely 的數據在第二季與你們原先預期相比如何——也請提醒我們，退保（disenrollment）如何影響市場的病情嚴重度（acuity），也就是說，我們看到的所有槓桿是否都集中在青銅（Bronze）計畫？如果是，這又如何幫助在黃金（Gold）族群中的風險調整（risk adjuster）？謝謝。

And thanks for the question. So individual ACA is tracking ahead of our full year expectations. We continue to expect modest year-over-year margin improvement. And what's really encouraging to us is that, that better -- is that better retention has come alongside favorable claims experience. We certainly entered 2026 position for an elevated cost environment while preserving those affordable coverage choices, and we've certainly seen that play out well.

謝謝你的提問。個人 ACA 的表現目前優於我們對全年預期。我們仍預期年對年毛利率會有溫和改善。而最令我們鼓舞的是：更好的——也就是更好的留存率，伴隨著有利的理賠經驗一同出現。我們在 2026 年初就以較高成本環境為前提進行布局，同時保留可負擔的保障選擇，而目前看來確實執行得很不錯。

With the greater membership shift towards Bronze plans to your point, it obviously affects our risk adjustment position. But ACA still continues to perform ahead of our expectations, even after we incorporate that impact. And the September wait helped us inform that -- helped inform that assessment -- we certainly accrued appropriately for it, and we feel good about where we stand as of today.

如你所說，會員結構更往青銅計畫移動，確實會影響我們的風險調整部位。但即使把這個影響納入後，ACA 的表現仍持續優於我們的預期。而 9 月的權重（September wait）也幫助我們形成——幫助我們完善那項評估——我們也已就此適當提列（accrued），並且對截至今日的狀況感到有信心。

Next question, please.

下一個問題，請。

Ben Hendrix, RBC Capital Markets.

Ben Hendrix，RBC 資本市場。

Great. Thank you very much. I wanted to switch back to Medicaid and the margin expansion you're expecting for next year. Just a little more color there. We've talked a lot about the better rate alignment, but I'm wondering if we could touch on some of the other aspects you think are going to drive expansion next year, particularly the care management actions, clinical oversight and interventions you've talked about prior.

太好了。非常感謝。我想把話題切回 Medicaid，以及你們預期明年會有的毛利率擴張。想請你們再多補充一些細節。我們談了很多更好的費率對齊（rate alignment），但我想知道是否也能談談你們認為明年推動擴張的其他因素，特別是你們先前提過的照護管理行動、臨床監督與介入措施。

And then any changing on how you're thinking about the footprint rationalization for next year? Any update there or milestones you've reached on the care management specifically? Thanks.

另外，你們對明年版圖（footprint）合理化的想法是否有任何變化？在照護管理方面，有沒有任何更新或已達成的里程碑？謝謝。

Thanks for the question. So we are strengthening Medicaid cost management really by acting directly on the utilization and the payment patterns that are driving elevated trend. So for example, in behavioral health, we are strengthening clinical oversight and care ordination that's supported by evidence-based review and enhanced analytics. At the same time, we're streamlining authorization processes to support appropriate treatment with less administrative friction on payment integrity, we're expanding claims review and coding policies, including behavioral health payment guidelines AI-enabled analytics have helped us here, identify potentially inappropriate billing and utilization patterns earlier.

謝謝你的提問。我們正在強化 Medicaid 的成本管理，主要是直接針對推升趨勢的使用量（utilization）與支付型態（payment patterns）採取行動。例如在行為健康（behavioral health）方面，我們正在強化臨床監督與照護協調（care coordination），並以實證為基礎的審查與強化的分析能力作為支撐。同時，我們也在精簡授權流程，以在支付完整性（payment integrity）上減少行政摩擦、支持適當治療；我們也在擴大理賠審查與編碼政策，包括行為健康的支付指引；AI 驅動的分析在此也幫了我們，能更早識別可能不適當的請款與使用型態。

You saw some of that in the Wall Street Journal this morning. The idea here is allowing our teams to investigate and respond more quickly. We are also thinking through our provider networks in markets to ensure better alignment of provider performance with affordability, while importantly preserving member access pharmacy management, reimbursement, side of care action, they all complement that work. And so we expect those initiatives to continue to make a growing contribution over time, especially as we begin to step into 2027.

你們今天早上在《華爾街日報》也看到其中一些內容。這裡的想法是讓我們的團隊能更快地調查並回應。我們也在重新檢視各市場的醫療提供者網路，以確保醫療提供者的績效與可負擔性更一致，同時重要的是仍要維持會員可近性；藥事管理、給付（reimbursement）、照護場域（site of care）行動等，也都與這項工作相互補強。因此我們預期這些計畫會隨時間推進而帶來愈來愈大的貢獻，特別是當我們開始邁入 2027 年之際。

Thank you. Next question.

謝謝。下一個問題。

Dave Windley, Jefferies.

Jefferies 的 Dave Windley。

Thanks for taking my question. I wanted to focus on a question on Carelon Risk businesses. During this multiyear period of higher trend pressure, the Carelon risk businesses, the margins there seem to have been able to weather that better seeing less volatility in medical cost pressure than, say, the overall risk business, the health benefits business.

謝謝讓我提問。我想聚焦在 Carelon 風險業務的一個問題。在這段多年期、趨勢壓力較高的期間，Carelon 的風險業務那邊的利潤率似乎更能承受，醫療成本壓力的波動性比起例如整體風險業務、健康福利業務要小。

I'm wondering if and when trend moderates in some of these areas where Carelon takes risk. Can it benefit from the lower cost pressure? Or is it kind of similarly insulated going forward, where we should expect more stability as we have seen over the last several years?

我想請教的是，如果在 Carelon 承擔風險的某些領域裡，趨勢壓力放緩，它是否能受益於較低的成本壓力？還是說它在未來同樣相對具備隔離效果，因此我們應該如同過去幾年所見，預期會更穩定？

I appreciate the question this morning. And again, I just want to complement on the Carelon oriented focus. You can tell I'm very passionate about this area. Maybe let me focus your question a little bit on behavioral health because I think this will be indicative of the broader dynamic that you're calling out here.

我很感謝今天早上的這個問題。另外，我也想再次稱讚你對 Carelon 導向焦點的關注。你可以看得出來我對這個領域非常有熱情。或許我先把你的問題稍微聚焦在行為健康（behavioral health），因為我認為這會反映你在這裡所指出的更廣泛動態。

And if I look at Carelon's behavioral health business, our performance here reflects both the value of our clinical programs and the economics of the contracts. And those contracts are important because they define the population and services that we cover and how risk is shared, which really means we're giving Carelon a different financial exposure than that of our broader health plan.

如果我看 Carelon 的行為健康業務，我們在這裡的表現同時反映了臨床方案的價值以及合約的經濟性。而這些合約很重要，因為它們界定了我們所涵蓋的人群與服務，以及風險如何分攤；這實際上意味著，相較於我們更廣泛的健康計畫，Carelon 承擔的是不同的財務曝險。

And certainly, Carelon's not insulated from broader cost pressures, but its financial results don't mirror the overall cost in we're seeing. So for example, in behavioral health, the clinical value that we're generating is different. That clinical value also supports our health plans. And an example I can give is serious mental illness program serves our affiliated Medicaid members. It allows us to bring those physical and behavioral health care components together, and we do that through more intensive cost management.

當然，Carelon 並非不受更廣泛成本壓力影響，但它的財務結果並不會與我們所看到的整體成本完全同步。例如在行為健康方面，我們所創造的臨床價值是不同的。這個臨床價值也支持我們的健康計畫。我可以舉的例子是：嚴重精神疾病方案服務我們關聯的 Medicaid 會員。它讓我們能把身體與行為健康照護的組成整合在一起，而我們是透過更密集的成本管理來做到這點。

It also helps with medication adherence, it reduces inpatient and emergency department use and allows us to, at the Carelon level, delivered gross margin that's ahead of plan, even in a business or product where you typically see high cost trends.

它也有助於用藥依從性，降低住院與急診使用，並讓我們在 Carelon 層級，即使是在通常會看到高成本趨勢的業務或產品中，也能交付高於健康計畫的毛利。

And those are the results that demonstrate that the unique attributes that Carelon offers in terms of caring for complex and chronic populations, where we can continue to deliver value even in an environment where cost trend is pressured in the health plan side of the business.

而這些結果證明了 Carelon 在照護複雜與慢性族群方面所提供的獨特屬性；即使在健康計畫端的成本趨勢承壓的環境下，我們仍能持續交付價值。

Thank you, Mark. And the other thing, Dave, I would also think about is we're also seeing Carelon be deeper and broader in its impact and its growth is coming from that as well where we have an opportunity to scale both inside of Elevance, but also importantly, externally with Elevance as we brought these capabilities together. And I think it is the synergy of bringing those capabilities to focus on these high-cost populations. That's really the opportunity that we see for continued growth.

謝謝你，Mark。Dave，另外我也會這樣看：我們也看到 Carelon 的影響更深更廣，而它的成長也來自於此；我們有機會在 Elevance 內部擴大規模，但同樣重要的是，當我們把這些能力整合起來之後，也能在外部市場擴張，並以 Elevance 的名義對外提供。我認為，把這些能力協同起來、聚焦在這些高成本族群上，這正是我們看到可持續成長的機會所在。

Next question, please.

下一個問題，請。

Jason Cassorla, Guggenheim Securities.

Guggenheim Securities 的 Jason Cassorla。

Great. Thanks for taking my question. Maybe going back to the exchanges. I guess, first, it sounds like you're looking to exit this year with at least 1.2 million members. It would suggest that, that would be something close to like a mid- to high single-digit sequential drop in exchange enrollment versus this quarter. Is there anything specific driving that dynamic? Or is that just conservatism?

好的。謝謝讓我提問。或許回到交易所（exchanges）的話題。我想，首先，聽起來你們希望今年年底至少有 120 萬名會員。這似乎意味著，相較於本季的交易所投保人數，序列（sequential）會出現大約中到高個位數的下滑。有什麼特定因素在驅動這個變化嗎？還是只是保守估計？

And then you talked about sustaining your improved performance next year. It will take more than one cycle for the risk pool to get back to correct, I guess any thoughts on kind of like how you're thinking about the overall exchange market enrollment for next year and how that shakes out to would be helpful.

另外你們提到明年要維持改善後的表現。我想風險池要回到正確狀態不只需要一個週期；想請問你們對明年整體交易所市場投保人數的看法，以及最終會如何發展，若能分享會很有幫助。

Jason, I appreciate the opportunity to cover a little bit here. So the effectuation rates and the retention that we are seeing in the exchange markets have been better than we expected. And that supports our stronger year-end membership outlook. We ended the third quarter with approximately 1.3 million individual ACA members, and that compared to our expectation of about $1.2 million.

Jason，謝謝你讓我們有機會在這裡多說一些。我們在交易所市場看到的生效率（effectuation rates）與續保率都比預期更好。這也支持我們對年底會員數更強的展望。我們在第三季末約有 130 萬名個人 ACA 會員，對比我們原先預期約為 120 萬。

Affordability has obviously been an important driver. Obviously, as consumers take greater premium responsibility following the expiration of the enhanced subsidies. We have seen a meaningful shift towards those lower premium brand plans. And it's those options that are helping people maintain coverage and support better situation across our markets.

可負擔性顯然一直是重要的驅動因素。顯然，隨著加強型補貼到期後，消費者需要承擔更多保費責任。我們看到明顯轉向那些保費較低的品牌方案。而正是這些選項在幫助人們維持保障，並在我們各個市場中支撐更好的狀況。

We're also quite encouraged by the passive renewal cohort, lapses as the a 90-day grace period expired back in April, they were modestly lower than we anticipated, and that left us with a stronger membership base entering both the second and the third quarters, and a favorable experience has continued as the year has progressed.

我們也對被動續保族群感到相當鼓舞；在 4 月 90 天寬限期到期後的失效（lapses）幅度比我們預期略低，這讓我們在進入第二季與第三季時擁有更強的會員基礎，而且隨著年度推進，有利的經驗表現也持續延續。

We've also seen sales in some of our expansion markets, exceeding expectations and lapses sort of remaining below those midyear assumptions. So fourth quarter still allows for some attrition above historical levels as consumers adjust but even with that assumption, we now expect to end the year with at least 1.2 million individual ACA members.

我們也看到在部分擴張市場的銷售超出預期，而失效情況也大致維持在低於年中假設的水準。因此，第四季仍可能出現高於歷史水準的一些流失，因為消費者在調整；但即便納入這項假設，我們現在仍預期年底至少會有 120 萬名個人 ACA 會員。

Next question, please.

下一個問題，請。

Elizabeth Anderson, Evercore ISI.

Evercore ISI 的 Elizabeth Anderson。

Hi, guys. Good morning, and thanks so much for the question. Maybe a longer-term one about the commercial market. As we continue to see people -- more people shift away from like risk-based to sort of more ASO-type membership, how do you kind of guys kind of ensure that you capture your fair share or more than your fair share of those members as they switch and then able to integrate some of your other products Carelon that you guys have been highlighting on the pools, so we could sort of think about that on a longer-term basis in terms of that growth rate?

嗨，各位。早安，也非常感謝讓我提問。我想問一個比較長期、關於商業市場（commercial market）的问题。隨著我們持續看到更多人從類似風險承擔型（risk-based）轉向較偏 ASO 類型的會員結構時，你們如何確保在這些會員轉換時，能取得你們應得的市占、甚至高於應得的市占，並且能把你們一直強調的其他 Carelon 產品整合進這些客群中？這樣我們就能從長期角度思考其成長率。

Yes. Let me ask Morgan to comment on that.

是的。讓我請 Morgan 來評論一下。

Elizabeth, when I think about the long-term view of the commercial space, I find it one that's, in my opinion, intact. And the markets -- most of our customers look at their health benefit plan as part of their human capital strategy, so they work together hand in glove, so to speak.

Elizabeth，當我從長期角度看商業領域時，我認為它在我看來仍然是穩固的。而市場上——我們的大多數客戶把他們的健康福利計畫視為其人力資本策略的一部分，因此兩者是密切配合、相互協作的。

Cost is changing. People are looking for different funding mechanisms as you just described. We've certainly talked about it a bit between our balance funded as well as our ASO solutions. We do that all the way down market up into our national accounts, of course, which is primarily all on a self-funded basis. This isn't new, and we're seeing people move that way. And so people are still thinking, let's work with a payer that's got a solid network, solid clinical management to avoid having just a stitch together model which we've seen people avoid.

成本正在改變。人們正在尋找不同的資金籌措機制，正如你剛才所描述的。我們確實也談過一些，包含我們的平衡資金（balance funded）以及 ASO 解決方案。我們從中小型市場一路做到大型市場，當然也包括我們的全國性客戶（national accounts），那部分主要都是自籌資金（self-funded）基礎。這並不新鮮，我們也看到人們朝這個方向移動。因此，人們仍在思考：要與一個擁有穩健網路、穩健臨床管理能力的支付方合作，以避免只用拼湊式的模式——我們也看到人們會避免那種做法。

That being, we -- the cost pressure is indeed there. That said, I do think we've got solutions in place for every member in every geography. And we're ready for it, and we're actually in the middle of it, right, quite now. We've been selling different funding mechanisms for several years.

也就是說，我們——成本壓力確實存在。話雖如此，我確實認為我們已為各地區的每一位成員準備好解決方案。而且我們已經準備就緒，實際上我們正處於其中，對，就是現在。我們已經銷售不同的資金籌措機制好幾年了。

Thank you Morgan. And Elizabeth, we just recently had our session with our largest employers. And I just want to share a couple of points, which I think Resonate and Morgan talked to. One is, I think our cost position is resonating. Our ability to drive affordability is really important to employers across the spectrum regardless of size, and that has been I think, a differentiator for us.

謝謝你，Morgan。Elizabeth，我們最近才剛與我們最大的雇主客戶進行了會議。我想分享幾點，我認為這也呼應了 Resonate 和 Morgan 所談到的。第一點是，我認為我們的成本定位正在引起共鳴。我們推動可負擔性的能力，對各種規模的雇主都非常重要，我想這一直是我們的差異化優勢。

The second is integration. We have seen significant amount of large customers in particular coming back to us, as Morgan mentioned earlier in the call, because they want an integrated solution, and that includes also our Carelon capability. So we're seeing more pull-through opportunity with pharmacy and the value we can create.

第二點是整合。我們看到相當多的大型客戶，特別是如 Morgan 先前在電話會議中提到的，因為他們想要一個整合式解決方案而回到我們這裡，而這也包含我們的 Carelon 能力。因此，我們在藥局（pharmacy）方面看到更多的帶動效應（pull-through）機會，以及我們能創造的價值。

And then just simplicity, our ability to really allow their associates to manage care seamlessly. And that's an area that we've been investing in, particularly with some of our digital solutions. More importantly, our care management as well as our advocacy. So I would just bring it together, we feel very good about the commercial market and the progress we've seen. But again, there's a lot of pressure on employers and affordability is paramount. So we want to ensure that we have options. I mentioned a bit about our alternative health plans. That's an opportunity to provide other affordable solutions for employers, certainly down market.

再來是簡化，也就是我們真正讓他們的員工能夠無縫地管理照護的能力。這是我們一直在投資的領域，特別是透過一些數位解決方案。更重要的是，我們的照護管理以及我們的倡議服務（advocacy）。所以總結來說，我們對商業市場以及我們所看到的進展感到非常樂觀。但同樣地，雇主面臨很大壓力，而可負擔性至關重要。因此我們希望確保我們有各種選項。我稍早提到我們的替代型健康計畫。這是為雇主提供其他可負擔解決方案的機會，當然也包括較低端市場。

So thanks for the question. And next question, please?

所以謝謝你的提問。下一題，請？

Ryan Langston, TD Cowen.

Ryan Langston，TD Cowen。

Great. Thanks. In Medicare Advantage, is it fair to say, at least right now that 12% earnings growth next year does not assume getting back to your long-term target margin? And then based on the assumptions of low double-digit cost trend growth in commercial risk, should we expect that enrollment to further contract next year? Thank you.

很好。謝謝。在 Medicare Advantage（聯邦醫療保險優勢計畫）方面，是否可以說，至少就目前而言，明年 12% 的獲利成長並未假設回到你們的長期目標利潤率？另外，基於商業風險（commercial risk）低兩位數的成本趨勢成長假設，我們是否應預期明年該業務的投保人數會進一步收縮？謝謝。

Felicia?

Felicia？

Good morning, and thank you for the question. I think we feel very good about how we are positioned in our Medicare Advantage business. As you know, we started this journey in 2026 even before that, taking a very disciplined approach to our market positioning and very much focus on our footprint and where we believe we have the right to win that we've done that.

早安，謝謝你的提問。我認為我們對 Medicare Advantage 業務的布局非常有信心。如你所知，我們在 2026 年就開始了這段旅程，甚至更早，採取非常嚴謹的方式來進行市場定位，並高度聚焦於我們的覆蓋版圖，以及我們認為具備勝出權（right to win）的區域，而我們也確實做到了。

As we head into 2027, we are building off that strength. We are going to deliver, as you know, in 2026, margins of at least 2% and as we move into 2027, the expectation is that we improve on that margin position. So we feel good about how we're positioned from a Medicare Advantage perspective, and we'll continue along the trajectory to move our long-term target margin range of 3% to 5%.

展望 2027 年，我們將在這些優勢基礎上再接再厲。如你所知，我們在 2026 年將交付至少 2% 的利潤率，而進入 2027 年後，預期我們會在此利潤率基礎上進一步改善。因此，從 Medicare Advantage 的角度來看，我們對自身定位感到樂觀，並將持續沿著軌跡前進，朝我們 3% 到 5% 的長期目標利潤率區間邁進。

Next question, please.

下一題，請。

Whit Mayo, Leerink Partners.

Whit Mayo，Leerink Partners。

Hey, thanks for squeezing me in. Just back on Medicaid. CMS issued some guidelines on ABA therapy back in August and appear some states are responding to this maybe some more than others. I'd just be curious your views on those guidelines and what may now be better within your control as it relates to ABA therapy spend?

嘿，謝謝讓我插隊提問。回到 Medicaid（醫療補助）方面。CMS 在 8 月針對 ABA 治療發布了一些指引，看起來有些州正在回應，可能有些州反應更積極。我想請教你們對這些指引的看法，以及就 ABA 治療支出而言，現在有哪些部分可能更在你們可控範圍內？

Felicia?

Felicia？

Yes. Thank you for the question. Where we sit today, we are very much focused on strengthening our overall medical cost management and behavioral health is certainly an area of opportunity. Many of our states have been working with us to think about ABA therapy. And as you know, it's one of the areas where we've seen very high utilization.

是的，謝謝你的提問。就我們目前的情況而言，我們非常專注於強化整體醫療成本管理，而行為健康（behavioral health）確實是一個機會領域。我們許多州的合作夥伴一直在與我們一起思考 ABA 治療。如你所知，這也是我們看到使用率非常高的領域之一。

I want to be clear, we want our members to have access to the right care at the right place and at the right time. What we are trying to do is to make sure that as this area has expanded, we are leveraging our AI capabilities to understand abnormalities in terms of claims and what's happening with respect to this population.

我想說清楚，我們希望會員能在正確的地點、正確的時間獲得正確的照護。我們正在做的是，確保在這個領域擴張的同時，我們能運用 AI 能力來理解理賠（claims）中的異常情況，以及這個族群相關的狀況。

So we appreciate the support from CMS and certainly from our state partners as we continue to focus on this growing category as we go forward. But it will be important that we deploy our payment integrity capabilities to make sure that we are reviewing claims across the spectrum to avoid any type of misuse in the Medicaid space, but at the same time, making sure that bandwidth have access to the care that they need. So thank you for the question.

因此，隨著我們持續聚焦於這個不斷成長的類別，我們感謝 CMS 的支持，也感謝各州合作夥伴的支持。但同時也很重要的是，我們要部署支付完整性（payment integrity）能力，確保我們能全面審查各類理賠，避免 Medicaid 領域的任何不當使用；但同時，也要確保會員能獲得他們所需要的照護。所以謝謝你的提問。

Thank you, Felicia, and thank you to everyone who joined us this morning. Our third quarter results reflect the meaningful progress that we're making across Elevance Health and the benefits of the actions we've taken to strengthen our performance across the NRI. As you heard today, our earnings foundation is stronger, and we're entering 2027 with greater visibility and greater momentum.

謝謝你，Felicia，也謝謝今天早上加入我們的各位。我們第三季的結果反映出我們在 Elevance Health 全面推進的實質進展，以及我們為強化 NRI 各項表現所採取行動帶來的效益。如同各位今天所聽到的，我們的獲利基礎更為穩固，我們正以更高的能見度與更強的動能邁入 2027 年。

As we look ahead, we remain confident in our ability to deliver at least 12% adjusted earnings per share growth in 2027, supported by the continuing margin improvement in health benefits, our ongoing expansion of Carelon and the greater operating efficiency across our enterprise.

展望未來，我們仍對在 2027 年交付至少 12% 的調整後每股盈餘（EPS）成長充滿信心；這將由健康福利（health benefits）持續的利潤率改善、Carelon 的持續擴張，以及全企業更高的營運效率所支撐。

Thank you for your interest in Elevance Health, and have a great rest of 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 November 21, 2026. You may access the replay system at any time by dialing (800) 391-9853 and international participants can dial (203) 369-3269.

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，至 2026 年 11 月 21 日止。您可隨時撥打 (800) 391-9853 進入重播系統，國際與會者可撥打 (203) 369-3269。

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

今天的會議到此結束。感謝各位的參與，並感謝使用 Verizon 會議服務。您現在可以掛線。