Humana Inc (HUM) 2025 Q1 法說會逐字稿

Good day, and thank you for standing by. Welcome to Humana's first quarter 2025 earnings call. (Operator Instructions) Please be advised that today's conference is being recorded.

您好，感謝您的支持。歡迎參加 Humana 2025 年第一季財報電話會議。（操作員指示）請注意，今天的會議正在錄音。

I would now like to hand the conference over to your speaker today, Lisa Stoner, Vice President of Investor Relations. Please go ahead.

現在，我想將會議交給今天的發言人，投資者關係副總裁麗莎·斯托納 (Lisa Stoner)。請繼續。

Thank you, and good morning. I hope everyone had a chance to review our press release and prepared remarks, which are available on our website. We will begin this morning with brief remarks from Jim Rechtin, Humana's President and Chief Executive Officer; and Chief Financial Officer, Celeste Mellet, which will be followed by a Q&A session, where Jim and Celeste will be joined by George Renaudin, President of Humana's Insurance segment.

謝謝，早安。我希望每個人都有機會閱讀我們的新聞稿和準備好的發言稿，這些都可以在我們的網站上找到。今天上午，我們將首先由 Humana 總裁兼首席執行官 Jim Rechtin 發表簡短講話；以及首席財務官 Celeste Mellet 的會談，隨後是問答環節，屆時 Jim​​ 和 Celeste 將與 Humana 保險部門總裁 George Renaudin 一起參加。

Before we begin our discussion, I need to advise call participants of our cautionary statement. Certain of the matters discussed in this conference call are forward-looking and involve a number of risks and uncertainties. Actual results could differ materially. Investors are advised to read the detailed risk factors discussed in our latest Form 10-K, our other filings with the Securities and Exchange Commission, and our first quarter 2025 earnings press release as they relate to forward-looking statements, along with other risks discussed in our SEC filings. We undertake no obligation to publicly address or update any forward-looking statements and future filings or communications regarding our business or results.

在我們開始討論之前，我需要向通話參與者告知我們的警告聲明。本次電話會議討論的某些事項具有前瞻性，涉及若干風險和不確定性。實際結果可能存在重大差異。建議投資者閱讀我們最新的 10-K 表格、我們向美國證券交易委員會提交的其他文件以及我們 2025 年第一季度收益新聞稿中討論的與前瞻性陳述相關的詳細風險因素，以及我們向美國證券交易委員會提交的文件中討論的其他風險。我們不承擔公開發表或更新有關我們的業務或業績的任何前瞻性聲明和未來文件或通訊的義務。

Today's press release, our historical financial news releases, and our filings with the SEC are also available on our Investor Relations site. Call participants should note that today's discussion includes financial measures that are not in accordance with generally accepted accounting principles or GAAP. Management's explanation for the use of these non-GAAP measures and reconciliations of GAAP to non-GAAP financial measures are included in today's press release. Any references to earnings per share or EPS made during this conference call refer to diluted earnings per common share.

今天的新聞稿、我們的歷史財經新聞稿以及我們向美國證券交易委員會提交的文件也可在我們的投資者關係網站上查閱。電話會議參與者應注意，今天的討論包括不符合公認會計原則或 GAAP 的財務指標。今天的新聞稿中包含了管理階層對使用這些非公認會計準則 (non-GAAP) 指標的解釋以及公認會計準則 (GAAP) 與非公認會計準則 (non-GAAP) 財務指標的調節。本次電話會議中提到的每股盈餘或每股盈餘均指稀釋後每股普通股收益。

Finally, this call is being recorded for replay purposes. That replay will be available on the Investor Relations page of Humana's website, humana.com, later today.

最後，本次通話將會被錄音以供重播。重播將於今天稍晚在 Humana 網站 humana.com 的投資者關係頁面上提供。

With that, I'll turn the call over to Jim.

說完這些，我就把電話轉給吉姆。

Thanks, Lisa. Good morning, everyone, and thanks for joining us. We are pleased with our start to 2025. We are reaffirming our full-year guidance. We came in ahead of plan for Q1. And I will note that some of the outperformance in the quarter is timing related. It is also still early in the year, so we are continuing to monitor trends. This includes changes in consumer behavior due to the IRA.

謝謝，麗莎。大家早安，感謝大家的參與。我們對 2025 年的開始感到滿意。我們重申全年指引。我們提前完成了第一季的計劃。我要指出的是，本季的部分優異表現與時機有關。今年還處於初期階段，因此我們仍在持續監測趨勢。這包括由於 IRA 而導致的消費者行為的變化。

There's nothing new on our litigation related to CMS' 2026 star ratings. We are still waiting on a ruling. I think the best way to describe where we are at at this moment is that while there are still challenges to navigate, there are no surprises. The external environment is evolving as we expected, and we are executing against the things we control.

我們與 CMS 2026 年星級評定相關的訴訟並沒有什麼新消息。我們仍在等待裁決。我認為描述我們目前狀況的最佳方式是，雖然仍有挑戰需要克服，但沒有什麼意外。外部環境正在按照我們預期的方式發展，我們正在根據自己控制的範圍採取行動。

We have scheduled an investor conference on June 16. We have three objectives: one, provide a clearer picture of the earnings power of the business; two, explain what it will take to unlock that earnings power; and three, give you clarity on how to track our progress.

我們已安排於 6 月 16 日召開投資者會議。我們的目標有三：一、更清楚地描繪企業的獲利能力；二、解釋如何才能釋放獲利能力；第三，讓您清楚了解如何追蹤我們的進度。

Now I will briefly describe the progress we are making operationally. And as usual, I will frame my comments today around the four basic drivers of our business. That is product and experience, which drive customer growth; clinical excellence, which delivers clinical outcomes and medical margin; a highly efficient back office and capital allocation; and growth in CenterWell and Medicaid.

現在我將簡要介紹我們在營運方面取得的進展。像往常一樣，我今天的評論將圍繞著我們業務的四個基本驅動力。那就是產品和體驗，推動客戶成長；臨床卓越，提供臨床結果和醫療利潤；高效的後台辦公室和資本配置；以及 CenterWell 和 Medicaid 的成長。

Regarding our Medicare product and experience, there are no changes to our membership guidance for 2025. We had strong performance in OEP, and the early outlook for the rest of the year is trending positively. As we head into the bid cycle, we believe the rate notice better reflects the trend environment and should enable greater industry stability.

關於我們的醫療保險產品和體驗，2025 年的會員指導沒有變化。我們在 OEP 方面表現強勁，今年剩餘時間的早期前景也呈現正面趨勢。隨著我們進入投標週期，我們相信利率通知能夠更好地反映趨勢環境，並能提高產業穩定性。

Regarding clinical excellence, operationally, we continue to make progress on Stars. We are closing gaps in care and driving both quality and experience for our customers. For example, through recent partnerships, we are better engaging members who don't have a primary care provider. We are doing this by pairing in-person home visits with virtual health. We expect this work will close gaps in care by 25% year over year.

關於臨床卓越性，從營運角度來看，我們在 Stars 上繼續取得進展。我們正在縮小護理方面的差距，並為客戶提供更優質、更豐富的體驗。例如，透過最近的合作，我們可以更好地吸引那些沒有初級保健提供者的會員。我們透過將面對面的家訪與虛擬健康相結合來實現這一目標。我們預計這項工作將使護理差距逐年縮小 25%。

Another effort is through our medication adherence campaigns in which we are seeing 30% to 50% reduction year over year in members with late refills.

另一項措施是透過我們的藥物依從性活動，我們發現延遲補藥的會員數量比去年同期減少了 30% 至 50%。

Regarding a highly efficient back office, our G&A costs for the quarter were slightly better than expectations. This was largely due to the timing of costs that will be incurred in the second and third quarter. However, we are also seeing good progress in our cost management efforts. One example is increased use of AI in our contact centers. This technology quickly surfaces complex information to our representatives can have more impactful interactions with our members while reducing call times.

關於高效率的後台辦公室，我們本季的一般及行政費用略優於預期。這主要是由於第二季和第三季將產生的成本的時間安排。然而，我們的成本管理工作也取得了良好的進展。其中一個例子就是我們的聯絡中心越來越多地使用人工智慧。這項技術可以快速向我們的代表提供複雜的訊息，從而與我們的會員進行更有影響力的互動，同時減少通話時間。

Regarding capital allocation and growth in our CenterWell and Medicaid businesses, we're seeing robust patient and membership growth in Primary Care and Medicaid, continued growth in our value-based models in home health, and volume growth in specialty pharmacy. Over the last year, we've added 30 new centers through acquisition and partnership, which are helping to fuel our growth in Primary Care. We received an intent to award notice from Illinois for their new Dual-Eligible Special Needs program. And CenterWell Pharmacy has started its work as the fulfillment center for NovoCare's weight loss medication directed to cash pay customers. As you may have seen in the news yesterday, we have also reached fulfillment agreements with three other companies in the past few days.

關於我們 CenterWell 和 Medicaid 業務的資本配置和增長，我們看到初級保健和醫療補助中的患者和會員人數強勁增長，家庭保健中基於價值的模型持續增長，專業藥房的銷量也在增長。去年，我們透過收購和合作增加了 30 個新中心，這有助於推動我們在初級保健領域的成長。我們收到了伊利諾伊州關於其新的雙重資格特殊需求計劃的授予意向通知。CenterWell Pharmacy 已開始擔任 NovoCare 減肥藥的配送中心，面向現金支付客戶。正如大家昨天在新聞中看到的，我們在過去幾天也與其他三家公司達成了履行協議。

All in, I am encouraged by our recent performance and growth. And with that, I will turn it over to Celeste for a few remarks before we go to Q&A.

總而言之，我們最近的表現和成長令我感到鼓舞。在進入問答環節之前，我將把時間交給 Celeste 發表一些評論。

Thank you, Jim. I would reinforce that while it remains early, we've had a solid start to the year. The underlying fundamentals of the business, including membership and patient growth, revenue and medical cost trends are developing as expected. And we have been doing substantial work around operating efficiencies with a focus on increasing flexibility and operating leverage while also making incremental investments to improve member and patient outcomes and support operational excellence, positioning the company for long-term success.

謝謝你，吉姆。我想強調的是，雖然現在還為時過早，但我們今年已經有了一個好的開始。業務的基本面，包括會員和患者的成長、收入和醫療成本趨勢，都在預期發展。我們一直在提高營運效率方面做大量工作，重點是提高靈活性和營運槓桿，同時進行增量投資以改善會員和患者的治療效果並支持卓越運營，為公司的長期成功做好準備。

The EPS outperformance in the quarter was largely driven by a shift in the expected timing of certain expenses. As a result, we are pleased to reaffirm our full-year outlook, including adjusted EPS guidance of approximately $16.25 and expected insurance segment benefit ratio of 90.1% to 90.5%.

本季每股收益的優異表現主要是由於某些費用預期時間的轉變所致。因此，我們很高興重申我們的全年展望，包括調整後的每股盈餘指引約為 16.25 美元，以及預期保險部門收益率為 90.1% 至 90.5%。

Looking ahead, we remain focused on managing the levers within our control, expanding margins, and realizing the earnings potential of the business. These levers include quality with a focus on delivering industry-leading Stars results on a sustainable basis, clinical excellence, operating efficiencies and continued maturity of our Medicaid and CenterWell businesses through their respective J curves.

展望未來，我們將繼續專注於管理我們控制範圍內的槓桿、擴大利潤率並實現業務的獲利潛力。這些槓桿包括品質（重點是可持續地提供行業領先的 Stars 結果）、臨床卓越性、營運效率以及透過各自的 J 曲線持續成熟我們的 Medicaid 和 CenterWell 業務。

I'm also spending time ensuring every dollar of the balance sheet drives value. Given my background, this is something that has been a major focus for me in prior roles, and I see a real opportunity to continue to increase the efficiency of our balance sheet.

我還花時間確保資產負債表中的每一美元都能創造價值。鑑於我的背景，這是我在之前的職位中一直關注的重點，我看到了繼續提高資產負債表效率的真正機會。

All in, we believe there is substantial value to be unlocked at Humana over the mid and longer term, and we look forward to sharing more at our investor conference in June.

總而言之，我們相信 Humana 在中長期將釋放出巨大的價值，我們期待在 6 月的投資者會議上分享更多內容。

With that, I will turn the call back to Lisa to start the Q&A.

說完這些，我會把電話轉回給麗莎，開始問答環節。

Great. Thank you, Celeste. Before starting the Q&A, just a quick reminder that to fairness in those waiting in the queue, we ask that you please try to limit yourself to one question. Operator, with that, please introduce the first caller.

偉大的。謝謝你，塞萊斯特。在開始問答之前，為了公平起見，請快速提醒一下，請盡量將自己限制在一個問題上。接線員，請介紹第一位來電者。

Sarah James, Cantor Fitzgerald.

莎拉詹姆斯，費茲傑拉領唱者。

Thank you. I was wondering if you could help us with how much of your investments moved out of 1Q. Did it move into 2Q? And outside of the timing of that, did 1Q come in in line with your expectations?

謝謝。我想知道您是否能幫助我們了解第一季您的投資轉出了多少。它進入第二季了嗎？除了時間之外，第一季的表現是否符合您的預期？

So when we gave guidance for several hundred million dollars in investments earlier in the year, we said that the timing would be unclear. Most of the impact of the incremental investments flowed through the MLR in the first quarter was only about 10 basis points. That was in large part because many of the Stars investments that Jim spoke about ramped later in the quarter, and we would expect them to be higher in the second through the fourth. So still the same expectations for the level of investments in the year just later in the year versus the first quarter.

因此，當我們在今年稍早給出數億美元投資指引時，我們表示時間尚不明確。一季透過國債流入的新增投資的影響大部分只有10個基點左右。這在很大程度上是因為吉姆談到的許多明星投資在本季度後期都有所增加，我們預計它們在第二季度到第四季度會更高。因此，與第一季相比，今年稍後的投資水準預期仍然相同。

Ben Hendrix, RBC Capital Markets.

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

Thank you very much. I was wondering if you could give us an update on your thoughts around the past to the 3% MA margin target? Clearly, the Stars ruling will have a big impact there. But just anything changing on kind of the overall investment focus, investment targets, and then kind of the impact you're thinking against this better-than-expected MA rate update we're seeing for 2026? Thank you.

非常感謝。我想知道您是否可以向我們介紹一下您對過去 3% MA 保證金目標的看法？顯然，Stars 的裁決將產生重大影響。但是，整體投資重點、投資目標是否會改變？您認為這會對我們在 2026 年看到的優於預期的 MA 利率更新產生什麼影響？謝謝。

Yeah. largely, we would describe things as we're in the same place that we've been. We're focused on getting back to a 3% margin. As you noted, the exact timing is tied to the outcome on Stars. It's very much where we are focused, but there's no meaningful change or update from what we've communicated in the past.

是的。很大程度上，我們會以我們曾經去過的地方的視角來描述事物。我們致力於恢復 3% 的利潤率。正如您所指出的，具體時間與星星的結果有關。這正是我們關注的重點，但與我們過去所傳達的內容相比，並沒有什麼有意義的改變或更新。

Justin Lake, Wolf Research.

賈斯汀·萊克，沃爾夫研究公司。

Thanks. Just sticking on Stars for a second. I was hoping to see if you had any update on timing. How you are expecting to handle bids, or how we should think you're going this handle it if you don't get an answer by the time you have to submit?

謝謝。只要停留在星星上一秒鐘。我希望看到您是否有任何關於時間的更新。您希望如何處理投標，或者如果您在提交時沒有得到答复，我們應該認為您將如何處理？

And then most importantly, I remember last quarter, you talked about the fact that you had made some real progress coming out of 2024 on your Stars initiatives for 2026 Stars, right, that will come out in October. I'm just curious, I know it's impossible to say where you end up, obviously, given all the volatility and the cut points. But I was wondering if you could tell us, if the cut points don't change, do you feel like you made enough progress that ex cut points, you're going to see enough underlying Star performance improvement to get your Stars back, right, or to be 4 Stars and predominantly in 2026?

然後最重要的是，我記得上個季度，您談到了這樣一個事實：您在 2024 年的 Stars 計劃中取得了一些真正的進展，而 2026 年的 Stars 計劃將於 10 月發布。我只是好奇，我知道，考慮到所有的波動性和臨界點，顯然不可能說出你最終會走向何方。但我想知道您是否可以告訴我們，如果分數線不變，您是否覺得自己取得了足夠的進步，除了分數線之外，您是否會看到足夠多的潛在星級表現提升，從而讓您的星級回歸，對嗎，或者成為 4 星級，並且主要在 2026 年？

Yeah. This is Jim. Let me hit a few things at a high level, and then I'll hand it off to George as well. There were multiple questions in there, so I'm going to try to hit each of them. Stars litigation, we really do not have insight into the timing. It really is it really is the legal system that dictates what that timing is, and we do not have any more visibility than you do. I will let George touch on bids here in a second.

是的。這是吉姆。讓我從高層次談一些事情，然後我也會把它交給喬治。其中有多個問題，所以我將嘗試回答每一個問題。明星訴訟，我們確實沒有洞察時機。確實是法律體系決定了時間安排，我們並不比你們更清楚。稍後我將讓喬治談談這裡的出價。

And then on the outlook on Stars, I'm going to continue to reiterate that we felt good about the progress we made in the fourth quarter of last year, and we feel good about the progress we're making this year. What we're really not going to do is speculate on what exactly that means and what the cut points of this or that. That's a level of speculation that we're just not really going to entertain. But we do feel good about the progress operationally. I think that's the most important message.

然後關於 Stars 的展望，我將繼續重申，我們對去年第四季的進展感到滿意，我們對今年的進展感到滿意。我們實際上不會去猜測這到底意味著什麼以及這個或那個的切點是什麼。我們不會真正考慮這種程度的猜測。但我們確實對營運方面的進展感到滿意。我認為這是最重要的訊息。

And George, do you want to talk about the bids?

喬治，你想談談出價嗎？

Sure. Sure. Thanks, Jim. Justin, the places where we are right now in bids is actually, they're ongoing right now. We're actively working through the Stars strategy. And as we've talked about before, work through the mitigation, diversification strategy really with the idea of reducing the amount of concentration we have on certain contracts.

當然。當然。謝謝，吉姆。賈斯汀，我們現在所處的競標地點實際上正在進行中。我們正在積極實施「星辰」策略。正如我們之前所討論的，透過緩解和多樣化策略來真正減少我們對某些合約的關注。

As we've talked about, that's going to be a multiyear process as we work that through. We're currently working through that diversification. We're working through the bids. Given the competitive nature of the bids, we're not going to share our pricing strategy for competitive reasons, obviously, and we're not going to give any specifics there. But I will tell you that what we're looking to do is balance membership and margins, focusing on maximizing long-term earnings power of the business, and we have to keep that in mind for the future as well. So that's our take going into it.

正如我們所討論的，這將是一個多年的過程。我們目前正在努力實現多樣化。我們正在處理投標事宜。鑑於投標的競爭性質，我們顯然不會出於競爭原因分享我們的定價策略，也不會透露任何具體細節。但我會告訴你，我們希望做的是平衡會員數量和利潤率，專注於最大限度地提高企業的長期獲利能力，我們也必須牢記這一點。這就是我們的看法。

With regard to some of the targets, as we've talked about before, we've set internal targets, contemplating an appropriate buffer as we have our internal teams working towards ever-increasing performance. And so that's the take we're going to have there and that we have to have in order to make sure that we return to industry-leading Stars results.

對於一些目標，正如我們之前談到的，我們已經設定了內部目標，考慮到適當的緩衝，因為我們的內部團隊正在努力提高績效。這就是我們要採取的行動，我們必須這樣做才能確保我們恢復到業界領先的 Stars 成績。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

Can you provide more color on your experience in Part D relative to expectations? And specifically, can you comment on the pace that seniors are tracking into the catastrophic phase? And are there any early indications for how senior behavior or manufacturer behavior is changing this year? Thanks.

您能否提供更多與預期相關的 D 部分體驗的詳細資訊？具體來說，您能否評論一下老年人進入災難階段的速度？是否有任何早期跡象表明今年老年人的行為或製造商的行為將如何變化？謝謝。

A few things. One, generally, trends across our business are trending in line and consistent with our expectations. Our guidance contemplated on the medical side, mid-single-digit growth in trend, and that's consistent with what we're seeing. And on the pharmacy side, low double digits growth, and that is also consistent with what we're seeing.

有幾件事。首先，整體而言，我們業務的趨勢與我們的預期一致。我們的指導考慮了醫療方面，中等個位數的成長趨勢，這與我們所看到的一致。在藥房方面，成長率保持在兩位數以下，這也與我們所看到的情況一致。

We have seen some of the dynamics that have been called out, including higher trends in oncology. We did see that last year, and again, contemplated in our guidance, everything is tracking in line, generally in line with our expectations.

我們已經看到了一些已被指出的動態，包括腫瘤學的上升趨勢。我們確實在去年看到了這一點，並且再次在我們的指導中考慮到，一切都在按計劃進行，總體上符合我們的預期。

Stephen Baxter, Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

Thanks. Just obviously, there's been a lot of membership change on the individual side of the business in particular. I guess, can you walk us through your visibility on risk adjustment at this point in the year and whether that needs to be thought about differently from a visibility point of view versus maybe the recent few years?

謝謝。顯然，個人業務方面的會員人數已經發生了很大變化。我想，您能否向我們介紹一下您對今年這個時候風險調整的認識，以及是否需要從認識的角度與最近幾年進行不同的思考？

And then I imagine you've gone back and probably done some diligence on group MA in light of some of the industry commentary over the past couple of weeks. Can you just give a better sense of kind of maybe what you've looked at on the group MA side? And obviously, the PMPMs are up there, a decent amount more than the individual books. Just trying to make sure that you don't feel like you're seeing some kind of behavioral response to that. Thank you.

然後我想你已經回去了，並且可能根據過去幾週的一些行業評論對 MA 集團做了一些盡職調查。您能否更詳細地介紹一下您在 MA 組方面看到的情況？顯然，PMPM 的數量很高，比單本書的數量多得多。只是想確保你不會感覺到你看到了對此的某種行為反應。謝謝。

It's George. Thanks for the question. So I'll talk a little bit about the membership shifts we're seeing, and I'll hit on group MA real briefly.

是喬治。謝謝你的提問。因此，我將稍微談談我們看到的會員變化，並簡要介紹 MA 小組。

With regard to the membership shifts we're seeing, we're pleased with our membership changes to date, given the members that we gained versus those we exited. We are focused on the long-term earnings power of the business, and what we're seeing is a shift to higher lifetime value segments and membership. We're seeing strong year-to-date performance in markets with a high concentration of members in our best-performing markets, including markets such as Florida, Illinois, and Texas. We're seeing a higher than historical percentage of our non-D-SNP members coming from other plans, which has some good implications for the MRA question that you asked.

關於我們所看到的會員變化，考慮到我們增加的會員數量和我們退出的會員數量，我們對迄今為止的會員變化感到滿意。我們專注於業務的長期獲利能力，我們看到的是轉向更高終身價值細分市場和會員資格的轉變。我們看到，今年迄今為止，在表現最佳的市場中，會員集中度較高的市場表現強勁，包括佛羅裡達州、伊利諾伊州和德克薩斯州等市場。我們發現來自其他計劃的非 D-SNP 成員的比例高於歷史水平，這對您提出的 MRA 問題具有一些良好的啟示。

We want members with sustainable margins. They're pleased with the progress we've made there. So on the individual side, we're very pleased with our strategy thus far, and that's playing out as we had desired.

我們希望會員擁有可持續的利潤。他們對我們在那裡取得的進展感到滿意。因此，從個人角度來看，我們對迄今為止的策略非常滿意，而且其進展正如我們所期望的那樣。

On the group MA side, group MA is performing as expected to date. Revenue medical cost trends develop in line with our expectations. You may recall that in the past quarters, we've talked about the fact that the group segment is one that has had historical multiyear rate change -- guarantees, and that has led to some degradation as we have expected in our earnings guidance. We remain focused on improving those MA margins through renewal cycles. And what I can say today is that we've not seen any changes in behavior concerning trends due to that repricing activity.

在 MA 集團方面，迄今為止，MA 集團的表現符合預期。醫療成本收入趨勢符合我們的預期。您可能還記得，在過去的幾個季度中，我們討論過這樣一個事實，即集團部門是一個經歷了多年歷史性利率變化（擔保）的部門，這導致了一些損失，正如我們在盈利預測中預期的那樣。我們仍然致力於透過更新周期來提高這些 MA 利潤率。今天我可以說的是，我們並沒有看到由於重新定價活動而導致的趨勢行為的任何變化。

So we're happy with where we are with group MA and that it is in line with our expectations.

因此，我們對 MA 集團的現狀感到滿意，並且它符合我們的預期。

And if I could add just to clarify, everything is in line with our expectations to date for both the health plan and CenterWell as it relates to MRA and revenue. The v28 impact is as expected as it was for 2024. And as a reminder, we did call out a pretty significant Humana health plan impact from v28 last year. We called out about 160 basis point impact for 2025, and that is playing out as expected.

我可以補充說明一下，到目前為止，一切都符合我們對健康計劃和 CenterWell 在 MRA 和收入方面的預期。v28 的影響與 2024 年的預期一致。提醒一下，我們去年確實指出了 v28 對 Humana 健康計畫的重大影響。我們預測 2025 年的影響將達到約 160 個基點，而這項結果正符合預期。

AJ Rice, UBS.

瑞銀的 AJ Rice。

Thanks for the comments so far. I guess I'm just trying to think through. You have reiterated that you still have a long-term target of 3% pretax margin in MA. There's a lot of moving parts. Obviously, the open Stars litigation, the Part D changes and how that may play out next year depending on how they do the demonstration projects, et cetera. But you do have a better-than-expected rate update.

感謝您迄今為止的評論。我想我只是想仔細想想。您曾重申，您仍有一個在 MA 達到 3% 稅前利潤率的長期目標。有很多活動部件。顯然，開放的 Stars 訴訟、D 部分變更以及明年可能如何展開取決於他們如何開設展示範項目等等。但您的利率更新確實好於預期。

When you throw all that and everything else into the mix, the trajectory that you're on, is your -- I know you'll give more detail at the Investor Day, but is there any high-level comments you can make about whether the trajectories change your optimism about the progression you can make in '26, '27, and '28 back towards your target margins?

當你把所有這些和其他所有因素都考慮進去時，你所走的軌跡就是你的——我知道你會在投資者日提供更多細節，但你能否就這些軌跡是否會改變你對 26 年、27 年和 28 年朝著目標利潤率邁進的樂觀態度發表一些高層評論？

Yeah. AJ, it's Jim. I'll start off here, and then we'll see if there's anything to add. The headline is, if you set Stars aside, we feel good about the underlying progress of the business. And then the challenge, of course, is then to reconcile that with the Stars outcomes that are unknown.

是的。AJ，我是吉姆。我將從這裡開始，然後我們看看是否還有什麼需要補充。標題是，如果你把星星放在一邊，我們對業務的基本進展感到滿意。當然，接下來的挑戰是將其與未知的星星結果相協調。

And so we do feel good about the underlying progress of the business. And to your point, one of our objectives at the investor conference is to be able to provide a little bit more color into what does that mean and how can you see it. You hit all of the many variables that are largely external that we're having to navigate. And yes, there's a whole bunch of puts and takes in there. The rate notice does better reflect trend, and there are regulatory headwinds that we're still navigating. You know what they all are. They're not new. And we expect that to continue. There's going to be puts and takes in the external environment.

因此，我們對業務的潛在進展感到滿意。正如您所說，我們投資者會議的目標之一就是能夠更詳細地解釋這意味著什麼以及您如何看待它。您遇到了我們必須應對的眾多主要外部變數。是的，這裡面有很多東西。利率通知確實更好地反映了趨勢，而且我們仍在應對監管阻力。你知道它們都是什麼。它們並不新鮮。我們預計這種情況將會持續下去。外部環境將會改變。

What we are really focused on are what are the things that we can control. And there are things that we can control around medical cost, around G&A, around, obviously, Stars. And that really is differentially where we're focused, and that's where we're going to spend most of our time when we get to the investor conference.

我們真正關注的是那些我們能夠控制的事情。我們可以控制醫療費用、一般及行政費用，當然還有明星費用。這確實是我們關注的重點，也是我們在投資者會議上花費大部分時間的地方。

Joshua Raskin, Nephron Research.

Joshua Raskin，腎元研究。

Thanks. Could you provide an overview of the integration strategies you have between the Insurance segment and CenterWell? And within that, can you share performance trends on some of the cohorts and how those have been moving through CenterWell in recent years? I'm really just looking for an update on sort of levels of success you're having in these TBC arrangements and maybe how you plan to accelerate or not accelerate that in the future.

謝謝。您能否概述一下保險部門和 CenterWell 之間的整合策略？在此範圍內，您能否分享一些群體的表現趨勢以及這些群體近年來在 CenterWell 的發展？我實際上只是想了解您在這些 TBC 安排中取得的成功程度，以及您計劃在未來如何加速或不加速這一進程。

Want to start?

想要開始嗎？

Yes, I'll start, and then George may add some pieces on the integration component of the question. At the highest level, what I would again say is we're seeing strong patient growth. We're seeing that both because we're adding clinics, and we're seeing it within clinics. So we're seeing it on both sides. So that's a positive.

是的，我先開始，然後喬治可能會補充一些關於這個問題的整合部分的內容。從最高層面來說，我想再次強調的是，我們看到患者數量強勁成長。我們看到這種情況是因為我們正在增加診所，而且我們在診所內也看到了這種情況。所以我們從兩方面都看到了這一點。這是積極的。

The member growth within maturing clinics is largely in line with where we have been modeling it and expecting it and forecasting it. And so again, we feel good about that. The v28 mitigation efforts are continuing to take hold, and the v28 impact is not really much different at all from what we modeled a couple of years ago. It's almost spot on.

成熟診所的會員成長情況與我們一直以來的建模、預期和預測基本一致。因此，我們對此感到非常高興。v28 緩解措施正在繼續實施，v28 的影響與我們幾年前模擬的情況並沒有太大不同。這幾乎是完全正確的。

And so in total, we feel very good about the Primary Care business in the direction it's headed in. Obviously, the J curves are multiyear. It takes time to work through those like this is an investment that you have to have some patience around. But we feel very good about the nature of the investment and where it's headed. And you're seeing each tranche of new centers performing pretty consistently in the J curve as you would hope or expect. And so that's kind of where we're at broadly.

總的來說，我們對初級保健業務的發展方向感到非常樂觀。顯然，J 曲線是多年的。解決這些問題需要時間，這是一項投資，你必須要有耐心。但我們對於這項投資的性質和未來發展方向感到非常滿意。而且您會看到每一批新中心在 J 曲線上的表現都相當一致，正如您所希望或期望的那樣。這就是我們大致的現況。

And then I'm going to make one comment on integration. Then I'm going to let George jump in. The main message across CenterWell, so this is not just Primary Care, this is across all three pieces of CenterWell, is that all three of those businesses have positive contributions to our Stars performance within the plan to our accurate diagnosis and follow-up of preventative care and the impact that that has on the plan and with retention of members. And so when you really think about, hey, how does that business help? It helps us with the core parts of how you deliver care effectively to MA members, and that's good for the plan. Like that is it in a nutshell.

然後我將對整合發表一點評論。然後我要讓喬治加入。CenterWell 傳達的主要訊息是，這不僅僅是初級保健，而是 CenterWell 的所有三個部分，所有這三家業務都對我們計劃中的 Stars 表現、我們的準確診斷和預防性護理的跟進以及這對計劃和會員保留的影響做出了積極貢獻。所以當你真正思考，嘿，這項業務有什麼幫助？它幫助我們了解如何有效地為 MA 成員提供護理的核心部分，這對計劃來說是件好事。簡而言之就是這樣。

With that, I'm going to hand it to George. He can give you a couple of specific examples.

說完這些，我要把它交給喬治。他可以給你舉幾個具體的例子。

Jim, thanks. So we're seeing a growing share of our members with CenterWell PCO, with our Primary Care organization, which is a big positive. And in line with that, you also see the interaction with our CenterWell Pharmacy and CenterWell Home. And the general thing that we see there is better health outcomes, for example, reduced ER visits, better care and all sorts of medical adherence measures, better care as far as screenings go, and frankly, just more interactions with the patient and our member, which is all very positive, which leads to the Stars results that Jim just mentioned being positive and higher retention.

吉姆，謝謝。因此，我們看到 CenterWell PCO 和我們的初級保健組織的會員比例正在不斷增長，這是一個很大的積極因素。同時，您也可以看到我們與 CenterWell Pharmacy 和 CenterWell Home 之間的互動。我們普遍看到的是更好的健康結果，例如，減少急診就診次數，更好的護理和各種醫療依從性措施，更好的篩檢護理，坦率地說，與患者和我們的會員之間的互動更多，這些都是非常積極的，這導致了 Jim 剛才提到的 Stars 結果是積極的，並且保留率更高。

So all in all, the continuing and the interaction between the insurance side of the business and CenterWell side of the business is very integrated. We are constantly figuring out how we can work better together to deliver better results for our members and their patients.

總而言之，保險業務和 CenterWell 業務之間的持續和互動是非常緊密的。我們一直在思考如何才能更好地合作，為我們的會員及其患者提供更好的結果。

Joanna Gajuk, Bank of America.

美國銀行的喬安娜‧加朱克 (Joanna Gajuk)。

Thank you for taking the questions. So on CenterWell, actually, one question there. What drove outperformance in that segment earnings? You said something in the release along the lines of there's some timing. So I guess before, you were talking about some shift in timing around the investments you were making around Stars, but was there something else that was maybe different in CenterWell? So can you talk about the results in the quarter? Thank you.

感謝您回答這些問題。關於 CenterWell，實際上有一個問題。是什麼推動了該部門收益的優異表現？您在新聞稿中說過類似這樣的時間安排。所以我想，之前您談到了您對 Stars 進行的投資時機的一些變化，但 CenterWell 是否還有其他不同之處？那麼您能談談本季的業績嗎？謝謝。

It's Celeste. So about a third of our beat in the quarter was driven by CenterWell. And so that beat was driven predominantly by PCO and pharmacy. So some is timing related in terms of admin expense, but there is a portion that could be durable, such as favorable pharmacy drug mix. Specifically, we saw favorability on the specialty side, including better-than-expected mix and strong agnostic sales. And then on the PCO side, we did have higher-than-expected patient growth. And then there was some PPD favorability, which we don't expect to repeat. So this could be durable, but it's early in the year, and we're keeping an eye on that.

是 Celeste。因此，本季我們的業績約有三分之一是由 CenterWell 推動的。因此，這一節拍主要由 PCO 和藥房推動。因此，就管理費用而言，有些因素與時間有關，但有些因素可能是持久的，例如有利的藥房藥物組合。具體來說，我們看到了專業方面的良好表現，包括好於預期的產品組合和強勁的不可知銷售。在 PCO 方面，我們的患者成長確實高於預期。然後出現了一些 PPD 有利因素，我們預計這種情況不會再發生。因此，這種趨勢可能會持續下去，但現在還處於年初階段，我們仍在密切關注。

Lance Wilkes, Bernstein.

蘭斯威爾克斯、伯恩斯坦。

Great. Again, on CenterWell, can you talk a little bit about how the individual businesses within CenterWell are performing relative to your '25 and long-term kind of target margin expectations? And within Primary Care, can you talk a little bit about what drove the external revenue growth there? And in general, maybe just a little color on the puts and takes on internal versus external patient growth. Thanks.

偉大的。再次，關於 CenterWell，您能否稍微談談 CenterWell 內部各個業務的表現相對於您 25 年和長期目標利潤預期如何？在初級保健領域，您能否談談推動其外部收入成長的因素？總的來說，也許只是對患者內部和外部成長的體現做了一些說明。謝謝。

It's Celeste. So as I had called out, about a third of our beat in the quarter was driven by CenterWell. Home was in line. PCO was ahead of expectations. Pharmacy was ahead of expectations. As I called out, some of the pharmacy and PCO components that -- specifically the specialty mix and the patient growth could be durable for the year and drive higher results for the year, but it's too early to call out, or it's too early to call on that.

是 Celeste。正如我所說的那樣，本季我們的業績約有三分之一是由 CenterWell 推動的。家裡正在排隊。PCO 超出了預期。藥房的表現超出了預期。正如我所說的，一些藥房和 PCO 組成部分 - 特別是專業組合和患者增長可能會在今年持續下去並推動今年的更高業績，但現在下結論還為時過早，或者說現在下結論還為時過早。

In terms of -- hopefully, I'm answering your question the right way. The growth, revenue growth in CenterWell was driven by a combination of the patient growth, the higher-than-expected patient growth, as well as some favorable PPD. So the patient growth could sustain itself, the PPD would not typically higher in the first quarter. Because of the outperformance in CenterWell, we did have variability in our benefit ratio in the quarter.

就——希望我能正確回答你的問題。CenterWell 的成長和收入成長是由患者成長、高於預期的患者成長以及一些有利的 PPD 等因素共同推動的。因此患者成長可以維持，PPD 通常不會在第一季更高。由於 CenterWell 的出色表現，我們本季的收益率確實存在波動。

Over the course of the year, we would expect the benefit ratio for insurance and the consolidated to be consistent. In this case, the consolidated was lower because of that outperformance, and that's really driven by intercompany eliminations.

我們預計全年保險和合併的福利比率將保持一致。在這種情況下，由於業績優異，合併利潤較低，而這實際上是由公司間抵銷所致。

Erin Wright, Morgan Stanley.

摩根士丹利的艾琳·賴特。

Great. Thanks. On the Medicaid side of the business, how are you thinking now in terms of visibility into that state rate mismatch and how that's progressing now and your confidence in terms of as we go into the second half and resolution of that? And anything in terms of calling out in terms of utilization across that business? Thanks.

偉大的。謝謝。在醫療補助業務方面，您現在如何看待州費率不匹配的可見性以及目前的進展情況，以及您對我們進入下半年並解決這個問題的信心？在整個業務利用率方面有什麼要求嗎？謝謝。

It's George. I'll take this one. So Medicaid is emerging, as we've talked about. It's a pretty strong scaled business with a lot of potential earnings contribution as we go forward. Right now, what we're seeing is Medicaid is performing in line with our expectations for the quarter, and we are prouder and prouder every day to serve an ever growing group of Medicaid members working with our, say, partners.

是喬治。我要這個。正如我們所討論的，醫療補助計劃正在興起。這是一個規模相當強大的業務，隨著我們未來的發展，它將帶來很大的潛在獲利貢獻。目前，我們看到醫療補助計劃的表現符合我們對本季度的預期，而且我們每天都越來越自豪能夠與我們的合作夥伴一起為不斷增長的醫療補助計劃成員群體提供服務。

The Medicaid success is something that we're very proud of. We're presenting a fresh new face on Medicaid through our company through the Healthy Horizons product that we have, and we're excited about the success we've had there. We continue to have strong growth. We've had approximately 100,000 growth year-to-date, in line with the 175,000 to 250,000 growth we expected for the year. We're very excited about ending -- starting to get to a footprint of 13 states.

醫療補助計劃的成功令我們感到非常自豪。我們公司透過我們擁有的「健康視野」產品為醫療補助計劃帶來了全新的面貌，我們對在那裡取得的成功感到非常興奮。我們持續保持強勁成長。今年迄今為止，我們的成長人數約為 10 萬人，與我們預計的 175,000 至 25 萬人的成長人數一致。我們非常高興能夠結束這一進程——開始涵蓋 13 個州。

Georgia declined to rebid the contract, which we're glad to see. And we were selected, as Jim talked about in his opening remarks, for new Illinois contracts for the FIDE and LTSS business. That's pretty exciting because it opens up access to 450,000 duals in Illinois, which is a major win for us, and we're very excited about that. The expansion population continues to grow for us. Virginia implementation is on track and going well. And what we're seeing is modest improvement in margins in '25 as our rates are just to reflect recent trend experience.

我們很高興看到喬治亞州拒絕重新競標該合約。正如吉姆在開幕詞中提到的那樣，我們被選中承擔伊利諾伊州的 FIDE 和 LTSS 業務新合約。這非常令人興奮，因為它為伊利諾伊州的 450,000 個雙打比賽開闢了通道，這對我們來說是一個重大勝利，我們對此感到非常興奮。我們的擴張人口持續成長。維吉尼亞州的實施工作正在按計劃進行，進展順利。我們看到 25 年利潤率略有改善，因為我們的利率只是反映了最近的趨勢經驗。

So overall, we're happy with where we are. We're growing it as we've expected, and we're seeing trends in line with our expectations.

總體而言，我們對目前的狀況感到滿意。我們正在按照預期發展，我們看到的趨勢也符合我們的預期。

I'm going to add just one thing. You had asked about visibility into kind of state-level rate adjustments. One of the benefits of having now expanded into more states and more programs is that while you're not going to get every state right every year, the broader this program grows, the more you can forecast it across states. And so we did not get every single state right this last cycle, and I'm sure we will not get every state right in the next cycle.

我只想補充一點。您曾詢問過有關州級利率調整的可見度。現在擴展到更多州和更多項目的好處之一是，雖然你不可能每年都正確地了解每個州的情況，但這個項目的範圍越廣，你就越能預測各州的情況。因此，在上一個週期中，我們並沒有讓每個州都正確，而且我確信，在下一個週期中，我們也不會讓每個州都正確。

But across the states, it actually was, once again, pretty close to where we expected it to be. And we think we've built in pretty reasonable expectations for the back half of this year and the adjustments that we'll see there as well.

但就各州而言，它實際上再次非常接近我們預期的水平。我們認為，我們對今年下半年以及我們將看到的調整建立了相當合理的期望。

Yeah, that's fair, Jim. And I'll also add that our state partners have been very collaborative in working with us on those rates. And we do have visibility now to 76% of our rate for this year. So again, we feel very good about where we are in our projections.

是的，這很公平，吉姆。我還要補充一點，我們的州合作夥伴在製定這些費率方面與我們進行了非常積極的合作。現在我們確實可以預見今年的利率將達到 76%。因此，我們對我們的預測結果感到非常滿意。

Lisa Gill, JPMorgan.

摩根大通的麗莎吉爾。

Thanks very much. Celeste, I want to go back to your comment around mid-single-digit trend that you're seeing on the medical side. Can you maybe just talk about the level of visibility you have? And did you see any variability as you were exiting the quarter? And then just secondly, I just want to make sure I understand the cadence of earnings. I think that you noted that 60% to 65% of Part D is coming in Q1 because of the changes under IRA. Is there anything else we should be aware of as we think about the cadence of earnings throughout 2025?

非常感謝。塞萊斯特，我想回到你關於醫療方面看到的中等個位數趨勢的評論。能否談談您的知名度水平？當您退出本季時，您是否看到任何變化？其次，我只是想確保我了解收益的節奏。我認為您已經注意到，由於 IRA 的變化，D 部分的 60% 到 65% 將在第一季到達。當我們考慮 2025 年全年的獲利節奏時，還有哪些事情我們應該注意？

Yeah. So as I called out, '25 trends are generally developing as expectations. As you know, the first-quarter flu season was heavy. We did anticipate that because it started later. It didn't scale up in the fourth quarter as it normally would. And we also were in the middle of the spike when we gave our guidance.

是的。所以正如我所說的，『25趨勢總體上正在按照預期發展。眾所周知，第一季流感季節較為嚴重。我們確實預料到了這一點，因為它開始得比較晚。第四季度，其規模並未像往常一樣擴大。當我們給予指導意見時，我們也正處於高峰期。

Beyond the flu, based on the data we have to date, trends are developing as expected. We have data through the end of April, and nothing that we've seen gives us pause. So, so far, in line with our expectations and what's built into our guidance range.

除了流感之外，根據我們迄今為止所掌握的數據，趨勢正在按預期發展。我們掌握了截至四月底的數據，沒有發現任何值得我們擔心的情況。因此，到目前為止，符合我們的預期和指導範圍。

In terms of the cadence of earnings, to your question, our earnings will be front loaded, predominantly driven by IRA. So higher in the first, lower in the second, lower in the third, lower in the fourth. You can see the opposite move, so lower in the first, higher in the second, higher in the third, higher in the fourth in terms of the benefit ratio. One other thing to consider as it relates to the end of the year is that our guidance does anticipate a doc fix in late in the third quarter or in the fourth quarter.

就獲利節奏而言，對於您的問題，我們的獲利將是前期投入，主要由 IRA 驅動。因此，第一個較高，第二個較低，第三個較低，第四個較低。您可以看到相反的走勢，因此從收益率來看，第一個較低，第二個較高，第三個較高，第四個較高。與年底相關的另一件事需要考慮的是，我們的指導確實預計在第三季末或第四季修復文件。

And the impact of that, typically, a full year is -- you get a full-year impact, which you have to recognize in a very short period of time. That would be reflected possibly just in the fourth quarter, depending on when it comes through. So that would put pressure on the end of the year, but it's contemplated within our guidance.

其影響通常是全年的——你會得到全年的影響，你必須在很短的時間內認識到這一點。這可能只會在第四季度反映出來，具體取決於具體時間。因此這會給年底帶來壓力，但這是在我們的指導範圍內的。

Michael Ha, Baird.

麥可·哈，貝爾德。

Thank you. Just a quick clarification from your prepared remarks. You mentioned remaining committed to individual MA margins of at least 3% over time. That change in wording from '27 to over time, anything to read into there? Is that implying '27 is still the target?

謝謝。只是根據您準備好的發言作一個快速澄清。您提到要長期致力於個人 MA 利潤率至少達到 3%。從 27 年開始措辭發生了變化，隨著時間的推移，有什麼可解讀的嗎？這是否意味著 27 仍然是目標？

And I understand your '25 adjusted EPS guide unchanged, but GAAP EPS revised lever of about $1.20 or 8%, there's like there's a pretty large (inaudible) valuation adjustment made for your CenterWell Primary Care centers. Are you marking down the fair value of those centers? Curious if you could talk us through that.

而且我了解到您的 25 年調整後每股收益指南保持不變，但 GAAP 每股收益修正槓桿約為 1.20 美元或 8%，這對您的 CenterWell 初級保健中心進行了相當大的（聽不清）估值調整。您是否正在降低這些中心的公平價值？好奇您是否可以跟我們講講這個。

And I know, Jim, you mentioned your confidence on v28 mitigation efforts, CenterWell. I just wanted to clearly ask, is there any change at all in the post v28 world and your thinking, your viewpoint on the expected J curve of these primary general overall cohort maturation story value-based care, meaning all of your most mature cohorts are still expected to do the same targeted margin going forward as you had targeted for v28? So basically, no structural impairment at all to value-based care because of v28?

我知道，吉姆，你提到了你對 CenterWell v28 緩解措施的信心。我只是想清楚地問一下，在 v28 之後的世界裡，您的想法、您對這些主要一般整體隊列成熟故事基於價值的護理的預期 J 曲線的看法是否有任何變化，這是否意味著所有最成熟的隊列仍然有望實現與 v28 相同的目標利潤率？那麼基本上，v28 不會對基於價值的照護造成任何結構性損害嗎？

Yeah. There are a bunch of pieces in there. I will try to hit a few and then see if the team wants to hit any of the others. Let me start with the 3%. I was not intending to make any change from past commentary. So we are still targeting '27. We don't see any reason that we would not be back to normalized margins in '27 at this point in time. And obviously, it's 2027. But no change from what we've said historically on that front.

是的。裡面有一堆碎片。我會嘗試擊中幾個，然後看看球隊是否想擊中其他的。讓我先從 3% 開始。我無意改變過去的評論。所以我們的目標仍然是 27 年。我們認為目前沒有理由不能在 27 年恢復正常利潤率。顯然是 2027 年。但與我們過去在這方面所說的相比沒有任何變化。

And then going back to the J curves and the CenterWell business, no structural impairment to the performance of those businesses. So once again, we have operationalized or are in the process of operationalizing things that will offset the impact of v28. We expect those J curves to mature as we would before. And the team is doing really, really good work to make sure that that happens.

然後回到 J 曲線和 CenterWell 業務，這些業務的表現沒有受到結構性損害。因此，我們再次啟動或正在啟動一些可以抵消 v28 影響的措施。我們預計這些 J 曲線會像以前一樣成熟。團隊正在做著非常出色的工作以確保這一目標的實現。

It's Celeste. Just to add, first, the ability to hit the MA margin will be partially dependent on Stars. So that will be a big important piece for 2027. Second, as it relates to the move in the put-call, it's a pretty -- it's a very complicated calculation.

是 Celeste。補充一下，首先，達到 MA 利潤的能力部分取決於 Stars。所以這對 2027 年來說將會是一件重要的事情。其次，由於它與看跌期權和看漲期權的變動有關，因此這是一個非常複雜的計算。

There is no implication that we are writing down those assets, that's unrelated to v28. It's just that there is a lot of ins and outs in that calculation. There's nothing to read into the adjustment in the GAAP EPS guidance.

這並不意味著我們正在減記這些資產，這與 v28 無關。只是那份算計裡面有很多來龍去脈。GAAP EPS 指南中的調整並沒有任何可解讀之處。

And can I just add as well that the disproportionate impact of v28 for high-acuity patients was something that was well understood and considered in our forecast, the bid work we've done, the bid work we're doing now. And we have shared in the past, as Celeste said, I think, early on in the call, that bid impact on both the health plan and CenterWell side was very well understood, and it's trending as we've expected. As a reminder, we called out very early the significant health plan impact versus the industry, where we had a higher impact because of a greater share of members with high-performing value-based providers. And that's been continuing to be true and is in line with our expectations.

我還可以補充一點，v28 對高敏感度患者的不成比例的影響是我們在預測、我們已經完成的競標工作和我們現在正在進行的競標工作中充分理解和考慮的。正如 Celeste 所說，我們過去曾分享過，我認為，在電話會議的早期，投標對健康計劃和 CenterWell 方面的影響是眾所周知的，而且趨勢正如我們預期的那樣。提醒一下，我們很早就指出了健康計劃對整個行業的巨大影響，由於我們擁有大量擁有高績效價值型提供者的會員，因此我們的影響力更大。事實一直如此，也符合我們的預期。

David Windley, Jefferies.

傑富瑞的戴維溫德利 (David Windley)。

Thanks for taking my questions. I believe -- and I want to focus on membership, please. Included in the membership decline this year was, I think, about 140,000 duals. I'm wondering if you could comment on the magnitude of margin help you get this year from exiting that particular block of business. Would you aspire to try to get those back in future years? And does 2026 contemplate any more additional exits? Or is that completely done? I think you said that in the past, but I don't remember your answer.

感謝您回答我的問題。我相信—我想專注於討論會員資格。我認為，今年會員人數的減少包括約 14 萬名雙重會員。我想知道您是否可以評論今年退出該特定業務為您帶來的利潤幫助有多大。您是否希望在未來幾年內重新獲得這些？2026 年是否會考慮更多退出？或者說已經完全完成了？我想你以前說過這個，但我不記得你的答案。

We have said without specifically getting into member cohorts, that's a 100,000 level, is that we saw a material -- we targeted and have seen a material improvement in our margins through the plans and the markets that we exited, and we're not going to get on some more specifics.

我們說過，雖然沒有具體涉及會員群體，但這是一個 100,000 的水平，我們看到了一種材料 - 我們已經瞄準並看到了通過我們退出的計劃和市場利潤率的實質性提高，我們不會透露更多細節。

As it relates to duals, to the extent that the -- pursuing those members drive sustainable long-term value for us, we will target them, but we are not going to chase growth for growth's sake if it does not drive sustainable long-term value.

就雙重關係而言，如果追求這些成員能為我們帶來可持續的長期價值，我們就會瞄準他們，但如果不能帶來可持續的長期價值，我們就不會為了成長而追求成長。

The only thing I would add to that, Celeste, is that the additional recent wins we've had in Medicaid really is setting us up for a good grounding as we are preparing ourselves for success in that marketplace, which opens up many dual markets, just as the example I gave regarding Illinois earlier.

我唯一想補充的是，塞萊斯特，我們最近在醫療補助計劃方面取得的額外勝利確實為我們奠定了良好的基礎，我們正在為在該市場取得成功做準備，這開闢了許多雙重市場，就像我之前在伊利諾伊州舉的例子一樣。

And I'm going to add one more thing. I believe you asked how are we thinking about exits in 2026. Every year, there's some puts and takes on places where you're adding plans and stepping away from plans, but we expect it to be a normal year. We're not expecting an outsized level of exits the way that we did this past year. This past year, largely did what we wanted and needed it to do. And so again, we're looking at kind of the normal puts and takes you would see in most years as we head into 2026.

我還要補充一點。我相信您問過我們如何考慮 2026 年的退出。每年，都會有一些事情發生，例如增加計劃或放棄計劃，但我們預計這將是正常的一年。我們並不期望出現像去年那樣大規模的退出。過去的一年，我們基本上完成了我們想要做的和需要做的事情。因此，當我們進入 2026 年時，我們再次看到大多數年份中都會出現的正常收益和收益。

George Hill, Deutsche Bank.

德意志銀行的喬治·希爾。

Thanks for taking my questions. I wanted to follow up on the visibility to cost trend. So as you said, you had data through the end of April. I assume that you meant that was for pharmacy and not for core medical. So I'd be interested in your comments on kind of core medical visibility, where you are here and where you think you are from the end of the year?

感謝您回答我的問題。我想追蹤成本趨勢的可見性。正如您所說，您擁有截至四月底的數據。我認為您的意思是那是針對藥房而不是核心醫療。因此，我對您對核心醫療可見性的評論很感興趣，您目前的情況以及您認為到年底您的情況如何？

And then I kind of wanted to follow quickly on Dave's question on membership acuity. And I guess if you look at the total individual book, we know that you lost about the 140,000 duals members. I guess I would just like macro comments on how much member acuity of the entire book came down and comments on how you think about that as it relates to profitability. And are you seeing -- do you feel like you're seeing better member profitability pursuing a lower acuity book of business or a higher acuity book of business? Thank you.

然後我想快速回答一下戴夫關於會員敏銳度的問題。我想，如果你看一下個人總帳本，我們就會知道你失去了大約 14 萬名雙重會員。我想我只是想就整本書的會員敏銳度下降了多少做出宏觀評論，並評論一下您如何看待這與盈利能力的關係。您是否看到－您是否覺得追求較低敏銳度業務的會員獲利能力較好，還是追求較高敏銳度業務的會員獲利能力較好？謝謝。

So in terms of data, we have authorization data, claims data, as well as insights from our CenterWell assets, including SNF insights from OneHome, drug pipeline and authorizations from our pharmacy, which can be a very, very early indicator of challenges if they are rising, patient utilization from PCO, and we also spent a lot of time with other provider and vendor partners. And nothing we're seeing through the end of April suggest trends outside of our guidance.

因此，就數據而言，我們擁有授權數據、索賠數據以及來自 CenterWell 資產的見解，包括來自 OneHome 的 SNF 見解、來自我們藥房的藥物管道和授權，如果挑戰正在增加，這些可以作為挑戰的非常早期指標，來自 PCO 的患者利用率，我們還花了很多時間與其他提供者和供應商合作夥伴合作。截至四月底，我們看到的趨勢均不符合我們的預期。

In terms of complete claims, we have fully completed claims, mostly fully completed claims through the end of February, but significant data through the end of April.

就完整申領人數而言，截至 2 月底，我們已經全部申領完畢，大部分申領人數已經全部完畢，但截至 4 月底，仍有大量數據。

And then last, with regard to your other question about member acuity, I'll just repeat what I said before regarding we're seeing a shift to higher lifetime value segments. We have strong in-year performance in markets where we have very good performing value-based partners like Florida and Illinois and Texas. And we continue to see that develop as we would like it to as this year goes on. And we're also seeing an interesting thing that we're seeing right now is higher overall member bounce back rates in OEP than we are expecting, which is all very positive to our projections.

最後，關於您關於會員敏銳度的另一個問題，我只想重複我之前所說的內容，關於我們正看到向更高終身價值細分市場的轉變。在佛羅裡達州、伊利諾伊州和德克薩斯州等擁有表現優異的價值型合作夥伴的市場中，我們取得了強勁的年度業績。隨著今年的過去，我們繼續看到它按照我們所希望的方式發展。我們也看到一個有趣的事情，那就是我們現在看到的 OEP 中整體會員的反彈率高於我們的預期，這對我們的預測來說非常積極。

Ann Hynes, Mizuho.

安‧海因斯 (Ann Hynes)，瑞穗。

Thank you. What is the v28 headwind in 2026 to MA rate versus the 160 bps in 2025? Thanks.

謝謝。2026 年 v28 逆風對 MA 利率的影響與 2025 年的 160 個基點相比是多少？謝謝。

Yeah. I'm not sure exactly where that question -- how to answer it other than to say that v28 was phased in over three years. And so when we gave our guidance and when we talked about what we thought the impact was going to be for v28, it is exactly in line with what we talked about at the time. We called out that significant impact versus the industry at CMS release in their note, and we're seeing it develop just as we said, where, for us, it's about 160 basis points higher than what CMS has said the industry impact would be.

是的。我不確定這個問題的具體內容——除了說 v28 是在三年內分階段實施的之外，如何回答它。因此，當我們給予指導並談論我們認為 v28 的影響時，它與我們當時談論的完全一致。我們在 CMS 發布的報告中指出，相對於行業而言，這一影響顯著，而且我們看到它的發展正如我們所說的那樣，對於我們而言，它比 CMS 所說的行業影響高出約 160 個基點。

Okay. I want to thank everybody for joining us today, and I want to thank you for your interest in Humana. I also want to thank our 65,000 associates who serve our members and patients every day. We appreciate everybody's support, and we hope you have a great day. Thank you.

好的。我要感謝今天與我們一起的各位，也感謝你們對 Humana 的關注。我還要感謝每天為我們的會員和患者服務的 65,000 名同事。我們感謝大家的支持，並祝福大家有個愉快的一天。謝謝。

This concludes today's conference call. Thank you for participating. You may now disconnect.

今天的電話會議到此結束。感謝您的參與。您現在可以斷開連線。