Humana Inc (HUM) 2025 Q2 法說會逐字稿

Good day, and thank you for standing by. Welcome to the Humana second-quarter 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 第二季財報電話會議。（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 Lisa Stoner, Vice President of Investor Relations. Please go ahead.

現在，我想將會議交給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 both available on our website.

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，它們都可以在我們的網站上找到。

We will begin this morning with brief remarks from Jim Rechtin, Humana's President and Chief Executive Officer; and Chief Financial Officer, Celeste Mellet. Following these remarks, we will host a question-and-answer session where Jim and Celeste will be joined by George Renaudin, President of Humana's Insurance segment.

今天上午，我們將首先聽取 Humana 總裁兼執行長 Jim Rechtin 和財務長 Celeste Mellet 的簡短演講。在這些演講之後，我們將舉辦問答環節，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.

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。

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 second-quarter 2025 earnings press release as they relate to forward-looking statements along with other risks discussed in our SEC filings.

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 年第二季度收益新聞稿中討論的詳細風險因素，因為它們與前瞻性陳述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有關。

We undertake no obligation to publicly address or update any forward-looking statements and future filings or communications regarding our business or results. Today's press release, our historical financial news releases, and our filings with the SEC are also available on our Investor Relations site.

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。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。

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.

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, the 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，通話將被錄音以供重播。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 will turn the call over to Jim Rechtin.

說完這些，我會把電話轉給 Jim Rechtin。

Thank you, Lisa. Good morning, everyone, and thank you for joining us. As you've already seen, we delivered a good second quarter and first half relative to our expectations. The outperformance was driven primarily by CenterWell Pharmacy as well as better-than-expected individual MA membership.

謝謝你，麗莎。大家早安，感謝大家的收看。正如您已經看到的，我們第二季和上半年的業績表現優於我們的預期。優異表現主要得益於 CenterWell Pharmacy 以及優於預期的個人 MA 會員資格。

Our second-quarter medical cost trends were in line with expectations. And given these results in our solid first quarter, we are raising our full-year 2025 EPS outlook from approximately $16.25 to approximately $17. While we still have challenges to navigate, the external environment this year continues to evolve largely in line with our expectations, and we are executing against our plan.

我們第二季的醫療成本趨勢符合預期。鑑於我們第一季的穩健業績，我們將 2025 年全年每股收益預期從約 16.25 美元上調至約 17 美元。雖然我們仍面臨挑戰，但今年的外部環境繼續按照我們的預期發展，我們也正在按照計劃執行。

There's actually a lot happening, and I have a great deal to cover today. So let me just remind everybody that I'll frame my comments as I typically do around the four basic drivers of our business.

實際上發生了很多事情，今天我要講的內容也很多。因此，請允許我提醒大家，我將像往常一樣圍繞我們業務的四個基本驅動力來發表我的評論。

The first driver is MA product and experience, which drive customer growth and retention. Second is clinical excellence, which delivers clinical outcomes and medical margin. Third is delivering a highly efficient back office. And fourth is capital allocation and growth in both CenterWell and Medicaid.

第一個驅動因素是 MA 產品和體驗，它們推動客戶成長和保留。第二是臨床卓越，它提供臨床結果和醫療利潤。第三是提供高效率的後台辦公室。第四是 CenterWell 和 Medicaid 的資本配置和成長。

Let me start with our Medicare product and experience. Individual MA membership, as I mentioned before, has declined less than we expected. Part of this improvement is that we've seen more bounce back members.

讓我先介紹一下我們的醫療保險產品和經驗。正如我之前提到的，個人 MA 會員人數的下降幅度低於我們的預期。這種改善的部分原因是我們看到了更多反彈的會員。

So these are members who chose another plan last autumn during AEP, but have come back to us during OEP and ROY. These members typically have better year one economics because we know them, and we can provide better clinical care.

這些成員去年秋天在 AEP 期間選擇了另一個計劃，但在 OEP 和 ROY 期間又回到了我們身邊。由於我們了解這些成員，因此他們通常具有更好的第一年經濟狀況，並且我們可以提供更好的臨床護理。

As you may remember from Investor Day, our retention strategy is an important lever for us on our path to a more sustainable and reliable margins. And so we're excited to see these members returning to Humana. We are also taking aggressive steps to continue to improve the experience for our members in an effort to build upon this performance.

您可能還記得投資者日，我們的保留策略是我們實現更永續和可靠利潤率的重要槓桿。因此，我們很高興看到這些成員重返 Humana。我們也正在採取積極措施，持續改善會員的體驗，並努力在此基礎上再接再厲。

There's a couple of examples. The first is, last week, Humana announced new actions to simplify and streamline the prior authorization process. This builds on the recent commitments made by multiple health plans, including Humana, that were announced by AHIP and June.

有幾個例子。首先，上週，Humana 宣布了新的舉措，以簡化和精簡事先授權流程。這是基於 AHIP 和 June 宣布的多家健康計劃（包括 Humana）近期做出的承諾。

Humana's actions, which go even further than our initial commitment through AHIP will help ensure our members get the right care in a timely manner, while also reducing administrative burdens for physicians as well as improving the experience for our members.

Humana 的行動比我們最初透過 AHIP 所做的承諾更進一步，將有助於確保我們的會員及時獲得正確的護理，同時減輕醫生的行政負擔並改善我們會員的體驗。

I think it's important that we remind everyone that we believe that prior authorization is an important check and balance to ensure appropriate care. It's just that it should be invisible to our members.

我認為我們必須提醒大家，我們相信事先授權是確保適當照護的重要製衡手段。只是它對我們的會員來說應該是不可見的。

In another example of our focus on experience, we have entered into a new partnership with the health care software company, Epic. This partnership makes Humana the first health insurer to integrate health plan information directly into MyChart accounts.

我們注重體驗的另一個例子是，我們與醫療保健軟體公司 Epic 建立了新的合作關係。此次合作使 Humana 成為第一家將健康計畫資訊直接整合到 MyChart 帳戶的健康保險公司。

Why is this important? This brings health plan coverage information into the same place where members frequently go to manage their care decisions. In essence, it provides increased transparency to the cost of care. We know that visibility into the cost of care when care decisions are being made is a big deal for our members, and we want to do everything we can to provide that visibility and transparency.

為什麼這很重要？這將健康計劃覆蓋資訊集中到會員經常去管理其護理決策的地方。本質上，它提高了護理成本的透明度。我們知道，在做出護理決策時了解護理成本對我們的會員來說非常重要，我們希望盡一切努力提供這種可見性和透明度。

Now let me turn to clinical excellence. We are going to focus today almost exclusively on Stars. We'll hit BY '27 and '28 along with the Stars litigation. I'll start with the Stars litigation.

現在讓我來談談臨床卓越性。今天我們將幾乎只專注於星星。我們將在 27 年和 28 年期間與 Stars 訴訟一起展開。我先從 Stars 訴訟案說起。

The court dismissed our case a couple of weeks ago on administrative grounds. They did this because we had not exhausted the optional appeals process with CMS when we originally filed our lawsuit. The appeals process with CMS is now over, and so we have refiled our Stars case in the same court.

幾週前，法院以行政理由駁回了我們的訴訟。他們這樣做是因為我們在最初提起訴訟時尚未用盡 CMS 的可選上訴程序。與 CMS 的上訴程序現已結束，因此我們已在同一法院重新提起 Stars 訴訟。

As we wait for a new ruling, our path forward remains the same. We are continuing to press ahead with urgency on BY '27 and BY '28. Operationally, we are continuing to make strong progress. We are closing gaps in care and driving both quality and experience for our customers. And so there's no change in our message or our tone here today.

在等待新的裁決時，我們的前進道路保持不變。我們將繼續緊急推進 BY '27 和 BY '28 目標。在營運方面，我們正在繼續取得強勁進展。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。因此，我們今天在這裡傳達的訊息和語氣沒有任何變化。

As a reminder, for BY' '27 results, we will be entering a quiet period when we receive planned preview data. So after today's call, we will not be discussing BY '27 Stars until the final results are released by CMS in October.

提醒一下，對於 BY' '27 的結果，當我們收到計劃的預覽資料時，我們將進入一個安靜期。因此，在今天的電話會議之後，我們將不會討論 BY '27 Stars，直到 10 月 CMS 發布最終結果。

Shifting to the area of a highly efficient back office. We have a lot of activity happening in this area right now. During Investor Day, we shared that we were focused on transforming the organization, transforming the organization to enable scalable growth, and drive operating leverage.

轉移到高效率的後台辦公室區域。我們現在在這個領域開展了很多活動。在投資者日期間，我們分享了我們專注於轉變組織，轉變組織以實現可擴展的成長並推動營運槓桿。

This is a multi-year transformation. And it will include both near-term tactical cost programs, but also longer-term efforts to change how we operate through increased automation and use of technology.

這是一個多年的轉變。它不僅包括近期的戰術成本計劃，還包括透過提高自動化程度和使用技術來改變我們的運作方式的長期努力。

This week, we notified eligible employees of an early retirement program to help accelerate efforts with our operating model and to streamline cost. In the next few months, we will also be expanding our efforts to contract out additional aspects of our shared services functions.

本週，我們通知符合資格的員工實施提前退休計劃，以幫助加快我們的營運模式並精簡成本。在接下來的幾個月裡，我們還將加強將共享服務功能的其他方面外包出去。

We are doing this in an effort to streamline and optimize outsourcing capabilities. We will also be evolving some of our employee benefits to bring them in line with industry standards.

我們這樣做是為了簡化和優化外包能力。我們也將改善部分員工福利，使其符合業界標準。

I really want to emphasize that while these changes will reduce cost, the intent is to enable our broader strategy. This will be a multi-year transformation. It will be taken at a measured pace. And the objective is to create a more nimble technology-enabled organization that can respond more quickly to consumer needs and expectations.

我確實想強調的是，雖然這些變化會降低成本，但目的是為了實現我們更廣泛的策略。這將是一場持續多年的轉型。我們將以穩健的步伐進行。我們的目標是創建一個更靈活的技術支援型組織，以便能夠更快地回應消費者的需求和期望。

Now let me turn to capital allocation and the growth of our Medicaid and CenterWell businesses. We're seeing exciting progress in both businesses right now.

現在讓我來談談資本配置以及我們的醫療補助和 CenterWell 業務的成長。我們現在看到這兩項業務都取得了令人興奮的進展。

Strategic expansion of Medicaid continues with the launch of the Virginia contract. This brings our active footprint to 10 states with three more states awarded and pending.

隨著維吉尼亞州合約的啟動，醫療補助計劃的策略擴張仍在繼續。這使得我們的活躍足跡擴展到 10 個州，另有 3 個州已獲得授權或正在等待授權。

I know there's been a lot of curiosity about the impact of the Big Beautiful Bill. Our footprint in Medicaid is largely in non-expansion states, and it tends to be skewed towards the LTSS, or long-term support services population.

我知道很多人對《美麗大法案》的影響感到好奇。我們在醫療補助方面的業務主要集中在非擴張州，並且往往偏向 LTSS 或長期支持服務人口。

These geographies in this population are less impacted by the bill. So while the bill will certainly have some impact, we expect it to be more muted for us versus Medicaid broadly. We remain committed to our Medicaid strategy and the assumptions we made at Investor Day about margin progression.

該人群中的這些地區受該法案的影響較小。因此，儘管該法案肯定會產生一些影響，但我們預計，與醫療補助計劃相比，它對我們的影響會更小。我們仍然致力於我們的醫療補助策略以及我們在投資者日對利潤率成長做出的假設。

Finally, we are encouraged by our CenterWell Pharmacy outperformance year to date. This has been driven by two things. We've seen higher direct-to-consumer volume, and we have seen favorability in specialty pharmacy which is seeing higher volumes and more favorable drug mix than expected.

最後，我們對 CenterWell Pharmacy 今年迄今的優異表現感到鼓舞。這是由兩件事推動的。我們看到直接面向消費者的銷售量增加，我們看到專業藥局的青睞，其銷售量和藥品組合都比預期的要高。

So to conclude, all in, we are pleased with our solid performance year to date and our improved full-year 2025 outlook. As we look ahead, we remain focused on delivering a more stable and compelling MA margin. We continue to have conviction that the strong core fundamentals and growth outlook for MA will allow us to deliver compelling shareholder value over the long term.

總而言之，我們對今年迄今的穩健業績以及 2025 年全年前景的改善感到滿意。展望未來，我們將繼續致力於提供更穩定、更具吸引力的 MA 利潤率。我們始終堅信，MA 強勁的核心基本面和成長前景將使我們能夠長期為股東創造引人注目的價值。

And with that, I will turn it to Celeste for a few remarks before we go to Q&A.

在進入問答環節之前，我將請 Celeste 發表一些評論。

Thank you, Jim. Our second-quarter results reflect solid execution across the enterprise as we focus on returning the business to its full earnings power. And while we remain appropriately prudent in our assumptions heading into the back half of the year, to date, the underlying fundamentals of the business, including membership and patient growth, revenue, and medical cost trends, are developing in line to better than expected.

謝謝你，吉姆。我們第二季的業績反映了整個企業的穩健執行，因為我們專注於讓企業恢復其全部獲利能力。儘管我們對下半年的假設仍然保持適當謹慎，但到目前為止，包括會員和病患成長、收入和醫療成本趨勢在內的業務基本面發展都比預期好。

We are pleased that our performance and outlook support our improved full-year adjusted EPS outlook of approximately $17. And it is important to note that this outlook contemplates an additional approximately $100 million in incremental investments to improve member and patient outcomes and support operational excellence.

我們很高興我們的業績和前景支持我們改善的全年調整後每股收益預期，約 17 美元。值得注意的是，這一前景考慮額外增加約 1 億美元的投資，以改善會員和患者的治療效果並支持卓越營運。

The additional investments are focused in areas where we have seen strong returns to date, such as pairing in-home visits with virtual health to better engage members who don't have a primary care provider and closing gaps in care.

額外投資集中在迄今為止我們已看到強勁回報的領域，例如將上門訪問與虛擬醫療相結合，以更好地吸引沒有初級保健提供者的會員並縮小護理方面的差距。

Turning to the balance sheet and capital deployment. We continue to execute on our efforts to increase the efficiency of our balance sheet and fortify our foundation. And we're making the progress on the sale of non-core assets and optimizing our capital requirements. We will share more on these efforts that plans finalize in the coming months.

轉向資產負債表和資本配置。我們將繼續努力提高資產負債表的效率並鞏固我們的基礎。我們在出售非核心資產和優化資本需求方面正在取得進展。我們將在未來幾個月內分享更多有關這些計劃最終確定的努力的資訊。

With respect to capital deployment, we will remain prudent in our near-term approach, taking a balanced view to evaluating capital investments and returns. As I shared with you at our recent Investor Day, we intend to focus on maximizing shareholder value by executing on share buybacks to offset dilution from stock-based compensation, growing individual -- growing dividends in line with earnings as they recover; and over the long term, executing on accretive M&A for which we have a proven track record.

在資本配置方面，我們將在短期內保持審慎的態度，以平衡的眼光評估資本投資和回報。正如我在最近的投資者日上與大家分享的那樣，我們打算專注於最大化股東價值，透過執行股票回購來抵消股票薪酬稀釋，隨著收益的恢復而增加個人股息；從長遠來看，執行我們擁有良好業績記錄的增值性併購。

Accordingly, we completed approximately $100 million of share repurchases in the second quarter to offset dilution from employee issuance and do not have additional repurchases contemplated for 2025. During the quarter, we also opportunistically bought back approximately $200 million of debt due in 2027 using the proceeds from our bond issuance earlier this year.

因此，我們在第二季度完成了約 1 億美元的股票回購，以抵消員工發行造成的稀釋，並且不考慮在 2025 年進行額外的回購。本季度，我們也利用今年稍早發行債券的收益，趁機回購了約 2 億美元的 2027 年到期的債務。

Looking ahead, we will continue to manage the levers within our control, focused on delivering best-in-class clinical excellence, transforming the company to enable scalable growth, and driving enhanced operating leverage. We believe that these efforts will allow us to expand margin and realize the earnings potential of the business while driving better outcomes for our members, patients, and associates.

展望未來，我們將繼續管理我們控制範圍內的槓桿，專注於提供一流的臨床卓越服務，轉型公司以實現可擴展的成長，並提高營運槓桿。我們相信，這些努力將使我們能夠擴大利潤並實現業務的獲利潛力，同時為我們的會員、患者和同事帶來更好的結果。

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 and Jim. Before starting the Q&A, just a quick reminder. For fairness to those waiting in the queue, which we do have a long list in the queue, we ask that you please limit yourself to one question.

偉大的。謝謝你，Celeste 和 Jim。在開始問答之前，先簡單提醒一下。為了對排隊等候的人公平起見，我們排隊的人名單很長，我們要求您將問題限制在一個範圍內。

So operator, with that, if you'll please introduce the first caller.

接線員，請您介紹第一位來電者。

Ann Hynes, Mizuho.

安‧海因斯 (Ann Hynes)，瑞穗。

In your prepared remarks, you highlighted that cost trends were in line or better than your expectations. Can you talk about what cost trend is actually better than your expectations? And within that, can you just talk about how Medicaid is doing since some of your peers are having some trend problems in that book of business?

在您準備好的發言中，您強調成本趨勢符合或比您預期的好。您能談談哪些成本趨勢實際上比您的預期更好嗎？在此範圍內，您能否談談醫療補助計劃的執行情況，因為您的一些同行在業務方面遇到了一些趨勢問題？

Yeah. We called out that our -- the results we are seeing generally are in line to better than our expectations. So on the revenue side, we are seeing better-than-expected performance. In CenterWell, we saw higher-than-expected patient growth earlier in the year. And as Jim called out, we have seen better-than-expected revenue growth near term on the pharmacy side of things.

是的。我們呼籲——我們所看到的結果總體上符合甚至好於我們的預期。因此，在收入方面，我們看到的表現優於預期。在 CenterWell，我們在今年早些時候看到了高於預期的患者成長。正如吉姆所說，我們看到藥房方面的收入成長近期好於預期。

On the insurance side, membership growth also, as Jim called out, well, it's going to be better than expected. Our guidance now assumes membership decline of around 500,000 -- up to 500,000 versus 550,000 before. That is driving higher revenue with an in-line MLR.

在保險方面，正如吉姆所說，會員成長也將比預期更好。我們現在的預測是會員人數將減少約 50 萬人——從之前的 55 萬人減少到 50 萬人。這透過線上 MLR 推動了更高的收入。

In terms of our overall medical and operating costs, with the exception of the investments we called out earlier, the -- those are trending in line or within the range of our expectations -- in some cases, on the better end of our expectations.

就我們的整體醫療和營運成本而言，除了我們之前提到的投資之外，這些成本趨勢都符合我們的預期或在我們的預期範圍內——在某些情況下，甚至比我們的預期更好。

And then to your last question on Medicaid, Jim talked a bit -- and I'll turn it over to George about the states we're in and the programs that we're in, which is really allowing our business to deliver on what we expected for the year. I'll turn it over to George to talk more about that.

然後，關於您關於醫療補助的最後一個問題，吉姆談了一點——我將把它交給喬治，談談我們所在州和我們所在的項目，這確實使我們的業務能夠實現我們對今年的預期。我將把這個問題交給喬治進一步討論。

Yeah. So as you think about our Medicaid business, as Jim said, you talked about the footprint. But there are really a few reasons why you can’t extrapolate across the whole industry that the Medicaid performance. And really, that's a result of three significant differences that you have to think about with Medicaid.

是的。因此，當您考慮我們的醫療補助業務時，正如吉姆所說，您談到了足跡。但確實存在一些原因導致你無法推斷整個醫療補助行業的表現。事實上，這是由醫療補助計劃 (Medicaid) 的三個顯著差異造成的，您必須考慮這些差異。

One is the products that we're in. And so as Jim said, we're much more oriented towards the LTSS population than the traditional Medicaid population. So that's one factor that you have to think about.

一是我們的產品。正如吉姆所說，我們更注重長期服務人口，而不是傳統的醫療補助人口。這是你必須考慮的因素。

The second is the state footprint. And as you think about the state footprint and where we are, we are in states that -- we have worked very well with the states on the rate development and things are moving well there.

第二是國家足跡。當您考慮州足跡和我們所在的位置時，我們所在的州 - 我們與各州在利率制定方面進行了很好的合作，那裡的情況進展順利。

Now one of the things you may say is, well, you're large in Florida. I think that one of our competitors did acknowledge that their Florida problem was really specific to a population that we don't have exposure to. So again, you have to think about product first. You have to think about the state footprint.

現在你可能會說，嗯，你在佛羅裡達州很大。我認為我們的一個競爭對手確實承認，他們在佛羅裡達州的問題實際上是針對我們沒有接觸過的人群而言的。所以，你必須先考慮產品。你必須考慮國家足跡。

And then the third part that is really important to think about with Medicaid is the network structure. And we believe that our network structure with our heavy emphasis on value-based care creates a differentiator versus where we are elsewhere.

對於醫療補助計劃來說，真正需要思考的第三個部分是網路結構。我們相信，我們的網絡結構高度重視基於價值的護理，與其他地方相比，我們具有差異化優勢。

So with regard to Medicaid, we're really proud of the development we've had and the expansion we've had into now 10 full states and three more coming online.

因此，就醫療補助而言，我們為所取得的發展和擴展感到非常自豪，目前我們已經涵蓋了 10 個州，另外還有 3 個州即將上線。

One thing that we should also mention is, for example, we now have a new Illinois contract that will be coming on. It's a big opportunity for us that emphasizes our prioritization of Medicaid, where we're focusing very hard in states that are linked -- where the Medicaid and D-SNPs are linked and where Humana has an outsized dual membership to protect. So we feel good about development we've seen in Medicaid to date.

我們還應該提到的一件事是，例如，我們現在有一份即將生效的新伊利諾伊州合約。這對我們來說是一個巨大的機會，強調了我們對醫療補助的優先考慮，我們非常重視相關的州 - 醫療補助和 D-SNP 是相關的，並且 Humana 擁有大量的雙重會員資格需要保護。因此，我們對醫療補助計劃迄今為止的發展感到滿意。

Yeah. I think just to sum it up for you, Ann, Medicaid is running in line with our expectations. We're continuing to make progress on new states, and we feel good about where we are.

是的。安，我想總結一下，醫療補助計畫的運作符合我們的預期。我們在新的州繼續取得進展，我們對目前的狀況感到滿意。

Kevin Fischbeck, Bank of America.

凱文‧菲施貝克，美國銀行。

Great. I was wondering if you could talk a bit more about the Part D performance and then any comments you have on the CMS regulations that were just released a couple of days ago, how you're thinking about that for 2026.

偉大的。我想知道您是否可以多談談 D 部分的表現，然後您對幾天前剛發布的 CMS 法規有何評論，以及您對 2026 年的看法。

I will talk about performance to date, and then I'll turn it over to George to talk about the recent CMS announcement.

我將談論迄今為止的表現，然後我將把話題交給喬治來談論最近的 CMS 公告。

So first, not a lot to say about Part D. The member mix and Rx trends are tracking in line with our expectations today. If you recall, we did have -- we were expecting low double-digit trend on the Rx side of things, and it's in line with our expectations.

首先，關於 D 部分沒有太多要說的。會員組合和 Rx 趨勢符合我們今天的預期。如果你還記得的話，我們確實有 - 我們預計 Rx 方面的趨勢將呈現低兩位數，而且這符合我們的預期。

We haven't seen any unexpected behavioral changes to date, and members are hitting their MOOP so far in line with the expectations. So the ramp over the course of the year as members work through that.

到目前為止，我們還沒有看到任何意外的行為變化，而且成員迄今為止的 MOOP 表現都符合預期。因此，隨著成員們努力完成這項任務，這一數字將在一年內逐漸上升。

And I'll turn it over to George on additional comments.

我將把補充評論交給喬治。

Yeah, Celeste. There's not a lot more to say other than we did consider the IRA changes in our bid strategy and then how we set our guidance. Especially, drug trend is high. I mean, let's just say that it is because it is. And -- but that's as expected. And that's the good news is developing as we expected.

是的，塞萊斯特。除了我們確實考慮了 IRA 在我們的競標策略中的變化以及如何設定我們的指導之外，沒有什麼可說的了。尤其是毒品趨勢十分嚴重。我的意思是，我們就說這是因為這是。而且——但這是意料之中的。好消息正在按照我們預期的那樣發展。

We're confident in the pricing strategy that we've seen. Our co-pay versus co-insurance structure is working out the way we intended. So this year, we're seeing PDP develop as we expected, as Celeste said. Members are moving through the corridors as we expected. So that's good.

我們對所見的定價策略充滿信心。我們的共同支付與共同保險結構正在按照我們預期的方式發揮作用。因此，正如 Celeste 所說，今年我們看到 PDP 的發展符合我們的預期。正如我們預期的那樣，成員們正在走廊上走動。這很好。

On the pharmacy for next year and on some of the things that you're seeing in the -- for example, CMS released the recent rules and the national average bid, et cetera. Given the uncertainty of the IRA for '26, we did bid back in conservatively given the changes in the risk corridors.

關於明年的藥房以及您看到的一些事情——例如，CMS 發布了最近的規則和全國平均出價等等。考慮到 26 年 IRA 的不確定性，我們確實根據風險走廊的變化保守地重新出價。

It's come in the way the risk corridors work and the way that the national average bid has worked. It's a little bit better than we expected, which is positive from what we are seeing in direct subsidy. The industry Part D appears to be more consistent next year and within the range of our expectations to slightly better.

它體現在風險走廊的運作方式和全國平均出價的運作方式。這比我們預期的要好一點，從我們看到的直接補貼來看，這是正面的。明年，D 部分產業表現似乎更加穩定，並且在我們的預期範圍內，甚至略有改善。

Andrew Mok, Barclays.

巴克萊銀行的 Andrew Mok。

One of your peers noted a pretty meaningful pullback in the individual PPO market next year. Just curious how you're thinking about the implications of that to your own membership growth and margins for next year.

您的一位同事指出，明年個人 PPO 市場將出現相當顯著的回檔。只是好奇您如何看待這對您明年的會員成長和利潤的影響。

Yeah, let me make a couple of quick comments, and then I'm going to hand off to George to walk you through some of the specifics.

是的，讓我簡單評論幾句，然後我會把發言權交給喬治，讓他向你們介紹一些具體細節。

The -- first of all, big question I know for the entire industry right now given all the discussions that are out there. And there's really, I think, two questions underneath the question. One is, we recognize that there's a lot of talk about.

首先，根據目前的所有討論，我知道這是整個產業目前面臨的一個大問題。我認為這個問題背後其實有兩個問題。一是，我們認識到有很多討論。

Hey, is there an unattractive population from a risk standpoint that tends to bounce around from plan to plan? And then second, why do we seem to feel good about where we're at as we -- both this year and as we head into next year?

嘿，從風險的角度來看，是否存在一個缺乏吸引力的群體，他們往往會在各個計劃之間搖擺不定？其次，為什麼我們似乎對今年以及明年的處境感到滿意？

And the high-level response to that is -- and we try to convey this at the Investor Day -- is we don't see bad membership. We see bad benefit packages and products.

高層對此的回應是——我們試圖在投資者日傳達這一點——我們並不認為會員人數很糟糕。我們看到了糟糕的福利待遇和產品。

And so if your product and your benefit structure is in the right place, all members can be good, profitable, attractive membership. And we feel like we have taken good steps in the last two years to put our product in a good place.

因此，如果您的產品和福利結構正確，所有會員都可以成為優秀、有利可圖、有吸引力的會員。我們覺得，過去兩年我們已經採取了良好的措施，讓我們的產品處於良好的地位。

And again, we feel good about that. We're seeing that this year. We feel good about the trajectory into next year.

我們對此再次感到高興。我們今年就看到了這一點。我們對明年的發展軌跡充滿信心。

And to the extent that others in the industry did not take similar steps in the past or taking it now, we think that's good for everybody. We think that's good for the sector. We think that's good for the industry. We think that is a positive thing.

如果業內其他公司過去沒有採取類似措施，或者現在沒有採取類似措施，我們認為這對每個人來說都是好事。我們認為這對該行業有利。我們認為這對產業有利。我們認為這是一件好事。

And that at the highest level is how we're thinking about it, but let me let George walk through some of the detail behind that. George?

這就是我們在最高層面上對此的看法，但請容許我讓喬治介紹背後的一些細節。喬治？

Yeah. As Jim said, I understand why everyone is thinking about this question. But let me start by reminding you of the market dynamics that we've played out over the last few years.

是的。正如吉姆所說，我理解為什麼每個人都在思考這個問題。但首先讓我提醒大家過去幾年我們所經歷的市場動態。

We were transparent almost two years ago now in discussing utilization trends we are seeing and the impact of v28, and we made adjustments each year since then. We are -- the only plan's to reduce benefits in any way in '24, and we reduced more benefits and more significantly than just about all of our competitors in '25.

大約兩年前，我們在討論我們看到的利用率趨勢和 v28 的影響時就已經很透明了，從那時起我們每年都會做出調整。我們是唯一一家在 24 年以任何方式減少福利的公司，而且我們在 25 年減少的福利比幾乎所有競爭對手都多，而且幅度更大。

In addition to that, we executed on the combination of plan and benefit county exits, impacting 560,000 members. Given these two rounds of significant benefit cuts, we have a significant gap to peers benefit value while some peers held their benefits stable or even invested more in their benefits.

除此之外，我們還實施了計劃和福利縣退出相結合的措施，影響了 56 萬名會員。經過這兩輪大幅的福利削減，我們與同行的福利價值存在明顯差距，而一些同行的福利保持穩定，甚至在福利方面投入更多。

Now it's important to look at the granular MACVAT data. I know a lot of you had pulled that Milliman MACVAT information, but you have to isolate the growth plans. Because if you simply look at the averages without taking out the legacy plans that no one is really selling anymore, you'll get an inaccurate view of how the plans compare.

現在，查看詳細的 MACVAT 數據非常重要。我知道你們中的很多人都已經提取了 Milliman MACVAT 信息，但你們必須隔離增長計劃。因為如果您只是簡單地看平均值而不去掉那些實際上已經沒有人銷售的舊計劃，那麼您對計劃的比較結果就會不准確。

However, if you evaluate the growth plans, those plans you actually see growth on over the last couple of years, you will see a significant gap to our peers that has resulted from the two years of benefit reductions we've implemented.

然而，如果你評估一下成長計劃，那些你在過去幾年裡真正看到成長的計劃，你會發現我們與同行之間存在顯著差距，這是我們實施的兩年福利削減造成的。

And additionally, we also did plan county exits for 2025 that impacted 560,000 members. We've recaptured 40% of those members in other MA offerings.

此外，我們還制定了 2025 年縣退出計劃，影響 56 萬名成員。我們已透過其他 MA 產品重新俘虜了 40% 的會員。

Our goal, if you will recall, was 50%. And we would have been happy with even more recapture because those plans, we feel confident are being priced correctly. So keep in mind, this 40% recapturing of these exited members, as you hear the 2025 trends that we're saying today, are tracking in line with expectations.

如果你還記得的話，我們的目標是 50%。我們很高興能獲得更多的回收收益，因為我們相信這些計劃的定價是正確的。所以請記住，這些退出會員的重新獲得率達到 40%，正如您聽到的我們今天所說的 2025 年趨勢一樣，是符合預期的。

To reiterate, when members rejoined us in plans that were priced appropriately, considering the funding and medical cost trends, we're tracking in line with expectations that we set out in our guidance. We have also specifically evaluated how those recaptured members and plans are performing, and we feel good about our benefit structure and the members we recaptured where we price them for the long-term value.

重申一下，當會員重新加入我們定價合理的計劃時，考慮到資金和醫療成本趨勢，我們會按照我們在指導中設定的預期進行追蹤。我們還專門評估了這些重新俘虜的會員和計劃的表現，我們對我們的福利結構和我們重新捕獲的會員感到滿意，我們根據他們的長期價值為他們定價。

And for 2026, our benefits are largely stable. In some places, we may have invested a little bit; and in others we may have pulled back some. But even with the significant cut by peers, if they do that for '26, we still anticipate having a gap to the next richest benefit in the market based upon an in-depth analysis of our competitors' opportunities under the various bid rules, including the TBC rules.

到2026年，我們的福利基本上保持穩定。在某些地方，我們可能投入了一點；而在其他地方，我們可能撤回了一些。但即使同行大幅削減成本，如果他們在 26 年也這樣做，我們仍然預計，根據對競爭對手在各種投標規則（包括 TBC 規則）下的機會的深入分析，我們與市場上下一個最富有的福利公司存在差距。

So the point is we continue to feel good about the current run rate of our plans and are confident that our plans are priced appropriately given the funding environment cost trends that we're all experiencing, even should we have greater growth.

因此，關鍵是我們繼續對我們計劃的當前運行率感到滿意，並且相信，考慮到我們都在經歷的融資環境成本趨勢，即使我們有更大的增長，我們的計劃的定價也是合理的。

Stephen Baxter, Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

I was hoping you could speak to what you saw in terms of in-patient utilization trends in Medicare Advantage during the second quarter. For context, one of your competitors spoke to an accelerating trend in the second quarter. So it would be good to get your perspective on your data that you have to date.

我希望您能談談第二季度醫療保險優勢計劃住院患者利用率趨勢方面的情況。就背景而言，您的一位競爭對手談到了第二季的加速趨勢。因此，最好了解您對迄今為止所掌握的數據的看法。

Yeah. So on the in-patient side of things, things are trending in line to -- on the better end of our expectations when you take into account of admissions and the cost per unit. So we're not seeing an acceleration of anything,.

是的。因此，就住院情況而言，如果考慮到入院人數和每單位成本，情況將趨於符合我們的預期。因此，我們沒有看到任何加速的跡象。

If anything, in the beginning of the year, because of the timing of the flu season, it was a little bit higher, but in line with our expectations. So where --- things are trending as we sail along.

如果有什麼不同的話，那就是今年年初，由於流感季節的到來，這個數字會稍微高一些，但符合我們的預期。那麼 --- 隨著我們繼續航行，事情正在發生哪些趨勢？

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究公司。

I thought I'd take a shot at getting the latest on Stars. I understand you're going to go quiet, and I know you don't have the cut points yet. So there's no way to know what your Stars are specifically going to do.

我想嘗試了解有關 Stars 的最新動態。我知道你會保持沉默，而且我知道你還沒找到切入點。因此，你無法知道你的星星具體要做什麼。

But I do believe that planned preview one has gone out. And so you have a decent idea or at least a starting point in terms of how your own performance looks. And if you might expect, there's a lot of focus on this.

但我確實相信，計劃中的預覽版已經發布了。這樣，您就對自己的表現有一個不錯的想法，或者至少有一個起點。正如你所料，人們對此關注頗多。

So I would love to know if you could share with us here how your own performance has been in Stars. Do you feel like you've taken -- when we see the final data, regardless of how the cut points end up and therefore, how your stars end up, will investors be able to see a pretty strong step forward in terms of underlying performance in your Star metrics?

所以我很想知道您是否可以在這裡與我們分享您在《星星》中的表現。您是否覺得您已經採取了行動——當我們看到最終數據時，無論分數線如何，以及您的星級如何，投資者是否能夠看到您的星級指標在潛在表現方面取得了相當大的進步？

Yeah. Planned preview one data is not out. And honestly, if it was, we would not be talking about BY 27 at all. So it is not out at this point. And so we do not have any -- or if it is, we're not aware; but I don't think it's out. And so we don't have any additional visibility.

是的。計劃預覽一期的數據還沒出來。老實說，如果是這樣的話，我們根本就不會談論 BY 27 了。所以現在還沒有結果。因此我們沒有任何消息——或者如果有的話，我們也不知道；但我不認為已經知道了。因此我們沒有任何額外的可見性。

Look, what I'd say -- and this is going to be consistent with what I've said in the past. We were behind where we needed to be back in September -- late September, early October last year. We have made really good operational progress. We genuinely feel good about it.

瞧，我要說的是──這與我過去所說的一致。去年 9 月（9 月底、10 月初）我們的業績就已經落後於預期。我們的營運取得了非常好的進展。我們真的對此感到高興。

And you will see the underlying metric performance -- you will see improvement in the underlying metric performance. Meaning, if you go metric by metric, our performance has gotten better. It really is a question of how much has the industry improved along with us and therefore, where are the cut points.

您將看到底層指標性能—您將看到底層指標性能的改善。意思是，如果你逐一衡量指標，我們的表現就會變得更好。這確實是一個問題，即行業與我們一起進步了多少，以及切入點在哪裡。

And at this point, with the lack of PP1 data, we just don't have visibility into that, which again is why we will enter a quiet period here over the next couple of months as that data does become available.

目前，由於缺乏 PP1 數據，我們無法了解這一點，這也是為什麼在接下來的幾個月裡，隨著這些數據的可用，我們將進入一個平靜期。

Erin Wright, Morgan Stanley.

摩根士丹利的艾琳·賴特。

Great. I was wondering if you could talk a little bit more about the specialty pharmacy strength and what was driving that and some of the Part D dynamics that flow through there from an IRA perspective. And how is that playing out relative to your expectations at this point?

偉大的。我想知道您是否可以從 IRA 的角度進一步談談專業藥房的優勢、推動其發展的因素以及其中涉及的一些 D 部分動態。目前來看，這結果與您的預期相比如何？

So on the specialty pharma and I would just say in the CenterWell pharmacy business in general, part of what's driving our outperformance this year is strategic changes to how we're organizing and marketing that business. So we've invested a lot in building a strong partnership with pharma companies, and that's done a couple of things for us.

因此，就專業製藥以及 CenterWell 藥局業務而言，我想說，今年推動我們業績優異的部分原因是我們對該業務的組織和行銷方式進行了策略性變革。因此，我們投入了大量資金與製藥公司建立牢固的合作關係，這為我們帶來了許多好處。

One, it's creating new opportunities through this direct-to-consumer model. That's the Novo partnership we have. That -- we've also partnered with Ro and Weight Watchers to sell some GLP-1s. We expect to see more of this type of business over time. We're excited about the progress this year. It's coming ahead of our expectations.

首先，它透過這種直接面向消費者的模式創造了新的機會。這就是我們與 Novo 的合作關係。我們也與 Ro 和 Weight Watchers 合作銷售一些 GLP-1。我們期望隨著時間的推移，看到更多此類業務。我們對今年的進展感到非常興奮。它超出了我們的預期。

The second piece that's driving outperformance -- I should say the second piece is, generally, there's broader outperformance from what we understand in specialty in the industry this year. But our specific performance is further boosted by winning additional access to multiple limited distribution drugs that we previously wouldn't have been able to access.

推動績效優異的第二個因素——我應該說，第二個因素是，總體而言，從我們了解的今年該行業專業領域來看，業績優異的現象更為普遍。但是，透過贏得以前無法獲得的多種有限分銷藥物的額外使用權，我們的具體業績得到了進一步提升。

So this is really driven by the partnerships I called out. In the past, other pharmacies have gotten them and we have been excluded from that. And now, we are included. So really excited about some of the progress and the momentum in that business.

所以這實際上是由我所呼籲的合作夥伴關係所推動的。過去，其他藥局都得到了這些藥物，而我們卻被排除在外。現在，我們也被包括在內。因此，我對該業務的一些進展和發展勢頭感到非常興奮。

In terms of the PDP trends in general, as I called out earlier, the member mix and the Rx trends are tracking in line with our expectations. And there haven't been any unexpected behavioral changes.

就 PDP 整體趨勢而言，正如我之前提到的，會員組合和 Rx 趨勢符合我們的預期。並且沒有出現任何意外的行為變化。

Joshua Raskin, Nephron Research.

Joshua Raskin，腎元研究。

Last quarter, you spoke about, I think, a couple of hundred million of additional investments that were mitigating upside to the guidance. And I believe last I heard you say, there was another $100 million. I want to confirm that's incremental spend that is in addition to the couple of hundred from 1Q. And then I'm curious why not invest more instead of letting it flow through the guidance this quarter?

上個季度，您談到了數億美元的額外投資，我認為這些投資正在削弱預期的上行空間。我記得上次聽您說過，還有另外 1 億美元。我想確認一下，這是在第一季幾百美元支出的基礎上增加的支出。然後我很好奇為什麼不投入更多，而是讓它流經本季的指導？

I did think you might ask that question. So look, we -- that is right. We are confirming your question. It is an incremental $100 million.

我確實認為你可能會問這個問題。所以你看，我們——這是對的。我們正在確認您的問題。這是增量的 1 億美元。

We see a lot of opportunity to invest across the business, really focusing on our transformation, where we have incremental investments in some of our member retention work, AI, general operational efficiencies, a little bit on Stars where we're seeing high performance.

我們看到了許多在整個業務中進行投資的機會，真正專注於我們的轉型，我們對一些會員保留工作、人工智慧、一般營運效率進行了增量投資，在我們看到高績效的明星方面也進行了少量投資。

The -- we are looking at where it makes sense to spend money. We don't want to just spend money to spend it. We're not going to spend it where there aren't good returns.

我們正在考慮把錢花在何處才合理。我們不想只是為了花錢而花錢。我們不會把錢花在沒有良好回報的地方。

Will we continue to look for additional opportunities? Absolutely. And -- but we are spending that $100 million where we think we can really drive a return and accelerate some of our transformation work and potential upside in Stars.

我們會繼續尋找更多機會嗎？絕對地。而且 — — 但我們認為，我們花費這 1 億美元確實可以帶來回報，並加速我們的一些轉型工作和 Stars 的潛在上升空間。

Yes. The one thing I would just add to that is we pulled some investment forward. So things we thought we were going to do next year got pulled into this year. But ultimately, you run into just a limit on how much of that you can do.

是的。我想補充一點，我們提前進行了一些投資。所以我們原本計劃明年要做的事情就被拖到今年了。但最終，你能做的事情終究會有限。

How much can you operationally absorb in any given period of time? We'd love to be pulling more forward. But right now, we're digesting the investments that we're making, and that's a big part of it as well.

在任何給定的時間段內，您能夠吸收多少營運資源？我們很樂意取得更多進步。但現在，我們正在消化我們所做的投資，這也是其中很重要的一部分。

AJ Rice, UBS.

瑞銀的 AJ Rice。

Just wanted to ask about two quick things related to CenterWell. You continue to grow that membership on the value-based primary care side and seem to be hitting your metrics there. I wonder -- one thing you emphasized is that you're member agnostic, where maybe some of your other peers in that space are more focused on the medically complex. Is that part of why you're seemingly doing better?

只是想問一下與 CenterWell 相關的兩個問題。您繼續增加基於價值的初級保健方面的會員數量，並且似乎正在達到您的指標。我想知道——您強調的一件事是，您是會員不可知論者，而該領域的其他一些同行可能更關注醫學複雜性。這是為什麼你看起來表現得更好的原因之一嗎？

And then I just would, also in CenterWell ask, do you have any update on home health rule? I know you're moving that to more value-based as well. But I think you're still one of the biggest fee-for-service providers and the proposed rules challenging.

然後我同樣想問 CenterWell，您對家庭健康規則有什麼更新嗎？我知道您也正在將其轉向更基於價值的方向。但我認為你們仍然是最大的收費服務提供者之一，而擬議的規則具有挑戰性。

It's just hard to know how much that's likely to impact the overall enterprise, given it's still -- even though you're big in that space -- relatively small in terms of the entire enterprise.

很難知道這會對整個企業產生多大的影響，因為儘管你在這個領域很大，但相對於整個企業來說它仍然相對較小。

Yeah. So let me -- on your first question on patient growth, it's really -- we've opened more clinics. Those clinics are ramping. They're doing well. It's a combination of word of mouth and marketing.

是的。那麼，關於您關於患者成長的第一個問題，我來回答，我們確實開設了更多的診所。這些診所正在迅速發展。他們做得很好。這是口碑和行銷的結合。

There isn't a particular kind of patients that's driving higher-than-expected growth. We're pleased with what we're seeing. And even with the higher payment growth, trends and our expectations for that business are consistent with what we would have thought.

並沒有哪一種特定類型的患者能夠推動高於預期的成長。我們對所見所聞感到滿意。即使支付成長率較高，該業務的趨勢和預期也與我們的預期一致。

In terms of home health, yeah, we're disappointed by the proposed 6%-plus net rate reduction. We really don't think it's reflective of the wage and other inflation that the industry is experiencing. Labor makes up almost 75% of that rate, and the rate is supposed to be tied to that.

就家庭保健而言，是的，我們對提議的 6% 以上的淨費率降低感到失望。我們確實不認為它反映了該行業正在經歷的工資和其他通膨。勞動力幾乎佔該比率的 75%，並且該比率應該與之掛鉤。

We also had anticipated that CMS would eventually implement a behavioral adjustment. We did not anticipate that it would be as high as proposed. It also said the data is supposed to be collected through the end of '26 and then analyze then.

我們也預料到 CMS 最終會實施行為調整。我們沒有預料到它會像提議的那麼高。它還表示，數據預計將在 26 年底前收集完畢，然後進行分析。

So data is still being collected. So we believe it's early to make this adjustment. We're continuing to advocate and educate the administration on the need for reasonable home health reimbursement, and we're evaluating the impact on our home health businesses as proposed.

因此數據仍在收集中。因此我們認為現在做出這項調整還為時過早。我們將繼續倡導和教育政府部門合理家庭保健報銷的必要性，並且我們正在評估其對我們的家庭保健業務的影響。

But we do have a natural hedge in our insurance business. It wouldn't fully offset any -- if this is implemented as proposed, it wouldn't fully offset it. But we believe we have other levers at the enterprise level that can absorb the headwind that isn't naturally offset by insurance.

但我們的保險業務確實存在自然對沖。它不會完全抵消任何——如果按照提議實施，它不會完全抵消它。但我們相信，我們在企業層面還有其他槓桿可以吸收保險無法自然抵銷的逆風。

Ben Hendrix, RBC Capital Markets.

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

Just wanted to go back to the commentary you made on MA benefit actions in '24 and '25 in a more conservative approach you've taken versus some peers. To what extent could that put you at a disadvantage from a member experience perspective ahead of Stars? And maybe you can remind us what types of investments you're making right now that could mitigate some of that and lend some confidence in reaching that -- your targets for the '28 bonus year.

我只是想回到您對 24 年和 25 年 MA 福利行動的評論，與一些同行相比，您採取了更保守的態度。從會員體驗的角度來看，這在多大程度上會使您比 Stars 處於劣勢？也許您可以提醒我們，您目前正在進行哪些類型的投資，這些投資可以減輕其中的一些影響，並為實現 28 年獎金年度的目標提供一些信心。

Yeah, great question. We are monitoring this closely is where I would start. Certainly, any time that you take benefit actions, it does create some abrasion with members.

是的，很好的問題。我們正在密切監視這一點，這就是我要說的。當然，任何時候採取有益行動，都會與會員產生一些摩擦。

We have been extremely active and diligent in essentially taking offsetting operating actions. So making sure that we're being very clear in how we communicate and explain the changes to our members, making sure that we're responsive to their concerns, et cetera.

我們一直非常積極且勤勉地採取抵銷性的營運行動。因此，我們要確保非常清楚地向我們的成員溝通和解釋這些變化，確保我們對他們的擔憂做出回應，等等。

And all in all, we feel pretty good about where we are at on that specific item, meaning member experience related to cuts and benefits last year. But yes, I mean, every time you go through a set of cuts, there is some member abrasion and you have to take that into account in your operations and adjust for it.

總而言之，我們對這項特定項目的現狀感到非常滿意，這意味著會員在去年與削減和福利相關的體驗。但是是的，我的意思是，每次進行一組切割時，都會有一些構件磨損，您必須在操作中考慮到這一點並進行調整。

George, is there anything that you would add to that?

喬治，您還有什麼要補充的嗎？

Yeah, Jim. I would just add that there are a number of things that we follow there. We monitor NPS on a regular basis. On every call [right to] that's taken, we try to monitor NPS we're mentoring. We are -- sorry, monitoring both the NPSR, which is the NPS for relationship; and NPST, which is the NPS with each transaction each time we get a call from a member and every time we interact with the member.

是的，吉姆。我只想補充一點，我們在那裡關注了很多事情。我們定期監控 NPS。在接到每通電話時，我們都會嘗試監控我們正在指導的 NPS。抱歉，我們正在同時監控 NPSR（關係的 NPS）和 NPST（每次我們接到會員的電話以及每次與會員互動時每次交易的 NPS）。

And we're not seeing anything concerning in that data. We also, of course, are doing a cap surveys. If you think about the surveys that CMS does every year, we do those to monitor what's happening. We're not seeing anything very alarming there at all. In fact, things are looking fairly good.

我們沒有從這些數據中看到任何令人擔憂的事情。當然，我們也在進行上限調查。如果您想想 CMS 每年的調查，我們進行這些調查是為了監控正在發生的事情。我們根本沒有看到任何令人擔憂的事情。事實上，情況看起來相當不錯。

And keep in mind, some of the other things that we are doing here actually impact and help the member experience. Jim mentioned the Epic MyChart, where we're the first plan to try to integrate what members interact with their provider and have them have their provider and payer show up in one spot to improve that member experience.

請記住，我們在這裡做的其他一些事情實際上會影響並幫助會員體驗。吉姆提到了 Epic MyChart，我們首先計劃嘗試整合會員與其提供者之間的互動，並讓他們的提供者和付款人出現在一個地方，以改善會員體驗。

And they can see all their information about their plan, while at the same time, checking on their next appointment. And the number of the activities of the millions of dollars that you've heard Jim and Celeste talk about that we're investing in are investing very much in the member experience itself.

他們可以看到有關他們的計劃的所有信息，同時還可以查看他們的下一次預約。正如吉姆和塞萊斯特所說，我們投資的數百萬美元的活動很大程度上是為了會員體驗本身。

And so the activities that we're taking in Stars, yes, they improve health outcomes and they improve our stars. But the reason for that is predominantly because we're also improving the member experience, making sure that our members are getting the care that they need.

是的，我們在 Stars 中採取的活動確實改善了健康狀況，也提高了我們的星級。但主要原因在於我們也在改善會員體驗，確保我們的會員得到他們所需的照護。

And ultimately, what they're looking for is that they can get the care they need, that they are being proactively outreached to get care that's appropriate for them, and also doing so in a way that is affordable. And we believe that the actions we've taken -- we've talked about the cuts we made before and how we're very, very -- we use a lot of analysis to make those decisions got what benefits cuts we make to ensure care remains affordable.

最終，他們尋求的是能夠獲得所需的護理，能夠主動地為他們提供適合他們的護理，並以可承受的方式獲得護理。我們相信，我們所採取的行動——我們之前討論過我們所做的削減，以及我們如何——我們使用了大量的分析來做出這些決定，得到了我們所做的削減所帶來的好處，以確保醫療費用仍然是可以負擔得起的。

So all the actions we've taken have very much had that member experience in mind. One of the things that I love about some of the teammate changes we've had in the company over the past year or two is that we brought in other expertise, such as David Dintenfass who works on the ELT with us and is making sure that we're very focused on that consumer experience.

因此，我們採取的所有行動都充分考慮了會員的體驗。我對過去一兩年公司團隊成員變動感到高興的一點是，我們引進了其他方面的專業知識，例如與我們一起從事 ELT 工作的 David Dintenfass，他確保我們非常注重消費者體驗。

So there are a whole host of actions that I can point to where we're actually trying to improve the member experience while at the same time taking prudent actions in our benefit designs.

因此，我可以指出我們實際上正在採取一系列行動，試圖改善會員體驗，同時在我們的福利設計中採取審慎的行動。

Yeah, let me pull it back to just point out two things. One, the bounce-back membership that we are seeing this year, I think, actually is proof that a bunch of those measures are working.

是的，讓我回顧一下，只指出兩件事。首先，我認為，我們今年看到的會員人數反彈實際上證明其中的一系列措施正在發揮作用。

And so again, we look at the bounce back, the degree of bounce back, membership that is coming through OEP and ROY. And it makes us feel very good that we're doing the right things to adjust to the benefit changes that we made last year.

因此，我們再次觀察反彈情況、反彈程度以及透過 OEP 和 ROY 獲得的會員資格。我們感到非常高興，因為我們正在採取正確的措施來適應去年所做的福利變化。

And then the second thing is -- this is really what you're driving at is, are we taking this into account in our Stars calculations? And do we still feel good about our overall Stars performance and the direction that it's headed even when you account for this?

第二件事是──這確實是你想要表達的意思，我們在計算星星時是否考慮到了這一點？即使考慮到這一點，我們是否仍然對 Stars 的整體表現和發展方向感到滿意？

And the answer to that is yes. We're certainly taking it into account. And even when you think about some of that member of raising that comes from reduced benefits. We feel good about the direction we're headed in. We feel good about the trajectory for BY '28.

答案是肯定的。我們當然會考慮到這一點。甚至當您考慮到部分會員的薪資上漲是由於福利減少所致時。我們對於我們前進的方向感到滿意。我們對 BY '28 的發展軌跡感到滿意。

George Hill, Deutsche Bank.

德意志銀行的喬治·希爾。

Jim, you just spoke about this, but could you provide a little bit more color on what's driving the bounce back on the members that are returning to Humana intra year? Where are those guys coming from? And what do you think from a benefits perspective that's bringing those people back?

吉姆，您剛才談到了這一點，但是您能否更詳細地說明一下是什麼因素推動了年內重返 Humana 的會員的反彈？那些傢伙是從哪裡來的？從利益角度來看，您認為是什麼讓這些人回來了？

Yes, happy to hit that. The -- so first of all, it is disproportional in places where we saw loss membership, which I don't think will surprise anybody. But within the regions where we've seen lost membership, it's pretty broad-based. There's no specific pattern across those regions.

是的，很高興能達到這一點。首先，在會員人數減少的地方，這種現像是不成比例的，我認為這不會讓任何人感到驚訝。但在我們發現會員人數流失的地區，情況相當廣泛。這些地區沒有特定的模式。

And generally, what we see is that when somebody makes a decision to leave Humana and then bounces back, more times than not, it's because they were surprised by what they were getting when they made the change. And the surprise might be that they didn't really understand the benefit package.

一般來說，我們看到的是，當有人決定離開 Humana 後又重新回來時，很多時候是因為他們對做出改變後得到的結果感到驚訝。令人驚訝的是，他們可能並不真正了解福利待遇。

The surprise might be something around customer service. But typically, they were surprised. And then they come back to Humana where they have experience, where they know what they're getting from an experience standpoint from -- and again, this is why we want to be so clear about the benefit packages.

驚喜可能與客戶服務有關。但通常情況下，他們會感到驚訝。然後他們回到 Humana，在這裡他們擁有經驗，他們從經驗的角度知道他們能得到什麼——這就是為什麼我們要如此清楚地說明福利。

The more clear we are and the more that they feel informed, the more comfortable they are with the decisions that we have to make even when they're hard decisions. And I think that is part of what you're seeing.

我們越清楚，他們就越了解情況，他們就越能接受我們必須做出的決定，即使這些決定很艱難。我認為這就是您所看到的部分情況。

Again, I'll just -- George, anything you would add or anything -- any other color there?

再說一次，我只是——喬治，你想添加什麼或任何東西——還有其他顏色嗎？

No, Jim. I think you're right. It's about the product and services and whether or not they got what they expected when they left us to go somewhere else. And they were the empty they know we have good services.

不，吉姆。我認為你是對的。這關乎產品和服務，以及當他們離開我們去其他地方時是否得到了他們所期望的東西。他們一聽就知道我們提供優質的服務。

As we talked about at Investor Day, we're known for our service, and we're known for the way we approach our membership. So I think that all just plays into it.

正如我們在投資者日上談到的，我們以我們的服務而聞名，我們以我們對待會員的方式而聞名。所以我認為這一切都是起著作用的。

David Windley, Jefferies.

傑富瑞的戴維溫德利 (David Windley)。

I wondered if you could remind us what your assumptions for trend were this year in light of your comments about costs developing in line with those? I know Celeste referenced the low double digit for pharmacy. Just curious to get the other components. And then what are you assuming for trend in '26 relative to what you were experiencing in '25, please?

我想知道您是否可以根據您對成本發展趨勢的評論，提醒我們您對今年趨勢的假設是什麼？我知道 Celeste 提到了藥局的低兩位數。只是好奇想獲得其他組件。那麼相對於 25 年所經歷的情況，您對 26 年的趨勢有何假設？

So yes, we -- as we said, on pharmacy, we were expecting low double digits. We continue to expect low double digits into next year. And then on the medical cost side, our expectations were for mid to high single digits, and our expectations for next year are consistent with that.

所以是的，正如我們所說，在藥房方面，我們預計成長率將達到兩位數。我們預計明年的成長率仍將保持在兩位數以下。在醫療成本方面，我們預期是中高個位數，我們對明年的預期與此一致。

Whit Mayo, Leerink Partners.

惠特·梅奧 (Whit Mayo)，Leerink Partners。

I know the lawsuit that you have probably colors your answer, but just any updated thoughts on RADV, whether you have to make assumptions and bids around prospective CMS clawbacks on premium payments that they actually make it through the 2019 audit.

我知道您所面臨的訴訟可能會影響您的答案，但您對 RADV 有什麼新想法嗎？您是否必須對 CMS 未來保費追回做出假設和出價，以確保他們能夠真正通過 2019 年的審計。

Yeah, there's really not a lot of color that we have to provide on this one. Partially, yes, with the litigation, there's a limit to what we can say. But partially, there's just a lot of unknowns, to be frank. And so very little color to add on this particular topic.

是的，我們確實沒有太多的顏色可以提供。部分而言，是的，由於存在訴訟，我們能說的話是有限的。但坦白說，部分原因還是有很多未知數。因此，關於這個特定主題，可以添加的內容非常少。

Jim, if I could just add one thing, in just we have long supported the offering of the contracts. As long as it takes into account the actuarial equivalence between MA and fee-for-service.

吉姆，如果我可以補充一點的話，我們長期以來一直支持提供合約。只要考慮到 MA 和按服務收費之間的精算等值性。

Sarah James, Cantor.

莎拉詹姆斯，領唱者。

I was hoping you could clarify the moving pieces in the guide based. If I take about a third of the 1Q beat that was described to CenterWell and all the 2Q beat run rate just for the investment spend, I get pretty close to the boost about $0.06 below.

我希望您能夠闡明指南中的移動部分。如果我把向 CenterWell 描述的第一季超出預期的三分之一和第二季度超出預期的所有運行率僅用於投資支出，那麼我得到的增幅就非常接近低於 0.06 美元的水平。

Is that the right way to think about it that the guide lease is primarily run rating the CenterWell outperformance year to date? Or are there other main pieces? And can we think about the CenterWell strength as being sustainable beyond 2025?

這樣想是否正確，即主要透過對 CenterWell 今年迄今的優異表現進行評級來指導租賃？或者有其他主要部分嗎？我們是否可以認為 CenterWell 的優勢在 2025 年後仍具有可持續性？

That is right. We are assuming some of the outperformance will continue through the year, particularly on the CenterWell PCO growth. So that will continue into this year and into next year. And then the performance on pharmacy side of things, the specialty outperformance, and then the direct-to-consumer momentum that we have.

沒錯。我們假設部分優異表現將持續全年，特別是 CenterWell PCO 的成長。這種狀況將持續到今年和明年。然後是藥局方面的表現、專業方面的優異表現，以及我們直接面對消費者的動能。

We also, as we called out, have better-than-expected membership. So our guidance for the year is up to 500,000 loss versus 550,000 previously. So that will run through the year and into next year. There were some things in the first quarter in particular, that were timing of one-timers in nature, and we're not run rating those.

正如我們所呼籲的，我們的會員人數也比預期的要好。因此，我們對今年的虧損預期是最多虧損 50 萬，而先前的預期是虧損 55 萬。因此這將持續到今年和明年。特別是在第一季度，有些事情本質上是一次性事件，我們不會對這些事件進行評分。

Michael Ha, Baird.

麥可·哈，貝爾德。

I understand you feel strongly about your benefit richness and confident in attracting good profitable membership. I'm curious though. Is there any level of membership growth percentage that you think if growth starts tracking to like 15%, 20%, 25%, where it could begin to potentially compromise earnings next year and if you were to get early sense of that through AEP, would you work to tap that growth if necessary?

我了解您對自己的福利豐富性有著強烈的感覺，並且有信心吸引到有良好盈利能力的會員。但我很好奇。您認為，如果會員成長率達到 15%、20%、25% 左右，可能會對明年的收益產生影響嗎？如果您能透過 AEP 提前了解這一點，您是否會在必要時努力利用這種成長？

And then also, I understand plan preview one data is not out yet, but I believe plans have already received the raw results for cost center metrics earlier this month. Any ability to comment on how those results look out to your expectations, especially since there's such high sensitivity of even missing one single quality Star rating?

另外，我知道計劃預覽一數據尚未公佈，但我相信該計劃已於本月初收到了成本中心指標的原始結果。您能否評論一下這些結果是否符合您的期望，尤其是考慮到即使缺少一個品質星級評定也具有如此高的敏感度？

Yeah. So we are not going to comment on any of the data that we've received from CMS. And again, we'll -- we're headed in that quiet period, and we really will not be commenting again until we reach October.

是的。因此我們不會對從 CMS 收到的任何數據發表評論。再說一次，我們正進入平靜期，直到十月我們才會再次發表評論。

The -- I've now lost track. What was the first question? Membership. Yeah, yeah. Here's basically how we think about it.

——我現在記不清了。第一個問題是什麼？會員資格。是啊是啊。我們對此的基本看法如下。

So first of all, we feel good about the product, and we feel good that the membership that we're going to be receiving will be good at whatever level it is. Is there a certain level where operationally, it could, in theory, become challenging? Sure.

因此，首先，我們對產品感到滿意，我們很高興看到，無論會員資格等級如何，我們的會員資格都是良好的。從理論上講，操作上是否存在某種程度的挑戰性？當然。

Do we anticipate that, that is likely to happen? No. Will we monitor it and make adjustments as we need to? Yes. To the degree that we can operationally absorb the growth, then the real question I think then you're asking is, hey, is there a year one drag that we're worried about heading into next year?

我們是否預料到這種情況會發生？不。我們會對其進行監控並根據需要做出調整嗎？是的。就我們在營運上能夠吸收成長的程度而言，我認為您真正要問的問題是，嘿，是否存在我們擔心明年會出現的拖累？

If it's good growth and good membership, we will be focused on long-term value. And we will explain that to you and we will continue to grow. We will be very clear, and we'll be very transparent. Again, when we look at it, do we think the likelihood that we're in that situation is very high?

如果成長良好且會員人數眾多，我們會專注於長期價值。我們會向您解釋這一點，並且我們將繼續成長。我們會非常清楚，而且非常透明。再說一遍，當我們審視這個問題時，我們是否認為我們處於這種情況的可能性很高？

No, not really. Is it theoretically possible? It is. But the main question we will ask is, can we operationally absorb it, not are we afraid of year one economics and therefore, turn off growth? Does that -- hopefully, that answers the question.

不，不是真的。理論上可能嗎？這是。但我們要問的主要問題是，我們能否在營運中吸收它，而不是我們是否害怕第一年的經濟狀況，因此而停止成長？希望這能回答這個問題。

Yeah. Maybe if I can add a much less strategic and more tactical. That timing of when membership growth matters a lot. So the AEP numbers that you have a full year to absorb the marketing. But if you pick up a member late in the year -- so if we picked the members late this year, late next year, they tend to come with a headwind because you don't really have a lot of revenue associated with them, and you have a lot of marketing up. We do have all of our expectations for any back-end growth in '25 reflected in our guidance as we go.

是的。也許我可以添加一些少一點戰略性多一點戰術性的東西。會員成長的時機非常重要。因此，AEP 數字表明您有整整一年的時間來吸收行銷。但如果你在年底招募會員——如果我們在今年年底、明年年底招募會員，他們往往會給你帶來不利影響，因為你實際上並沒有從他們身上獲得很多收入，而且你還需要做大量的營銷工作。我們對 25 年後端成長的所有期望確實都反映在我們的指導中。

Hey, with that, I just want to thank everybody for joining us this morning. And I want to thank everybody for your interest in Humana. And finally, I want to thank our 65,000 associates who serve our members and patients every day. We appreciate your support, and we hope you have a great day. Thanks.

嘿，說到這裡，我只想感謝大家今天早上加入我們。我要感謝大家對 Humana 的關注。最後，我要感謝我們每天為會員和患者服務的 65,000 名同事。我們感謝您的支持，並祝福您有個愉快的一天。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。